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Master Thesis

Biopsies prostatiques ciblées guidées par IRM dans le diagnostic du cancer de prostate‎ : revue de la littérature et expérience clinique initiale avec l'Urostation®

Abstract : The systematic review of the literature showed that research is focused on two main areas: direct biopsy guidance inside the MRI, and MRI-ultrasound fusion. The first offer a high precision, but are still limited by the accessibility, cost and duration of these procedures. Image fusion is a promising compromise, associating the precision and specificity of multiparametric MRI, and the accessibility and usability of transrectal ultrasound. Several systems have therefore been developped, including the Urostation®, to allow biopsy guidance based on 3D ultrasound and MRI fusion. Between November, 2011 and August, 2012, we prospectively included 30 patients presenting with an indication for prostate biopsies, who first had a multiparametric MRI in the Grenoble University Hospital. A 12-core randomised biopsy protocol was performed, as well as 2 targeted biopsies in case of suspicious lesion. Prostate cancer was detected in 14 cases (47%), including 3 cancers with MRI considered normal. Eleven cancers were considered clinically significant. In our study, a 2-core targeted biopsy protocol performed only in case of abnormal MRI with a PI-RADS score >8 would have missed one significant cancer, but avoided 15 unnecessary procedures and 2 cases of over-diagnosis of insignificant cancers, with a 91% sensitivity for the detection of significant prostate cancer. Further, larger studies are needed to define the place of MRI prior to biopsy, of targeted biopsies, and finally of MRI-ultrasound fusion, in the context of the developpement of robotics, emergence of focal therapies, and reflection on over-treatment.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-00748921
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Submitted on : Tuesday, November 6, 2012 - 3:52:37 PM
Last modification on : Tuesday, May 11, 2021 - 11:36:17 AM
Long-term archiving on: : Saturday, December 17, 2016 - 8:01:04 AM

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  • HAL Id : dumas-00748921, version 1
  • PPN : 165181656

Citation

Gaelle Fiard. Biopsies prostatiques ciblées guidées par IRM dans le diagnostic du cancer de prostate‎ : revue de la littérature et expérience clinique initiale avec l'Urostation®. Médecine humaine et pathologie. 2012. ⟨dumas-00748921⟩

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