Division of Surgery and Interventional Science, University College London, London, UK.
Eur Urol. 2011 Apr;59(4):477-94. doi: 10.1016/j.eururo.2010.12.009. Epub 2010 Dec 21.
Multiparametric magnetic resonance imaging (mpMRI) may have a role in detecting clinically significant prostate cancer in men with raised serum prostate-specific antigen levels. Variations in technique and the interpretation of images have contributed to inconsistency in its reported performance characteristics.
Our aim was to make recommendations on a standardised method for the conduct, interpretation, and reporting of prostate mpMRI for prostate cancer detection and localisation.
DESIGN, SETTING, AND PARTICIPANTS: A consensus meeting of 16 European prostate cancer experts was held that followed the UCLA-RAND Appropriateness Method and facilitated by an independent chair.
Before the meeting, 520 items were scored for "appropriateness" by panel members, discussed face to face, and rescored.
Agreement was reached in 67% of 260 items related to imaging sequence parameters. T2-weighted, dynamic contrast-enhanced, and diffusion-weighted MRI were the key sequences incorporated into the minimum requirements. Consensus was also reached on 54% of 260 items related to image interpretation and reporting, including features of malignancy on individual sequences. A 5-point scale was agreed on for communicating the probability of malignancy, with a minimum of 16 prostatic regions of interest, to include a pictorial representation of suspicious foci. Limitations relate to consensus methodology. Dominant personalities are known to affect the opinions of the group and were countered by a neutral chairperson.
Consensus was reached on a number of areas related to the conduct, interpretation, and reporting of mpMRI for the detection, localisation, and characterisation of prostate cancer. Before optimal dissemination of this technology, these outcomes will require formal validation in prospective trials.
多参数磁共振成像（mpMRI）可能在检测血清前列腺特异性抗原（PSA）水平升高的男性中具有临床意义的前列腺癌方面发挥作用。技术的变化和图像的解释导致其报告的性能特征不一致。
我们旨在就用于检测和定位前列腺癌的前列腺 mpMRI 的进行、解释和报告的标准化方法提出建议。
设计、设置和参与者：一次由 16 名欧洲前列腺癌专家参加的共识会议按照加州大学洛杉矶分校-兰德适宜性方法进行，并由一名独立主席协助。
在会议之前，通过面板成员对 520 个项目进行了“适宜性”评分，然后进行了面对面讨论和重新评分。
在与成像序列参数相关的 260 个项目中，有 67%达成了一致。T2 加权、动态对比增强和弥散加权 MRI 是纳入最低要求的关键序列。在与图像解释和报告相关的 260 个项目中，也达成了 54%的共识，包括各序列上恶性肿瘤的特征。还就沟通恶性肿瘤概率的 5 分制达成了一致意见，最低需要 16 个前列腺感兴趣区，包括可疑病灶的图像表示。局限性在于共识方法。众所周知，主导人格会影响小组的意见，并通过中立主席加以抵消。
在 mpMRI 的进行、解释和报告的多个方面达成了共识，用于检测、定位和特征描述前列腺癌。在这种技术得到最佳传播之前，这些结果需要在前瞻性试验中进行正式验证。
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