Utilidad de las biopsias guiadas cognitivamente por resonancia magnética para mejorar la detección del cáncer de próstata

Identificador:  TDX:2777

Handle: https://hdl.handle.net/20.500.11797/TDX2777

Autors:  Garcia Bennett, Josep

Resum:
MOTIVATION: Magnetic resonance targeted biopsies (MR-TB) increase the detection of prostate cancer (PCa) in patients with previous biopsies (PB) but it is unclear whether additional systematic biopsies (SB) should be performed in these patients. Moreover, TB may not be as efficient in patients without PB due to different tumor characteristics. OBJETIVES: 1. To evaluate whether MR-TB obtain a sample of the dominant lesion with respect to SB, in patients with PB. 2. To evaluate the differences in cancer detection rate between TB and SB, in patients without PB. METHODS: In 41 patients with PB, a MR-TB was carried out towards the most aggressive lesion on MRI and subsequently an SB towards the rest of the segments of the prostate. Gleason and tumor volumes were compared between the MR-TB and SB. In 60 patients without PB, a 12 core SB was carried out before an MR-TB. Clinically significant PCa (cs-PCa) detection rates and efficiency variables were compared between both techniques. RESULTS: MR-TB achieved a cancer detection rate of 46,3% and detected the dominant lesion in 95% of patients with PB. There were no significant differences in detection rates for cs-PCa between an MR-TB and a SB, in patients without PB. However, MR-TB was significantly more efficient than SB. CONCLUSIONS: MR-TB are able to obtain a sample of the most aggressive lesion in patients with PB avoiding the need for a SB to correctly grade a PCa. MR-TB achieved the same detection rate for cs-PCa and increase the efficiency of the biopsies compared to SB.