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磁共振成像用于长期主动监测活检决策

Riccardo Leni^1,2,3, Amy L Tin¹, Nicole Liso^1,4

¹Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

BJU international

|May 29, 2025

概括

磁共振成像 (MRI) 仅仅是不足以跳过前列腺癌活检5年后的积极监测. 结合MRI,PSA密度和先前的活检结果可能有助于量身定制监测强度.

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:

主动监测 (AS) 是低风险前列腺癌的管理策略.
在AS期间,常规活检是标准的,但如果不进行活检,可能会减少患者的负担.
需要长期数据来完善AS协议.

研究的目的:

为了确定磁共振成像 (MRI) 发现,前列腺特异性抗原 (PSA) 密度或之前的活检结果是否可以安全地省略AS5年后的活检.
为了确定重新分类到更高等级组 (GG) 前列腺癌的预测因素.

主要方法:

分析一个单一机构的AS队列 (n=221) 患有1级前列腺癌.
患者接受了6年计划的核磁共振成像和活检.
多变量逻辑回归评估了重新分类到GG≥2的预测因素,包括PI-RADS得分,PSA密度和之前的活检状态.

主要成果:

22%的患者在6年后被重新分类为GG≥2.
PSA 密度和 PI-RADS 4-5 评分预测了重新分类;之前的阴性活检是保护性的.
在PI-RADS 1-2 MRI的男性中,省略6年活检有12%的错过GG≥2.2的风险.
缺失GG≥2的最低风险 (5.3%) 是先前有负面活检和PSA密度<0.10 ng/mL/cc的患者.

结论:

一个毫无疑问的MRI单独是不足以省略6年的AS活检.
结合MRI,PSA密度和先前的活检状态,显示了定制监测强度的前景.
在临床实施之前,建议在更大的队列中进一步验证.

关键词:

积极监督是指积极的监督.多参数磁共振成像技术前列腺癌是前列腺癌.重新分类的重新分类是什么监视活检检测监视活检检测

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