1. Prospective nonrandomized study of diagnostic accuracy comparing prostate cancer detection by transrectal ultrasound-guided biopsy to magnetic resonance imaging with subsequent MRI-guided biopsy in biopsy-naïve patients
- Author
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Isidro Cogollos Acuña, Ana I Linares Quevedo, Luis Martínez Piñeiro, Jesus Diez Rodríguez, Marta Muñoz Fernández de Legaría, Leopoldo Cogorno, Roberto Castellucci, Isabel Salmerón Béliz, and Francisco J Sánchez Gómez
- Subjects
Adult ,Image-Guided Biopsy ,Male ,medicine.medical_specialty ,Neoplasias de la próstata ,Urology ,030232 urology & nephrology ,Risk Assessment ,Lesion ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Medicina preventiva ,Prostate ,Biopsy ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Tecnología médica ,Aged ,Ultrasonography ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Prostatic Neoplasms ,Reproducibility of Results ,Magnetic resonance imaging ,Rectal examination ,Middle Aged ,Prostate-Specific Antigen ,Cáncer ,medicine.disease ,Magnetic Resonance Imaging ,medicine.anatomical_structure ,Nephrology ,030220 oncology & carcinogenesis ,Radiology ,Transrectal ultrasound guided biopsy ,medicine.symptom ,business ,Ultrasonido enfocado transrectal de alta intensidad - Abstract
Background: To evaluate the diagnostic efficacy in cancer prostate (PCa) of Multiparametric prostate magnetic resonance imaging (mp-MRI) targeted biopsy compared to standard systematic transrectal ultrasound-guided biopsy (TRUSGB) in biopsy-naïve patients. Methods: A total of 168 biopsy-naïve men with clinical suspicion of PCa due to elevated PSA levels and/or an abnormal digital rectal examination were consecutively enrolled from July 2011 to July 2014. All patients underwent TRUSGB. Patients with equivocal (Pi-rads 3) or suspicious lesion (Pi-rads 4-5), were additionally biopsied using two cores, by the same operator (cognitive technique). Results: Among the 168 cases, mp-MRI was equivocal for PCa (Pi-rads 3) in 46 subjects (27.4%) and suspicious (Pi-rads 4, 5) in 40 cases (23.8%). Of the 69 patients with PCa, standard TRUSGB showed Gleason ≥7 in 75% of patients with Pirads 3 and 77.8% in cases with Pirads 4-5 on mp-MRI. Among the 40 patients with Pi-rads 4-5 lesion on the MRI, cognitive mp-MRI-guided biopsy (MRCGB) detected a higher number of cases of PCa with a Gleason score equal or superior to 7 (90%) with a higher negative predictive value (97.5%) than cases with Pi-rads 3 lesion or subjects with TRUSGB alone. Conclusions: mp-MRI followed by selective biopsy seems to be a valuable tool to improve the diagnosis of intermediate and high risk PCa compared to standard TRUSGB. Sin financiación 1.449 JCR (2017) Q3, 56/76 Urology & Nephrology 0.439 SJR (2017) Q3, 43/66 Nephrology No data IDR 2017 UEM
- Published
- 2017