Comparison of MR-TRUS Fusion Biopsy and Cognitive Fusion Biopsy Techniques in Patients with Suspected Prostate Cancer with Mp-MRI

Abstract

We aimed to compare the efficiency of MR-Transrectal Ultrasonography (MR-TRUS) guided fusion biopsy and Cognitive Fusion (CF) biopsy techniques used to detect prostate cancer in patients with PIRADS 3 (Prostate Imaging Reporting and Information System) and higher lesions in Multiparametric Magnetic Resonance (mp-MR) examination. In our clinic between 2017-2022, 96 patients had selected who pre-biopsy mp-MR examinations had PIRADS 3 and above lesions, a PSA value between 2-20 ng/ml, and never had a prostate biopsy before, retrospectivly. Ninety-six patients who underwent 48 MR-TRUS and 48 CF fusion biopsies were selected within the first 6 months after the mp-MR examination. Parameters such as patient age, PSA value, prostate volume, size of lesions, and PIRADS score were evaluated. There was no significant difference between the groups in demographic data, PSA values, prostate volumes, size of lesions, and PIRADS scores (p>0.05). The cancer detection rate in any localization was 41.7% (20/48 patients) in the CF group and 39.6% (19/48 patients) in the MR-TRUS fusion biopsy group. The difference between the two groups was not significant (p=0.835). Cancer detection rates were 85% (17/20 patients) in the CF group and 73.7% (14/19 patients) in the MR-TRUS group on the targeted lesion. No significant difference was observed between these two groups (p=0.518). In conclusion, the CF biopsy technique may be preferred to MR-fusion biopsy because the success of detecting cancer is similar, its application is more accessible, and its cost is lower.

Keywords

• prostate cancer
• multiparametric magnetic resonance imaging (mp-MRI)
• MRI-fusion biopsy
• Cognitive fusion biopsy

Mp-MR ile Prostat Kanseri Şüphesi Bulunan Hastalarda, MR-TRUS Füzyon Biyopsi ve Kognitif Füzyon Biyopsi Tekniklerinin Karşılaştırılması

Abstract

Bu çalışmada, Multiparametrik Manyetik Rezonans (mp-MR) tetkikinde PIRADS 3 (Prostat Görüntüleme Raporlama ve Bilgi Sistemi) ve üzeri lezyonu bulunan hastalarda MR- Transrektal Ultrasonografi (MR-TRUS) eşliğinde füzyon biyopsi ve kognitif Füzyon (KF) biyopsi tekniklerinin prostat kanseri saptamadaki etkinliklerinin karşılaştırılması amaçlanmıştır. Kliniğimizde 2017-2022 yılları arasında biyopsi öncesi yapılmış mp-MR tetkiklerinde PIRADS 3 ve üzeri lezyonu bulunan, PSA değeri 2-20 ng/ml arasında olan, daha önce hiç prostat biyopsisi yapılmamış ve mp-MR tetkiki sonrası ilk 6 ay içerisinde 48 MR-TRUS, 48 KF füzyon biyopsisi yapılmış 96 hasta seçildi. Hasta yaşı, PSA değeri, prostat volümü, lezyonların boyutu ve PIRADS skoru gibi parametreler değerlendirildi. Gruplar arasında demografik verilerde, PSA değerleri, prostat volümleri ve lezyonların boyut ve PIRADS skorlarında anlamlı farklılık saptanmadı (p>0.05). Kognitif füzyon yapılan grupta herhangi bir lokalizasyonda kanser yakalama oranı %41,7 (20/48 hasta), MR-TRUS füzyon biyopsi yapılan grupta %39,6 (19/48 hasta) bulundu. İki grup arasında istatistiksel olarak anlamlı farklılık saptanmadı (p=0,835). Hedefli biyopsi sonuçlarında ise kanser saptama oranları KF grubunda %85 (17/20 hasta), MR-TRUS grubunda %73,7 (14/19 hasta) bulundu. Bu iki grup arasında da anlamlı farklılık izlenmedi (p=0,518). Sonuç olarak, kanser yakalama başarısının benzer olması, uygulamasının daha kolay ve maliyetinin daha düşük olması nedeniyle KF biyopsi tekniği MR-füzyon biyopsisine tercih edilebilir.

Keywords

• prostat kanseri
• multiparametrik manyetik rezonans görüntüleme (mp-MRG)
• MR-Füzyon biyopsi
• Kognitif füzyon biyopsi

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