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多参数MRI向前列腺活检:什么时候省略系统活检?
Pietro Pepe1, Ludovica Pepe2, Vincenzo Fiorentino3
1Urology Unit, Cannizzaro Hospital, Catania. piepepe@hotmail.com.
概括
将系统性前列腺活检 (SPBx) 与向性前列腺活检 (TPBx) 结合起来,最大限度地提高了临床上显著的前列腺癌 (csPCa) 检测. 一个减少的活检方案,只关注MRI病变的ipsilateral侧,错过了csPCa.
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:
- 前列腺癌 (PCa) 诊断依赖于准确的活检技术.
- 多参数磁共振成像 (mpMRI) 改善可疑病变的局部化.
研究的目的:
- 为了评估PCa的检测率,使用mpMRI融合向活检 (TPBx) 结合ipsilateral系统性前列腺活检 (SPBx).
主要方法:
- 495名疑似PCa的男性接受了PI-RADS评分病变≥3.3的跨经SPBx和TPBx.
- 从2023年1月到2023年12月收集的数据.
主要成果:
- 在50.5%的男性中检测到PCa;14.4%的mpMRI阴性.
- 在ISUP等级组2中,SPBx诊断出更多的惰性PCa (38.5%对5.8%),而TPBx在ISUP等级组2中显示出更高的临床显著PCa (csPCa) 率 (97.3%对85.4%).
- SPBx和TPBx在GG5瘤中诊断出100%的csPCa;89.4%的csPCa病例在负的mpMRI侧被发现.
结论:
- 结合SPBx和TPBx可以最大限度地进行csPCa诊断.
- 一个仅限于mpMRI病变的ipsilateral侧的减少活检方案错过了csPCa的11.6%.
- SPBx和TPBx在PI-RADS评分5的病变中诊断出100%的csPCa.
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