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主要评分:与MRI相比的诊断性能和附加值,用于检测临床上显著的前列腺癌

Shikuan Guo, Fei Kang¹, Shuaijun Ma²

¹Departments of Nuclear Medicine.

Clinical nuclear medicine

|December 11, 2023

概括

基于68Ga-PSMA PET/CT的PRIMARY得分优于MRI在检测临床上显著的前列腺癌 (csPCa). 将PRIMARY得分与MRI得分相结合,可以提高诊断准确度,减少MRI结果阴性或模两可的男性不必要的活检.

科学领域:

在瘤学瘤学.
放射学放射学是一门学科.
核医学就是核医学.

背景情况:

多参数MRI (mpMRI) 是前列腺癌检测的标准.
负面或模两可的MRI结果导致不必要的活检.
基于68Ga-PSMA PET/CT的PRIMARY评分显示,对csPCa检测有希望.

研究的目的:

在外部验证csPCa的PRIMARY分数的表现.
评估PRIMARY得分对MRI分类的诊断价值的增加.

主要方法:

在活检前对431名男性进行了68Ga-PSMA PET/CT和MRI的回顾性队列研究.
使用ROC曲线和决策曲线分析评估的绩效.
主要得分 + 核磁共振被认为是积极的,主要得分为3-5或PI-RADS 4/5.5.

主要成果:

主要得分AUC (0.873) 显著高于MRI (0.786) 的csPCa.
在敏感度,特异性,PPV和NPV方面,PRIMARY得分优于PI-RADS.
主要得分+MRI提高了灵敏度 (96.0%) 和NPV (91.5%) 与MRI单独相比,避免了24.6%的活检.
综合方法在PI-RADS 1-3的男性中显示出益处,但PI-RADS 4/5.5的男性没有.

结论:

主要得分优于MRI的csPCa检测.
PRIMARY评分的附加诊断价值在阴性或模两可的MRI的男性中最为显著.
主要分数+MRI增强了csPCa检测,减少了不必要的活检.

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