Copyright
©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Cognitive magnetic resonance imaging-ultrasound fusion transperineal targeted biopsy combined with randomized biopsy in detection of prostate cancer
Cheng Pang, Miao Wang, Hui-Min Hou, Jian-Yong Liu, Zhi-Peng Zhang, Xuan Wang, Ya-Qun Zhang, Chun-Mei Li, Wei Zhang, Jian-Ye Wang, Ming Liu
Cheng Pang, Miao Wang, Hui-Min Hou, Jian-Yong Liu, Zhi-Peng Zhang, Xuan Wang, Ya-Qun Zhang, Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
Miao Wang, Jian-Yong Liu, Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
Chun-Mei Li, Department of Radiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, Beijing, China
Wei Zhang, Department of Pathology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, Beijing, China
Jian-Ye Wang, Ming Liu, Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China, China
Author contributions: Pang C and Wang M designed the study, acquired and analyzed the data, wrote the paper, and contributed equally to this article; Hou HM, Liu JY and Zhang ZP contributed to data analysis and interpretation; Wang X and Zhang YQ revised the paper; Li CM, Zhang W and Wang JY acquired and analyzed the data; Liu M designed the research, revised the paper and supervised the report; all authors made critical revisions related to the important intellectual content of the manuscript and provided the final approval of the version of the article to be published.
Supported by the Beijing Hospital Clinical Research 121 Project (BJ-2018-090 to Ming Liu).
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of Beijing Hospital (2018BJYYEC-028-02).
Informed consent statement: Written informed consent was obtained from the patient or his/her guardians prior to the study.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Ming Liu, MD, Chief Doctor, Professor, Surgeon, Surgical Oncologist, Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 Dahua Road, Dongcheng District, Beijing 100730, China.
liumingbjh@126.com
Received: January 20, 2021
Peer-review started: January 20, 2021
First decision: September 28, 2021
Revised: October 15, 2021
Accepted: November 3, 2021
Article in press: November 3, 2021
Published online: December 26, 2021
Processing time: 337 Days and 9.3 Hours
BACKGROUND
Prostate cancer (PCa) is one of the most common cancers among men. Various strategies for targeted biopsy based on multiparametric magnetic resonance imaging (mp-MRI) have emerged, which may improve the accuracy of detecting clinically significant PCa in recent years.
AIM
To investigate the diagnostic efficiency of a template for cognitive MRI-ultrasound fusion transperineal targeted plus randomized biopsy in detecting PCa.
METHODS
Data from patients with an increasing prostate-specific antigen (PSA) level but less than 20 ng/mL and at least one lesion suspicious for PCa on MRI from December 2015 to June 2018 were retrospectively analyzed. All patients underwent cognitive fusion transperineal template-guided targeted biopsy followed by randomized biopsy outside the targeted area. A total of 127 patients with complete data were included in the final analysis. A multivariable logistic regression analysis was conducted, and a two-sided P < 0.05 was considered statistically significant.
RESULTS
PCa was detected in 66 of 127 patients, and 56 cases presented clinically significant PCa. Cognitive fusion targeted biopsy alone detected 59/127 cases of PCa, specifically 52/59 cases with clinically significant PCa and 7/59 cases with clinically insignificant PCa. A randomized biopsy detected seven cases of PCa negative on targeted biopsy, and four cases had clinically significant PCa. PSA density (OR: 1.008, 95%CI: 1.003-1.012, P = 0.001; OR: 1.006, 95%CI: 1.002-1.010, P = 0.004) and Prostate Imaging-Reporting and Data System (PI-RADS) scores (both P < 0.001) were independently associated with the results of cognitive fusion targeted biopsy combined with randomized biopsy and targeted biopsy alone.
CONCLUSION
This single-centered study proposed a feasible template for cognitive MRI-ultrasound fusion transperineal targeted plus randomized biopsy. Patients with higher PSAD and PI-RADS scores were more likely to be diagnosed with PCa.
Core Tip: Prostate biopsy remains the standard diagnostic modality before curative treatment. Cognitive magnetic resonance imaging (MRI)-ultrasound fusion biopsy is a more accessible and economical biopsy technique for small-sample institutions to realize imaging-guided targeted biopsy. In this study, we proposed a customized template and reported a feasible approach for cognitive MRI-ultrasound fusion biopsy with our single institutional experience. The results from this retrospective study revealed that a high yield of cancer, and that patients with higher prostate-specific antigen density and Prostate Imaging-Reporting and Data System scores are more likely to be diagnosed with prostate cancer under this biopsy strategy.
