病变密度的预测价值在增强多参数MRI中用于检测临床显著的前列腺癌
Ali Khatib1, Zizo Al-Daqqaq2, Anna J Black1
1University of British Columbia Department of Urologic Sciences, British Columbia, Canada.
Urologic oncology
|January 31, 2026
概括
在MRI上的损伤密度有效地预测了经过活检的男性临床显著的前列腺癌 (csPCa). 这一指标可以帮助减少不必要的活检,同时最大限度地减少遗漏的csPCa病例.
科学领域:
- 放射学 放射学是一门学科.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
背景情况:
- 前列腺癌的检测依赖于成像和活检.
- 准确预测临床显著的前列腺癌 (csPCa) 对于患者管理至关重要.
- 需要新的成像指标来提高诊断准确度.
研究的目的:
- 评估多参数MRI (mpMRI) 病变密度的预测能力,以确定csPCa.
- 评估在接受针对性前列腺活检的男性中损伤密度的实用性.
主要方法:
- 对接受MRI向活检的患者的回顾性分析 (2019-2023年).
- 损伤密度的计算 (最长的损伤直径/前列腺体积).
- 多变量后勤回归和ROC分析以确定预测值.
主要成果:
- 在csPCa病例中,损伤密度明显高 (0.34 mm/cc) 与非csPCa (0.22 mm/cc) 相比.
- 损伤密度独立预测了csPCa,表现优于PSA密度和年龄 (AUC 0.71).
- 0.15mm/cc的门值可以避免29.2%的活检,其中<10%的遗漏csPCa.
结论:
- 损伤密度是针对性活检中csPCa的独立预测指标.
- 这一指标可以补充PI-RADS和PSA密度,以指导活检.
- 损伤密度为优化前列腺活检决策提供了一个实用的工具.
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