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首页> 美国卫生研究院文献>Diagnostics >Utilization of Multiparametric MRI of Prostate in Patients under Consideration for or Already in Active Surveillance: Correlation with Imaging Guided Target Biopsy
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Utilization of Multiparametric MRI of Prostate in Patients under Consideration for or Already in Active Surveillance: Correlation with Imaging Guided Target Biopsy

机译：在思考或已经在主动监测中考虑或已经在主动监测中的患者中患者多射金MRI的利用：与成像引导靶活检的相关性

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This study sought to assess the value of multiparametric magnetic resonance image (mp-MRI) in patients with a prostate cancer (PCa) Gleason score of 6 or less under consideration for or already in active surveillance and to determine the rate of upgrading by target biopsy. Three hundred and fifty-four consecutive men with an initial transrectal ultrasound-guided (TRUS) biopsy-confirmed PCa Gleason score of 6 or less under clinical consideration for or already in active surveillance underwent mp-MRI and were retrospectively reviewed. One hundred and nineteen of 354 patients had cancer-suspicious regions (CSRs) at mp-MRI. Each CSR was assigned a Prostate Imaging Reporting and Data System (PI-RADS) score based on PI-RADS v2. One hundred and eight of 119 patients underwent confirmatory imaging-guided biopsy for CSRs. Pathology results including Gleason score (GS) and percentage of specimens positive for PCa were recorded. Associations between PI-RADS scores and findings at target biopsy were evaluated using logistic regression. At target biopsy, 81 of 108 patients had PCa (75%). Among them, 77 patients had upgrading (22%, 77 of 354 patients). One hundred and forty-six CSRs in 108 patients had PI-RADS 3 = 28, 4 = 66, and 5 = 52. The upgraded rate for each category of CSR was for PI-RADS 3 (5 of 28, 18%), 4 (47 of 66, 71%) and 5 (49 of 52, 94%). Using logistic regression analysis, differences in PI-RADS scores from 3 to 5 are significantly associated with the probability of disease upgrade (20%, 73%, and 96% for PI-RADS score of 3, 4, and 5, respectively). Adding mp-MRI to patients under consideration for or already in active surveillance helps to identify undiagnosed PCa of a higher GS or higher volume resulting in upgrading in 22%.
机译：本研究寻求评估在前列腺癌（PCA）Gleasone患者的患者中的多射磁共振图像（MP-MRI）的价值，其考虑或已经在积极监测中，并确定了目标活检的升级速度。在临床考虑或已经在积极监测的临床考虑下，有三百五十四个连续的男性，初始经型超声引导（TRUS）活组织检查确认的PCA GLEASES评分为6或更少，或者已经在积极监测中接受了MP-MRI，并回顾性地审查。在MP-MRI的患者中有一百九九患者在癌症可疑地区（CSRS）。每个CSR都被分配了基于PI-RADS V2的前列腺成像报告和数据系统（PI-RADS）得分。 119名患者中的一百八个患者接受了CSR的确认成像引导活检。记录了病理结果，包括Gleason评分（GS）和PCA阳性标本百分比。使用Logistic回归评估PI-RADS评分和目标活检的发现之间的关联。在目标活检，108名患者的81名患有PCA（75％）。其中，77名患者升级（22％，354名患者中的22％）。 108名患者中的一百四十六个CSR有PI-RAD 3 = 28,4 = 66和52.每种CSR的升级率为PI-RAD 3（5分，18％）， 4（47个，共66,71％）和5（49个，共52,94％，共94％，共52％）。使用Logistic回归分析，PI-RADS评分3至5的差异显着与疾病升级（20％，73％和96％的PI-RADS分别为3,4和5的概率）显着相关。向正在考虑或已经处于主动监测的患者中向患者添加MP-MRI有助于鉴定未诊断的GS或更高体积的未诊断PCA，导致22％的升级。

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