Numerous studies have shown that magnetic resonance imaging (MRI)-targeted biopsy approaches are superior to traditional systematic transrectal ultrasound guided biopsy (TRUS-Bx). The optimal number of biopsy cores to be obtained per lesion identified on multiparametric MRI (mpMRI) images, however, remains a matter of debate. The aim of this study was to evaluate the incremental value of additional biopsy cores in an MRI-targeted “in-bore”-biopsy (MRI-Bx) setting. Two hundred and forty-five patients, who underwent MRI-Bx between June 2014 and September 2021, were included in this retrospective single-center analysis. All lesions were biopsied with at least five biopsy cores and cumulative detection rates for any cancer (PCa) as well as detection rates of clinically significant cancers (csPCa) were calculated for each sequentially labeled biopsy core. The cumulative per-core detection rates are presented as whole numbers and as proportion of the maximum detection rate reached, when all biopsy cores were considered. CsPCa was defined as Gleason Score (GS) ≥ 7 (3 + 4). One hundred and thirty-two of 245 Patients (53.9%) were diagnosed with prostate cancer and csPCa was found in 64 (26.1%) patients. The first biopsy core revealed csPCa/ PCa in 76.6% (49/64)/ 81.8% (108/132) of cases. The second, third and fourth core found csPCa/ PCa not detected by previous cores in 10.9% (7/64)/ 8.3% (11/132), 7.8% (5/64)/ 5.3% (7/132) and 3.1% (2/64)/ 3% (4/132) of cases, respectively. Obtaining one or more cores beyond the fourth biopsy core resulted in an increase in detection rate of 1.6% (1/64)/ 1.5% (2/132). We found that obtaining five cores per lesion maximized detection rates. If, however, future research should establish a clear link between the incidence of serious complications and the number of biopsy cores obtained, a three-core biopsy might suffice as our results suggest that about 95% of all csPCa are detected by the first three cores.

中文翻译：

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MRI 引导的前列腺孔内活检 – 确定所需的最佳核心数量


大量研究表明，磁共振成像（MRI）靶向活检方法优于传统的系统性经直肠超声引导活检（TRUS-Bx）。然而，在多参数 MRI (mpMRI) 图像上识别的每个病变所需获得的最佳活检核心数量仍然存在争议。本研究的目的是评估 MRI 靶向“孔内”活检 (MRI-Bx) 设置中额外活检核心的增量价值。这项回顾性单中心分析纳入了 2014 年 6 月至 2021 年 9 月期间接受 MRI-Bx 的 245 名患者。使用至少五个活检核心对所有病变进行活检，并计算每个顺序标记的活检核心的任何癌症 (PCa) 的累积检出率以及临床显着癌症 (csPCa) 的检出率。当考虑所有活检核心时，累积的每核心检测率以整数和达到的最大检测率的比例表示。 CsPCa 定义为格里森评分 (GS) ≥ 7 (3 + 4)。 245 名患者中，132 名 (53.9%) 被诊断患有前列腺癌，64 名 (26.1%) 患者中发现 csPCa。第一次活检核心显示 76.6% (49/64)/81.8% (108/132) 的病例为 csPCa/PCa。第二个、第三个和第四个核心在 10.9% (7/64)/ 8.3% (11/132)、7.8% (5/64)/ 5.3% (7/132) 和 3.1 中发现了以前的核心未检测到的 csPCa/ PCa分别为 % (2/64)/ 3% (4/132) 案例。在第四个活检核心之外获得一个或多个核心导致检出率增加 1.6% (1/64)/ 1.5% (2/132)。我们发现每个病变获得五个核心可以最大限度地提高检测率。 然而，如果未来的研究应该在严重并发症的发生率和获得的活检核心数量之间建立明确的联系，那么三核心活检可能就足够了，因为我们的结果表明，约 95% 的 csPCa 是由前三个核心检测到的。