在经会阴前列腺活检中,对索引病灶进行映射靶向活检的有效性。

IF 3.1 3区 医学 Q1 UROLOGY & NEPHROLOGY International Braz J Urol Pub Date : 2024-05-01 DOI:10.1590/S1677-5538.IBJU.2023.0558
Nahuel Paesano, Violeta Catalá, Larisa Tcholakian, Xavier Alomar, Miguel Barranco, Enric Trilla, Juan Morote
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引用次数: 0

摘要

目的:评估在经会阴融合影像前列腺活组织检查中对指标病变进行映射靶向活组织检查(MTB)以检测有临床意义的前列腺癌(csPCa)的有效性:对309名疑似PCa的男性患者进行了回顾性分析,这些患者在西班牙巴塞罗那的Creu Blanca参考中心接受了前列腺活检。前列腺成像报告和数据系统(PI-RADS v.2.1)的磁共振成像(MRI)由放射科专家对活检前双参数磁共振成像进行重新分类,用于分割可疑病灶。使用 Artemis™ 平台对可疑病灶进行经会阴 MTB 和 12 核系统性活检。CsPCa的定义是国际泌尿病理学会分级组≥2:192名男性(62.1%)检出了CsPCa,其中PI-RADS 2的检出率为6.3%,PI-RADS 3的检出率为26.8%,PI-RADS 4的检出率为87.3%,PI-RADS 5的检出率为93.1%。指标病变的 MTB 发现了 185 个 csPCa(96.3%)。有 3 例病例(1.6%)仅在系统活检中发现了 csPCa,另有 4 例病例(2.1%)仅在第二个疑似病灶中发现了 csPCa。在指标病灶的 MTB 中建立了 csPCa 检测预测模型,其 AUC 为 0.918(95% CI 0.887-0.950):该模型有可能避免23.3%的前列腺活检,而不会漏掉额外的csPCa病例。在经会阴融合前列腺活检中,指标病灶的 MTB 对识别 csPCa 非常有效。所开发的预测模型成功减少了近四分之一的活组织检查需求,且不会遗漏csPCa病例。
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The effectiveness of mapping-targeted biopsies on the index lesion in transperineal prostate biopsies.

Purpose: To evaluate the effectiveness of mapping-targeted biopsies (MTB) on the index lesion for the detection of clinically significant prostate cancer (csPCa) in transperineal fusion-image prostate biopsies.

Materials and methods: A retrospective analysis was conducted on 309 men with suspected PCa who underwent prostate biopsies at the Creu Blanca reference center in Barcelona, Spain. The Prostate Imaging-Reporting and Data System (PI-RADS v.2.1) of the magnetic resonance images (MRI) were reclassified by an expert radiologist reading of pre-biopsy biparametric MRI used for segmentation of suspected lesions. Transperineal MTB of suspicious lesions and 12-core systematic biopsies were performed using the Artemis™ platform. CsPCa was defined as International Society of Urological Pathology grade group ≥ 2.

Results: CsPCa was detected in 192 men (62.1%), with detection rates of 6.3% for PI-RADS 2, 26.8% for PI-RADS 3, 87.3% for PI-RADS 4, and 93.1% for PI-RADS 5. MTB of the index lesion identified 185 csPCa (96.3%). CsPCa was detected solely in systematic biopsies in three cases (1.6%), while an additional four cases (2.1%) were identified only in the second suspected lesion. A predictive model for csPCa detection in MTB of the index lesion was developed, with an AUC of 0.918 (95% CI 0.887-0.950).

Conclusions: This model had the potential to avoid 23.3% of prostate biopsies without missing additional csPCa cases. MTB of the index lesion was highly effective for identifying csPCa in fusion transperineal prostate biopsies. A developed predictive model successfully reduced the need for almost one quarter of biopsies without missing csPCa cases.

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来源期刊
International Braz J Urol
International Braz J Urol UROLOGY & NEPHROLOGY-
CiteScore
4.60
自引率
21.60%
发文量
246
审稿时长
6-12 weeks
期刊介绍: Information not localized
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