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超声波回声效应是PI-RADS的补充,用于临床上显著的前列腺癌风险分层
Garret Wegner1,2, Amir Khan1, Michael Panagos1,3
1Division of Urology, Department of Surgery, University of Maryland, School of Medicine, Baltimore, MD, USA.
Prostate cancer and prostatic diseases
|October 6, 2025
概括
在MRI-超声波融合活检期间的超声波回声效应改善了临床显著前列腺癌 (csPCa) 的检测. 将声源性与PI-RADS评分相结合,可以提高前列腺癌的诊断准确度.
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:
- 多参数磁共振成像 (MP-MRI) 和超声波导向的融合活检是诊断前列腺癌的关键工具.
- 显著比例的PI-RADS 3和4病变是良性的,需要改进的诊断方法.
- 在目前的诊断途径中,临床显著的前列腺癌 (csPCa) 检测仍然是一个挑战.
研究的目的:
- 评估MRI-超声波融合活检期间的病变回声性与csPCa检测之间的关联.
- 确定回声性是否可以提高前列腺癌PI-RADS评分的诊断准确性.
- 评估共振性和PI-RADS评分在识别csPCa的联合实用性.
主要方法:
- 对接受标准和向MP-MRI/US融合导向活检的患者的回顾性分析.
- 根据超声波回声性对病变进行分类,分为强度低,弱度低或非低.
- 定义csPCa作为格里森得分≥7进行分析.
主要成果:
- 强度低的病变显示出明显更高的csPCa检测率 (45%) 与弱度低的病变 (25%) 和非低的病变 (11.8%) 相比.
- 声源性改善了所有PI-RADS类别的csPCa检测,特别是PI-RADS ≤3病变.
- 与单独的任何一个因素相比,PI-RADS和回声效应的组合显示出更高的诊断性能 (AUC 0.7434).
结论:
- 损伤回声性是一种有价值的成像生物标志物,可以在MRI-超声波融合活检期间增强csPCa的检测.
- 与PI-RADS评分一起将回声性纳入风险评估可以显著改善活检决策和诊断准确性.
- 声源性是PI-RADS评分的补充工具,在诊断临床上显著的前列腺癌中提供了更高的精度.
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