前列腺癌诊断的双参数与多参数MRI:PRIME诊断临床试验
Alexander B C D Ng1,2, Aqua Asif1,2, Ridhi Agarwal3
1Division of Surgery and Interventional Science, UCL, London, United Kingdom.
JAMA
|September 10, 2025
概括
双参数核磁共振是诊断前列腺癌的多参数核磁共振的经济有效替代方案. 这项研究发现双参数MRI在检测临床意义上的前列腺癌方面不低于多参数MRI.
科学领域:
- 癌症学
- 放射学
- 医学成像
背景情况:
- 多参数核磁共振 (mpMRI) 是诊断临床显著前列腺癌的标准.
- 资源的局限性阻碍了MPRI的广泛应用.
- 双参数核磁共振 (bpMRI) 提供了一个更短,更便宜的替代方案.
研究的目的:
- 确定bpMRI是否与mpMRI在诊断临床显著前列腺癌方面没有劣势.
- 评估bpMRI在增加医疗保健系统能力和降低成本方面的潜力.
主要方法:
- 预期的,多中心的,患者内非劣势试验,涉及疑似前列腺癌的活检的男性.
- 参与者接受了bpMRI (T2加权和扩散加权序列) 和mpMRI (包括动态对比增强序列).
- 放射科医生最初报告了对DCE盲目的bpMRI发现,然后报告了完整的mpMRI发现.
主要成果:
- 在检测具有临床意义的前列腺癌方面,bpMRI与mpMRI无差 (29. 2%与29. 6%).
- 在bpMRI和mpMRI之间,临床无意义癌症的检测率也相似 (9. 2%和9. 6%).
- 99% 的bpMRI扫描具有足够的诊断质量.
结论:
- 双参数核磁共振是前列腺癌诊断多参数核磁共振的可行且不劣的替代方案.
- 采用bpMRI可以显著增加MRI产量并降低全球医疗保健成本.
- 可能成为前列腺癌诊断的新标准,
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