Portal de Periódicos da CAPES

MP58-06 DIAGNOSTIC PERFORMANCE OF MIXED TARGETED PROSTATE BIOPSY APPROACHES USING MICRO-ULTRASOUND AND MRI-FUSION BIOPSIES

2022; Lippincott Williams & Wilkins; Volume: 207; Issue: Supplement 5 Linguagem: Inglês

10.1097/ju.0000000000002641.06

1527-3792

Davide Maffei, Cesare Saitta, Pier Paolo Avolio, Marco Paciotti, Vittorio Fasulo, Nicola Frego, Pietro Diana, Massimo Lazzeri, Rodolfo Hurle, Alberto Saita, Giorgio Guazzoni, Paolo Casale, Nicolò Maria Buffi, Giovanni Lughezzani,

Molecular Biology Techniques and Applications

You have accessJournal of UrologyCME1 May 2022MP58-06 DIAGNOSTIC PERFORMANCE OF MIXED TARGETED PROSTATE BIOPSY APPROACHES USING MICRO-ULTRASOUND AND MRI-FUSION BIOPSIES Davide Maffei, Cesare Saitta, Pier Paolo Avolio, Marco Paciotti, Vittorio Fasulo, Nicola Frego, Pietro Diana, Lazzeri Massimo, Rodolfo Hurle, Alberto Rosario Saita, Giorgio Ferruccio Guazzoni, Paolo Casale, Nicolò Maria Buffi, and Giovanni Lughezzani Davide MaffeiDavide Maffei More articles by this author , Cesare SaittaCesare Saitta More articles by this author , Pier Paolo AvolioPier Paolo Avolio More articles by this author , Marco PaciottiMarco Paciotti More articles by this author , Vittorio FasuloVittorio Fasulo More articles by this author , Nicola FregoNicola Frego More articles by this author , Pietro DianaPietro Diana More articles by this author , Lazzeri MassimoLazzeri Massimo More articles by this author , Rodolfo HurleRodolfo Hurle More articles by this author , Alberto Rosario SaitaAlberto Rosario Saita More articles by this author , Giorgio Ferruccio GuazzoniGiorgio Ferruccio Guazzoni More articles by this author , Paolo CasalePaolo Casale More articles by this author , Nicolò Maria BuffiNicolò Maria Buffi More articles by this author , and Giovanni LughezzaniGiovanni Lughezzani More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002641.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: MR imaging(MRI) has gained a central role in prostate cancer (PCa) diagnosis. High-resolution micro-ultrasound (mUS) is a new imaging modality enabling real-time targeted prostate biopsies. We compared the diagnostic performance of MRI and mUS for the detection of clinically significant PCa (GS≥7; csPCa). METHODS: We prospectively enrolled 685 patients with clinical suspicion of PCa and available MRI. The PRI-MUS protocol was used to identify target lesions on mUS. All subjects received mUS and MRI targeted biopsy as well as systematic biopsies. The csPCa detection rate was assessed and stratified according to the bioptic strategy. RESULTS: Mean age was 65.2 (SD7.8)yr, median PSA was 7.1(IQR 5.0-9.7)ng/mL and median prostate volume was 50 (IQR 35-70)mL. Overall, 41.6% patients were in the repeat biopsy setting. Suspicious lesions were identified by mUS and MRI in 535(78.1%) and 627 (91.5%) patients, respectively. PCa and csPCa were diagnosed in 52.5% and 37.0% of patients. CsPCa detection rates increased from 27.8% to 38.1% and 67.7% in patients with PRI-MUS 3, 4 and 5 lesions, respectively (p<0.01). Similarly, csPCa detection rates increased from 18.2% to 39.7% and 65.1% in patients with PI-RADS 3, 4 and 5 lesions, respectively (p<0.01). MUS-targeted cores were positive for csPCa in 183/258 (70.9%) patients, while combination of mUS-targeted and systematic biopsies detected 246 (95.3%) csPCa. MRI-targeted cores were positive for csPCa in 198 (76.7%) patients, while combination with randomized biopsies detected 250 (96.9%) csPCa. Only 12 csPCa were diagnosed by MRI-targeted cores alone, while 8 csPCa patients were detected uniquely on mUS-targeted cores. MUS imaging provided high sensitivity with 90.7% csPCa patients (234/258) having at least one PRI-MUS score ≥3 lesion. NPV was 84.0% (126/150 patients without target lesions classified benign or GS6). PPV and specificity were 43.7% and 29.5% respectively. MRI sensitivity, specificity, PPV and NPV were 96.9%, 29.5%, 43.7% and 84.0%. CONCLUSIONS: MUS is a promising imaging modality for targeted prostate biopsies, enabling high sensitivity to detect PCa. This work suggests that mUS and MRI both represent essential targeting modalities for csPCa diagnosis, which can similarly maximize the diagnostic performance of prostate biopsies. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e993 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Davide Maffei More articles by this author Cesare Saitta More articles by this author Pier Paolo Avolio More articles by this author Marco Paciotti More articles by this author Vittorio Fasulo More articles by this author Nicola Frego More articles by this author Pietro Diana More articles by this author Lazzeri Massimo More articles by this author Rodolfo Hurle More articles by this author Alberto Rosario Saita More articles by this author Giorgio Ferruccio Guazzoni More articles by this author Paolo Casale More articles by this author Nicolò Maria Buffi More articles by this author Giovanni Lughezzani More articles by this author Expand All Advertisement PDF DownloadLoading ...