Cancer - Prostate(구연) International Session Ⅱ (I-002) Crystal B (3F) 11월 29일(목) 15:00-16:00 초음파 유도 생검과 자기공명영상 유도하 생검의 전립선암 진단율 비교 부산대학교병원, 부산대학교 의과대학 비뇨기과학교실 박지훈, 박시균, 강병진, 백승룡, 김경환, 구자윤, 하홍구 Introduction Use of only MR fusion targeted biopsy without sextant biopsy is controversial, because of risk of missing cancer. To investigate whether MR fusion biopsy could be alternative to systematic biopsy, this study was conducted by comparing the detection rate of MR fusion biopsy with that of systematic biopsy for detecting PCA. Material and Method The patients with high PSA and suspicious lesions of MRI were enrolled, and performed the systematic biopsy with MR fusion targeted biopsy with Affiniti 70, Philips. Clinically significant PCA (CS PCA) was defined as Gleason socre 3+4=7 or greater (ISUP grade group 2 or greater). Results From October 2016 through July 2018, a total of 170 patients were enrolled. The average age is 66.3 (IQR 61-72) years, and an average PSA is 10.32 (IQR 4.99-9.99) ng/mL. Of the 170 patients, 124 had never received biopsy before, and 46 were not detected in the previous biopsy. A total of 2080 cores were performed in total systemic biopsies, and 641 cores in MR fusion biopsies. With systematic biopsy, 42.9% were detected as PCA, and 22.9% as CS PCA. With MR-fusion biopsy, 31.2% were detected as PCA, and 19.4% as CS PCA. The overall detection rate between the two groups was statistically significantly different, but there was no significant difference for detecting CS PCA. Detection rate per core is 14.7% for systematic biopsy, while 24.5% for MR fusion biopsy. In the case of CS PCA, detection rate were 8.3% and 13.3%, respectively, and the difference was statistically significant. Conclusion MR-fusion biopsy was not inferior to systematic biopsy for detecting CS PCA, although was inferior for detecting PCA. As detection rate per core, MR fusion targeted biopsy was superior at detecting both PCA and CS PCA to systematic biopsy. MR fusion biopsy could be alternative to systemic biopsy for detecting CS PCA, particularly in biopsy naïve patient with PSA lower than 10 ng/mL. keywords : MR-fusion targeted biopsy, systematic biopsy, prostate cancer