医学
活检
磁共振成像
前列腺癌
前列腺
经直肠超声检查
前列腺活检
癌症
放射科
核医学
内科学
作者
Toshitaka Shin,Thomas B. Smyth,Osamu Ukimura,Nariman Ahmadi,Andre Luis Abreu,Masakatsu Oishi,Hiromitsu Mimata,Inderbir S. Gill
出处
期刊:BJUI
[Wiley]
日期:2017-01-23
卷期号:120 (2): 233-238
被引量:22
摘要
Objective To assess the diagnostic yield of targeted prostate biopsy in African‐American (A‐A) men using image fusion of multi‐parametric magnetic resonance imaging (mp MRI ) with real‐time transrectal ultrasonography ( US ). Patients and Methods We retrospectively analysed 661 patients (117 A‐A and 544 Caucasian) who had mp MRI before biopsy and then underwent MRI / US image‐fusion targeted biopsy ( FTB ) between October 2012 and August 2015. The mp MRI s were reported on a 5‐point Likert scale of suspicion. Clinically significant prostate cancer ( CSPC ) was defined as biopsy Gleason score ≥7. Results After controlling for age, prostate‐specific antigen level and prostate volume, there were no significant differences between A‐A and Caucasian men in the detection rate of overall cancer (35.0% vs 34.2%, P = 0.9) and CSPC (18.8% vs 21.7%, P = 0.3) with MRI / US FTB . There were no significant differences between the races in the location of dominant lesions on mp MRI , and in the proportion of 5‐point Likert scoring. In A‐A men, MRI / US FTB from the grade 4–5 lesions outperformed random biopsy in the detection rate of overall cancer (70.6% vs 37.2%, P = 0.003) and CSPC (52.9% vs 12.4%, P < 0.001). MRI / US FTB outperformed random biopsy in cancer core length (5.0 vs 2.4 mm, P = 0.001), in cancer rate per core (24.9% vs 6.8%, P < 0.001), and in efficiency for detecting one patient with CSPC (mean number of cores needed 13.3 vs 81.9, P < 0.001), respectively. Conclusions Our key finding confirms a lack of racial difference in the detection rate of overall prostate cancers and CSPC with MRI / US FTB between A‐A and Caucasian men. MRI / US FTB detected more CSPC using fewer cores compared with random biopsy.
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