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
ARTICLE HIGHLIGHTS
Research background
Various strategies for targeted biopsy (TBx) based on multiparametric magnetic resonance imaging (mp-MRI) have emerged, which may improve the accuracy of detecting clinically significant PCa in recent years. Cognitive fusion targeted biopsy is a more ecnomical and accessible strategy but requires more experience.
Research motivation
As cognitive fusion targeted biopsy requires higher level of experience, a more easily followed template would be meaningful for the generalization of this technique and could help reduce operator variability.
Research objectives
To investigate the diagnostic efficiency of a template for cognitive MRI-ultrasound fusion transperineal targeted plus randomized biopsy in detecting PCa, and to evaluate the potential influencing factors for the detection rate.
Research methods
Patients with elevated PSA levels but less than 20 ng/mL, and having at least on suspicious lesion on MRI were retrospectively studied. The detection rate of all cancer and clinically significant cancer were calculated. Multivariate logistic regression analysis was used to analyze the potential influencing factors.
Research results
Cognitive fusion targeted biopsy alone detected 59/127 cases of PCa, specifically 52/59 cases with clinically significant PCa (csPCa) . A randomized biopsy showed an approximate 7.1% added value for csPCa detection. PSA density and PI-RADS score were independently associated with the results of cognitive fusion targeted biopsy combined with randomized biopsy and targeted biopsy alone.
Research conclusions
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 using this biopsy strategy.
Research perspectives
Prospective multicentered studies are needed to further test our template and to confirm the influencing factors for the detection rate.
