Comparative analysis of transrectal and transperineal biopsy in diagnosis of prostate cancer / 中国介入影像与治疗学

ABSTRACT

Objective: To compare the detection rate of prostate cancer (PCa) of transrectal and transperineal biopsy. Methods: Totally 128 patients with first time diagnosed PCa were enrolled, including 62 patients in transrectal approach group and 66 patients in transperineal approach group. The detection rate of PCa and clinically significant prostate cancer (CsPCa) of biopsy in patients with different total prostate specific antigen (TPSA) levels were compared between two approaches. Among them, 104 cases (42 cases in transrectal approach group and 62 cases in transperineal approach group) underwent CEUS on the basis of routine ultrasound examination, while 83 cases (28 cases in transrectal approach group and 55 cases in transperineal approach group) underwent targeted puncture. The detection rate of PCa and CsPCa of systematic puncture and targeted puncture were compared between the two groups. Results: The detection rate of PCa and CsPCa was 35.48% (22/62) and 25.81% (16/62) in transrectal approach group, 42.42% (28/66) and 28.79% (19/66) in transperineal approach group (P=0.471, 0.676). There was no significant difference in detection rates of PCa and CsPCa between the two approaches at different TPSA levels (all P>0.05). There was no significant difference in PCa detection rates (35.48% [22/62] vs 40.91% [27/66]; P=0.587), positive needle number/total times (14.25% [106/744] vs 14.52% [115/792]; P=0.879) nor CsPCa detection rates (25.81% [16/62] vs 28.79% [19/66]; P=0.676) between the two approaches. There were significant differences in PCa detection rates (35.71% [10/28] vs 14.55% [8/55]; P=0.002) and positive needle number/total times (30.77% [24/78] vs 6.76% [10/148]; P<0.001) between the two approaches. Conclusion: There is no significant difference in the detection rate of PCa and CsPCa between transrectal and transperineal approaches in ultrasound-guided prostate biopsy. CEUS can guide targeted prostate biopsy. Choosing the same patient position and anatomical section as CEUS can improve the detection rate of prostate cancer of biopsy.