全身磁共振成像为高危前列腺癌患者分期

IF 5.1 2区 医学 Q1 ONCOLOGY
Andrew M. Fang, Brian F. Chapin, Charles W. Shi, Jia Sun, Aliya Qayyum, Vikas Kundra, Paul G. Corn, Deborah A. Kuban, Gregory C. Ravizzini, Devaki Shilpa S. Surasi, Jingfei Ma, Tharakeswara K. Bathala
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引用次数: 0

摘要

背景用计算机断层扫描(CT)和骨闪烁扫描(BS)等传统成像方法对高危前列腺癌(HRPCa)患者进行分期并不理想。因此,我们旨在比较全身磁共振成像(WBMRI)与传统成像对 HRPCa 患者进行分期的准确性。方法我们前瞻性地招募了新诊断的 HRPCa 患者(前列腺特异性抗原≥20 ng/ml 和/或分级组≥4)。患者在评估后 30 天内接受 BS、腹部和盆腔 CT 以及 WBMRI 检查。主要终点是WBMRI和传统成像检测淋巴结和骨转移性疾病的诊断效果。参考标准由组织病理学或随访 6 个月时所有可用的临床信息确定。为了比较诊断测试,采用了精确麦克尼马检验和接收者操作特征曲线下面积(AUC)。WBMRI检测淋巴转移的敏感性、特异性和准确性分别为0.60(95%置信区间0.32-0.84)、0.84(0.74-0.92)和0.80(0.71-0.88),而CT则分别为0.20(0.04-0.48)、0.92(0.84-0.97)和0.80(0.71-0.88)。WBMRI检测骨转移的敏感性、特异性和准确性分别为0.25(0.03-0.65)、0.94(0.87-0.98)和0.88(0.80-0.94),而CT和BS分别为0.12(0-0.53)、0.94(0.87-0.98)和0.87(0.78-0.93)。结论对于HRPCa患者的分期,WBMRI在检测淋巴转移方面优于CT,在检测骨转移方面与CT和BS一样出色。还需要进一步的研究来评估 WBMRI 的成本效益以及 PSMA PET 和 WBMRI 联合应用的效用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Whole-body magnetic resonance imaging for staging patients with high-risk prostate cancer

Whole-body magnetic resonance imaging for staging patients with high-risk prostate cancer

Background

Staging patients with high-risk prostate cancer (HRPCa) with conventional imaging of computed tomography (CT) and bone scintigraphy (BS) is suboptimal. Therefore, we aimed to compare the accuracy of whole-body magnetic resonance imaging (WBMRI) with conventional imaging to stage patients with HRPCa.

Methods

We prospectively enrolled patients with newly diagnosed HRPCa (prostate‐specific antigen ≥20 ng/ml and/or Grade Group ≥4). Patients underwent BS, CT of the abdomen and pelvis, and WBMRI within 30 days of evaluation. The primary endpoint was the diagnostic performances of detecting metastatic disease to the lymph nodes and bone for WBMRI and conventional imaging. The reference standard was defined by histopathology or by all available clinical information at 6 months of follow-up. To compare diagnostic tests, Exact McNemar’s test and area under the curve (AUC) of the receiver operating characteristics curves were utilized.

Results

Among 92 patients enrolled, 15 (16.3%) and 8 (8.7%) patients were found to have lymphatic and bone metastases, respectively. The sensitivity, specificity, and accuracy of WBMRI in detecting lymphatic metastases were 0.60 (95% confidence interval 0.32–0.84), 0.84 (0.74–0.92), and 0.80 (0.71–0.88), respectively, while CT were 0.20 (0.04–0.48), 0.92 (0.84–0.97), and 0.80 (0.71–0.88). The sensitivity, specificity, and accuracy of WBMRI to detect bone metastases were 0.25 (0.03–0.65), 0.94 (0.87–0.98), and 0.88 (0.80–0.94), respectively, while CT and BS were 0.12 (0–0.53), 0.94 (0.87–0.98), and 0.87 (0.78–0.93). For evaluating lymphatic metastases, WBMRI demonstrated a higher sensitivity (p = 0.031) and discrimination compared to CT (0.72 versus 0.56, p = 0.019).

Conclusions

For staging patients with HRPCa, WBMRI outperforms CT in the detection of lymphatic metastases and performs as well as CT and BS in the detection of bone metastases. Further studies are needed to assess the cost effectiveness of WBMRI and the utility of combined PSMA PET and WBMRI.

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来源期刊
Prostate Cancer and Prostatic Diseases
Prostate Cancer and Prostatic Diseases 医学-泌尿学与肾脏学
CiteScore
10.00
自引率
6.20%
发文量
142
审稿时长
6-12 weeks
期刊介绍: Prostate Cancer and Prostatic Diseases covers all aspects of prostatic diseases, in particular prostate cancer, the subject of intensive basic and clinical research world-wide. The journal also reports on exciting new developments being made in diagnosis, surgery, radiotherapy, drug discovery and medical management. Prostate Cancer and Prostatic Diseases is of interest to surgeons, oncologists and clinicians treating patients and to those involved in research into diseases of the prostate. The journal covers the three main areas - prostate cancer, male LUTS and prostatitis. Prostate Cancer and Prostatic Diseases publishes original research articles, reviews, topical comment and critical appraisals of scientific meetings and the latest books. The journal also contains a calendar of forthcoming scientific meetings. The Editors and a distinguished Editorial Board ensure that submitted articles receive fast and efficient attention and are refereed to the highest possible scientific standard. A fast track system is available for topical articles of particular significance.
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