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微超声波导向与MRI导向的前列腺癌诊断活检:OPTIMUM随机临床试验
Adam Kinnaird1, Ferdinand Luger2, Hannes Cash3,4
1Division of Urology, Departments of Surgery and Oncology, University of Alberta, Edmonton, Canada.
JAMA
|March 23, 2025
概括
高分辨率的微超声波导向活检是MRI融合导向活检的可行替代方案,用于检测显著的前列腺癌. 这项研究发现微超声波无劣,为图像引导的前列腺活检提供了新的选择.
科学领域:
- 尿道病学
- 癌症学
- 医学成像
背景情况:
- 前列腺癌的诊断通常依赖于活检.
- 核磁共振导向活检是一种常见的方法,但正在探索替代方法.
- 高分辨率的微超声波可以在活检期间改善成像.
研究的目的:
- 为了比较微超声波导向活检与MRI融合导向活检在诊断前列腺癌中的有效性.
- 为了确定微超声波导向活检是否与MRI融合导向活检相比,用于检测格里森等级2或更高的前列腺癌.
主要方法:
- 一个多中心的,随机的,非劣势性试验,
- 参与者被分配到微超声波导向活检,微超声波/MRI融合导向活检,或MRI/传统的美国融合导向活检.
- 主要结局是发现格里森等级2组或更高癌症的比率.
主要成果:
- 微超声波导向活检与核磁共振导向活检相比,其检测率为47. 1%,而格里森等级2+癌症的检测率为42. 6%.
- 与美国常规的融合导向活检相比,微超声波/MRI活检也显示出非劣质性.
- 在单独针对性活检检测格莱森等级2或更高癌症的频率上没有发现显著差异.
结论:
- 高分辨率微超声波导向活检是MRI融合导向活检的非劣质替代方法,用于诊断未经活检的男性的前列腺癌.
- 微超声波为图像引导前列腺活检提供了一个有前途的替代成像方法.
- 这种技术可以扩大前列腺癌诊断和分期的选择.
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