Comparative study on prostate cancer detection rates of MRI-guided in-bore biopsy versus cognitive fusion biopsy for patients with prostate specific antigen levels<20 μg/L / 中华老年医学杂志

ABSTRACT

Objective:To compare the differences in prostate cancer detection rate between MRI-guided in-bore biopsy(MRI-BX)and cognitive fusion biopsy(COG-BX)in patients with prostate specific antigen(PSA)levels<20 μg/L.Methods:From January 2015 to December 2018, clinical data of 195 patients with PSA levels<20 μg/L were consecutively included in this retrospective study.Of these patients, 80 underwent MRI-BX procedures and 115 underwent COG-BX procedures.Clinical data including age, PSA, prostate volume, PSA density(PSAD), Prostate Imaging Reporting and Data System(PI-RADS)scores, overall prostate cancer detection rate and detection rate of clinically significant prostate cancer were compared and analyzed.Results:There was no significant difference in age, PSA, prostate volume, PSAD and PI-RADS scores between the two groups.There was no significant difference in total prostate cancer detection rate between the MRI-BX and COG-BX groups(53.8% or 43/80 vs.50.4% or 58/115, P=0.649), while the detection rates for clinically significant prostate cancer showed a significant difference between the two groups(58.1% or 25/43 vs.82.8% or 48/58, P=0.006). There was no significant difference in prostate cancer detection rate between the MRI-BX and COG-BX groups in patients with PSA<10 μg/L(45.2% or 28/62 vs.48.0% or 36/75, P=0.740), while a significant difference was found in the detection rate of clinically significant prostate cancer between the two groups in patients with PSA<10 μg/L(50.0% or 14/28 or 91.7% or 33/36, P=0.001). Conclusions:The overall prostate cancer detection rate does no differ between MRI-BX and COG-BX in patients with PSA levels<20 μg/L or with suspicious MRI lesions(PI-RADS3), but the COG-BX procedure has a higher detection rate than the MRI-BX procedure for clinically significant prostate cancer, especially in patients with PSA<10 μg/L.