探索多参数定量磁共振成像在避免对 PI-RADS 3-4 患者进行不必要活检方面的价值。

IF 2.2 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Zijian Gong, Fei Jiang, Zhixuan Liu, Zefei Chen, Yun Peng, Jia Qiu, Hongxing Ying, Lianggeng Gong, Jiankun Dai, Yinquan Ye
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引用次数: 0

摘要

目的:验证酰胺质子转移加权(APTw) MRI、弥散峰度成像(DKI)和表观弥散系数(ADC)三种多参数定量序列对前列腺成像报告和数据系统(PI-RADS)核心值为3-4的患者活检决策的增强作用。材料与方法:纳入96例经病理证实的PI-RADS v2.1评分为PI-RADS 3-4分的受试者。2名放射科医师和1名资深放射科医师获得APT、ADC、平均扩散率(MD)和平均峰度(MK)值的平均值。对参数选择进行单因素和多因素logistic回归分析。采用受试者工作特征(ROC)分析来评估模型的性能。采用Delong检验比较各模型的ROC曲线下面积(auc)。计算每个模型避免不必要活检的比例(特异性)和遗漏csPCa的比例(1敏感性)。结果:在PI-RADS 3-4队列中,APT、MD、MK和ADC值诊断csPCa的auc分别为0.730 (95%CI: 0.626, 0.834)、0.682(95%CI: 0.562, 0.802)、0.610(95%CI: 0.482, 0.739)和0.706(95%CI: 0.593, 0.819)。联合模型的AUC为0.851 (95%CI: 0.767, 0.934) (P)结论:结合aptwi - mri、DKI和ADC的新型诊断模型对PI-RADS 3-4病变患者分层活检必要性提供了增加的诊断价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Exploring the value of multiparametric quantitative magnetic resonance imaging in avoiding unnecessary biopsy in patients with PI-RADS 3–4

Exploring the value of multiparametric quantitative magnetic resonance imaging in avoiding unnecessary biopsy in patients with PI-RADS 3–4

Exploring the value of multiparametric quantitative magnetic resonance imaging in avoiding unnecessary biopsy in patients with PI-RADS 3–4

Purpose

To validate the performance of three multiparametric quantitative sequences, including amide proton transfer-weighted (APTw) MRI, diffusion kurtosis imaging (DKI) and apparent diffusion coefficient (ADC), in the enhancement of biopsy decision-making in patients with Prostate Imaging-Reporting and Data System (PI-RADS) core of 3–4.

Materials and methods

A total of 96 participants who scored as PI-RADS 3–4 according to PI-RADS v2.1 and pathologically confirmed were enrolled. The mean of APT, ADC, mean diffusivity (MD) and mean kurtosis (MK) values were acquired by two radiologists and a senior radiologist. The univariate and multivariate logistic regression analyses were performed for parameters selection. Receiver operating characteristic (ROC) analysis was employed to assess the performance of models. The Delong test was applied to compare the area under the ROC curves (AUCs) between models. The proportion of unnecessary biopsies avoided (specificity) and csPCa missed (1-sensitivity) were calculated for each model.

Results

In this PI-RADS 3–4 cohort, the AUCs for the diagnosis of csPCa were 0.730 (95%CI: 0.626, 0.834), 0.682(95%CI: 0.562, 0.802), 0.610(95%CI: 0.482, 0.739) and 0.706(95%CI: 0.593, 0.819) for APT, MD, MK and ADC values, respectively. The combined model yielded the significantly higher AUC of 0.851 (95%CI: 0.767, 0.934) (P < 0.05), and achieved a best trade-off between missing csPCa and avoiding unnecessary biopsy than other models (Youden = 0.615).

Conclusion

A novel diagnostic model incorporating APTw-MRI, DKI and ADC has been shown to provide incremental diagnostic value in stratifying biopsy necessity for patients with PI-RADS 3–4 lesions.

Graphical abstract

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来源期刊
Abdominal Radiology
Abdominal Radiology Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
5.20
自引率
8.30%
发文量
334
期刊介绍: Abdominal Radiology seeks to meet the professional needs of the abdominal radiologist by publishing clinically pertinent original, review and practice related articles on the gastrointestinal and genitourinary tracts and abdominal interventional and radiologic procedures. Case reports are generally not accepted unless they are the first report of a new disease or condition, or part of a special solicited section. Reasons to Publish Your Article in Abdominal Radiology: · Official journal of the Society of Abdominal Radiology (SAR) · Published in Cooperation with: European Society of Gastrointestinal and Abdominal Radiology (ESGAR) European Society of Urogenital Radiology (ESUR) Asian Society of Abdominal Radiology (ASAR) · Efficient handling and Expeditious review · Author feedback is provided in a mentoring style · Global readership · Readers can earn CME credits
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