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Einfluss der klinischen und interventionellen Parameter im Rahmen der mpMRT/TRUS Fusionsbiopsie der Prostata auf die Detektionsrate des Prostatakarzinoms

dc.contributor.advisorLeitsmann, Marianne PD Dr.
dc.contributor.authorKraushaar, Cornelius Lukas
dc.titleEinfluss der klinischen und interventionellen Parameter im Rahmen der mpMRT/TRUS Fusionsbiopsie der Prostata auf die Detektionsrate des Prostatakarzinomsde
dc.title.translatedImpact of clinical and interventional parameters in the context of mpMRI/TRUS fusion biopsy of the prostate on the detection rate of prostate cancerde
dc.contributor.refereeLeitsmann, Marianne PD Dr.
dc.description.abstractengProstate cancer is one of the most common cancers in men worldwide. In this context, this study investigates clinical and interventional parameters that may influence the detection rate of prostate cancer in the context of a fusion biopsy of the prostate based on a fusion image of transrectal ultrasound (TRUS) and multiparametric magnetic resonance imaging (mpMRI). The study focuses on the type of intraoperative image fusion of magnetic resonance imaging (MRI) images and "live" TRUS images and the extent to which rigid or elastic fusion can be diagnostically superior. A retrospective data analysis of 438 male patients who underwent an mpMRI/TRUS fusion biopsy of the prostate or a transperineal biopsy using the Transperineal Optimized Prostate Biopsy (TOP) algorithm between March 2016 and June 2019 was performed. Increasing age (univariable p < 0.001; multivariable odds ratio (OR) = 3.16; 95% confidence interval (CI) 1.29 - 8.10; p = 0.013 resp. OR = 9.68; CI 3.75 - 26.75; p < 0.001), higher serum levels of prostate specific antigen (PSA) (univariable p < 0.001; multivariable OR = 6.08; CI 1.75 - 24.81; p = 0.007 and OR = 13.69; CI 3.43 - 64.23; p < 0.001 and OR = 34.00; CI 5.62 - 248.66; p < 0.001, respectively) and higher Prostate Imaging Reporting and Data System (PI-RADS) scores (univariable p = 0.001; multi-variable OR = 2.80; CI 1.44 - 5.62; p = 0.003) were shown to be positive predictors of the presence of a tumor. Increasing prostate volume (univariable p < 0.001; multivariable OR = 0.12; CI 0.04 - 0.30; p < 0.001 or OR = 0.02; CI 0.00 - 0.05; p < 0.001) and higher values of the international prostate symptom score (IPSS) (univariable p = 0.002 or multivariable OR = 0.39; CI 0.02 - 0.75; p = 0.006 and OR = 0.39; CI 0.12 - 1.21; p = 0.103) were shown to be negative predictors of the presence of a tumor in both univariable and multivariable analysis. Regarding the tumor detection rate, there was no statistically significant difference between elastic and rigid fusion (univariable p = 0.142). The mean minimum distance of systematically positive cylinders differed significantly between rigid and elastic fusion (3.6 mm and 4.9 mm, respectively; p = 0.013) in favor of rigid fusion. The inverse correlation of prostate volume and tumor detection rate exists in this study despite sufficient organ coverage using the TOP algorithm, suggesting a lower prevalence of prostate cancer in large glands. This study showed no clear superiority of one type of fusion regarding the tumor detection rate of prostate cancer, whereby the smaller distances resp. greater scatter of systematically positive cylinders after rigid fusion are interpreted as an expression of greater examiner dependency. Accordingly, rigid fusion is an option especially for experienced
dc.contributor.coRefereeUhlig, Johannes PD Dr.
dc.contributor.thirdRefereeSchön, Margarete Prof. Dr.
dc.subject.engprostate cancerde
dc.subject.engmpMRI/TRUS fusion biopsyde
dc.subject.engrigid fusionde
dc.subject.engelastic fusionde
dc.affiliation.instituteMedizinische Fakultätde
dc.notes.confirmationsentConfirmation sent 2024-03-01T19:45:01de

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