阳性多参数前列腺核磁共振检查患者的管理:AJR 专家小组叙述审查
Nelly Tan1, Jordan R Pollock1, Daniel J A Margolis2
1Department of Radiology, Division of Abdominal Radiology, Mayo Clinic Arizona, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ 85054.
AJR. American journal of roentgenology
|October 25, 2023
概括
多参数MRI (mpMRI) 有助于检测前列腺癌. 负的mpMRI结果需要谨慎管理,活检通常不推给平均风险患者,但被认为是高风险个体.
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MRI (mpMRI) 对于 PSA 升高患者的前列腺癌风险分层至关重要.
- 虽然mpMRI检测到大多数显著的癌症,但管理负面结果 (PI-RADS 1-2) 仍然具有挑战性.
- 国际指南建议在活检前进行前列腺MRI,但MRI后的管理需要澄清.
研究的目的:
- 对管理PSA升高和前列腺阴性mpMRI患者的文献进行审查.
- 为这些患者的临床管理提供基于证据的指导.
主要方法:
- 关于前列腺核磁共振和高血水平的现有文献的叙述性综述.
- 对负面mpMRI发现的管理策略的分析.
主要成果:
- 在平均风险患者的mpMRI阴性后,系统活检通常不建议;对于高风险患者,它被认为是高风险的.
- 如果选择PSA查而不是活检,需要重复MRI的明确触发因素.
- 阴性MRI和活检的患者应遵循现有的PSA查指南.
结论:
- 阴性前列腺mpMRI的管理需要个性化风险评估.
- 目前的证据不支持在阴性mpMRI后常规使用生物标志物,AI或PSMA PET.
- 需要进一步的研究,以优化对前列腺MRI阴性结果的后续策略.
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