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Magnetic resonance imaging of prostate and the success rates in statistics of guided biopsy of the prostate
 HEFLER, Jakub
A carcinoma of a prostate is a very serious and common disease in the Czech republic and even in the whole world. It's incidence in 2018 was 62,5 in 100 000 across the Czech republic. To this day incidence and mortality slowly decreases. Diagnosis of a prostate carcinoma is started with a palpating examination per rectum. Then we determine a patient's PSA. If the PSA level is high, the patient is indicated for a biopsy od the prostate which is done with an ultrasound navigation. For more precise biopsy we use an image fusion. This means that the urologist, which is doing the biopsy, fuses an MRI image with the ultrasound. During the biopsy 10-15 samples are taken and they're histologically examined. A pathologist then determines a Gleason score of the carcinoma which takes values of 1-5 and it shows a differentiation and type of the carcinoma. Medical professionals also measure the risk of having a prostate carcinoma with PI-RADS 2.1 system. This system also has a scale of 1 to 5. A guided biopsy is usually done to patients with PI-RADS 4 or 5. For this bachelor thesis I used data from an urology department of Nemocnice České Budějovice. I took data about patients that were examined from April of 2019 to June of 2021. During that time 288 patients were examined. 45 patients that went through a MR guided biopsy were randomly chosen and their data were statistically processed. Goals of this work were: - Creating an informational text that contains anatomy and fysiology of the prostate, a mechanism of the MRI and a description on a guided biopsy of a prostate. - Determination of a statistical succes rate of an MRI guided biopsy of a prostate. Also there were hypothesis: H1: If it happens that laboratory and hystological results are not corresponding, majority of the patients are indicated for an MRI guided biopsy of the prostate. H2: At least 80% of patients have a positive result for a prostate carcinoma after an MRI navigated biopsy of a prostate. An informational text was created so the fist goal was fulfilled. Goal number 2 was fulfilled also because a statistical rate of positive and negative results of the guided biopsy were determined. This rate is 73% positive and 27% negative findings so it is necessary to reject a hypothesis H2. We can accept a hypothesis H1 according to information from MUDr. Černý that takes care of the MRI guided biopsies in Nemocnice České Budějovice.
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