Arsov C, Blondin D, Rabenalt R, Antoch G, Albers P, Quentin M
Klinik für Urologie, Universitätsklinikum Düsseldorf, Düsseldorf.
Urologe A. 2012 Jun;51(6):848-56. doi: 10.1007/s00120-012-2825-6.
The use of multi-parametric MRI and MRI-guided biopsy for the detection of prostate cancer is rapidly increasing. This is a pilot study to evaluate the consensus-based international MRI scoring system as decision criterion for targeted MRI-guided prostate biopsy.
After a multi-parametric 3-T MRI (T2-weighted imaging, diffusion-weighted imaging, and dynamic contrast-enhanced MRI) in 23 consecutive patients a total of 47 lesions were scored according to a 5-point scale for each MRI sequence. A total score of ≥ 10 points was considered to be suspicious for prostate cancer. All 47 lesions were histologically assessed after MRI-guided biopsy.
At the cut-off score of 10 points, sensitivity, specificity, negative predictive value and positive predictive value of multi-parametric MRI were 94.1, 43.3, 92.9 and 48.5%, respectively.
A standardised scoring of lesions on multi-parametric MRI is feasible. The cut-off value leads to excellent values for sensitivity and negative predictive value. The values for specificity and positive predictive value are modest. Lesions with a total score <10 points are very unlikely to be malignant.
多参数磁共振成像（MRI）和MRI引导下活检在前列腺癌检测中的应用正在迅速增加。这是一项初步研究，旨在评估基于共识的国际MRI评分系统作为MRI引导下靶向前列腺活检的决策标准。
对23例连续患者进行多参数3-T MRI（T2加权成像、扩散加权成像和动态对比增强MRI）检查后，根据每个MRI序列的5分制对总共47个病灶进行评分。总分≥10分被认为可疑为前列腺癌。在MRI引导下活检后，对所有47个病灶进行组织学评估。
在截断分数为10分时，多参数MRI的敏感性、特异性、阴性预测值和阳性预测值分别为94.1%、43.3%、92.9%和48.5%。
对多参数MRI上的病灶进行标准化评分是可行的。截断值导致敏感性和阴性预测值的良好结果。特异性和阳性预测值的结果一般。总分<10分的病灶极不可能是恶性的。
