Reevaluatıng Pı-rads 3 Lesıons Upgraded to 4: The Emergence of a New Subgroup?

IF 3.4 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Diğdem Kuru Öz, Sezer Nil Yılmazer Zorlu, Zeynep Eskalen, Nuray Haliloğlu, Ayşe Erden
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引用次数: 0

Abstract

Objectives: The study aims to evaluate PI-RADS 4 lesions, including those with primary diffusion restriction (diffusion-weighted imaging score 4) and those upgraded from PI-RADS 3 due to positive dynamic contrast-enhanced findings, and to compare outcomes between these groups while also assessing cancer detection rates and prostatitis between upgraded cases and PI-RADS 3 lesions.

Methods: In this single-center cohort study, peripheral zone lesions classified as PI-RADS 3 and 4 by multiparametric magnetic resonance imaging (MRI) and biopsied via MRI/Transrectal ultrasound-guided targeted biopsy were analyzed.

Results: Of 420 peripheral zone lesions from 272 patients, 202 were PI-RADS 3, 81 PI-RADS 3 + 1, and 137 PI-RADS 4. Cancer detection rates significantly differed between PI-RADS 3 + 1 and PI-RADS 4 (38.3% vs 73% for overall cancer; 6.2% vs 30.7% for clinically significant cancer, p < 0.001). PI-RADS 3 + 1 lesions had significantly higher cancer detection rates than PI-RADS 3 lesions (38.3% vs 19.8%, p = 0.001). Prostatitis was significantly more prevalent in PI-RADS 3 (34.7%) and PI-RADS 3 + 1 (29.6%) than in PI-RADS 4 (10.9%) lesions (p < 0.001).

Conclusion: PI-RADS 3 + 1 lesions show significantly different cancer detection rates from both PI-RADS 3 and 4, suggesting they should be managed as a distinct entity. Higher prevalence of prostatitis in PI-RADS 3 + 1 lesions indicates that clinical evaluation for inflammatory conditions may help reduce unnecessary biopsies in this subgroup.

Advances in knowledge: PI-RADS 3 + 1 lesions show higher cancer detection than PI-RADS 3 but lower than PI-RADS 4, and are more frequently associated with prostatitis than PI-RADS 4. These findings support individualized management to avoid unnecessary biopsies.

Reevaluatıng Pı-rads 3 Lesıons升级到4:一个新的子组的出现?
目的:本研究旨在评估PI-RADS 4级病变,包括原发性弥散受限(弥散加权成像评分为4分)和PI-RADS 3级病变因动态增强结果阳性而升级的病变,并比较两组之间的结果,同时评估升级病例与PI-RADS 3级病变之间的癌症检出率和前列腺炎。方法:在本单中心队列研究中,分析经多参数磁共振成像(MRI)分类为PI-RADS 3和4的外周区病变,并通过MRI/经直肠超声引导的靶向活检进行活检。结果:272例患者420例外周区病变中,PI-RADS 3型病变202例,PI-RADS 3 + 1型病变81例,PI-RADS 4型病变137例。PI-RADS 3 + 1和PI-RADS 4的癌症检出率显著差异(38.3% vs 73%);结论:PI-RADS 3 + 1病变与PI-RADS 3和4病变的肿瘤检出率存在显著差异,提示应将其作为一个独立的实体进行管理。前列腺炎在PI-RADS 3 + 1病变中的较高患病率表明,对炎症状况的临床评估可能有助于减少该亚组中不必要的活检。知识进展:PI-RADS 3 + 1病变的癌检出率高于PI-RADS 3,但低于PI-RADS 4,且与前列腺炎的相关性高于PI-RADS 4。这些发现支持个体化治疗以避免不必要的活检。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
British Journal of Radiology
British Journal of Radiology 医学-核医学
CiteScore
5.30
自引率
3.80%
发文量
330
审稿时长
2-4 weeks
期刊介绍: BJR is the international research journal of the British Institute of Radiology and is the oldest scientific journal in the field of radiology and related sciences. Dating back to 1896, BJR’s history is radiology’s history, and the journal has featured some landmark papers such as the first description of Computed Tomography "Computerized transverse axial tomography" by Godfrey Hounsfield in 1973. A valuable historical resource, the complete BJR archive has been digitized from 1896. Quick Facts: - 2015 Impact Factor – 1.840 - Receipt to first decision – average of 6 weeks - Acceptance to online publication – average of 3 weeks - ISSN: 0007-1285 - eISSN: 1748-880X Open Access option
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