A comparative study of transperineal software-assisted magnetic resonance/ultrasound fusion biopsy and transrectal cognitive fusion biopsy of the prostate

Springer Science and Business Media LLC - 2022
Po-Fan Hsieh1,2,3, Tian-You Chang3, Wei-Ching Lin2,4, Han Chang5, Chao-Hsiang Chang3, Chi-Ping Huang2,3, Chi-Rei Yang3, Wen-Chi Chen3, Yi-Huei Chang3, Yu-De Wang3, Wen-Chin Huang1, Hsi-Chin Wu2,3,6
1Graduate Institute of Biomedical Sciences, School of Medicine, China Medical University, Taichung, Taiwan
2School of Medicine, China Medical University, Taichung, Taiwan
3Department of Urology, China Medical University Hospital, Taichung, Taiwan
4Department of Radiology, China Medical University Hospital, Taichung, Taiwan
5Department of Pathology, China Medical University Hospital, Taichung, Taiwan
6Department of Urology, China Medical University Beigang Hospital, Beigang, Yunlin, Taiwan

Tóm tắt

The advantages and disadvantages of transperineal and transrectal biopsies remain controversial in the era of prostate targeted biopsy. In this study, we compared the cancer detection and complication rates of transperineal magnetic resonance/ultrasound (MR/US) fusion biopsy and transrectal cognitive fusion biopsy of the prostate. This was a comparative study of two prospectively collected cohorts. Men with clinically suspected prostate cancer and prostate imaging reporting and data system (PI-RADS) score ≥ 3 lesions on multi-parametric magnetic resonance imaging (mpMRI) were enrolled. They underwent either transperineal software fusion biopsy or transrectal cognitive fusion biopsy and systematic biopsy. The detection rates of any prostate cancer and clinically significant prostate cancer (csPC, defined as Gleason score ≥ 3 + 4) and the complication rates between both groups were analysed. Ninety-two and 85 patients underwent transperineal software fusion and transrectal cognitive fusion biopsies, respectively. The detection rate for any prostate cancer was similar between both groups (60.8% vs. 56.4%, p = 0.659). In terms of csPC detection, transperineal fusion biopsy outperformed transrectal fusion biopsy (52.2% vs. 36.5%, p = 0.036). In multivariate regression analysis, age, PI-RADS score > 3, and transperineal route were significant predictors of csPC. Meanwhile, transperineal biopsy resulted in a higher rate of urinary retention than transrectal biopsy (18.5% vs. 4.7%, p = 0.009). No serious infectious complications were noted, although a patient developed sepsis after transrectal biopsy. Transperineal software fusion biopsy provided a higher csPC detection rate than transrectal cognitive fusion biopsy and carried minimal risk for infectious complications in patients with MRI-visible prostate lesions.

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Tài liệu tham khảo

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