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更新PI-RADS 2.1版本前列腺MRI的诊断性能基准:系统审查和元分析

Benedict Oerther¹, Andrea Nedelcu¹, Hannes Engel¹

¹From the Department of Radiology (B.O., A.N., H.E., F.B., M.B.), Institute for Evidence in Medicine (C.S., T.B.), Institute of Medical Biometry and Statistics (G.S.), Department of Urology (A.S., C.G.), and Berta-Ottenstein-Programme (A.S), Faculty of Medicine, University of Freiburg Medical Center, Freiburg, Germany; Department of Radiology & Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands (I.G.S); and Department of Diagnostic and Interventional Radiology, Medical Faculty OWL, University of Bielefeld, Klinikum Lippe, Röntgenstrasse 18, 32756 Detmold, Germany (M.E., M.B.).

|August 13, 2024

概括

这项研究为前列腺成像报告和数据系统 (PI-RADS) 版本2.1提供了最新的诊断准确度和癌症检测率. 这些发现有助于使用MRI治疗临床显著的前列腺癌 (csPCa).

科学领域:

放射学放射学是一门学科.
在瘤学瘤学.
医疗成像医学成像

背景情况:

前列腺MRI利用前列腺成像报告和数据系统 (PI-RADS) 进行临床显著的前列腺癌 (csPCa) 检测.
PI-RADS 2.1 版本是当前的标准,需要更新性能评估.
一个系统审查和元分析基础设施确保定期更新PI-RADS诊断性能.

研究的目的:

估计前列腺MRI的PI-RADS版本2.1类别的诊断准确性.
为了确定与每个PI-RADS类别相关的癌症检测率 (CDR).
通过可靠的诊断性能数据支持基于证据的患者管理.

主要方法:

从2019年3月到2022年8月,对主要数据库 (PubMed,Embase,Cochrane) 和试验登记册进行系统的文献搜索.
包括报告PI-RADS v2.1诊断准确度或CDRs的研究,主要结果为csPCa.
对病变和患者级数据的元分析,以得出聚合的灵敏度,特异性和CDR,包括子组分析.

主要成果:

包括70项研究 (11,686个病变,13,330名患者) 的元分析.
对于PI-RADS≥3,总结灵敏度为96%和特异性为43% (SROC AUC为0.86).
对于PI-RADS ≥4,灵敏度为89%和特异性为66% (SROC AUC为0.89).对于PI-RADS ≥4,灵敏度是89%和特异性是66% (SROC AUC为0.89).
癌症检测率从PI-RADS 1的6%到PI-RADS 5的84%不等.

结论:

为PI-RADS 2.1版本的诊断准确度和癌症检测率提供了当前的估计.
提供前列腺MRI解释质量评估的基准.
根据MRI发现,有助于改进基于前列腺癌的患者管理策略.

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