[MRI-TRUS targeted biopsy combined with large-section prostate pathology for accurate diagnosis of prostate cancer].

ABSTRACT

Objective: To investigate the application value of MRI-transrectal ultrasound (TRUS) targeted biopsy combined with large-section prostate pathology in the diagnosis of prostate cancer (PCa). METHODS: Totally, 310 patients with suspected PCa underwent MRI-TRUS targeted biopsy combined with large-section prostate pathology (the observation group, n = 183) or standard 12-core TRUS biopsy (the control group, n = 127) in our hospital from January 2018 to December 2020. We compared the findings of biopsies and the detection rate of PCa between the two groups of patients. RESULTS: There were no statistically significant differences between the observation and control groups in the detection rates of PCa (35.52% vs 27.56%, P > 0.05), clinically significant PCa (30.60% vs 23.62%, P > 0.05) and clinically insignificant PCa (4.92% vs 3.94%, P > 0.05). The rate of positive punctures and the length of cancer tissue in the positive puncture were 27.50% and (4.68 ± 1.24) mm in the observation group, significantly higher than 22.38% and (3.70 ± 1.11) mm in the control (P < 0.05). The number of targeted punctures per case was markedly lower than that of system combined with targeted punctures (3 ï¼»1－5ï¼½ vs 15 ï¼»13－17ï¼½, P < 0.05). No statistically significant differences were observed between the targeted biopsy and system combined with targeted biopsy in the detection rates of PCa, clinically significant PCa and clinically insignificant PCa, the rate of positive punctures, or the length of cancer tissue in the positive puncture (P > 0.05). As the MRI features of PCa, the rates of T2WI low signal, irregular shape, blurred edge of lesions and DWI high signal were 63.08%, 76.92%, 83.08% and 84.62%, respectively, significantly higher than those of the benign lesions (P < 0.05), while the apparent diffusion coefficient (ADC) value of PCa was remarkably lower (ï¼»0.81 ± 0.15ï¼½ ×10－3mm2/s) than that of the benign lesions (P < 0.05). CONCLUSIONS: MRI-TRUS targeted biopsy combined with large-section prostate pathology has a high application value in the diagnosis of PCa, which can reduce the number of punctures and differentiate benign from malignant prostatic lesions in MRI images.