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多参数MRI与双参数MRI在PSA水平低于10 ng/mL患者首轮认知靶向前列腺穿刺活检中的比较

Comparison of Multiparametric and Biparametric MRI in First Round Cognitive Targeted Prostate Biopsy in Patients with PSA Levels under 10 ng/mL.

作者信息

Lee Dong Hoon, Nam Jong Kil, Lee Seung Soo, Han Ji Yeon, Lee Joon Woo, Chung Moon Kee, Park Sung Woo

机构信息

Department of Urology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.

Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.

出版信息

Yonsei Med J. 2017 Sep;58(5):994-999. doi: 10.3349/ymj.2017.58.5.994.

Abstract

PURPOSE

To determine the efficacy of cognitive targeted prostate biopsy using biparametric magnetic resonance imaging (b-MRI) for patients with prostate-specific antigen levels under 10 ng/mL.

MATERIALS AND METHODS

We reviewed data from 123 consecutive patients who underwent cognitive targeted prostate biopsy using prostate MRI. Of these patients, the first 55 underwent prostate biopsy using multiparametric MRI (mp-MRI), and the remaining 68 underwent prostate biopsy using b-MRI. For b-MRI, we generated T2 weighted axial imaging and diffusion-weighted imaging sequences. We found that 62 of the 123 men had suspicious lesions on MRI (32 of the 55 men in the mp-MRI group and 30 of the 68 men in the b-MRI group). We compared the prostate cancer detection rates and the proportions of clinically significant prostate cancer between the different MRI sequences.

RESULTS

Between the two MRI groups, there were no statistically significant differences in prostate cancer detection rate and proportions of clinically significant prostate cancer (41.8% vs. 30.9%, p=0.208 and 82.6% vs. 76.2%, p=0.598). Among the 62 men who had suspicious lesions on MRI, the prostate cancer detection rates were 62.5% and 63.3% (p=0.709) in the mp-MRI and b-MRI groups, respectively, and the proportions of clinically significant prostate cancer were 95.0% and 84.2% (p=0.267).

CONCLUSION

Prostate biopsy using b-MRI showed similar performance to that using mp-MRI for detecting prostate cancer and clinically significant prostate cancer. Considering the satisfactory performance and cost effectiveness of b-MRI, this technique could be a good option for obtaining intraprostatic information for first round prostate biopsy.

摘要

目的

确定使用双参数磁共振成像(b-MRI)对前列腺特异性抗原水平低于10 ng/mL的患者进行认知靶向前列腺活检的疗效。

材料与方法

我们回顾了123例连续接受前列腺MRI认知靶向前列腺活检患者的数据。在这些患者中,前55例接受了多参数MRI(mp-MRI)引导的前列腺活检,其余68例接受了b-MRI引导的前列腺活检。对于b-MRI,我们生成了T2加权轴位成像和扩散加权成像序列。我们发现123名男性中有62人在MRI上有可疑病变(mp-MRI组的55名男性中有32人,b-MRI组的68名男性中有30人)。我们比较了不同MRI序列之间的前列腺癌检出率和临床显著前列腺癌的比例。

结果

在两个MRI组之间,前列腺癌检出率和临床显著前列腺癌的比例没有统计学显著差异(41.8%对30.9%,p = 0.208;82.6%对76.2%,p = 0.598)。在MRI上有可疑病变的62名男性中,mp-MRI组和b-MRI组的前列腺癌检出率分别为62.5%和63.3%(p = 0.709),临床显著前列腺癌的比例分别为95.0%和84.2%(p = 0.267)。

结论

使用b-MRI进行前列腺活检在检测前列腺癌和临床显著前列腺癌方面表现与使用mp-MRI相似。考虑到b-MRI令人满意的性能和成本效益比,该技术可能是第一轮前列腺活检获取前列腺内信息的一个好选择。

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