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Fang JH, Zhang L, Xie X, Zhao P, Bao L, Kong F. Comparative diagnostic accuracy of multiparametric magnetic resonance imaging-ultrasound fusion-guided biopsy versus systematic biopsy for clinically significant prostate cancer. PeerJ 2023; 11:e16614. [PMID: 38107582 PMCID: PMC10725670 DOI: 10.7717/peerj.16614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/15/2023] [Indexed: 12/19/2023] Open
Abstract
Purpose To examine the accuracy of transperineal magnetic resonance imaging (MRI)-ultrasound (US) fusion biopsy (FB) in identifying men with prostate cancer (PCa) that has reached a clinically relevant stage. Methods This investigation enrolled 459 males. In 210 of these patients (FB group), transperineal MRI/US fusion-guided biopsies were performed on the suspicious region, and in 249 others, a systematic biopsy (SB) was performed (SB group). We compared these groups using Gleason scores and rates of cancer detection. Results PCa cases counted 198/459 (43.1%), including 94/249 (37.8%) in the SB group and 104/210 (49.5%) in the FB group. FB was associated with higher overall diagnostic accuracy relative to SB (88.5% and 72.3%, P = 0.024). FB exhibited greater sensitivity than SB (88.9% and 71.2%, P = 0.025). The area under the curve for FB and SB approaches was 0.837 and 0.737, respectively, such that FB was associated with an 11.9% increase in accuracy as determined based upon these AUC values. Relative to SB, FB was better able to detect high-grade tumors (GS ≥ 7) (78.85% vs. 60.64%, P = 0.025). Conclusion Transperineal MRI-US fusion targeted biopsy is superior to the systematic one as an approach to diagnosing clinically significant PCa, as it is a viable technical approach to prostate biopsy.
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Affiliation(s)
- Jian-hua Fang
- Department of Medical Ultrasound, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hang Zhou, Zhejiang, China
| | - Liqing Zhang
- Department of Radiology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hang Zhou, Zhejiang, China
| | - Xi Xie
- Department of Urology Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hang Zhou, Zhejiang, China
| | - Pan Zhao
- Department of Pathology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hang Zhou, Zhejiang, China
| | - Lingyun Bao
- Department of Medical Ultrasound, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hang Zhou, Zhejiang, China
| | - Fanlei Kong
- Department of Medical Ultrasound, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hang Zhou, Zhejiang, China
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Cao H, Xu W, Xu Y, Rong X, Xiao X, Feng H, Wang X, Wang L, Qi T, Zhang L. Value of synthetic MRI quantitative parameters in preprocedural evaluation for TRUS/MRI fusion-guided biopsy of the prostate. Prostate 2023. [PMID: 37157155 DOI: 10.1002/pros.24550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 03/17/2023] [Accepted: 04/24/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Transrectal ultrasonography (TRUS)/magnetic resonance imaging (MRI) fusion-guided biopsy has a high clinical application value. However, this technique has some limitations, which limit its use in routine clinical practice. Therefore, the selection of suitable proatate lesions for this technique is worthy of our attention. Synthetic MRI (SyMRI) is capable of quantifying multiple relaxation parameters, which might have potential value in preprocedural evaluation for TRUS/MRI fusion-guided biopsy of the prostate. The aim of our study is to examine the value of SyMRI quantitative parameters in preprocedural evaluation for TRUS/MRI fusion-guided biopsy of the prostate. METHODS We prospectively selected 148 lesions in 137 patients who underwent prostate biopsy in our hospital. Next, 2-4 needles of TRUS/MRI fusion-guided biopsy combined with 10 needles of system biopsy (SB) were used as the protocol for prostate biopsy. Before biopsy, the MAGiC sequences of the MRI images of the enrolled patients underwent post-processing, and the longitudinal relaxation time (T1), transverse relaxation time (T2), and proton density (PD) were extracted. The biopsy pathology results were used as a gold standard to compare the differences in SyMRI quantitative parameters between benign and malignant prostate lesions in the peripheral and transitional zones. The receiver operating characteristic (ROC) curves were plotted to confirm the optimal SyMRI quantitative parameter for prostate lesion benignancy/malignancy performance, and the cutoff values of these parameters were used for grouping the lesions. The single-needle biopsy prostate cancer (PCa)-positivity rates (number of positive biopsy needles/total biopsy needles) and PCa overall detection rates by TRUS/MRI fusion-guided biopsy and SB were compared in different subgroups. RESULTS The T1 and T2 values can determine the benignancy/malignancy of prostate transition lesions(p < 0.01), and the T2 value has a greater diagnostic performance (p = 0.0376). The T2 value can determine the benignancy/malignancy of prostate peripheral lesions. The optimal diagnostic cutoff values for T2 were 77 and 81 ms, respectively. The single-needle PCa positivity rate of TRUS/MRI fusion-guided biopsy was higher than SB for any prostate lesions in different subgroups (p < 0.01). However, only in the subgroup of transition zone lesions with T2 ≤ 77 ms, the PCa overall detection rate of TRUS/MRI fusion-guided biopsy was significantly higher than that of SB (p = 0.031). CONCLUSION SyMRI-T2 value can provide a theoretical basis for the selection of suitable lesions for TRUS/MRI fusion-guided biopsy.
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Affiliation(s)
- Haiyan Cao
- Department of Ultrasound, Affiliated Hospital of Yangzhou University, Medical Imaging Center, Yangzhou University, Yangzhou, China
- Department of Ultrasound, Yancheng First Hospital, Affiliated Hospital of Nanjing University Medical school (The First people's Hospital of Yancheng), Yancheng, China
| | - Wenjuan Xu
- Department of Radiology, Affiliated Hospital of Yangzhou University, Medical Imaging Center, Yangzhou University, Yangzhou, China
| | - Yan Xu
- Department of Ultrasound, Affiliated Hospital of Yangzhou University, Medical Imaging Center, Yangzhou University, Yangzhou, China
| | - Xin Rong
- Department of Ultrasound, Affiliated Hospital of Yangzhou University, Medical Imaging Center, Yangzhou University, Yangzhou, China
| | - Xiao Xiao
- Department of Ultrasound, Affiliated Hospital of Yangzhou University, Medical Imaging Center, Yangzhou University, Yangzhou, China
| | - Hao Feng
- Department of Ultrasound, Affiliated Hospital of Yangzhou University, Medical Imaging Center, Yangzhou University, Yangzhou, China
| | - Xiaoxiang Wang
- Department of Urology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Lei Wang
- Department of Pathology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Tingyue Qi
- Department of Ultrasound, Affiliated Hospital of Yangzhou University, Medical Imaging Center, Yangzhou University, Yangzhou, China
| | - Li Zhang
- Department of Interventional Radiology, Affiliated Hospital of Yangzhou University, Medical Imaging Center, Yangzhou University, Yangzhou, China
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Comparison of Accuracies between Real-Time Nonrigid and Rigid Registration in the MRI-US Fusion Biopsy of the Prostate. Diagnostics (Basel) 2021; 11:diagnostics11081481. [PMID: 34441415 PMCID: PMC8392836 DOI: 10.3390/diagnostics11081481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/13/2021] [Accepted: 08/13/2021] [Indexed: 11/17/2022] Open
Abstract
Magnetic resonance imaging (MRI) is increasingly important in the detection and localization of prostate cancer. Regarding suspicious lesions on MRI, a targeted biopsy using MRI fused with ultrasound (US) is widely used. To achieve a successful targeted biopsy, a precise registration between MRI and US is essential. The purpose of our study was to show any decrease in errors using a real-time nonrigid registration technique for prostate biopsy. Nineteen patients with suspected prostate cancer were prospectively enrolled in this study. Registration accuracy was calculated by the measuring distance of corresponding points by rigid and nonrigid registration between MRI and US, and compared for rigid and nonrigid registration methods. Overall cancer detection rates were also evaluated by patient and by core. Prostate volume was measured automatically from MRI and manually from US, and compared to each other. Mean distances between the corresponding points in MRI and US were 5.32 ± 2.61 mm for rigid registration and 2.11 ± 1.37 mm for nonrigid registration (p < 0.05). Cancer was diagnosed in 11 of 19 patients (57.9%), and in 67 of 266 biopsy cores (25.2%). There was no significant difference in prostate-volume measurement between the automatic and manual methods (p = 0.89). In conclusion, nonrigid registration reduces targeting errors.
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Barile A. Multimodality advanced imaging and intervention in gland diseases. Gland Surg 2020; 9:2211-2214. [PMID: 33447573 DOI: 10.21037/gs-20-592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Antonio Barile
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
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