Academic radiology · 2018
The Role of Transrectal Ultrasound for Finding Focal Lesions in Prostate Cancer Detection Compared to Systematic Sextant Biopsy.
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Choi Moon Hyung, Lee Young Joon, Jung Seung Eun
Аннотация
OBJECTIVES: To evaluate the difference in cancer detection rate between targeted biopsy of focal lesions detected on transrectal ultrasound (TRUS) and systematic sextant biopsy.
MATERIALS AND METHODS: This retrospective study included patients who underwent TRUS-guided prostate biopsy between April 2014 and April 2017 and classified them into three groups: (1) sextant biopsy group patients underwent systematic sextant biopsy without evaluation of focal lesions on TRUS (n = 400), (2) focal lesion group patients underwent targeted biopsy for TRUS-detected lesions (n = 496), and (3) nonfocal lesion group patients had no TRUS-detected focal lesions (n = 222). Positive biopsy rates were compared using Chi-square tests between biopsy groups in all patients and two subgroups divided by prostate-specific antigen (PSA) level of 10 ng/mL.
RESULTS: The positive biopsy rate decreased in the order of the focal lesion group, the sextant biopsy group, and the nonfocal lesion group. All prostate cancers and prostate cancers with a Gleason score ≥7 were detected more frequently among patients with PSA ≤10 ng/mL in the focal lesion group than in the sextant biopsy group ( p = 0.008 and 0.007, respectively) and less frequently among patients with PSA >10 ng/mL in the nonfocal lesion group than in the sextant biopsy group ( p = 0.007 and 0.003, respectively).
CONCLUSION: In conclusion, searching focal lesion by TRUS is useful for improving the positive biopsy rate and risk stratification of PCa compared to systematic sextant biopsy without careful TRUS examination.
MATERIALS AND METHODS: This retrospective study included patients who underwent TRUS-guided prostate biopsy between April 2014 and April 2017 and classified them into three groups: (1) sextant biopsy group patients underwent systematic sextant biopsy without evaluation of focal lesions on TRUS (n = 400), (2) focal lesion group patients underwent targeted biopsy for TRUS-detected lesions (n = 496), and (3) nonfocal lesion group patients had no TRUS-detected focal lesions (n = 222). Positive biopsy rates were compared using Chi-square tests between biopsy groups in all patients and two subgroups divided by prostate-specific antigen (PSA) level of 10 ng/mL.
RESULTS: The positive biopsy rate decreased in the order of the focal lesion group, the sextant biopsy group, and the nonfocal lesion group. All prostate cancers and prostate cancers with a Gleason score ≥7 were detected more frequently among patients with PSA ≤10 ng/mL in the focal lesion group than in the sextant biopsy group ( p = 0.008 and 0.007, respectively) and less frequently among patients with PSA >10 ng/mL in the nonfocal lesion group than in the sextant biopsy group ( p = 0.007 and 0.003, respectively).
CONCLUSION: In conclusion, searching focal lesion by TRUS is useful for improving the positive biopsy rate and risk stratification of PCa compared to systematic sextant biopsy without careful TRUS examination.