Comparison of the diagnostic performance of MRI/ultrasound fusion-guided prostate biopsy versus ultrasound-guided prostate biopsy in patients with suspected prostate cancer
DOI:
https://doi.org/10.53903/01212095.314Keywords:
Prostatic neoplasms, Prostate biopsy, Magnetic resonance imaging, UltrasonographyAbstract
Introduction: Transrectal ultrasound-guided prostate biopsy has been the diagnostic standard for prostate cancer. However, this technique may miss clinically significant lesions. MRI/ultrasound fusion-guided biopsy allows targeted sampling of suspicious lesions previously identified by imaging. Objective: To evaluate the diagnostic performance of MRI/ultrasound fusion-guided prostate biopsy compared to conventional ultrasound-guided biopsy for the detection of clinically significant prostate cancer. Methods: A cross-sectional diagnostic validation study was conducted at a specialized imaging center in Medellín, Colombia, between January and December 2020. A total of 115 patients with suspected prostate cancer (PSA > 3 ng/mL or abnormal digital rectal exam) underwent multiparametric MRI followed by both fusion-guided and conventional biopsies. The reference standard was the conventional biopsy. Sensitivity, specificity, and predictive values were calculated, and the detection of clinically significant cancer (Gleason ≥7) was compared between techniques. Results: A total of 115 patients with suspicious findings on multiparametric MRI (PIRADS ≥ 3) were included in the analysis. The MRI/ultrasound fusion-guided biopsy demonstrated a sensitivity of 91.7 %, specificity of 81.6 %, positive predictive value (PPV) of 36.7 %, and negative predictive value (NPV) of 98.2 %. Clinically significant cancer (Gleason ≥ 7) was detected in 26.1 % of cases with fusion biopsy, compared to 10.4 % with the conventional technique, with a statistically significant difference (p < 0.0001). Conclusion: MRI/ ultrasound fusion-guided prostate biopsy improves the detection of high-grade carcinomas compared to the conventional technique. Its use may enhance early diagnosis and timely treatment of clinically significant prostate cancer.
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