Division of Surgical and Interventional Sciences, University College London, London, UK.
Eur Urol. 2013 Oct;64(4):544-52. doi: 10.1016/j.eururo.2013.03.030. Epub 2013 Mar 20.
A systematic literature review of magnetic resonance imaging (MRI)-targeted prostate biopsy demonstrates poor adherence to the Standards for the Reporting of Diagnostic Accuracy (STARD) recommendations for the full and transparent reporting of diagnostic studies.
To define and recommend Standards of Reporting for MRI-targeted Biopsy Studies (START).
DESIGN, SETTING, AND PARTICIPANTS: Each member of a panel of 23 experts in urology, radiology, histopathology, and methodology used the RAND/UCLA appropriateness methodology to score a 258-statement premeeting questionnaire. The collated responses were presented at a face-to-face meeting, and each statement was rescored after group discussion.
Measures of agreement and consensus were calculated for each statement. The most important statements, based on group median score, the degree of group consensus, and the content of the group discussion, were used to create a checklist of reporting criteria (the START checklist).
The strongest recommendations were to report histologic results of standard and targeted cores separately using Gleason score and maximum cancer core length. A table comparing detection rates of clinically significant and clinically insignificant disease by targeted and standard approaches should also be used. It was recommended to report the recruitment criteria for MRI-targeted biopsy, prior biopsy status of the population, a brief description of the MRI sequences, MRI reporting method, radiologist experience, and image registration technique. There was uncertainty about which histologic criteria constitute clinically significant cancer when the prostate is sampled using MRI-targeted biopsy, and it was agreed that a new definition of clinical significance in this setting needed to be derived in future studies.
Use of the START checklist would improve the quality of reporting in MRI-targeted biopsy studies and facilitate a comparison between standard and MRI-targeted approaches.
对磁共振成像（MRI）靶向前列腺活检的系统文献回顾表明，在充分和透明报告诊断研究的标准（STARD）建议方面，对这些建议的遵循情况不佳。
定义并推荐 MRI 靶向活检研究的报告标准（START）。
设计、设置和参与者：一个由 23 名泌尿科、放射科、组织病理学和方法学专家组成的小组的每个成员都使用 RAND/UCLA 适宜性方法对 258 项会前调查问卷进行评分。整理后的答复在面对面会议上提出，在小组讨论后对每项声明进行重新评分。
为每个声明计算了一致性和共识度量。根据小组中位数评分、小组共识程度以及小组讨论的内容，最重要的声明用于创建报告标准清单（即 START 清单）。
最强烈的建议是分别使用 Gleason 评分和最大癌核心长度报告标准和靶向核心的组织学结果。还应该使用比较靶向和标准方法检测临床显著和临床不显著疾病的检出率的表格。建议报告 MRI 靶向活检的招募标准、人群的先前活检状况、简要描述 MRI 序列、MRI 报告方法、放射科医生的经验和图像注册技术。当使用 MRI 靶向活检对前列腺进行采样时，哪种组织学标准构成临床显著癌症存在不确定性，并且一致认为需要在未来的研究中在这种情况下定义临床意义的新定义。
使用 START 清单将提高 MRI 靶向活检研究的报告质量，并促进标准和 MRI 靶向方法之间的比较。
