Application of ultrasound and MRI image fusion navigation-guided puncture in Gleason classification of prostate cancer

Objective To evaluate the value of image fusion navigation-guided puncture in Gleason classification of prostate cancer by comparing magnetic resonance imaging (MRI) and trans-rectal ultrasound (TRUS) image fusion-guided puncture method with systemic puncture. Methods Between December 2016 and March 2019, a total of 150 patients with suspicious prostate cancer admitted to the Affiliated Hangzhou First People′s Hospital, Zhejiang University School of Medicine were included. All patients received TRUS/MRI image fusion navigation-guided puncture and then 10-needle systemic puncture. All the patients who had positive puncture results underwent laparoscopic radical prostatectomy to obtain pathological results. The detection rates of the two puncture methods and the consistency between puncture and surgical Gleason scores were compared. Results Of the 150 patients, 72 were diagnosed with prostate cancer. The detection rate of navigation puncture was 45.3% (68/150), and that of systemic puncture was 40.7% (61/150); there was no significant difference between the two methods (χ2=0.666, P=0.414). The detection rate of high-risk prostate cancer with Gleason score ≥ 8 was significantly higher in the navigation puncture group than in the systemic puncture group (33.8% vs 18.0%, χ2=4.131, P=0.042). The concordance of Gleason scores between prostate biopsy and radical prostatectomy was 72.1% and 54.1% for navigation puncture and systemic puncture, respectively, and the concordance rate was significantly higher in the navigation puncture group than in the systemic puncture group (χ2=4.479, P=0.034). Conclusion MRI/TRUS image fusion navigation-guided puncture is a more accurate method of obtaining prostate tissue specimens, and it can increase the detection rate of high-risk prostate cancer and provide an objective basis for the formulation of clinical treatment decisions. Key words: Prostatic neoplasms; Biopsy, needle; Ultrasonography; Magnetic resonance imaging