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Tytuł:
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Prostate Mapping for Cancer Diagnosis: The Madrid Protocol. Transperineal Prostate Biopsies Using Multiparametric Magnetic Resonance Imaging Fusion and Micro-Ultrasound Guided Biopsies.
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Autorzy:
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Rodríguez Socarrás ME; Department of Urology, Instituto Cirugía Urológica Avanzada (ICUA), Madrid, Spain.
Gomez Rivas J; Department of Urology, Instituto Cirugía Urológica Avanzada (ICUA), Madrid, Spain.
Cuadros Rivera V; Department of Urology, Instituto Cirugía Urológica Avanzada (ICUA), Madrid, Spain.
Reinoso Elbers J; Department of Urology, Instituto Cirugía Urológica Avanzada (ICUA), Madrid, Spain.
Llanes González L; Department of Urology, Instituto Cirugía Urológica Avanzada (ICUA), Madrid, Spain.
Michel Mercado I; Department of Urology, Instituto Cirugía Urológica Avanzada (ICUA), Madrid, Spain.
Fernandez Del Alamo J; Department of Urology, Instituto Cirugía Urológica Avanzada (ICUA), Madrid, Spain.
Juarez Del Dago P; Department of Urology, Instituto Cirugía Urológica Avanzada (ICUA), Madrid, Spain.
Sancha FG; Department of Urology, Instituto Cirugía Urológica Avanzada (ICUA), Madrid, Spain.
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Źródło:
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The Journal of urology [J Urol] 2020 Oct; Vol. 204 (4), pp. 726-733. Date of Electronic Publication: 2020 Apr 21.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: 2019- : [Philadelphia, PA] : Wolters Kluwer
Original Publication: Baltimore : Lippincott Williams & Wilkins
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MeSH Terms:
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Multiparametric Magnetic Resonance Imaging*
Ultrasonography, Interventional*/methods
Prostate/*diagnostic imaging
Prostate/*pathology
Prostatic Neoplasms/*diagnostic imaging
Prostatic Neoplasms/*pathology
Aged ; Humans ; Image-Guided Biopsy/methods ; Male ; Middle Aged ; Perineum ; Reproducibility of Results ; Retrospective Studies
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Contributed Indexing:
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Keywords: biopsy; multiparametric magnetic resonance imaging; prostatic neoplasms; ultrasonography
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Entry Date(s):
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Date Created: 20200422 Date Completed: 20201029 Latest Revision: 20201029
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Update Code:
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20240105
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DOI:
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10.1097/JU.0000000000001083
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PMID:
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32314932
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Purpose: We assessed the prostate cancer detection accuracy of transperineal prostate biopsy using multiparametric magnetic resonance imaging/ultrasound fusion targeted biopsy and micro-ultrasound during the same procedure. Micro-ultrasound is a new high-resolution imaging system that allows real-time targeted biopsy.
Materials and Methods: A total of 194 consecutive patients underwent transperineal prostate biopsies using real-time targeted micro-ultrasound (ExactVu™) and ultrasound fusion targeted biopsy (BiopSee®) in the same procedure, from February 2018 to September 2019. Biopsies were performed using a transperineal needle guide attached to the 29 MHz high-resolution micro-ultrasound transducer.
Results: The overall positive rate was 56% (108) for prostate cancer and 42% (81) for clinically significant prostate cancer (Gleason Grade Group greater than 1), and adding micro-ultrasound and magnetic resonance imaging detected significantly more clinically significant prostate cancer than systematic biopsy (p <0.001). Micro-ultrasound found 12 of 108 (11%) prostate cancers that were missed by all other techniques and 11 (92%) were clinically significant prostate cancer. PI-RADS® and PRI-MUS™ (Prostate Risk Identification Using Micro-Ultrasound) were strong predictors of clinically significant prostate cancer in a logistic regression model (AUC 0.76). For prostate specific antigen greater than 4 ng/ml, PI-RADS greater than 3, there was an improvement in detection rate between PRI-MUS 4 and PRI-MUS 5 (52% Gleason Grade Group greater than 1 to 92% Gleason Grade Group greater than 1). No fever or clinical infection was observed and 17 (8.7%) patients presented with minor complications (Clavien Dindo I).
Conclusions: This is the first study using a transperineal approach for micro-ultrasound guided biopsy and multiparametric magnetic resonance imaging fusion biopsy. The results show a high accuracy for prostate cancer and clinically significant prostate cancer diagnosis, without infectious complications. The proposed method should be validated in large randomized clinical trials.
Comment in: J Urol. 2020 Oct;204(4):732-733. (PMID: 32898982)
Comment in: J Urol. 2020 Oct;204(4):732. (PMID: 32898983)
