Clinical Original Article
Multiparametric magnetic resonance imaging/transrectal ultrasound (mpMRI/TRUS) fusion: a preliminary approach in targeted prostate biopsy
Xu Gao, Yan Wang, Haifeng Wang, Qingsong Yang, Yifan Chang, Ting Shi, Feng Zhu, Biming He, Xiucai Jin, Chuanliang Xu, Yinghao Sun
Published 2016-04-15
Cite as Chin J Urol, 2016, 37(4): 276-279. DOI: 10.3760/cma.j.issn.1000-6702.2016.04.011
Abstract
ObjectiveTo evaluate the feasibility and efficacy of multiparametric magnetic resonance imaging/transrectal ultrasound (mpMRI/TRUS) fusion guided targeted prostate biopsy.
MethodsFrom March 2014 to May 2015, 32 patients with a suspected lesion of prostate cancer (PCa) by mpMRI examinations had undergone mpMRI/TRUS fusion prostate biopsy. The age of the patients was 47~82 years (median 64 years ). Serum PSA before biopsy was 1.11~33.53 ng/ml (median 8.73 ng/ml). There were 13 cases with PSA<10ng/ml, 10 cases PSA 10~20ng/ml, and 9 cases PSA>20ng/ml. A 12-core systematic prostate biopsy guided by TRUS was performed, followed by real-time fusion of TRUS and MRI images after import of MRI DICOM images to the ultrasound system (GE, Logiq E9). The plane for biopsy was located, and a 2- to 3-core targeted biopsy was performed for each suspected lesion.
Results21 of 32 patients (65.6%) were diagnosed with PCa. For each individual, one to two suspected lesions were located by mpMRI, with 2 to 3 cores sampled at each suspect lesion. Four cases were diagnosed by systematic biopsy only, 11 were diagnosed by both systematic and targeted biopsy, and 6 were diagnosed by targeted biopsy only. For systematic biopsies, Gleason Scores were 6-8 (mean: 7.13), in which ≤6, 7, and ≥8 recorded 20%(3/15)、46.7%(7/15)、33.3%(5/15) , respectively. For targeted biopsies, Gleason Scores were 6~10 (mean: 7.47), in which ≤6, 7, and ≥8 recorded 17.6%(3/17)、47.1%(8/17)、35.3%(6/17), respectively. For the 11 patients who were diagnosed both by systematic and targeted biopsy, three patients had a higher Gleason Score in targeted biopsy than in systematic ones.
ConclusionsmpMRI/TRUS fusion markedly increases positive rate in prostate biopsy and reduces misdiagnosis of PCa with a higher Gleason Score. Further application of such technique relies on a more precise imaging of PCa lesions and future development of fusion imaging technology.
Key words:
Prostatic neoplasms; Magnetic resonance imaging; Ultrasonography; Biopsy
Contributor Information
Xu Gao
Department of Urology, Changhai Hospital Affiliated to Second Military Medical University, Shanghai 200433, China
Yan Wang
Haifeng Wang
Qingsong Yang
Yifan Chang
Ting Shi
Feng Zhu
Biming He
Xiucai Jin
Chuanliang Xu
Yinghao Sun