Causes of missed diagnosis in targeted prostate biopsy guided by mpMRI/TRUS fusion
Objective To investigate the causes of missed diagnosis in targeted prostate biopsy guided by mpMRl/TRUS fusion.Method The clinical data of 97 patients who underwent perineal prostate biopsy in our hospital from January 2021 to September 2023 were retrospectively analyzed.After mpMRI and Pl-RADS scores,mpMRI/TRUS fusion guided transperineal targeted prostate biopsy+transperineal system puncture biopsy was completed.The pathological diagnosis of targeted puncture biopsy and systematic puncture bi-opsy was compared to evaluate and analyze the causes of missed diagnosis of targeted puncture biopsy.Results A total of 52 patients were diagnosed with prostate cancer,of which 5(9.62%)were missed by targeted puncture and 6(11.53%)were missed by system-atic puncture biopsy.There was no significant difference in age between the missed and unmissed groups(P>0.05).But There was a significant difference in Prostate specific antigen(PSA),prostate volume(PV),PSAD,ISUP level(P<0.05).The pathological re-sults of missed diagnosis in 5 cases of targeted needle biopsy were re-compared with MRI:MRI of 3 cases of prostate cancer was nor-mal,MRl of 1 case was abnormal,and MRI of 1 case was upgraded to PL-RADS-3.Conclusion Early prostate cancer,large prostate,local anesthesia and patient cooperation,experience of MRI readers and puncture operators may be the causes of TB missed diagnosis.Therefore,personalized biopsy plans,better imaging techniques,rich experience in operation and film reading,and more intelligent fu-sion systems will reduce the missed diagnosis rate and increase the TB positive rate.
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