The Value of Magnetic Resonance/Ultrasound(MRI/US)Imaging Fusion-Guided Transperineal Prostate Needle Biopsy in the Diagnosis of Prostate Cancer

SHEN Bo; LI Anyu; ZHU Zheng; JIANG Ting; XU Ye; GU Xiaolei; WU Xiaoman; ZHOU Chao

doi:10.3639/i.issn.2095-3097.2024.10.034

Abstract：Objective To investigate the feasibility of using magnetic resonance/ultrasound(MRI/US)imaging fusion-guided transperineal prostate biopsy for diagnosing prostate cancer.Methods From October 2022 to May 2024,82 patients undergoing prostate biopsy at the Urology Department of the First People's Hospital of Taicang City,Jiangsu Province,were enrolled.All patients underwent both MRI/US fusion-guided prostate biopsy(MRI/US fusion-guided biopsy group)and traditional systematic prostate biopsy(traditional systematic biopsy group)via the perineum.Specimens were placed in numbered bottles and fixed in 10％neutral formaldehyde solution before being sent for examination.Results Among the 82 patients,55(67.07％)were diagnosed with prostate cancer.The MRI/US fusion-guided biopsy group had a pathological positive rate of 57.31％(47/82)and a negative rate of 42.69％(35/82),while the traditional systematic biopsy group had rates of 56.10％(46/82)and 43.90％(36/82),respectively.There was no statistically significant difference in positive rates between the two groups(P＞0.05).However,the combined positive rate of MRI/US fusion-guided and traditional systematic biopsies was higher than either alone(P＜0.05).The MRI/US fusion-guided biopsy group showed higher detection accuracy and sensitivity and a lower missed diagnosis rate compared to the traditional systematic biopsy group,although these differences were not statistically significant(P＞0.05).When combined,the MRI/US fusion-guided and traditional systematic biopsies had significantly higher accuracy and sensitivity and a lower missed diagnosis rate than either alone(P＜0.05).The MRI/US fusion-guided biopsy group had a total of 177 punctures,with 95 positive punctures(single-needle positive rate:53.67％).The traditional systematic biopsy group had 859 punctures,with 208 positive punctures(single-needle positive rate:24.21％).The single-needle positive rate was significantly higher in the MRI/US fusion-guided biopsy group(P＜0.05).Comparison of Gleason scores revealed that the MRI/US fusion-guided biopsy group had fewer cases with scores＜7 and more cases with scores＞8 compared to the traditional systematic biopsy group,but the difference in Gleason scores between the two groups was not statistically significant(P＞0.05).The pathological positive rate was 73.58％(39/53)in the total prostate-specific antigen(TPSA)＞10 ng/mL group and 55.17％(16/29)in the TPSA 4-10 ng/mL group,with a statistically significant difference between the two groups(P＜0.05).Conclusion Although there is no difference in prostate cancer detection rates between MRI/US fusion-guided and traditional systematic biopsies,MRI/US fusion-guided biopsy has significant advantages in the diagnosis of prostate cancer.It can improve diagnostic accuracy,reduce the number of punctures,and optimize treatment regimens.The combined application of MRI/US fusion-guided and traditional systematic biopsies can maximize the detection rate of prostate cancer.