Quentin Michael, Schimmöller Lars, Arsov Christian, Rabenalt Robert, Antoch Gerald, Albers Peter, Blondin Dirk
Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Dusseldorf, Germany.
Acta Radiol. 2013 Dec;54(10):1224-9. doi: 10.1177/0284185113492972. Epub 2013 Jul 22.
To estimate potential malignant lesions within the prostate gland, the usage of a scoring system has recently been proposed by a European consensus meeting.
To prospectively investigate a scoring system for functional prostate magnetic resonance imaging (MRI) using in-bore MR-guided prostate biopsy at 3-T.
Prostate MRI examinations of 59 patients (between February 2011 and May 2012) with no known prostate cancer, elevated prostate specific antigen (PSA) level, and unsuspicious digital rectal examination were included in the study. In each patient up to three lesions were defined and scored using a 5-point scoring system for each MR sequence (T2-weighted images, diffusion-weighted imaging, dynamic contrast-enhanced imaging). Following MRI-guided in-bore biopsy these lesions were correlated to the histopathological findings.
A total number of 144 lesions were defined in 59 patients. In 28 patients (51 lesions) MR-guided in-bore biopsy was positive for tumor (Gleason grade 6 or higher). A cut-off limit of 10 or more points in summation of the individual scores of all three sequences was used, leading to a 90% sensitivity, 63% specificity, 58% positive predictive value, and 92% negative predictive value.
A simple 5-point scoring system of functional prostate MRI achieves excellent sensitivity and moderate specificity for directing 3-T-guided prostate biopsy relative to the histopathological findings.
为了评估前列腺内潜在的恶性病变，欧洲共识会议最近提出了一种评分系统的应用。
前瞻性研究一种用于功能性前列腺磁共振成像（MRI）的评分系统，该系统采用3-T场强的磁共振引导下前列腺穿刺活检。
本研究纳入了59例患者（2011年2月至2012年5月期间）的前列腺MRI检查，这些患者无已知前列腺癌，前列腺特异性抗原（PSA）水平升高，且直肠指检无异常。在每位患者中，最多定义三个病变，并使用针对每个磁共振序列（T2加权图像、扩散加权成像、动态对比增强成像）的5分评分系统进行评分。在MRI引导下进行穿刺活检后，将这些病变与组织病理学结果进行关联。
59例患者共定义了144个病变。28例患者（51个病变）的磁共振引导下穿刺活检肿瘤呈阳性（Gleason分级为6级或更高）。使用所有三个序列的个体评分总和为10分或更高作为截断值，其灵敏度为90%，特异性为63%，阳性预测值为58%，阴性预测值为92%。
相对于组织病理学结果，一种简单的功能性前列腺MRI 5分评分系统在指导3-T场强引导下前列腺穿刺活检方面具有出色的灵敏度和中等的特异性。
