Greer Matthew D, Choyke Peter L, Turkbey Baris
Molecular Imaging Program, NCI, NIH, Bethesda, Maryland, USA.
Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA.
J Magn Reson Imaging. 2017 Jul;46(1):11-23. doi: 10.1002/jmri.25645. Epub 2017 Feb 25.
Much criticism has been leveled at screening for prostate cancer using prostate-specific antigen (PSA) testing, yet there is no suitable replacement to improve the detection of clinically significant cancer (CSC). Prostate multiparametric magnetic resonance imaging (mpMRI) combined with mpMRI-guided biopsies is one possible solution, as it reduces detection of low-grade disease and increases detection of CSC. However, mpMRI is critically limited by lack of standardization across institutions and low interobserver agreement. The Prostate Imaging Reporting and Diagnostic System version 2 (PI-RADSv2) aims to address these concerns. We discuss the clinical and technical considerations for implementing PI-RADSv2, how we have adapted to PI-RADSv2, and review current research. While PI-RADSv2 represents a major step forward for standardizing prostate mpMRI, it does not provide a level of standardization that is routine with clinical blood tests and reader reproducibility remains an issue. Future research should seek to further improve quality assurance of mpMRI building on the important contributions of PI-RADSv2.
5 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:11-23.
使用前列腺特异性抗原（PSA）检测筛查前列腺癌受到了诸多批评，但目前尚无合适的替代方法来提高对临床显著癌（CSC）的检测。前列腺多参数磁共振成像（mpMRI）结合mpMRI引导下活检是一种可能的解决方案，因为它减少了低级别疾病的检测，并增加了CSC的检测。然而，mpMRI受到各机构缺乏标准化以及观察者间一致性低的严重限制。前列腺影像报告和诊断系统第2版（PI-RADSv2）旨在解决这些问题。我们讨论了实施PI-RADSv2的临床和技术考虑因素、我们如何适应PI-RADSv2以及回顾当前的研究。虽然PI-RADSv2代表了前列腺mpMRI标准化的一大进步，但它并未提供临床血液检测那样的常规标准化水平，且读者的可重复性仍然是一个问题。未来的研究应在PI-RADSv2的重要贡献基础上，进一步提高mpMRI的质量保证。
5 技术疗效：2期 J. MAGN. RESON. IMAGING 2017;46:11 - 23.
