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阳性MRI患者的前列腺活检的协议是什么? 系统活检的兴趣按部门分类
A Zambon1, T-A Nguyen2,3, A Fourcade2
1Urology Department, Brest University Hospital, Brest, France. audrey.zambon@gmail.com.
Prostate cancer and prostatic diseases
|December 19, 2023
概括
系统活检 (SBx) 在与MRI向活检 (TBx) 相结合时,为前列腺癌诊断提供有限的附加值. 反侧叶中的SBx显示出非常低的效用,这表明在活检协议中可能会被遗漏.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
背景情况:
- 目前的前列腺癌 (PCa) 诊断依赖于PI-RADS ≥3病变的系统活检 (SBx) 和MRI向活检 (TBx).
- 与TBx相结合的SBx的附加值需要进一步评估.
研究的目的:
- 根据六分仪位置和MRI特征来确定SBx的诊断效用.
- 评估SBx在进行TBx时检测临床显著PCa (csPCa) 的增量值.
主要方法:
- 追溯分析371名接受过过直肠超声导向 (TRUS) 前列腺活检 (PBx) 的患者,此前有MRI.
- 根据MRI位置分类SBx:相同的,相邻的,两侧的和两侧的六边形.
- 增加值被定义为升级到csPCa (ISUP ≥2).
主要成果:
- 在PCa诊断中,SBx提供了整体10%的附加值.
- SBx的附加值因六分管位置而异 (5.1%相同,5.4%相邻,4.9%两侧,1.9%抵押).
- 与PI-RADS 3 (6.8%) 和PI-RADS 5 (6.7%) 相比,PI-RADS 4病变 (14%) 的SBx附加值更高.
结论:
- 反侧叶中的SBx在PCa检测中具有非常低的效用.
- 省略相反的SBx可能是一个可行的策略,以简化活检协议.
- 该研究强调了病变位置和MRI特征在优化前列腺活检策略中的重要性.
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