Objective: To assess the clinical value and safety of pelvic MRI combined with transurethral ultrasound (TRUS)-guided transperineal template mapping biopsy (TTMB) in the diagnosis of prostate cancer.
Methods: A total of 164 men underwent MRI plus TRUS-guided TTMB for the diagnosis of prostate cancer from December 2015 to May 2018. The patients averaged 71.2 years of age and, based on the PSA level, were divided into four groups: PSA <10 μg/L (n = 28), PSA 10－20 μg/L (n = 56), PSA 20.01－100 μg/L (n = 53) and PSA >100 μg/L (n = 27). All the patients received digital rectal examination, pelvic MRI and TRUS-guided X+12-core TTMB.
Results: The procedures of TRUS-guided TTMB were successfully completed in all the patients, with an average number of 14.2 (14－16) cores and mean operation time of 18 (15－28) minutes. Post-biopsy complications included transient hematuria in 4 cases, perineal hematoma in 12 and fever in 1, but no acute urinary retention. Pathological results revealed 95 cases of prostate cancer, 2 cases of ductal epithelial carcinoma, 63 cases of prostatic hyperplasia with benign interstitial inflammation, and 4 cases of atypical prostatic hyperplasia. The positive biopsy rates in the PSA <10 μg/L, 10－20 μg/L, 20.01－100 μg/L and >100 μg/L groups were 25.00%, 42.86%, 73.58% and 100.00% respectively, with statistically significant difference between the PSA <10 μg/L group and the PSA 20.01－100 μg/L and >100 μg/L groups (P < 0.01), but not between the PSA <10 μg/L and PSA 10－20 μg/L groups (P = 0.086).
Conclusions: Pelvic MRI combined with TRUS-guided X+12-core TTMB, with the advantages of high accuracy and low rate of complications, is an ideal approach to the diagnosis of prostate cancer.
Keywords: diagnosis; template-guided mapping; transperineal prostate biopsy; transurethral ultrasound; prostate cancer.