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针对假阳性目标活检风险的PI-RADS版本2.1类别的多变量分层:对前列腺活检决定的影响

Rossano Girometti¹, Gianluca Giannarini², Maria De Martino³

¹Institute of Radiology, Department of Medicine (DAME), University of Udine, University Hospital S. Maria della Misericordia - Azienda Sanitaria-Universitaria Friuli Centrale (ASU FC), p.le S. Maria ella Misericordia, 15, 33100 Udine, Italy.

European journal of radiology

|June 10, 2023

概括

识别假阳性前列腺癌活检的因素至关重要. 使用年龄,PSA密度和MRI发现的多变量模型提高了活检向精度.

科学领域:

放射学放射学是一门学科.
泌尿器科泌尿器科泌尿器科泌尿器科
在瘤学瘤学.

背景情况:

多参数磁共振成像 (mpMRI) 对于检测临床显著前列腺癌 (csPCa) 至关重要.
前列腺成像报告和数据系统版本2.1 (PI-RADSv2.1) 将病变分类,指导活检决策.
假阳性目标活检 (FP-TB) 可能导致不必要的手术和患者焦虑.

研究的目的:

确定在PI-RADSv2.1 ≥3结果中预测FP-TB的临床和mpMRI因素.
开发一种模型,以提高前列腺癌诊断的准确性,减少不必要的活检.

主要方法:

对221名接受mpMRI和跨膜活检 (系统和向) 的男性进行了回顾性分析.
开发和内部验证一个多变量模型来预测FP-TB,定义为没有csPCa (ISUP ≥2).
分析包括年龄,前列腺特异性抗原密度 (PSAD),PI-RADSv2.1类别和病变多焦点性.

主要成果:

较年轻的年龄 (<65岁),较低的PSAD (<0.15 ng/mL/mL) 和PI-RADS 4/5类别与较高的FP-TB风险有关.
多焦点性与FP-TB的风险较低有关.
多变量模型实现了0.815的曲线下的面积 (AUC),用于预测FP-TB.

结论:

将PI-RADSv2.1类别与多变量风险模型进行调整对于触发目标活检比单独进行未调整的PI-RADS或PSAD调整更有效.
这种方法可以提高csPCa检测的准确性,并减少假阳性活检.

关键词:

活检是为了检查生物质.假阳性反应是错误的.多参数磁共振成像技术前列腺的新生体前列腺瘤.

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