The role of multiparametric resonance and biopsy in prostate cancer detection: comparison with definitive histological r
- PDF / 631,098 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 59 Downloads / 188 Views
PELVIS
The role of multiparametric resonance and biopsy in prostate cancer detection: comparison with definitive histological report after laparoscopic/robotic radical prostatectomy S. Rapisarda1 · M. Bada2 · F. Crocetto3 · B. Barone3 · D. Arcaniolo4 · A. Polara1 · C. Imbimbo3 · G. Grosso1 Received: 31 July 2020 / Revised: 20 September 2020 / Accepted: 29 September 2020 © The Author(s) 2020
Abstract Purpose Magnetic Resonance Imaging (MRI) targeted biopsy increases overall detection rates and decreases the risk of clinically insignificant PCa detection. The aim of this retrospective study is to compare concordance rates regarding side of lesion and Gleason Score at fusion targeted/systematic biopsy and MRI with the definitive histologic report of prostatectomy specimen. Methods 115 patients underwent multiparametric (mp) MRI and successively fusion targeted/systematic biopsy. 107 patients, with a positive biopsy for PCa, further underwent laparoscopic/robotic radical prostatectomy. We compared surgical histologic report with biopsy histologic report for side of lesion and Gleason Score. We further compared PIRADS score at mpMRI with Gleason Score of both histologic reports. Results Concordance rate for mpMRI lesion side was 74% compared to biopsy and 52.3% compared to surgical histologic report (p 4 ng/ ml (two patients). All biopsies were carried out following a standardized protocol. T2-weighted axial, sagittal and coronal sequences of the mpMRI were uploaded into an MRI/US fusion device (Hitachi Arietta v70 with integrated real-time ultrasonography) and the suspicious lesions were marked in
Abdominal Radiology
three planes using the Real-time Virtual Sonography (RVS) software. Patients wereadministered a single dose of Sulfamethoxazole/Trimethoprim plus a periprostatic lidocaine infiltration nerve blockade before biopsy. Systematic biopsy protocol based on EAU guidelines was performed, including 12–16 cores collected in an extended-sextant template from lateral to medial of base, mid, and apex portions of the prostate on both sides. In addition, fusion targeted biopsy was performed on the previously identified mpMRI lesions with T2-weighted sequence overlapped on the real-time TRUS images. Each lesion was sampled in axial and sagittal planes. A diagrammatic report was taken per lesion for a maximum of two lesions while number of cores and histologic report was registered. We defined a clinically significant prostate cancer as any cancer with Gleason score ≥ 4 + 3 and/or any cancer occupying ≥ 6 mm of a biopsy core, in according to the PROMIS trial [18]. Patients with positive biopsy for PCa underwent robot-assisted radical prostatectomy at our institution.
Statistical analyses An Excel database was created to report all the previous data and the collected histologic reports of patients who underwent radical prostatectomy. All statistical analyses were conducted using SPSS software (version 25, SPSS Inc., Chicago, IL). Descriptive statistics included means and standard deviations for continuous varia
Data Loading...
