Background: prostate fusion biopsies are key in the diagnosis of prostate cancer (PCa); however, the fusion imaging system is not always user-friendly or reliable. The aim of this study was to assess the feasibility, accuracy, and effectiveness of transperineal fusion biopsies performed with a novel fusion imaging device equipped with AI-driven auto-contouring.Methods: data from 148 patients who underwent MRI-targeted and systematic prostate fusion biopsy with UroFusion (Esaote) were prospectively collected. All biopsies were performed in-office, under local anaesthesia.Results: cancer detection rate was 64% overall and 56% for clinically significant PCa (csPCa, ISUP ≥ 2). PCa was detected in 35%, 65% and 84% of lesions scored as PI-RADS 3, 4 and 5, respectively. Outfield positive systematic cores were found in the contralateral lobe in one third of cases. Median device-time to obtain fusion imaging was 5 min and median biopsy duration was 15 min. Median difference in volume estimation between ultrasound and MRI auto-contouring was only 1 cc. Detection rate did not differ between experienced and novice, supervised users.Conclusions: in this initial prospective experience, fusion biopsies performed with UroFusion AI-driven auto-contouring system appeared time-efficient, accurate, well tolerated, and user-friendly, with comparable outcomes between experienced and novice users. Systematic biopsies remain highly recommended given the non-negligible rates of positive outfield cores.
背景：前列腺融合活检是诊断前列腺癌（PCa）的关键手段，但现有融合成像系统的用户友好性和可靠性仍有提升空间。本研究旨在评估采用配备人工智能自动勾画功能的新型融合成像设备进行经会阴融合活检的可行性、准确性和有效性。 方法：前瞻性收集148例使用UroFusion（Esaote）系统进行MRI靶向联合系统穿刺前列腺融合活检的患者数据。所有活检均在门诊局部麻醉下完成。 结果：总体癌症检出率为64%，临床显著性前列腺癌（csPCa，ISUP分级≥2）检出率为56%。PI-RADS评分3、4、5级病灶的癌检出率分别为35%、65%和84%。三分之一的病例在对侧腺叶发现靶区外阳性系统穿刺条。设备获取融合成像中位时间为5分钟，活检操作中位时长为15分钟。超声与MRI自动勾画的体积估算中位差值仅为1毫升。经验丰富者与经指导的新手操作者之间的检出率无显著差异。 结论：在这项初步前瞻性研究中，采用UroFusion人工智能自动勾画系统实施的融合活检具有时间效率高、准确性好、耐受性佳及用户友好等特点，且经验丰富者与新手操作者的临床效果相当。鉴于靶区外阳性穿刺条发生率不容忽视，系统活检仍具有重要临床价值。
肿瘤(癌症)患者之家