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个人化风险适应模型在前列腺癌的积极监测期间使用MRI-一个叙述性审查
Davide Maffei1,2, Caroline M Moore3,4
1Division of Surgery & Interventional Science, University College London, London, UK. d.maffei@ucl.ac.uk.
European radiology
|April 4, 2025
概括
多参数MRI通过改善患者选择和风险分层来增强前列腺癌 (PCa) 主动监测 (AS). 以MRI为主导的协议可以个性化护理,减少患者负担和医疗保健成本.
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:
- 前列腺癌 (PCa) 很常见,组织学发现并不总是与临床意义相关.
- PSA 查发现的 PCa 病例比临床表现更多,强调需要更好的管理策略.
- 在15年内,PROTECT研究在手术,放射治疗和主动监测 (AS) 中显示了类似的PCa相关死亡率.
研究的目的:
- 审查磁共振成像 (MRI) 对前列腺癌主动监测 (AS) 的影响.
- 探索MRI如何改善患者选择,风险分层和个性化AS协议的开发.
- 解决标准化协议在管理异质PCa患者群体AS.在管理的局限性.
主要方法:
- 对有关MRI在前列腺癌诊断和监测中的使用现有文献和临床实践的审查.
- 来自UCLHAS队列的数据分析,重点关注MRI评估和进展预测因素.
- 对AS系列MRI评估的PRECISE建议进行检查.
主要成果:
- 多参数MRI (mpMRI) 可以有选择性地检测更高等级的PCa,有助于活检决策.
- 基线格里森等级和MRI指数病变可见性是AS治疗进展的关键预测因素.
- 核磁共振扫描改善了AS的选择,预测了治疗时间,并对患者进行了风险分层.
结论:
- 核磁共振显著提高了前列腺癌活跃监测患者选择和风险分层的准确性.
- 以MRI为主导,风险适应的协议可以个性化AS,潜在地减少患者负担和医疗保健成本.
- 动态的,风险分层的AS方法是优化前列腺癌管理的研究重点.
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