在怀疑患有前列腺癌的男性中,MRI信息化活检决策的瘤安全性
Charlie A Hamm1,2, Patrick Asbach1, Anna Pöhlmann3
1Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
JAMA oncology
|December 12, 2024
概括
为了诊断前列腺癌,多参数MRI (mpMRI) 是安全的. 阳性核磁共振扫描结果,避免前列腺活检 (PB) 的男性在三年内没有出现临床显著前列腺癌 (csPCa) 的风险增加.
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:
- 多参数MRI (mpMRI) 用于诊断临床显著的前列腺癌 (csPCa).
- 对于那些在阴性MRI后避免前列腺活检 (PB) 或在阳性MRI后有良性发现的男性的结果还不太清楚.
研究的目的:
- 在3年的监测期内,评估基于社区的MRI指导的诊断策略对疑似前列腺癌 (PCa) 的可行性和安全性.
- 根据MRI结果评估避免PB的男性的瘤结果.
主要方法:
- 一项为期3年的纵向队列研究,涉及593名疑似PCa的男性,遍及54个泌尿外科诊所和2个放射中心.
- 参与者接受了3-Tesla mpMRI. 参与者接受了3-Tesla mpMRI. 有负面或良性发现的男性避免了PB,并每6个月进行一次积极监测.
- 结果包括避免PB的男性比例和csPCa的检测率.
主要成果:
- 41%的男性在3年内避免了PB. 临床显著的前列腺癌 (csPCa) 在3年后在29%的男性中被检测出来.
- 在避免PB的阴性MRI结果的男性中,在3年监测期间,只有7人被诊断患有PCa (4csPCa).
- 在阳性MRI结果但在活检上发现良性结果的男性中,7%的男性在监测期间被诊断为csPCa.
结论:
- 在阴性多参数MRI (mpMRI) 后避免前列腺活检 (PB) 对于疑似前列腺癌 (PCa) 的男性来说,当有强大的监测系统时,在瘤学上是安全的.
- 这一策略证明了社区泌尿器科实践中的可行性.
- 该研究支持使用mpMRI指导PB决策并减少不必要的活检.
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