核磁共振輔助經直腸超音波切片於攝護腺癌診斷的臨床應用價值
邱鴻傑、謝博帆、黃志平、吳錫金、張兆祥
中國醫藥大學附設醫院 泌尿部
The clinical value of cognitive-registration magnetic resonance imaging trans-rectal ultrasound biopsy in clinical prostate cancer detection
Hung-Chieh Chiu, Po-Fan Hsieh, Chi-Ping Huang, His-Chin Wu, Chao-Hsiang Chang
Department of Urology, China Medical University Hospital, Taichung, Taiwan
Purpose:
The utilization of magnetic resonance imaging for target biopsy is growing gradually and it maximizes the clinical prostate cancer detection based on previous reports. The cognitive-registration MRI biopsy is the simplest, cheapest way without compromising the detection rate. The aim of our study is to compared the detection rate for prostate cancer in re-biopsy patient group between MRI cognitive-registration biopsy and conventional trans-rectal ultrasound-guided biopsy.
Materials and Methods:
Patients underwent trans-rectal ultrasound biopsy from Jan. 2012 to Dec. 2014 were retrospectively reviewed. In the re-biopsy group. they were divided into Group I: MRI cognitive-registration biopsy and Group II: conventional trans-rectal ultrasound-guided biopsy. The parameter of patient’s character and prostate cancer detection rate were compared.
Results:
1351 patients underwent trans-rectal ultrasound biopsy and 445 (32.42%) prostate cancer were diagnosed, while 906 patients (67.58%) remained negative for prostate cancer. 179 patients (13.25%) underwent re-biopsy owing to persist elevated PSA level. They were divided into two groups, 61 patients were enrolled in Group I: MRI cognitive-registration biopsy while 118 patients were enrolled in Group II: conventional trans-rectal ultrasound-guided biopsy. There was no significant difference between two groups in age , PSA level and biopsy burden. But the detection rate for prostate cancer is higher in MRI cognitive-registration biopsy than conventional trans-rectal ultrasound-guided biopsy. (44.26% VS 21.18% , p=0.001)
Conclusions:
MRI cognitive-registration biopsy increased the detection rate for prostate cancer than conventional trans-rectal ultrasound-guided biopsy. It maybe reduced the biopsy burden and associated cost, although it didn’t show statistically significant difference in our study.