經會陰部核磁共振與超音波影像融合與經直腸核磁共振與超音波影像融合之前列腺切片與前列腺癌診斷的相關性:國立臺灣大學醫學院附設醫院之經驗

張育誠1、邱士庭1、陳育青2、劉詩彬1、闕士傑1

國立臺灣大學醫學院附設醫院泌尿部；1

國立臺灣大學醫學院附設醫院影像醫學部；2

Magnetic Resonance Imaging/Ultrasound Fusion-guided Transperineal Magnetic Resonance Imaging/Ultrasound Fusion-guided Transrectal prostate biopsy in the diagnosis of prostate cancer: Experience in National Taiwan University Hospital, a tertiary medical center

Yu-Cheng Chang 1, Shih-Ting Chiu 1, Shih-Ping Liu 1, Yu-Ching Chen 2,

Jeff S Chueh 1

Department of Urology, National Taiwan University Hospital, Taipei, Taiwan 1

Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan 2

Purpose: To compare Magnetic resonance imaging/Ultrasound fusion-guided Transperineal [MRI-TP] and Magnetic resonance imaging/Ultrasound fusion-guided Transrectal [MRI-TR] prostate biopsy and evaluate the feasibility.

Methods: We collected data from 2019 to 2022 with 39 patients underwent MRI-TP prostate biopsy performed by urologist and 170 patients underwent MRI-TR prostate biopsy performed by radiologist and compare outcomes including overall prostate cancer detection rate, detection rate of high-grade prostate cancer [HGPC, Gleason score≧3+4] and complication.   

Results: A total of 209 patients with 279 lesions were included in the analysis. 39 patients with 51 lesions underwent MRI-TP by urologist showed cancer detection rate 74.5%, similar to others underwent MRI-TR. Also, HGPC detection rate in MRI-TP group was 60%, which was also similar to others underwent MRI-TR. For patient with previous negative biopsy result, the HGPC detection rate was 62.8% in MRI-TP group. For patient with previous low-grade prostate cancer [Gleason score 3+3], the HGPC detection rate was 83.3% in MRI-TP group. No patient underwent MRI-TP prostate biopsy developed infection or prostatitis. The average operation time was 39.8 minute in MRI-TP group.

Conclusions: To conclude, MRI-TP and MRI-TR prostate biopsy have the same diagnosis accuracy, but the MRI-TP approach seems to have a lower risk of infection and prostatitis.