Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica · 2026
Incremental detection of clinically significant prostate cancer by systematic biopsy outside MRI-targeted lesions during cognitive fusion local anaesthetic transperineal biopsy.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Udeh Emeka I, Coull Nadine, Musbahi Abdussalam, David Rotimi, Akiboye Richard
Аннотация
OBJECTIVE: To evaluate the incremental yield of clinically significant prostate cancer (csPCa) detected by systematic biopsy outside MRI-targeted lesions during cognitive fusion local anaesthetic transperineal prostate biopsy.
PATIENTS AND METHODS: This observational cohort study included men undergoing cognitive MRI-targeted prostate biopsy with concurrent systematic sampling. Pre-biopsy MRI findings were recorded using PI-RADS. The primary outcome was csPCa detected exclusively by systematic biopsy outside MRI-targeted lesions despite a negative targeted biopsy. Secondary outcomes included csPCa detection by targeted, systematic, and combined biopsy, PI-RADS subgroup analysis, and multivariable predictors of csPCa.
RESULTS: Overall, 770 men were included, of whom 767 had evaluable paired biopsy data. Most had PI-RADS 4 lesions (636/767, 82.9%). csPCa was detected by targeted biopsy in 320/767 men (41.7%), systematic biopsy outside MRI-targeted lesions in 196/767 (25.6%), and combined biopsy in 384/767 (50.1%). Exclusive outside-target systematic csPCa detection occurred in 64/767 men (8.3%), representing 16.7% of all csPCa detected. This rate was highest in PI-RADS 3 lesions (8/30, 26.7%). On multivariable analysis, overall csPCa detection was associated with age, PSA density, and PI-RADS score, whereas exclusive outside-target detection was inversely associated with PI-RADS score and positively associated with procedures performed by urologists. Spatial analysis showed that most systematic-only csPCa lesions were anatomically distinct from the index MRI-visible lesion.
CONCLUSIONS: Systematic biopsy outside MRI-targeted lesions detected additional csPCa in 64/767 men (8.3%) and frequently identified anatomically distinct lesions, supporting continued systematic sampling alongside MRI-targeted biopsy in selected patients.
PATIENTS AND METHODS: This observational cohort study included men undergoing cognitive MRI-targeted prostate biopsy with concurrent systematic sampling. Pre-biopsy MRI findings were recorded using PI-RADS. The primary outcome was csPCa detected exclusively by systematic biopsy outside MRI-targeted lesions despite a negative targeted biopsy. Secondary outcomes included csPCa detection by targeted, systematic, and combined biopsy, PI-RADS subgroup analysis, and multivariable predictors of csPCa.
RESULTS: Overall, 770 men were included, of whom 767 had evaluable paired biopsy data. Most had PI-RADS 4 lesions (636/767, 82.9%). csPCa was detected by targeted biopsy in 320/767 men (41.7%), systematic biopsy outside MRI-targeted lesions in 196/767 (25.6%), and combined biopsy in 384/767 (50.1%). Exclusive outside-target systematic csPCa detection occurred in 64/767 men (8.3%), representing 16.7% of all csPCa detected. This rate was highest in PI-RADS 3 lesions (8/30, 26.7%). On multivariable analysis, overall csPCa detection was associated with age, PSA density, and PI-RADS score, whereas exclusive outside-target detection was inversely associated with PI-RADS score and positively associated with procedures performed by urologists. Spatial analysis showed that most systematic-only csPCa lesions were anatomically distinct from the index MRI-visible lesion.
CONCLUSIONS: Systematic biopsy outside MRI-targeted lesions detected additional csPCa in 64/767 men (8.3%) and frequently identified anatomically distinct lesions, supporting continued systematic sampling alongside MRI-targeted biopsy in selected patients.