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Comparative analysis of the detection rate of prostate cancer in biopsies guided cognitively by multiparametric magnetic resonance imaging versus guided by transrectal ultrasound

Grant number: 17/15443-6
Support Opportunities:Scholarships in Brazil - Scientific Initiation
Effective date (Start): June 01, 2018
Effective date (End): May 31, 2019
Field of knowledge:Health Sciences - Medicine - Surgery
Principal Investigator:José Pontes Junior
Grantee:Gabriel Henrique Durigon
Host Institution: Universidade Nove de Julho (UNINOVE). Campus Vergueiro. São Paulo , SP, Brazil


Prostate cancer is the most common malignant tumor in men and the second leading cause of cancer death in Western countries. With the advent of prostate specific antigen (PSA) and the adoption of screening programs there was clearly an increased detection of the disease at an earlier stage. Tumor diagnosis is established by prostate biopsy that is usually guided by transrectal ultrasonography (TRUS), and is indicated in patients with suspected rectal rash or elevated PSA levels. However, the gray scale has low accuracy in tumor visualization and detection; Which results in the high false negative rates observed with conventional ultrasound-guided biopsy. Recent data from the literature indicate that multiparametric resonance imaging has been shown to be the best imaging test for prostate cancer, especially in aggressive tumors where it has excellent diagnostic sensitivity, and in those patients with multiple prior negative biopsies and high PSA persistence. Despite the promising initial data, there are controversies regarding the role of resonance in individuals without prior biopsy and how much resonance accurately aggregates ultrasound findings in the identification of prostate adenocarcinoma. The aim of the study is to compare retrospectively the rates of detection of the biopsy guided cognitively by multiparametric resonance versus guided by transrectal ultrasound with Doppler.We will retrospectively evaluate all patients undergoing prostate biopsy at the Prostate Institute of the Hospital Oswaldo Cruz between January 2010 and June 2017. Group 1 will be represented by cases guided by multiparametric resonance and 2 by patients submitted to ultrasound guided biopsy Trans-rectal (control group). We will correlate the detection rate according to the degree of suspicion for tumor observed at the resonance and with the occurrence of hypoechoic nodules identified by transrectal ultrasound. Anatomopathological correlations will be made between the changes observed in the imaging exams with the biopsy data: Gleason score, location of the positive fragments, agreement of the location of the positive fragment with the suspected area in the imaging examination and occurrence of positivity outside the suspected area. We will perform a subanalysis according to the existence or not of previous biopsy; And in those patients with positive biopsy and treated by radical prostatectomy we will evaluate the agreement of the Gleason score between the biopsy and the surgical specimen according to the imaging test used in the orientation of the biopsy. (AU)

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