Comparisons between magnetic resonance/ultrasound fusion-guided biopsy and standard biopsy in the diagnosis of prostate cancer

Abstract

Prostate-specific antigen is not useful for detection of prostate cancer in Chinese men. The major problems in prostate cancer patients are overdiagnosis and overtreatment. The objective of the study was to test the hypothesis that targeted biopsy is an accurate diagnostic tool for prostate cancer detection than standard biopsy in Chinese men.Total, 998 patients whom multiparticulate multiparametric magnetic resonance imaging had revealed at least 1 lesion in the prostate were included in a cohort. Patients were subjected to magnetic resonance imaging (MRI)/ultrasound (US) fusion-guided biopsy followed US-guided biopsy. Benefits of a diagnostic test were evaluated by decision curve analysis. Patients who were diagnosed as having prostate cancer by either of biopsies were subjected to radical prostatectomies followed by whole-mounted pathology (n = 578). Spearman rank correlation was performed between the biopsy results and the subtype of prostate cancer at 99% of confidence level.With respect to whole-mounted pathology, for US-guided biopsy, MRI/US fusion-guided biopsy, and combined data of both biopsies, sensitivities were 0.973, 0.983, and 0.973 and accuracies were 0.837, 0.91, and 0.917, respectively. MRI/US fusion-guided biopsy (P = .165) and combined data of both biopsies (P = .182) had the same specificity to whole-mount pathology. However, a US-guided biopsy had not the same specificity to whole-mount pathology (P = .0003). Decision-making zones for radical prostatectomy of different biopsies were in the order of combined data of both biopsies >MRI/US fusion-guided biopsy >US-guided biopsy.Only the targeted biopsy is recommended for the diagnosis of prostate cancer.

Endorectal power Doppler/grayscale ultrasound‑guided biopsies vs. multiparametric MRI/ultrasound fusion‑guided biopsies in males with high risk of prostate cancer: A prospective cohort study

“…In addition, the same sensitivity, negligible inconclusive results and high accuracy to those of the histopathology analysis of the surgical specimen were obtained. The results of the study were in line with those of previous studies (8,9,11–13,15,19,21,23). mpMRI/TRUS-guided biopsy promises the detection of clinically significant prostate cancer(s).…”

“…Between January 2013 and February 2019, a total of 1,215 males aged ≥40 years with complaints including weak flow during urination, difficulties to start urinating, weak flow of urine and a sensation of improper urinary bladder emptying were available at an outpatient setting of Dongguan People's Hospital Affiliated to Southern Medical University (Dongguan, China) and the First Affiliated Hospital of Anhui Medical University (Anhui, China) were included in the present study (19). Males with elevated prostate-specific antigen (normal range, ≤3.0 ng/ml for subjects <50 years, ≤3.5 ng/ml for 50–59 years, ≤4.5 ng/ml for 60–69 years and ≤5.5 ng/ml for ≥70 years) (20) or abnormal structure of the prostate on palpitation on rectal examination (hard, lumpy or enlarged prostate) under digital rectal examination (19) were included in the study.…”