攝護腺癌術前無確定診斷之病人術前PI-RADS分數及術後病理報告之分析
梅承恩1熊小澐3楊晨洸1王約翰4歐宴泉1,2
台中榮民總醫院外科部泌尿外科1研究部2放射線部3病理部4
Retrospective Analysis of Preoperatively PI-RADS score and of Post-Operative Pathological Report inPatients of Prostate Cancer without Preoperative Proof
Cheng-En Mei1, Siu-Wan Hung, MD3,Chun-Kuang Yang1, John Wang4 ,Yen-Chuan Ou1,2
1Division of Urology, Department of Surgery, 2Department of Research, 3Department of Radiation,4Department of Pathology, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
Purpose: MultiparametricMRI has become an important role in prostate cancer evaluation. Prostate Imaging Reporting and Data System (PI-RADS) is used to detect significant prostate cancer. In this study, we review the pre-operative MRI and radiology report among post-operative whole-mount photography. We want to identify the difference location of lesion between MRI and pathology.
Materials and Methods: From June 2011 to June 2015, 44 clinically suspected patients of prostate cancer received robotic-assisted laparoscopic prostatectomy with bilateral neurovascular bundle preservation and preoperative MRIwithout positive preoperative pathology report. Among them, 8 patient of prostate cancer has post-operative pathology report with whole-mount photography. We analysis pre-operative PI-RADS score and lesion of radiology report among post-operative pathology findings.
Results: There were 1 patient with PI-RADS score 3, 5 patients with PI-RADS score 4, 2 patients with PI-RADS score 5. Post-operative pathology report showed 5 patients with tumor located at apex or anterior lobe, 1patients with tumor located at bilateral lobes, and 1 patient with tumor located near lateral capsule (tumor less than 1%).1 patients have different location between radiology report and pathology report.
Conclusion: Transrectal ultrasound (TRUS)-guided, systematic needle biopsy is usually with anterior lobe or apex cancer miss. Lesion located via MRI with PI-RADS score 5 is more likely prostate cancer. PI-RADS score can help us to identify prostate cancer which is missed via TRUS biopsy.