Prostate biopsy guided by fusion ultrasonography: experience from a private clinic from Bragança Paulista, São Paulo, Brazil
DOI:
https://doi.org/10.37497/JMRReview.v2i1.48Keywords:
Prostate Cancer, Urology, Biopsy, Imaging TechniquesAbstract
Background: In the last decade, the introduction of multiparametric magnetic resonance imaging (mpMRI) and fusion ultrasound-targeted mpMRI (TBx) has generated great expectations about the diagnostic pathway for prostate cancer. This method also has better sensitivity for locating and detecting clinically significant tumors, and is used to target biopsies specifically to suspicious areas.
Aim: Through an observational study, evaluate the experience of a private clinic in performing TBx-guided prostate biopsies. Method: This is an observational, retrospective study, which used information from medical records already archived at the Instituto de Urologia Bragança, located in the city of Bragança Paulista – SP, Brazil, of patients treated from September 2021 to March 2023, and which performed TBx-guided prostate biopsies.
Results: In the present study, it was observed that the average age of the patients was approximately 66 years old, with an average PSA of 7.70 ng/mL. Among the patients evaluated, approximately one third had an increased risk of prostate cancer based on the values of the relationship between free PSA and total PSA. The most prevalent PIRADS classification in the studied sample was 4, and among patients with PIRADS classification 3, who would not naturally be indicated for biopsy, PSAd greater than 0.15 was identified in just over a third of them, suggesting that the they should also be subjected to examination. The majority of patients evaluated in our sample presented a negative result based on the Gleason scale. Among the positives, the most prevalent was 3+4.
Conclusion: This study evaluated our Service's experience in performing fusion ultrasound, describing the epidemiological profile of patients and identifying those who actually required prostate biopsy for cancer research. As the main result, it was possible to identify the superiority of fusion biopsy when compared to randomized biopsy. It is suggested that similar surveys be carried out in various regions of Brazil with a view to verifying whether the phenomenon observed in our region could be repeated on a national scale.
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