Borkowetz Angelika, Platzek Ivan, Toma Marieta, Renner Theresa, Herout Roman, Baunacke Martin, Laniado Michael, Baretton Gustavo B, Froehner Michael, Zastrow Stefan, Wirth Manfred P
Department of Urology, Technische Universitaet Dresden, Dresden, Germany.
Urol Int. 2017;99(2):177-185. doi: 10.1159/000477263. Epub 2017 May 23.
The study aimed to evaluate the prediction of Prostate Imaging Reporting and Data System (PI-RADS) with respect to the prostate cancer (PCa) detection rate and tumor aggressiveness in magnetic resonance imaging (MRI)/ultrasound-fusion-biopsy (fusPbx) and in systematic biopsy (sysPbx).
Six hundred and twenty five patients undergoing multiparametric MRI were investigated. MRI findings were classified using PI-RADS v1 or v2. All patients underwent fusPbx combined with sysPbx (comPbx). The lesion with the highest PI-RADS was defined as maximum PI-RADS (maxPI-RADS). Gleason Score ≥7 (3 + 4) was defined as significant PCa.
The overall PCa detection rate was 51% (n = 321; 39% significant PCa). The detection rate was 43% in fusPbx (n = 267; 34% significant PCa) and 36% in sysPbx (n = 223; 27% significant PCa). Nine percentage of significant PCa were detected by sysPbx alone. A total of 1,162 lesions were investigated. The detection rate of significant PCa in lesions with PI-RADS 2, 3, 4, and 5 were 9% (18/206), 12% (56/450), 27% (98/358), and 61% (90/148) respectively. maxPI-RADS ≥4 was the strongest predictor for the detection of significant PCa in comPbx (OR 2.77; 95% CI 1.81-4.24; p < 0.005).
maxPI-RADS is the strongest predictor for the detection of significant PCa in comPbx. Due to a high detection rate of additional significant PCa in sysPbx, fusPbx should still be combined with sysPbx.
本研究旨在评估前列腺影像报告和数据系统（PI-RADS）在磁共振成像（MRI）/超声融合活检（fusPbx）和系统活检（sysPbx）中对前列腺癌（PCa）检出率及肿瘤侵袭性的预测价值。
对625例行多参数MRI检查的患者进行研究。MRI检查结果根据PI-RADS v1或v2进行分类。所有患者均接受fusPbx联合sysPbx（comPbx）。将PI-RADS评分最高的病灶定义为最大PI-RADS（maxPI-RADS）。 Gleason评分≥7（3 + 4）定义为有临床意义的PCa。
总体PCa检出率为51%（n = 321；39%为有临床意义的PCa）。fusPbx的检出率为43%（n = 267；34%为有临床意义的PCa），sysPbx的检出率为36%（n = 223；27%为有临床意义的PCa）。仅通过sysPbx检出了9%有临床意义的PCa。共检查了1162个病灶。PI-RADS 2、3、4和5类病灶中有临床意义的PCa检出率分别为9%（18/206）、12%（56/450）、27%（98/358）和61%（90/148）。maxPI-RADS≥4是comPbx中有临床意义的PCa检出的最强预测指标（OR 2.77；95%CI 1.81 - 4.24；p < 0.005）。
maxPI-RADS是comPbx中有临床意义的PCa检出的最强预测指标。由于sysPbx对额外有临床意义的PCa有较高的检出率，fusPbx仍应与sysPbx联合使用。
