ABSTRACT
PURPOSE: To investigate the diagnostic efficacy of fusion guided multiparametric MRI (mpMRI)-transrectal ultrasound (TRUS) biopsy versus systematic biopsy of the prostate in patients with suspicion of prostate cancer. METHODS: A total of 185 patients with PI-RADS 3 lesions or higher underwent fusion guided targeted and systematic prostate biopsy. Histology of samples was correlated with PI-RADS score and biopsy method for each patient. RESULTS: A total of 81/185 (43.8%) cases positive for cancer were detected; 23/81 (28.4%) cases with clinically insignificant prostate cancer-insPCa and 58/81 (71.6%) cases with clinically significant prostate cancer-csPCa. There was a statistically significant difference in the overall detection of adenocarcinomas between methods (p = .035, McNemar test). Moreover, there was a statistically significant difference in the detection of insPCa between the two methods (p = .004, McNemar test). Systematic biopsy detected 13 patients with insPCa more (14.4%) than the targeted biopsy method. However, there is no statistical difference in the detection rate of csPCa between the two methods (p = 1, McNemar test). When both techniques were combined more cases of csPCa were detected. CONCLUSION: The combined implementation of fusion-guided targeted mpMRI-TRUS and systematic biopsy of the prostate provides higher detection number of csPCa, compared to each method alone. The potential of fusion-guided mpMRI-TRUS biopsy of the prostate needs to be further assessed since each method has its limitations; therefore, systematic prostate biopsy still plays an important role in clinical practice.
Subject(s)
Multiparametric Magnetic Resonance Imaging , Prostatic Neoplasms , Male , Humans , Prostatic Neoplasms/diagnostic imaging , Prostate/diagnostic imaging , Multiparametric Magnetic Resonance Imaging/methods , Magnetic Resonance Imaging , Prospective Studies , Ultrasonography, Interventional/methods , Image-Guided Biopsy/methodsABSTRACT
BACKGROUND: To evaluate and compare the recorded IOP values of the Pascal dynamic contour tonometer (PDCT) and the Goldmann applanation tonometer (GAT) after photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK). METHODS: Three groups of 84, 182 and 43 patients each were treated by PRK for myopia, LASIK for myopia and LASIK for hyperopia respectively. Intraocular pressure (IOP) measurements were performed in all eyes 1 day before and 1, 3, 6 and 12 months after treatment with PDCT and GAT. Ultrasound pachymetry was performed in all eyes preoperatively and at 1st month postoperatively. RESULTS: Preoperatively and postoperatively, GAT readings were lower than PDCT in all groups (all p < 0.05). Postoperatively in the PRK group, compared to the preoperative value, the mean differences of IOP recorded with GAT at 1st, 3rd, 6th and 12th month were -1.4 mmHg, -1.7 mmHg, -1.7 mmHg and -1.9 mmHg respectively (all p < 0.05). In the myopic LASIK group; the corresponding values with GAT were -3.6 mmHg, -3.6 mmHg, -3.6 mmHg and -3.5 mmHg (all p < 0.05), while in the hyperopic LASIK group the corresponding values were -1.1 mmHg, -0.7 mmHg, -1.1 mmHg and -0.9 mmHg (all p < 0.05). The mean IOP difference (GAT-PDCT) for myopic PRK, myopic LASIK and hyperopic LASIK were respectively -3.8 mmHg, -4.1 mmHg and -1.5 mmHg at the 12-month follow-up. No statistically significant changes were found for any group with the PDCT. CONCLUSIONS: GAT-determined IOP values were significant lower at all time-points after hyperopic LASIK, as well as myopic PRK or LASIK. The Pascal tonometry values remained unaffected for all groups.