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在前列腺癌分期中过度使用成像
Yoichiro Tohi1, Takuma Kato1, Kana Kohashiguchi1
1Department of Urology, Faculty of Medicine, Kagawa University, Kita-gun, Kagawa, Japan.
概括
在前列腺癌分期中过度使用成像是常见的. 减少低风险患者的计算机断层扫描和骨光学扫描可以显著降低医疗成本.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
背景情况:
- 前列腺癌的分期对于治疗决策至关重要.
- 目前的临床实践可能涉及到用于分期的广泛成像.
- 标准分期协议的成本效益需要评估.
研究的目的:
- 在现实世界的临床环境中检查前列腺癌分期实践.
- 评估基于风险分层的成像模式的诊断产量.
- 通过优化低风险患者的成像使用来估计潜在的成本节约.
主要方法:
- 对接受前列腺癌治疗的698名患者的回顾性分析.
- 根据D'Amico风险分类对患者进行分层.
- 评估计算机断层扫描 (CT) 和骨扫描的利用和发现.
- 通过在低风险病例中省略成像来计算潜在的成本降低.
主要成果:
- 15.7%的患者被归类为低风险,45.2%为中等风险,39.1%为高风险.
- 计算机断层扫描和骨扫描分别在88.3%和67.5%的低风险患者中使用.
- 在低风险和中等风险组中,转移的诊断率很低,主要在高风险患者中发现了显著的发现.
- 在低风险患者中,省略CT和骨扫描可以每年节省约407万美元.
结论:
- 诊断成像在前列腺癌分期中可能会被过度使用.
- 图像利用率高,即使在低风险患者中,诊断收益率最小.
- 优化成像协议可以大幅降低医疗保健成本.
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