Introduction and Objective: Prostate cancer detection is a difficult process despite different modalities that are available. The current standard of practice is based on stratifying risk using Prostate Specific Antig...Introduction and Objective: Prostate cancer detection is a difficult process despite different modalities that are available. The current standard of practice is based on stratifying risk using Prostate Specific Antigen (PSA), digital rectal examination (DRE) and performing a transrectal ultrasound (TRUS) or transperineal (TP) guided biopsy. Recent advances in three-tesla multiparametric magnetic resonance imaging (MP-MRI) technology and the availability of in-gantry MRI guided biopsies (MRGB) have added another diagnostic tool in management of prostate cancer. We review MRGB performed on high Prostate Imaging Reporting and Data System (PIRADS) score lesions in a single centre retrospective study. Materials and Methods: There were 77 patients (mean age 63) with high PIRADS score (4 and 5) that underwent in-gantry MRGB. All the biopsies were performed utilizing dynacad prostate biopsy system on a three-tesla MRI scanner by an urologist with assistance of an experienced radiologist. Two to three samples were obtained from each lesion using an MRI compatible 18-gauge biopsy needle. Three experienced pathologists evaluated the samples and provided the results and Gleason score in each positive sample. Results: Out of the total 77 high PIRADS patients, 54 were PIRADS score 4 (70%) and 23 PIRADS score 5 (30%). There were 22 positive biopsies for adenocarcinoma of prostate with a Gleason score of 3 + 3 = 6 or higher. Out of the 54 PIRADS score 4 lesions, 13 were positive (24%) and out of 23 PIRADS 5 lesions, 9 were positive (39%). The remaining 55 biopsies were negative for prostate cancer. Conclusion: We present our series of MRGB in patients with a high PIRADS score for prostate cancer. While this diagnostic paradigm was in its infancy stages, MRGB was positive in 24% of PIRADS 4 and 39% of PIRADS 5 lesions in this series.展开更多
多参数磁共振成像(multi-parametric magnetic resonance imaging,mp-MRI)是公认的前列腺疾病检查的最佳的影像学方法,特别是对前列腺癌(prostate cancer,PCa)的检出具有非常重要的意义。mp-MRI不仅可以清晰地显示前列腺的解剖结构及形...多参数磁共振成像(multi-parametric magnetic resonance imaging,mp-MRI)是公认的前列腺疾病检查的最佳的影像学方法,特别是对前列腺癌(prostate cancer,PCa)的检出具有非常重要的意义。mp-MRI不仅可以清晰地显示前列腺的解剖结构及形态学改变,还能在一定程度上反映组织学信息变化,引导靶向穿刺活检。随着扫描参数的进一步优化,许多研究者对mp-MRI在PCa早期诊断、治疗方案选择、疗效评价及预后评估等方面进行了多中心、大样本的深入研究。本文就目前mp-MRI在PCa的临床应用及研究进展进行总结。展开更多
文摘Introduction and Objective: Prostate cancer detection is a difficult process despite different modalities that are available. The current standard of practice is based on stratifying risk using Prostate Specific Antigen (PSA), digital rectal examination (DRE) and performing a transrectal ultrasound (TRUS) or transperineal (TP) guided biopsy. Recent advances in three-tesla multiparametric magnetic resonance imaging (MP-MRI) technology and the availability of in-gantry MRI guided biopsies (MRGB) have added another diagnostic tool in management of prostate cancer. We review MRGB performed on high Prostate Imaging Reporting and Data System (PIRADS) score lesions in a single centre retrospective study. Materials and Methods: There were 77 patients (mean age 63) with high PIRADS score (4 and 5) that underwent in-gantry MRGB. All the biopsies were performed utilizing dynacad prostate biopsy system on a three-tesla MRI scanner by an urologist with assistance of an experienced radiologist. Two to three samples were obtained from each lesion using an MRI compatible 18-gauge biopsy needle. Three experienced pathologists evaluated the samples and provided the results and Gleason score in each positive sample. Results: Out of the total 77 high PIRADS patients, 54 were PIRADS score 4 (70%) and 23 PIRADS score 5 (30%). There were 22 positive biopsies for adenocarcinoma of prostate with a Gleason score of 3 + 3 = 6 or higher. Out of the 54 PIRADS score 4 lesions, 13 were positive (24%) and out of 23 PIRADS 5 lesions, 9 were positive (39%). The remaining 55 biopsies were negative for prostate cancer. Conclusion: We present our series of MRGB in patients with a high PIRADS score for prostate cancer. While this diagnostic paradigm was in its infancy stages, MRGB was positive in 24% of PIRADS 4 and 39% of PIRADS 5 lesions in this series.
文摘多参数磁共振成像(multi-parametric magnetic resonance imaging,mp-MRI)是公认的前列腺疾病检查的最佳的影像学方法,特别是对前列腺癌(prostate cancer,PCa)的检出具有非常重要的意义。mp-MRI不仅可以清晰地显示前列腺的解剖结构及形态学改变,还能在一定程度上反映组织学信息变化,引导靶向穿刺活检。随着扫描参数的进一步优化,许多研究者对mp-MRI在PCa早期诊断、治疗方案选择、疗效评价及预后评估等方面进行了多中心、大样本的深入研究。本文就目前mp-MRI在PCa的临床应用及研究进展进行总结。
