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双参数和多参数前列腺MRI的NPV:一个比较的系统审查和元分析
Emmanuel Salinas-Miranda1, Adam Birosh1, Matthew D F Mcinnes1
1Department of Radiology, The Ottawa Hospital, Ottawa, ON, Canada.
AJR. American journal of roentgenology
|March 5, 2025
概括
双参数核磁共振 (bpMRI) 和多参数核磁共振 (mpMRI) 对临床显著的前列腺癌显示了相似的负预测值 (NPV). 这一发现支持bpMRI作为临床实践中mpMRI的可行替代品,可能改善患者护理.
科学领域:
- 尿道瘤学 尿道瘤学
- 诊断成像 诊断成像 诊断成像
- 放射学 放射学是一门学科.
背景情况:
- 越来越多的证据表明,双参数MRI (bpMRI) 与多参数MRI (mpMRI) 提供了可比的正预测值 (PPV).
- 对潜在缺失的癌症的担忧阻碍了bpmri的更广泛的临床采用.
- 本研究通过关注bpmri的负预测值 (NPV) 来解决这些问题.
研究的目的:
- 为了比较双参数MRI (bpMRI) 与多参数MRI (mpMRI) 的负预测值 (NPV).
- 评估bpMRI精确排除临床显著前列腺癌的能力 (国际泌尿病理学会 [ISUP]等级组≥2).
主要方法:
- 一项系统的文献搜索发现了18项报告比较bpMRI和mpMRI结果的研究.
- 用随机效应模型进行了聚合负面检查 (PI-RADS 1-2) 的元分析.
- 使用QUADAS-Comparative评估了偏差风险;根据研究设计,磁场强度和患者病史进行了子组分析.
主要成果:
- 在所有纳入研究中,bpMRI (92%) 和mpMRI (92%) 之间,聚合的NPV没有显著差异.
- 这一发现在排除具有偏差高风险的研究和子组分析 (1.5-T,3-T,活检素朴,先前做过活检的患者) 之后仍然是一致的.
- 在bpMRI和mpMRI之间没有观察到NPV的显著差异,无论具体的患者队列或成像参数.
结论:
- 这次元分析发现,双参数MRI (bpMRI) 和多参数MRI (mpMRI) 之间的负预测值 (NPV) 在检测临床上显著的前列腺癌方面没有显著差异.
- 这些结果支持在常规临床实践中使用bpMRI作为mpMRI的可靠替代品.
- 未来的研究应该优先考虑随机对照试验,并进行纵向随访,以进一步验证这些发现.
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