在前列腺MRI的桌上监测可以使适合的gadolinium对比度的使用

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Tom Syer^1,2, Bruno Carmo¹, Nimalam Sanmugalingam¹

¹Department of Radiology, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

European radiology

|March 15, 2025

概括

前列腺MRI的桌上监测在75.8%的患者中显著减少了加多对比剂的使用. 这种方法保持了诊断准确度和活检率,同时降低了成本并提高了读者的信心.

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:

基于加多的对比剂经常用于多参数MRI (mpMRI) 进行前列腺癌 (PCa) 检测.
常规使用加多可能并不总是临床上有益的,并带有相关的副作用和医疗保健费用.
其他监测策略可以优化对比剂的利用.

研究的目的:

为了比较桌上监测与标准护理mpMRI对前列腺MRI中加多对比度利用的影响.
评估桌上监测对诊断准确度,活检率和成本节省的影响.

主要方法:

一个机构18个月前期获取数据的回顾性观察性研究.
桌上监测包括放射科医生对T2和DWI图像进行实时审查,以指导动态对比增强 (DCE) 序列的获取.
倾向性得分匹配用于将被监测的队列与标准护理对照组进行比较,分析了加多的给药率,活检结果和诊断准确性 (PI-RADS v2.1).

主要成果:

在598名倾向分数匹配的患者中 (178名监测组),在餐桌监测组中的75.8% (135/178) 没有接受加多对比剂.
与对照组相比,桌面监测显示了可比的活检率 (52.2%与49.5%),PI-RADS 3/5评分率 (10.1%与7.4%),敏感性 (98.3%与99.2%) 和临床显著PCa检测的特异性 (63.9%与70.7%).
当获得DCE序列时,在67.4%的案例中被认为是有帮助的,并且提高了读者的信心. 估计节省了56677英的成本.

结论:

桌上监测显著减少了前列腺MRI中加多对比的需要,而不会影响诊断准确度或活检率.
这种个性化的协议方法将与对比相关的副作用和医疗保健成本降到最低.
桌上监测最大限度地发挥了mpMRI和双参数MRI的优势,提供了临床相关和具有成本效益的战略.

关键词:

对比媒介对比媒介.磁共振成像技术磁共振成像技术前列腺新生体前列腺瘤.

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