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PI-RADS升级规则:对前列腺癌检测的影响,以及避免MRI导向诊断途径的活检

Eduardo T de Oliveira Correia¹, Andrei S Purysko², Bruno Merz Paranhos³

¹Department of Radiology, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, Ohio 44106.

AJR. American journal of roentgenology

|February 14, 2024

概括

前列腺成像报告和数据系统 (PI-RADS) 升级规则提高了MRI导向前列腺癌诊断途径的临床净益. 遵循这些规则可以优化活检选择,平衡癌症检测,避免不必要的程序.

科学领域:

尿道瘤学尿道瘤学
放射学放射学是一门学科.
诊断途径诊断途径

背景情况:

前列腺成像报告和数据系统 (PI-RADS) 使用辅助发现来升级初始损伤得分.
关于PI-RADS升级规则对临床诊断途径的影响的证据有限.
评估这些升级规则的临床净益对于优化前列腺癌诊断至关重要.

研究的目的:

评估PI-RADS升级规则在前列腺癌MRI导向诊断途径中的临床净益.
为了比较诊断途径的性能,并没有应用PI-RADS升级规则.
分析临床上显著的前列腺癌 (csPCa) 检测和活检避免之间的权衡.

主要方法:

对前列腺核磁共振和活检 (MRI) 患者的前期维护注册的回顾性分析 (2016年1月 - 2020年5月).
主导性和升级性病变之间的csPCa检测率 (ISUP等级组≥2) 的比较.
决策曲线分析,以评估不同的MRI导向途径 (所有活检,MRI专注,基于风险) 的净收益,有或没有PI-RADS升级规则.

主要成果:

在PI-RADS 3和4类别中,主导性和升级性病变之间的csPCa检测没有显著差异.
无视PI-RADS升级规则的途径显示了活检避免率的增加,但没有显著改变csPCa检测.
每个指南的基于风险的途径在活检选择的特定概率值时显示出最高的净益.

结论:

忽视PI-RADS升级规则会降低基于风险的MRI导向诊断途径的临床净益.
支持遵守PI-RADS升级规则,以优化前列腺癌诊断中的活检选择.
这些规则在基于风险的途径中特别有价值,以平衡癌症检测并尽量减少不必要的活检.

关键词:

这就是为什么MRI是MRI.扩散磁力共振成像 (MRI) 扩散前列腺新生体前列腺瘤.

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