Magnetic resonance imaging-transrectal ultrasound cognitive fusion targeted biopsy on the diagnosis of prostate cancer: a research of 614 cases in single center

本研究旨在探索磁共振（MRI）-经直肠超声（TRUS）认知融合引导下的，经直肠前列腺靶向穿刺活检与经直肠前列腺系统穿刺活检对前列腺癌的检出率的差异性。回顾性纳入自 2016 年—2018 年于我院行前列腺多参数 MRI 检查后行前列腺穿刺活检的患者 614 例。对于根据 PI-RADS V2 评分 ≥ 3 分的患者同时行 MRI-TRUS 认知融合靶向活检和系统活检，对 PI-RADS V2 评分 ≤ 2 分的患者只行系统活检，比较靶向活检和系统活检在前列腺癌检出率方面的差异。结果显示认知融合靶向活检检出肿瘤 342 例（75.7%），系统活检检出肿瘤 358 例（79.2%），二者对于前列腺癌的检出率无显著差异（ χ2 = 1.621， P = 0.203）。靶向活检穿刺针数显著低于系统穿刺活检针数，减少了（9.3 ± 0.11）针（ P < 0.001）。靶向穿刺活检阳性针中肿瘤组织平均占比比系统穿刺活检多 10.8%（ P < 0.001）。研究结果表明 MRI-TRUS 认知融合引导的靶向穿刺与系统穿刺对于前列腺癌都具有较高的检出率。MRI-TRUS 有望减少穿刺针数，并能提供更多肿瘤组织。.; This study aims to compare the prostate cancer detection rate between magnetic resonance imaging (MRI)-transrectal ultrasound (TRUS) cognitive fusion targeted biopsy and systematic biopsy. A total of 614 patients who underwent transrectal prostate biopsy during 2016-2018 with multiparametric magnetic resonance imaging (mpMRI) were included. All patients with a PI-RADS V2 score ≥ 3 accepted both targeted biopsy and systematic biopsy, and those with a PI-RADS V2 score ≤ 2 only accepted systematic biopsy. Overall prostate cancer detection rate between the two biopsies was compared. MRI-TRUS cognitive fusion targeted biopsy identified 342 cases (75.7%) of prostate cancer while systematic biopsy identified 358 cases (79.2%). There was no significant difference in the detection rate between the two groups ( χ2 = 1.621, P = 0.203). Targeted biopsy had significant fewer biopsy cores compared with systematic biopsy, reducing (9.3 ± 0.11) cores ( P < 0.001) in average. Targeted biopsy had about 10.8% ( P < 0.001) more tumor tissues in positive cores compared with systematic biopsy. The results show that both MRI-TRUS cognitive fusion targeted biopsy and systematic biopsy have good detection rate on prostate cancer. Cognitive targeted biopsy may reduce biopsy cores and provide more tumor tissues in positive cores.