我们能依靠磁共振成像检测前列腺癌并制定手术计划吗?对一大批接受经会阴映射活检的患者进行综合分析。

IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY
Nidia Gómez Diez, Pedro de Pablos-Rodríguez, David Sánchez-Mateos Manzaneque, María Isabel Martín García, Paula Pelechano Gómez, María Barrios Benito, Ana Calatrava Fons, Jessica Aliaga Patiño, Juan Boronat Catalá, Álvaro Gómez-Ferrer Lozano, Augusto Wong Gutiérrez, Ángel García Cortés, Miguel Ramírez Backhaus, Juan Casanova Ramón Borja, Manel Beamud Cortés, José Luis Domínguez Escrig, Antonio Coy García
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引用次数: 0

摘要

目的:评估通过映射经会阴活检鉴定前列腺癌(PCa)的核磁共振成像和组织学一致性:利用 CAPROSIVO PCa 数据,对巴伦西亚肿瘤研究所(2016-2024 年)接受 MRI 和经会阴活检的患者进行每个病灶的回顾性分析。患者接受了带或不带感兴趣区(ROI)的核磁共振成像检查,随后接受了经会阴活检(3-5个核/ROI,20-30个系统性活检)。计算灵敏度(Se)、特异度(Sp)、阴性预测值(NPV)、阳性预测值(PPV)和曲线下面积(AUC),将 PI-RADS 3 病变视为阳性或阴性。格里森分级组(GG)> 1 定义为有临床意义的 PCa(csPCa):对 1325 名患者(中位年龄 67 岁,中位 PSA 6.3 纳克/毫升)的 1817 个病灶进行了分析。53%的磁共振成像呈阴性,GG>1的发生率为38.4%。MRI 阴性病例的 PCa 发生率各不相同:57.4% 阴性,30.2% GG 1,12.4% GG > 1。PI-RADS 3病变的结果不一:45.6%为良性,13.1%为GG 1,41.3%为GG > 1。9.2% 的 PI-RADS 4-5 病变为阴性,9% 为 GG 1,81.7% 为 GG > 1。对于 PI-RADS 3 阳性病变,Se、Sp、NPV、PPV 和 AUC 分别为 82.9%、75%、87.6%、67.4% 和 0.79。如果将 PI-RADS 3 视为阴性,则 Se 为 64.8%,Sp 为 91%,NPV 为 80.6%,PPV 为 81.7%,AUC 为 0.78:结论:核磁共振成像和前列腺活检图显示出中等程度的一致性。磁共振成像可能会漏诊五分之一的 csPCa 病灶,误判三分之一的 ROI。谨慎的 MRI 解读对于优化患者护理至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Can we rely on magnetic resonance imaging for prostate cancer detection and surgical planning? Comprehensive analysis of a large cohort of patients undergoing transperineal mapped biopsies.

Purpose: To evaluate MRI and histological concordance in prostate cancer (PCa) identification via mapped transperineal biopsies.

Methodology: Retrospective per-lesion analysis of patients undergoing MRI and transperineal biopsy at the Valencian Institute of Oncology (2016-2024) using CAPROSIVO PCa data. Patients underwent MRI, with or without regions of interest (ROI), followed by transperineal biopsies (3-5 cores/ROI, 20-30 systematic). Sensitivity (Se), specificity (Sp), negative predictive value (NPV), positive predictive value (PPV), and area under the curve (AUC) were calculated, considering PI-RADS 3 lesions as positive or negative. Gleason Grade Group (GG) > 1 defined clinically significant PCa (csPCa).

Results: 1817 lesions were analyzed from 1325 patients (median age 67, median PSA 6.3 ng/ml). 53% MRI were negative, GG > 1 prevalence was 38.4%. MRI-negative cases showed varying PCa rates: 57.4% negative, 30.2% GG 1, and 12.4% GG > 1. PI-RADS 3 lesions had mixed outcomes: 45.6% benign, 13.1% GG 1, and 41.3% GG > 1. 9.2% PI-RADS 4-5 lesions were negative, 9% GG 1, and 81.7% GG > 1. For PI-RADS 3 lesions considered positive, Se, Sp, NPV, PPV, and AUC were 82.9%, 75%, 87.6%, 67.4%, and 0.79 respectively. Considering PI-RADS 3 as negative yielded 64.8% Se, 91% Sp, 80.6% NPV, 81.7% PPV, and 0.78 AUC.

Conclusion: MRI and mapped prostate biopsies exhibited moderate concordance. MRI could miss up to one in five csPCa foci and misinterpret one in three ROIs. Careful MRI interpretation is crucial for optimizing patient care.

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来源期刊
World Journal of Urology
World Journal of Urology 医学-泌尿学与肾脏学
CiteScore
6.80
自引率
8.80%
发文量
317
审稿时长
4-8 weeks
期刊介绍: The WORLD JOURNAL OF UROLOGY conveys regularly the essential results of urological research and their practical and clinical relevance to a broad audience of urologists in research and clinical practice. In order to guarantee a balanced program, articles are published to reflect the developments in all fields of urology on an internationally advanced level. Each issue treats a main topic in review articles of invited international experts. Free papers are unrelated articles to the main topic.
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