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在积极监测期间,MRI是否准备好取代活检?

Adriano B Dias¹, Sungmin Woo², Riccardo Leni^3,4

¹University Medical Imaging Toronto; Joint Department of Medical Imaging; University Health Network-Sinai Health System-Women's College Hospital, University of Toronto, Toronto, ON, Canada.

European radiology

|July 4, 2024

概括

多参数MRI (mpMRI) 通过改善患者选择,有助于前列腺癌 (PCa) 的积极监测 (AS). 然而,它在AS期间监测疾病进展的有效性需要进一步的标准化和研究.

科学领域:

泌尿器科泌尿器科泌尿器科泌尿器科
放射学放射学是一门学科.
在瘤学瘤学.

背景情况:

积极监测 (AS) 是低风险和选择的中等风险前列腺癌 (PCa) 的管理策略.
多参数MRI (mpMRI) 越来越多地被采用在PCa的初级诊断和AS中.
顺序评估变化的前列腺癌放射性估计 (PRECISE) 标准指导AS协议.

研究的目的:

审查mpMRI在整个前列腺癌积极监测途径中的作用和性能.
评估mpMRI在患者选择,风险分层和监测疾病进展方面的实用性.
在AS中确定MPMRI应用中需要改进的领域.

主要方法:

对前列腺癌活跃监测中的mpMRI现有文献的系统审查.
在初始患者分层和后续评估中对mpMRI性能的分析.
评估mpMRI与活检结果和临床结果的一致性.

主要成果:

mpMRI在检测临床显著PCa (csPCa) 中显示出高负预测价值,支持其在初始选择和分层中的使用.
关于mpMRI在AS期间监测疾病进展的疗效的证据是相互矛盾的.
对MRI阴性csPCa,最佳MRI协议 (包括双参数MRI) 和人工智能 (AI) 的整合需要进一步调查.

结论:

mpMRI对于患者选择,风险分层和前列腺癌AS的随访至关重要.
由于目前的局限性,mpMRI不能完全取代AS中的活检.
标准化MRI协议对于克服局限性和提高mpMRI在前列腺癌AS中的有效性至关重要.

关键词:

积极监视活动的监视活动.磁共振成像技术磁共振成像技术前列腺癌是什么意思前列腺癌是什么意思

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