双参数前列腺MRI:一种实用的实施方法和比较分析。

IF 2.9 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Olivia Muhn, Darya Kurowecki, Michael N Patlas, Abdullah Alabousi
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引用次数: 0

摘要

前列腺癌(PCa)仍然是世界范围内男性癌症相关发病率和死亡率的主要原因。多参数MRI (mpMRI)是目前PCa检测、诊断和主动监测的金标准。然而,它对动态对比度增强(DCE)成像的依赖带来了安全问题、更高的成本和更长的扫描时间。省略DCE的双参数MRI (bpMRI)已成为保留t2加权和弥散加权成像的流线型替代方案。本文综述了bpMRI与mpMRI相比的技术考虑、诊断性能、临床应用和局限性。我们评估了bpMRI在检测临床显著性前列腺癌(csPCa)方面的敏感性、特异性和阴性预测值,强调了其在患者安全性、可及性和成本效益方面的优势。尽管有很好的发现,bpMRI的广泛临床应用受到成像方案的可变性、有限的大规模验证以及对遗漏的细微病变的担忧的阻碍。未来的发展方向包括标准化bpMRI协议,整合人工智能和生物标志物,以及开展多中心试验以确定其在PCa管理中的作用。bpMRI作为一种可靠、高效的成像工具具有巨大的潜力,可以在特定的临床背景下补充或取代mpMRI。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Biparametric Prostate MRI: A Practical Approach to Implementation and Comparative Analysis.

Prostate cancer (PCa) remains a leading cause of cancer-related morbidity and mortality among men worldwide. Multiparametric MRI (mpMRI) is currently the gold standard for PCa detection, diagnosis, and active surveillance. However, its reliance on dynamic contrast-enhanced (DCE) imaging introduces safety concerns, higher costs, and longer scan times. Biparametric MRI (bpMRI), which omits DCE, has emerged as a streamlined alternative that retains T2-weighted and diffusion-weighted imaging. This review critically examines the technical considerations, diagnostic performance, clinical applications, and limitations of bpMRI compared to mpMRI. We evaluate bpMRI's sensitivity, specificity, and negative predictive value in detecting clinically significant prostate cancer (csPCa), highlighting its advantages in terms of patient safety, accessibility, and cost-effectiveness. Despite promising findings, the widespread clinical adoption of bpMRI is hindered by variability in imaging protocols, limited large-scale validation, and concerns over missed subtle lesions. Future directions include standardizing bpMRI protocols, integrating artificial intelligence and biomarkers, and conducting multi-centre trials to establish its role in PCa management. bpMRI holds significant potential as a reliable and efficient imaging tool that could complement or replace mpMRI in select clinical contexts.

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来源期刊
CiteScore
6.20
自引率
12.90%
发文量
98
审稿时长
6-12 weeks
期刊介绍: The Canadian Association of Radiologists Journal is a peer-reviewed, Medline-indexed publication that presents a broad scientific review of radiology in Canada. The Journal covers such topics as abdominal imaging, cardiovascular radiology, computed tomography, continuing professional development, education and training, gastrointestinal radiology, health policy and practice, magnetic resonance imaging, musculoskeletal radiology, neuroradiology, nuclear medicine, pediatric radiology, radiology history, radiology practice guidelines and advisories, thoracic and cardiac imaging, trauma and emergency room imaging, ultrasonography, and vascular and interventional radiology. Article types considered for publication include original research articles, critically appraised topics, review articles, guest editorials, pictorial essays, technical notes, and letter to the Editor.
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