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磁共振成像基于风险计算器的比较,以预测前列腺癌风险

Hiten D Patel^1,2, Sebastiaan Remmers³, Jeffrey L Ellis²

¹Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

JAMA network open

|March 7, 2024

概括

磁共振成像 (MRI) 风险计算器在前列腺癌 (PCa) 检测方面表现有前途. 在欧洲和北美队列中,PLUM和RPCRC-MRI模型表现良好,但需要新的工具来进行生物标志物综合查.

科学领域:

泌尿器科泌尿器科泌尿器科泌尿器科
放射学放射学是指放射学
在瘤学瘤学.

背景情况:

基于磁共振成像 (MRI) 的风险计算器有可能提高传统的前列腺癌 (PCa) 预测.
有限的外部验证数据可用于在不同的国际队列和查范式中比较不同的MRI风险计算器.

研究的目的:

在外部验证和比较四个基于MRI的PCa风险计算器的性能:PLUM,UCLA-Cornell,Van Leeuwen和RPCRC-MRI.
为了在前列腺活检前接受MRI的欧洲和北美队伍中评估这些计算器.

主要方法:

一项多机构的诊断研究涉及2181名没有先前PCa诊断的成年男性,他们在活检前接受前列腺MRI.
分析了三个独特的队列:两个在欧洲/北美,在活检前使用MRI,一个结合前列腺健康指数 (PHI) 生物标志物.
用接收器运行特征曲线 (AUC),校准图和决策曲线分析来诊断临床显著的PCa (等级组≥2) 来评估性能.

主要成果:

所有测试的模型都在欧洲 (AUCs ~0.90) 和北美 (AUCs ~0.83-0.85) 队列中显示出良好的诊断歧视.
在北美队列中,PLUM和RPCRC-MRI模型显示出更好的校准.
在PHI队列中,所有模型都低估了风险;UCLA-Cornell (AUC 0.83) 和PLUM (AUC 0.82) 的表现最好. 范文模型在所有队伍中都被校准得很差.

结论:

支持PLUM和RPCRC-MRI模型在欧洲和北美环境中用于基于MRI的查途径.
开发特定的风险预测工具是必要的选途径,集成先进的生物标志物,如PHI,由于观察到的低预测.

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