MpMRI/TRUS Fusion Transrectal Guided Biopsy In Diagnosis Of Prostate Cancer:A Clinical Study

Objective: To report and explore the application value of targeted biopsy with multiparametric magnetic resonance imaging and transrectal ultrasound fusion images for the diagnosis of prostate cancer.Methods: From October 2018 to September 2019,123 patients with suspicion of prostate cancer were retrospectively evaluated in Suining Central hospital.All patients were evaluated by 1.5T multiparametric MRI(mpMRI).50 patients underwent 1-3 cores MRI/TRUS fusion biopsy transrectally and additionally a 13 cores systematic transrectal biopsy by the same time.And 73 patients underwent 13 cores systematic transrectal biopsy.Pathological findings of targeted and systematic biopsies were analyzed,the differences of the positive rate of puncture were compared between the two groups Results: There were no statistical differences between two groups in term of age,height,BMI,total prostate specific antigen(tPSA),prostate volume,digital rectal examination(DRE),f/tPSA,(P>0.05).There were 32 cases of PCa in group“CFB”,the positive rate of biopsy was 64%.There were 25 cases of clinically significant prostate cancer,with a positive rate of 50%.There were 24 cases of PCa in group“TRUSB”,the positive rate of biopsy was 32.9%.There were 23 cases of clinically significant prostate cancer,with a positive rate of 31.5%.The differences were statistically significant(P<0.05).In group“CFB”,There were 18 cases of begin prostatic hyperplasia/prostatitis,we find 1case of cisPCa(Gleason:1+2=3)after transurethral resection of the prostate.The number of cores in the “CFB” group were 744,the positive rate was 35.3% and the csPCa rate was31.6%.The number of cores in the “ TRUSB” group were 943,the positive rate was 24.2%and the csPCa rate was 22.7%.The differences were statistically significant(P<0.05).And the total number core of the “CFB” group was more than the “ TRUSB” group,The differences were statistically significant(P<0.05).There were 32 cases of PCa in group“CFB”,the positive rate of “TB” was 56%(28 cases),there were 21 cases ofcsPCa,with a positive rate of 42%.The positive rate of “SB” was 62%(31cases)and there were 25 cases of csPCa,with a positive rate of 50%.In this group,we found that 1 missed diagnosis case by SB and 3 missed diagnosis cases by TB.The Consistency of positive rate and csPCa rate between the”TB+SB”group and “TB” group were well.The Kappa value of the consistency test for the diagnosis of prostate cancer and csPCa was 0.834 and 0.840 respectively,the P value was less then 0.05.in the “CFB” group,the number of TB core were 94,and the positive rate was 50% and the csPCa rate was 41.5%.The number of SB core were 650,the positive rate was 33.2% and the csPCa rate was 30.2%.The differences were statistically significant(P<0.05).Conclusion: The combination of TB and SB in mpMRI/TRUS fusion transrectal guided biopsy is the best strategy at present.PI-RADS v2 can assistant to increase the detective efficiency and classify the severity of the PCa.