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首页> 外文期刊>The Journal of Urology >Usefulness of pre-biopsy multiparametric magnetic resonance imaging and clinical variables to reduce initial prostate biopsy in men with suspected clinically localized prostate cancer
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Usefulness of pre-biopsy multiparametric magnetic resonance imaging and clinical variables to reduce initial prostate biopsy in men with suspected clinically localized prostate cancer

机译：活检前多参数磁共振成像和临床变量可用于减少怀疑有临床局限性前列腺癌的男性的初始前列腺活检

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Purpose: We evaluated the usefulness of pre-biopsy multiparametric magnetic resonance imaging and clinical variables to decrease initial prostate biopsies. Materials and Methods: We prospectively evaluated 351 consecutive men with prostate specific antigen between 2.5 and 20 ng/ml, and/or digital rectal examination suspicious for clinically localized disease. All men underwent pre-biopsy multiparametric magnetic resonance imaging and initial 14 to 29-core biopsy, including anterior sampling. Three definitions of significant cancer were defined based on Gleason score and cancer volume (percent positive core and/or maximum cancer length). The overall cohort was divided into men at low risk - prostate specific antigen less than 10 ng/ml and normal digital rectal examination, and high risk - prostate specific antigen 10 ng/ml or greater and/or abnormal digital rectal examination. We evaluated the frequency of significant cancer according to magnetic resonance imaging and risk categories. Clinical variables as significant cancer predictors were analyzed using logistic regression. The sensitivity, specificity, and positive and negative predictive values of magnetic resonance imaging were calculated with or without clinical variables for significant cancer. Results: The frequency of significant cancer in men with negative vs positive magnetic resonance imaging was 9% to 13% vs 43% to 50% in the low risk group and 47% to 51% vs 68% to 71% in the high risk group. In men at low risk with negative magnetic resonance imaging prostate volume was the only significant predictor of significant cancer. In the low risk group the negative predictive value for significant cancer of a combination of positive magnetic resonance imaging and lower prostate volume (less than 33 ml) was 93.7% to 97.5%. Conclusions: Pre-biopsy multiparametric magnetic resonance imaging along with prostate volume decreases the number of initial prostate biopsies by discriminating between significant cancer and other cancer in men with prostate specific antigen less than 10 ng/ml and normal digital rectal examination.
机译：目的：我们评估了活检前多参数磁共振成像和临床变量对减少初始前列腺活检的有用性。材料和方法：我们前瞻性评估了351名连续男性，其前列腺特异性抗原在2.5至20 ng / ml之间，和/或对临床局部疾病可疑的直肠指检。所有男性均进行了活检前多参数磁共振成像以及包括前路取样在内的初始14到29芯活检。基于格里森评分和癌症体积（阳性核心百分比和/或最大癌症长度）定义了三种重要的癌症定义。整个队列分为低风险的男性-前列腺特异性抗原低于10 ng / ml和正常的直肠指检，高风险的-前列腺特异性抗原10 ng / ml或更高和/或异常的直肠指检。我们根据磁共振成像和风险类别评估了重大癌症的发生率。使用logistic回归分析作为重要癌症预测指标的临床变量。在有或没有重大癌症的临床变量的情况下，计算了磁共振成像的敏感性，特异性以及阳性和阴性预测值。结果：磁共振成像阴性和阳性的男性发生重大癌症的频率为9％至13％，而低风险组为43％至50％，高风险组为47％至51％对68％至71％ 。在具有负磁共振成像的低风险男性中，前列腺体积是重大癌症的唯一重要预测指标。在低风险组中，正磁共振成像和较低的前列腺体积（小于33 ml）的组合对重大癌症的阴性预测值为93.7％至97.5％。结论：活检前多参数磁共振成像与前列腺体积一起，通过区分前列腺特异性抗原低于10 ng / ml的男性和正常的直肠指检的重要癌症与其他癌症，减少了初始前列腺活检的数量。

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