Effectiveness of the «cognitive¼ biopsy in the diagnosis of prostate cancer in patients with a previous negative biopsy. / Efectividad de la biopsia «cognitiva¼ en el diagnóstico del cáncer de próstata en los pacientes con biopsia previa negativa.
Actas Urol Esp (Engl Ed)
; 43(1): 12-17, 2019.
Article
en En, Es
| MEDLINE
| ID: mdl-30131167
ABSTRACT
INTRODUCTION:
Evaluation of the effectiveness of cognitive biopsy (CB) in patients with clinical suspicion of prostate cancer (PC), and at least one negative biopsy (TRB). MATERIAL ANDMETHOD:
Retrospective study of 144 patients with at least one previous TRB and magnetic resonance imaging (MRI). The MRI nodules were classified based on PI-RADS v2 grouping pZa, pZpl and pZpm as the peripheral zone(PZ), Tza, Tzp and CZ as the transitional zone (TZ), and the AS zones as the anterior zone (AZ). A biopsy was indicated for nodules ≥PI-RADS 3. Uni and multivariate analysis was undertaken (logistic regression) to identify variables relating to a PI-RADS 3 tumour on biopsy.RESULTS:
The median age was 67 (IQR 62-72) years, the median PSA was 8.2 (IQR 6.2-12) ng/ml. A nodule was identified on MRI in the PZ in 97 (67.4%) cases, in the TZ in 29 (20.1%), and in the AZ in 41 (28.5%). PC was diagnosed on biopsy in 64 (44%) patients. The cancer rate in the PI-RADS 3 lesions was 17.5% (7/40), in the PI-RADS 4 47.3% (35/73), and in the PI-RADS 5 lesions it was 73.3% (22/29) (p=.0001). Multivariable analysis with variables that could influence the biopsy result in patients with PI-RADS 3 None (age, PSA, number of previous biopsies, rectal examination, PSAD, prostate volume or number of extracted cylinders) behaved as an independent tumour predictor.CONCLUSIONS:
The diagnostic performance of CB in patients with at least one previous negative biopsy was 44%, increasing according to the PI-RADS grade, and low in PI-RADS 3. No clinical variable predictive of cancer was found in patients with PI-RADS 3.Palabras clave
Texto completo:
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Base de datos:
MEDLINE
Asunto principal:
Neoplasias de la Próstata
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Imagen por Resonancia Magnética
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Adenocarcinoma
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Biopsia con Aguja Gruesa
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Biopsia Guiada por Imagen
Tipo de estudio:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Humans
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Male
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Middle aged
Idioma:
En
/
Es
Revista:
Actas Urol Esp (Engl Ed)
Año:
2019
Tipo del documento:
Article