Nuno Dias, Gianmarco Colandrea, Francisco Botelho, Lara Rodriguez-Sanchez, Camille Lanz, Petr Macek, Xavier Cathelineau
{"title":"微超声引导下前列腺癌活检的诊断准确性及临床应用。","authors":"Nuno Dias, Gianmarco Colandrea, Francisco Botelho, Lara Rodriguez-Sanchez, Camille Lanz, Petr Macek, Xavier Cathelineau","doi":"10.5173/ceju.2023.198","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>New technologies to improve quality of prostate biopsies are appearing in clinical practice.We evaluate the performance of a micro-ultrasound device and the Prostate Risk Identification using MicroUltraSound (PRI-MUS) score in detecting clinically significant prostate cancer (csPCa).</p><p><strong>Material and methods: </strong>We retrospectively reviewed data of 139 biopsy- naïve patients with suspicion of prostate cancer, who underwent diagnostic MRI and micro-ultrasonography (microUS), followed by transrectal prostatic biopsy (systematic ±targeted) under local anesthetic. The main objective was to evaluate the performance of the Prostate Risk Identification using MicroUltraSound (PRI-MUS) score in detecting csPCa, defined as International Society of Urological Pathology (ISUP) ≥2.</p><p><strong>Results: </strong>Of all patients, 97 (70%) were found to have PCa, and 62 (45%) having csPCa.Among 100 patients with positive microUS (PRI-MUS score ≥3), 23 (23%) had ncsPCa and 57 (57%) were diagnosed with csPCa (ISUP ≥2); and in 39 patients with negative microUS, 12 (31%) were diagnosed with ncsPCa and 5 (13%) with csPCa.A PRI-MUS score ≥3 presented a sensitivity, specificity, positive predictive value and negative predictive value of 92%, 44%, 57% and 95%, respectively, for the detection of csPCa.The PRI-MUS score had higher areas under the curve than Prostate Imaging Reporting & Data System (PI-RADS) both for targeted (AUC 0.801 vs 0.733) and systematic + targeted (AUC 0.776 vs 0.694) biopsies for csPCa detection.</p><p><strong>Conclusions: </strong>In our cohort, microUS performed well as a diagnostic tool through an easily implementable scale. MicroUS presented similar sensitivity and higher specificity than MRI in detecting csPCa. Further multicenter prospective studies may clarify its role in prostate cancer diagnosis.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/46/db/CEJU-76-198.PMC10091889.pdf","citationCount":"1","resultStr":"{\"title\":\"Diagnostic accuracy and clinical utility of micro-ultrasound guided biopsies in patients with suspected prostate cancer.\",\"authors\":\"Nuno Dias, Gianmarco Colandrea, Francisco Botelho, Lara Rodriguez-Sanchez, Camille Lanz, Petr Macek, Xavier Cathelineau\",\"doi\":\"10.5173/ceju.2023.198\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>New technologies to improve quality of prostate biopsies are appearing in clinical practice.We evaluate the performance of a micro-ultrasound device and the Prostate Risk Identification using MicroUltraSound (PRI-MUS) score in detecting clinically significant prostate cancer (csPCa).</p><p><strong>Material and methods: </strong>We retrospectively reviewed data of 139 biopsy- naïve patients with suspicion of prostate cancer, who underwent diagnostic MRI and micro-ultrasonography (microUS), followed by transrectal prostatic biopsy (systematic ±targeted) under local anesthetic. The main objective was to evaluate the performance of the Prostate Risk Identification using MicroUltraSound (PRI-MUS) score in detecting csPCa, defined as International Society of Urological Pathology (ISUP) ≥2.</p><p><strong>Results: </strong>Of all patients, 97 (70%) were found to have PCa, and 62 (45%) having csPCa.Among 100 patients with positive microUS (PRI-MUS score ≥3), 23 (23%) had ncsPCa and 57 (57%) were diagnosed with csPCa (ISUP ≥2); and in 39 patients with negative microUS, 12 (31%) were diagnosed with ncsPCa and 5 (13%) with csPCa.A PRI-MUS score ≥3 presented a sensitivity, specificity, positive predictive value and negative predictive value of 92%, 44%, 57% and 95%, respectively, for the detection of csPCa.The PRI-MUS score had higher areas under the curve than Prostate Imaging Reporting & Data System (PI-RADS) both for targeted (AUC 0.801 vs 0.733) and systematic + targeted (AUC 0.776 vs 0.694) biopsies for csPCa detection.</p><p><strong>Conclusions: </strong>In our cohort, microUS performed well as a diagnostic tool through an easily implementable scale. MicroUS presented similar sensitivity and higher specificity than MRI in detecting csPCa. Further multicenter prospective studies may clarify its role in prostate cancer diagnosis.</p>\",\"PeriodicalId\":9744,\"journal\":{\"name\":\"Central European Journal of Urology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/46/db/CEJU-76-198.PMC10091889.pdf\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Central European Journal of Urology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5173/ceju.2023.198\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Central European Journal of Urology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5173/ceju.2023.198","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 1
摘要
前言:提高前列腺活检质量的新技术正在临床实践中出现。我们评估了微超声设备的性能和使用微超声(PRI-MUS)评分检测临床显著性前列腺癌(csPCa)的前列腺风险识别。材料和方法:我们回顾性分析139例怀疑前列腺癌的活检- naïve患者的资料,这些患者接受了诊断性MRI和微超声检查(microUS),然后在局麻下进行了经直肠前列腺活检(系统±靶向)。主要目的是评估使用微超声(PRI-MUS)评分检测csPCa的前列腺风险识别的性能,csPCa的定义为国际泌尿病理学学会(ISUP)≥2。结果:在所有患者中,发现97例(70%)患有PCa, 62例(45%)患有csPCa。100例microUS阳性(PRI-MUS评分≥3)患者中,23例(23%)为ncsPCa, 57例(57%)诊断为csPCa (ISUP≥2);在39例microUS阴性患者中,12例(31%)诊断为ncsPCa, 5例(13%)诊断为csPCa。PRI-MUS评分≥3时,csPCa检测的敏感性为92%,特异性为44%,阳性预测值为57%,阴性预测值为95%。在csPCa检测的靶向活检(AUC 0.801 vs 0.733)和系统+靶向活检(AUC 0.776 vs 0.694)中,PRI-MUS评分曲线下面积均高于前列腺成像报告和数据系统(PI-RADS)。结论:在我们的队列中,microUS作为一种易于实施的诊断工具表现良好。MicroUS检测csPCa的灵敏度与MRI相近,特异度更高。进一步的多中心前瞻性研究可能阐明其在前列腺癌诊断中的作用。
Diagnostic accuracy and clinical utility of micro-ultrasound guided biopsies in patients with suspected prostate cancer.
Introduction: New technologies to improve quality of prostate biopsies are appearing in clinical practice.We evaluate the performance of a micro-ultrasound device and the Prostate Risk Identification using MicroUltraSound (PRI-MUS) score in detecting clinically significant prostate cancer (csPCa).
Material and methods: We retrospectively reviewed data of 139 biopsy- naïve patients with suspicion of prostate cancer, who underwent diagnostic MRI and micro-ultrasonography (microUS), followed by transrectal prostatic biopsy (systematic ±targeted) under local anesthetic. The main objective was to evaluate the performance of the Prostate Risk Identification using MicroUltraSound (PRI-MUS) score in detecting csPCa, defined as International Society of Urological Pathology (ISUP) ≥2.
Results: Of all patients, 97 (70%) were found to have PCa, and 62 (45%) having csPCa.Among 100 patients with positive microUS (PRI-MUS score ≥3), 23 (23%) had ncsPCa and 57 (57%) were diagnosed with csPCa (ISUP ≥2); and in 39 patients with negative microUS, 12 (31%) were diagnosed with ncsPCa and 5 (13%) with csPCa.A PRI-MUS score ≥3 presented a sensitivity, specificity, positive predictive value and negative predictive value of 92%, 44%, 57% and 95%, respectively, for the detection of csPCa.The PRI-MUS score had higher areas under the curve than Prostate Imaging Reporting & Data System (PI-RADS) both for targeted (AUC 0.801 vs 0.733) and systematic + targeted (AUC 0.776 vs 0.694) biopsies for csPCa detection.
Conclusions: In our cohort, microUS performed well as a diagnostic tool through an easily implementable scale. MicroUS presented similar sensitivity and higher specificity than MRI in detecting csPCa. Further multicenter prospective studies may clarify its role in prostate cancer diagnosis.