The Application Of Targeted Perineal Prostate Biopsy Guided By MRI/TRUS Fusion In The Diagnosis Of Prostate Cancer

Background:At present the incidence of prostate cancer is on the rise all over the world,among which the incidence of prostate cancer in Asian countries is lower than that in Europe and the United States,but in recent years,the incidence of prostate cancer has increased more rapidly than that in Europe and the United States[1].Nowadays,there are many clinical methods for the diagnosis of prostate cancer,among which the prostate biopsy technique is the gold standard for the diagnosis of prostate cancer.Now is the most commonly used in the clinical work of puncture by Transrectal ultrasound guided prostate biopsy(Transrectal ultrasound TRUS),but on the concrete scheme of prostate biopsy has not formed the unification of accepted standards.In the current clinical practice,the prostate biopsy puncture guided by transrectal ultrasound has the situation of missed diagnosis of prostate cancer[2].Transrectal prostate biopsy mainly includes two methods:transrectal cognitive fusion puncture and transrectal system puncture.Studies have suggested that the false negative rate of transrectal ultrasound-guided prostate biopsy targeting suspicious prostate targets can be as high as 30%?45%in the diagnosis of prostate cancer[3],while the false negative rate of transrectal ultrasound system biopsy targeting all prostate glands is 20%-30%[4].At the same time,in the imaging diagnosis of prostate cancer,magnetic resonance(MR)with its diffusion weighted imaging,dynamic enhanced scanning and other technical advantages,gradually plays an increasingly important guiding role in the diagnosis of prostate-related diseases.Therefore,mr-guided transrectal prostate biopsy has gradually gained certain recognition in clinical work due to its technical advantages[5].However,the low cost performance and difficult operation of this technique limit its clinical application.In recent years,will be more parameter resonance(multi-parameter magnetic resonance imaging,MRI)mp-image fusion and real-time ultrasound guided research more and more targeted biopsy of the prostate,the technology is mainly use mp-MRI on prostate cancer stove positioning accuracy and practicability of TRUS guided prostate biopsy combined with convenience[6],the MRI/fusion TRUS guided after perineal prostate biopsy technology arises at the historic moment.This study through the retrospective analysis by transrectal ultrasound guided prostate puncture cognitive fusion,the system of the prostate biopsy guided by transrectal ultrasound,MRI/fusion TRUS guided by the perineum targeted biopsy of the prostate,under the guidance of ultrasound through perineum system of prostate biopsy puncture method of four different clinical data,compare the advantages and disadvantages between different puncture,for clinical diagnosis of prostate cancer to provide some Suggestions for reference.Objectives:This article will through the retrospective analysis targeted by transrectal ultrasound guided prostate biopsy,the system of the prostate biopsy guided by transrectal ultrasound,MRI/TRUS imaging fusion under the guide of the perineal prostate puncture,ultrasound guided by the perineum system of prostate biopsy puncture method of four different clinical data obtained,for clinical diagnosis of prostate cancer to provide some Suggestions for reference.Materials and Methods:In this study,clinical data of 449 patients who underwent prostate biopsy in our hospital from January 2019 to December 2019 were systematically retrospectively analyzed.Clinical information included age,general biochemical indicators,PSA level,prostatic ultrasound,prostate MRI,rectal examination,biopsy tissue,biopsy tissue pathological results and Gleason score.Pathological results and Gleason score after radical prostatectomy.According to the different puncture methods,the enrolled patients were divided into four groups for retrospective comparison.Among them,96 patients underwent both transrectal ultrasound-guided prostatic cognitive puncture and transrectal ultrasound-guided prostatic system puncture at the same time,which were divided into two groups:transrectal cognitive puncture group and transrectal system puncture group.Fifty-two patients underwent both perineal targeted prostate puncture guided by MRI/TRUS imaging and perineal prostate cancer systematic puncture,which were divided into perineal fusion puncture group and perineal system puncture group.In addition,301 patients were divided into the tranrectal system puncture group by simple tranrectal system puncture.Clinical information of four groups of patients was retrospectively comparedResults:There were no statistically significant differences in age,PSA,prostate volume and digital rectal examination among the five groups of puncture patients(p>0.05).There were statistically significant differences in the number of positive needles for prostate cancer puncture between transrectal targeted puncture,ransrectal system puncture and transperineal fusion puncture(p<0.0001).In terms of the positive rate of prostate cancer,clinically significant prostate cancer and the risk grade of prostate cancer,there was no statistically significant difference between rectal targeted puncture,transrectal system puncture and transperineal fusion puncture(p>0.05).There was no statistically significant difference in the coincidence rate between the prostate biopsy pathology and the postoperative specimen pathology between the perineal fusion puncture group,the perineal fusion puncture group and the perineal fusion puncture group(P=0.5846).Conclusions:This clinical study found that MRI/TRUS fusion-guided perineal targeted prostate biopsy could improve the ratio of positive needle count for prostate biopsy and significantly reduce the number of needle count per capita.The MRI/trus-guided perineal prostate biopsy achieved the puncture effect of the other three puncture methods with fewer puncture needles.The coincidence rate between the biopsy pathology of MRI/TRUS fusion guided perineal prostate targeted puncture and the specimen pathology after radical surgery was similar to that of other puncture methods.Therefore,MRI/TRUS fusion-guided perineal prostate biopsy should be given priority in clinical practice when circumstances permit.