Overall detection rate of prostate cancer using MRI/US fusion-guided prostate biopsy in Rajavithi Hospital
DOI:
https://doi.org/10.52786/isu.a.108Keywords:
Detection rate, prostate cancer, MRI, ultrasound (US), fusion-guided, prostate biopsyAbstract
Objective: To study the detection rate of prostate cancer by using targeted MRI/US guided prostate biopsy in Rajavithi Hospital.
Materials and Methods: Patients with elevated PSA levels or abnormal digital rectal examinations who underwent prostate MRI with abnormal lesions (PIRADS ≥ 3) from January 2021 to October 2023 were enrolled onto the study. Patients under- went targeted MRI/US-guided biopsy, followed by a 12-core systematic transrectal ultrasound (TRUS) biopsy. The primary outcome was the overall detection rate of prostate cancer using MRI/US fusion-guided prostate biopsy. Secondary outcomes were the detection rate of prostate cancer in each PIRADS, detection of clinically significant prostate cancer in MRI/US-guided biopsy and complications.
Results: Patients 203 fulfilled the entry criteria and underwent both targeted MRI/US-guided biopsy and TRUS biopsy. The overall detection rate of prostate cancer from targeted MRI/US-guided biopsy was 32.50% which was significantly higher than detection by TRUS biopsy (25.60%, p < 0.05). In a subgroup analysis of each of PIRADS 3, 4 and 5, the detection rate was 8.8%, 40.50%, and 50.50%, respectively. MRI/US guided biopsy can more accurately detect clinically significant prostate cancer than TRUS biopsy (75.80% and 69.20%, respectively, OR1.39.95%CI 0.62-3.14, p = 0.54) with lower rates of insignificant prostate cancer (24.20% and 30.80%). However, the results did not reach statistical significance. The detection rate of prostate cancer when combining MRI/US fusion guided and TRUS biopsy was more successful than TRUS biopsy alone (38.90% vs. 25.60%, p < 0.05) or targeted MRI/US guide biopsy alone (38.90% vs. 32.50% p < 0.05). Complications included gross hematuria, fever, urinary retention and hematoma.
Conclusion: Targeted MRI/US-guided biopsy resulted in a higher detection rate of prostate cancer than systematic TRUS biopsy.
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