Feasibility and safety of transperineal prostate biopsy in the era of cognitive magnetic resonance imaging/ ultrasound fusion in prostate cancer detection

Zegarra-Montes L.; Sarria-Bardales G.; Martínez-Perez D.; Del-Castillo-Pacora R.; Dyer-Velarde-Álvarez R.; Trelles-De-Belaunde M. · Acta Medica Peruana (2022) · DOI: 10.35663/amp.2022.392.2331

Resumen

Objective: To describe the results of transperineal prostate biopsy by fusion of cognitive magnetic resonance imaging and ultrasound in the detection of cancer. Materials and methods: A retrospective case series study conducted at the Delgado Clinic between July 2019 and October 2021. Patients with digital prostate examination and/or abnormal Prostatic Specific Antigen and prostate MRI images with category lesions were included PI-RADS 4 or 5. Excluding patients with coagulation disorders, rectal injuries, impossibility for abduction, comorbidities for anesthesia. We recorded clinical and demographic characteristics, prostate-specific antigen data, prostate volume, PI-RADS lesions, cancer rates, and complications. Results: 18 patients were evaluated, with a mean age of 69.33 ± 7.67 years. The mean prostate specific antigen was 14.94 ± 12.42 ng/mL. The mean prostate volume was 57.72 ± 28.68 cc. At the digital examination of the prostate, 16/18 (88.88%) patients had suspected cancer. Biopsies with 19 cores were performed in patients whose NMRmP had lesions with PI-RADS category 4 in 6/18 (33.33%), of which 3 were positive for Adenocarcinoma and another 3 were negative for cancer. Biopsy with 16 PIRADS 5 cores in 12/18 (66.67%) patients, all of which were positive for cancer. Acinar adenocarcinoma in 15/18 (83.33%) with Gleason 6 in 2/18 (11.11%) and Gleason ≥ 7 in 13/18 (72.22%) patients. Mild complications such as hematuria 1/18 (5.6%), terminal dysuria 8/18 (44.4%) and perineal discomfort 7/18 (38.8%) and none infectious. Conclusions: transperineal prostate biopsy by fusion of cognitive magnetic resonance imaging and ultrasound is feasible, safe, with significant positivity rates and without infections.

Instituciones: Universidad Peruana Cayetano Heredia; Universidad Peruana de Ciencias Aplicadas; Universidad de San Martín de Porres