Clinical application of MRI-TRUS fusion guided transperineal prostate targeting combined with saturation biopsy in patients with suspected prostate cancer

Objective To assess the clinical value of MRI-TRUS fusion guided transperineal prostate targeting combined with saturation biopsy in patients with suspected prostate cancer. Methods From March 2018 to July 2018, 15 patients with suspected prostate cancer were treated at the Department of Urology, Xuanwu Hospital of Capital Medical University. All patients underwent prostate MRI and transrectal ultrasound (TRUS). MRI-TRUS fusion guided transperineal prostate targeting combined with saturated prostate biopsy was performed. According to the patient's PI-RAIDS score and MRI-TRUS fusion image, the highly suspected prostate cancer nodule area and suspicious nodule area were marked in different colors, which were used as puncture target and suspicious target areas. A total of 30 or 36 puncture needles were punctured in the target area, suspicious target area, and non-target area in each patient. The positive rate of puncture, pathological results, and complications were analyzed. Results A total of 20 targets and 5 suspicious targets were labeled in 15 patients. The puncture results from 17 targets and 3 suspicious targets in 12 patients were positive. The total positive rate of targeted puncture was 80% (20/25). The pathological results of puncture in all positive cases were prostate acinar carcinoma. The puncture results from 3 target areas and 2 suspicious target areas in the other 3 patients were negative, and the pathological results were reported as benign prostatic hyperplasia (BPH) with inflammatory changes. Prostate cancer cells were found in 5 cases at the same time in non-target area. The positive rate of prostate cancer diagnosed in non-target area was 33.3% (5/15). Of the 15 patients, only 1 developed hematuria after operation, which resolved on the 2nd day after operation, and 2 had perineal pain discomfort, which resolved on the 3rd day after operation. No patients had complications such as bloody stool, fever, sepsis, and acute urinary retention. Conclusion MRI-TRUS fusion guided transperineal prostate targeting combined with saturated biopsy has the advantages of high positive rate, few postoperative complications, and high safety and feasibility, representing an ideal method for prostate biopsy. Key words: Magnetic resonance imaging; Transrectal ultrasonography; Prostatic neoplasms; Prostate biopsy