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在焦点切除后的前列腺成像 (PI-FAB) 和跨大西洋前列腺评估建议 (TARGET) 的比较,用于在焦点治疗后检测前列腺癌复发前列腺磁共振成像 (MRI)
Denzel Zhu1, Kamil Malshy1, Zijing Cheng1
1Department of Urology, University of Rochester Medical Center, Rochester, NY.
Clinical genitourinary cancer
|March 10, 2026
概括
对前列腺癌监测的焦点治疗具有挑战性. 目前的PI-FAB和TARGETMRI评分系统显示敏感性有限,但在焦点治疗后检测复发时具有高负预测值.
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:
- 焦点治疗 (FT) 为中等风险前列腺癌 (PCa) 提供了一种节约组织的方法.
- 在多参数MRI (mpMRI) 上区分FT后纤维化与残留瘤使监测复杂化.
- PI-FAB和TARGET评分系统旨在改善临床上显著的PCa (cs-PCa) 复发的检测.
研究的目的:
- 为了比较PI-FAB和TARGET评分系统的诊断性能.
- 在现实环境中验证这些系统,以检测FT后的CS-PCa复发现场中.
主要方法:
- 从2019年到2023年对111名接受FT (HIFU或冷疗法) 的男性进行了回顾性审查.
- 对31名FT后mpMRI和活检的男性进行分析,使用PI-FAB和TARGET系统得分.
- 主要结局:在活检上检测现场的cs-PCa (等级组≥2);计算诊断准确度指标.
主要成果:
- 八名男性 (26%) 在活检时出现了cs-PCa,其中5人 (16%) 在实地复发.
- 在PI-FAB和TARGET系统中,准确度不高 (AUC为0.66和0.62).
- 敏感度: 60% (PI-FAB) 与40% (TARGET) 相比; 具体性: 73% 与85% 相比; PPV: 30% 与33% 相比; NPV: 90% 与88% 相比.
结论:
- PI-FAB和TARGET的mpMRI评分系统的灵敏度有限,但在现场检测cs-PCa复发时的NPV很高.
- 当前的mpMRI解释协议在FT后有局限性.
- 需要改进的监测工具来指导焦点治疗后的活检决策.
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