Division of Urology, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, University of Toronto, Toronto, Canada.
Division of Urology, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, University of Toronto, Toronto, Canada.
J Urol. 2016 Aug;196(2):361-6. doi: 10.1016/j.juro.2016.01.114. Epub 2016 Feb 13.
To our knowledge the role of magnetic resonance imaging as a first line screening test for prostate cancer is unknown. We performed a pilot study to evaluate the feasibility of prostate magnetic resonance imaging as the primary screening test for prostate cancer.
We recruited unselected men from the general population. Prostate multiparametric magnetic resonance imaging and random or targeted biopsies were performed in all patients, in addition to prostate specific antigen testing. We compared the performance of prostate magnetic resonance imaging and prostate specific antigen test results to predict prostate cancer.
Of the 47 recruited patients 18 (38.3%) had cancer while 29 (61.7%) had no evidence of cancer. The adjusted OR of prostate cancer was significantly higher for magnetic resonance imaging score than for prostate specific antigen level (2.7, 95% CI 1.4-5.4, p = 0.004 vs 1.1, 95% CI 0.9-1.4, p = 0.21). Among the 30 patients with a normal prostate specific antigen (less than 4.0 ng/ml) the positive predictive value in those with a magnetic resonance imaging score of 4 or more was 66.7% (6 of 9) and the negative predictive value in those with a magnetic resonance imaging score of 3 or less was 85.7% (18 of 21, p = 0.004).
In this pilot study we determined the feasibility of using multiparametric prostate magnetic resonance imaging as the primary screening test for prostate cancer. Initial results showed that prostate magnetic resonance imaging was better to predict prostate cancer than prostate specific antigen in an unselected sample of the general population.
据我们所知，磁共振成像作为前列腺癌一线筛查试验的作用尚不清楚。我们进行了一项初步研究，以评估前列腺磁共振成像作为前列腺癌主要筛查试验的可行性。
我们从普通人群中招募了未经选择的男性。所有患者均进行前列腺多参数磁共振成像和随机或靶向活检，并进行前列腺特异性抗原检测。我们比较了前列腺磁共振成像和前列腺特异性抗原检测结果预测前列腺癌的性能。
在 47 名招募的患者中，18 名（38.3%）患有癌症，而 29 名（61.7%）无癌症证据。调整后的磁共振成像评分与前列腺特异性抗原水平相比，前列腺癌的调整比值比显著更高（2.7，95%置信区间 1.4-5.4，p = 0.004 与 1.1，95%置信区间 0.9-1.4，p = 0.21）。在前列腺特异性抗原正常（<4.0ng/ml）的 30 名患者中，磁共振成像评分 4 分或以上的阳性预测值为 66.7%（9 例中的 6 例），磁共振成像评分 3 分或以下的阴性预测值为 85.7%（21 例中的 18 例，p = 0.004）。
在这项初步研究中，我们确定了使用多参数前列腺磁共振成像作为前列腺癌主要筛查试验的可行性。初步结果表明，在普通人群的未选择样本中，前列腺磁共振成像比前列腺特异性抗原更能预测前列腺癌。
