三维经直肠超声（TRUS）图像的分割被认为具有挑战性，临床医生常常缺乏可靠且易于使用的指标来评估融合磁共振成像（MRI）引导前列腺活检过程中其准确性。为评估三维TRUS和MRI分割之间的相对容积差异对目标活检结果的影响，连续纳入了2012年2月至2021年7月期间接受临床疑似前列腺癌MRI引导活检的成年男性患者。所有患者均进行了融合MRI引导前列腺活检，并使用了Koelis设备。使用来自分割的三维前列腺模型，计算了三维TRUS和MRI的前列腺体积。主要结果是经直肠超声和MRI之间的相对分割体积差（SVD），其等于MRI体积减去TRUS体积除以MRI体积（SVD = MRI体积 - TRUS体积/MRI体积），以及其与临床显著前列腺癌（例如，国际泌尿学病理学协会[ISUP] ≥2）在目标活检核心中的阳性相关性。总共有1721名患者进行了目标活检，共计5593个目标核心。在被诊断为临床显著前列腺癌的患者中，中位数相对SVD明显低于ISUP 0-1的患者（6.7％[四分位数范围 {IQR} -2.7, 13.6] vs 8.0％[IQR 3.3, 16.4]，p <0.01）。多元回归分析显示，相对SVD在MRI体积的10％以上与临床显著前列腺癌的检出率较低相关（奥斯比比 = 0.74 [95％置信区间：0.55-0.98]，p = 0.038）。 MRI分割体积的相对SVD在目标活检核心中与临床显著前列腺癌的较低检出率相关。相对SVD可以用作三维TRUS分割的每个过程的质量指标。在磁共振成像和经直肠超声体积分割之间存在≥10％的差异与在目标活检核心中检测显著前列腺癌的能力降低相关。版权所有©2023年由Elsevier B.V.出版。

Segmentation of three-dimensional (3D) transrectal ultrasound (TRUS) images is known to be challenging, and the clinician often lacks a reliable and easy-to-use indicator to assess its accuracy during the fusion magnetic resonance imaging (MRI)-targeted prostate biopsy procedure.To assess the effect of the relative volume difference between 3D-TRUS and MRI segmentation on the outcome of a targeted biopsy.All adult males who underwent an MRI-targeted prostate biopsy for clinically suspected prostate cancer between February 2012 and July 2021 were consecutively included.All patients underwent a fusion MRI-targeted prostate biopsy with a Koelis device.Three-dimensional TRUS and MRI prostate volumes were calculated using 3D prostate models issued from the segmentations. The primary outcome was the relative segmentation volume difference (SVD) between transrectal ultrasound and MRI divided by the MRI volume (SVD = MRI volume - TRUS volume/MRI volume) and its correlation with clinically significant prostate cancer (eg, International Society of Urological Pathology [ISUP] ≥2) positiveness on targeted biopsy cores.Overall, 1721 patients underwent a targeted biopsy resulting in a total of 5593 targeted cores. The median relative SVD was significantly lower in patients diagnosed with clinically significant prostate cancer than in those with ISUP 0-1: (6.7% [interquartile range {IQR} -2.7, 13.6] vs 8.0% [IQR 3.3, 16.4], p < 0.01). A multivariate regression analysis showed that a relative SVD of >10% of the MRI volume was associated with a lower detection rate of clinically significant prostate cancer (odds ratio = 0.74 [95% confidence interval: 0.55-0.98]; p = 0.038).A relative SVD of >10% of the MRI segmented volume was associated with a lower detection rate of clinically significant prostate cancer on targeted biopsy cores. The relative SVD can be used as a per-procedure quality indicator of 3D-TRUS segmentation.A discrepancy of ≥10% between segmented magnetic resonance imaging and transrectal ultrasound volume is associated with a reduced ability to detect significant prostate cancer on targeted biopsy cores.Copyright © 2023. Published by Elsevier B.V.