Impact of Ultrasonographic Findings on Cancer Detection Rate during Magnetic Resonance Image/ Ultrasonography Fusion-Targeted Prostate Biopsy

Purpose: To evaluate the impact of paired transrectal ultrasonography (TRUS) findings of index lesions identified by multiparametric magnetic resonance imaging (mpMRI) on the detection rate of clinically significant prostate cancer (csPCa, Gleason score ≥7) during MRI/US fusion-targeted biopsies. Materials and Methods: From 2019 to 2021, TRUS findings of paired index lesions were prospectively collected from MRI/US cognitive (cTB, n=299) or program-assisted (pTB, n=294) fusion-targeted biopsies. csPCa detection rates according to the presence of a paired hypoechoic lesion (HoEL) and predictive factors for csPCa detection by targeted biopsy were evaluated. Results: Among 593 patients with visible lesions on upfront mpMRI (Prostate Imaging-Reporting and Data System score ≥3), 288 (48.6%) had paired HoELs on TRUS. The csPCa detection rates in targeted biopsy patients with and without paired HoELs were 56.3% and 10.5% (p<0.001), respectively. Detection rates in patients with and without paired HoELs in the peripheral zone were 65.0% and 14.5%, respectively, and in the transition zone, 37.4% and 8.2%, respectively. In the cTB cohort, a paired HoEL (OR=6.25; p<0.001) was an independent predictive factor for the detection of csPCa in the target core, but not in the pTB cohort (OR=1.92; p=0.107). Conclusions: During MRI/US fusion-targeted biopsy, csPCa detection rate was higher in patients with paired HoELs on TRUS than in those without it. After adjustment of the zonal location and mpMRI findings, the presence of paired HoELs is an independent predictive factor for csPCa detection in cTB, but not in pTB. Therefore, paired HoELs improve only the targeting of visually estimated biopsies.

研究目的：本数据集旨在评估经多参数磁共振成像（multiparametric magnetic resonance imaging, mpMRI）检出的靶病灶的配对经直肠超声（transrectal ultrasonography, TRUS）表现，对MRI/US融合靶向活检术中临床显著性前列腺癌（clinically significant prostate cancer, csPCa，格里森评分≥7分）检出率的影响。
材料与方法：2019年至2021年，本研究前瞻性收集了接受认知融合靶向活检（cognitive fusion-targeted biopsy, cTB，n=299）或程序辅助融合靶向活检（program-assisted fusion-targeted biopsy, pTB，n=294）的患者的配对靶病灶TRUS表现数据。本研究评估了基于配对低回声病灶（paired hypoechoic lesion, HoEL）存在与否的csPCa检出率，以及靶向活检术中csPCa检出的预测因素。
结果：在593例初始mpMRI可见病灶（前列腺影像报告和数据系统（Prostate Imaging-Reporting and Data System, PI-RADS）评分≥3分）的患者中，288例（48.6%）的TRUS检查可见配对低回声病灶。存在与不存在配对低回声病灶的靶向活检患者中，csPCa检出率分别为56.3%和10.5%（p<0.001）。在外周带亚组中，存在与不存在配对低回声病灶的患者csPCa检出率分别为65.0%和14.5%；在移行带亚组中，该检出率分别为37.4%和8.2%。在cTB队列中，配对低回声病灶（比值比（odds ratio, OR）=6.25；p<0.001）是靶核心组织检出csPCa的独立预测因素，但在pTB队列中未发现该关联（OR=1.92；p=0.107）。
结论：在MRI/US融合靶向活检术中，存在配对经直肠超声低回声病灶的患者，其csPCa检出率显著高于无该表现的患者。在校正解剖带位置及mpMRI表现后，配对低回声病灶是cTB队列中csPCa检出的独立预测因素，但在pTB队列中并非如此。因此，配对低回声病灶仅能提升人工目测融合活检的靶向精准度。

搜集汇总

背景与挑战

背景概述

该数据集研究了经直肠超声（TRUS）发现的低回声病变（HoEL）对MRI/US融合靶向活检中临床显著前列腺癌（csPCa）检出率的影响。基于2019年至2021年593名患者的前瞻性数据，分析显示有配对HoEL的患者csPCa检出率显著更高（56.3% vs 10.5%），且HoEL在认知融合活检中是csPCa的独立预测因素，但在程序辅助融合活检中不是。数据集包含一个Excel文件，用于支持相关医学研究。