OBJECTIVES: To report our experience with free-hand transperineal targeted biopsy with real-time transrectal ultrasound (TRUS) and multiparametric magnetic resonance imaging (mpMRI) fusion images for the diagnosis of prostate cancer (PCa).
PATIENTS AND METHODS: A total of 62 consecutive patients suspicious of PCa at the mpMRI scan and PSA >4.0 ng/mL were recruited prospectively. Targeted biopsies (TBs) were carried out for each cancer-suspicious lesion and followed a 12-core systematic biopsy (SB) protocol. Pathological findings of TB and SB were analyzed.
RESULTS: The age of the patients was 68.38 ± 6.57 years (range 51-79 years). The preoperative PSA value was 10.21 ± 5.57 ng/mL (range 4.5-30.1 ng/mL). Preoperative prostate volume was 34.05 ± 9.86 mL (range 19-64 mL). The PCa patients detected by SB and/or TB were 34 (54.8 %). Cancer-detected rates of SB and TB cores were 7.53 and 26.2 %, respectively (P < 0.001). The positive core length of SB and TB cores was 3.71 ± 2.77 mm (range 1-14 mm) and 5.00 ± 3.04 mm (range 2-17 mm), respectively (P = 0.016). The positive core percent of SB and TB cores was 28.77 ± 20.13 % (range 7-100 %) and 35.76 ± 18.73 (range 11-100 %), respectively (P = 0.048). Moreover, clinically significant PCa cores detected by the SB and TB were 19 cores (2.6 %) and 48 cores (18.5 %), respectively (P < 0.001).
CONCLUSIONS: Free-hand transperineal TB using real-time TRUS and mpMRI fusion imaging has the ability to improve sampling quality and detect more clinically significant PCa compared with SB.
Zhang Q, Wang W, Yang R, Zhang G, Zhang B, Li W, Huang H, Guo H. Are you the author?
Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China.
Reference: Int Urol Nephrol. 2015 May;47(5):727-33.