College of Medicine & Health, University of Exeter, Exeter, UK.
Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK.
J Am Coll Radiol. 2020 Apr;17(4):486-495. doi: 10.1016/j.jacr.2019.08.031. Epub 2019 Sep 18.
To identify and characterize patient-centered outcomes (PCOs) relating to multiparametric MRI (mpMRI) and MRI-guided biopsy as diagnostic tests for possible prostate cancer.
Medline via OVID, EMBASE, PsycInfo, and the Cochrane Central register of Controlled Trials (CENTRAL) were searched for relevant articles. Hand searching of reference lists and snowballing techniques were performed. Studies of mpMRI and MRI-guided biopsy that measured any PCO were included. There were no restrictions placed on year of publication, language, or country for study inclusion. All database search hits were screened independently by two reviewers, and data were extracted using a standardized form.
Overall, 2,762 database search hits were screened based on title and abstract. Of these, 222 full-text articles were assessed, and 10 studies met the inclusion criteria. There were 2,192 participants featured in the included studies, all of which were conducted in high-income countries. Nineteen different PCOs were measured, with a median of four PCOs per study (range 1-11). Urethral bleeding, pain, and urinary tract infection were the most common outcomes measured. In the four studies that compared mpMRI or MRI-guided biopsy to transrectal ultrasound biopsy, most adverse outcomes occurred less frequently in MRI-related tests. These four studies were assessed as having a low risk of bias.
PCOs measured in studies of mpMRI or MRI-guided biopsy thus far have mostly been physical outcomes, with some evidence that MRI tests are associated with less frequent adverse outcomes compared with transrectal ultrasound biopsy. There was very little evidence for the effect of mpMRI and MRI-guided biopsy on emotional, cognitive, social, or behavioral outcomes.
确定并描述与多参数磁共振成像（mpMRI）和 MRI 引导下活检相关的以患者为中心的结局（PCOs），这些结局将作为可能的前列腺癌的诊断测试。
通过 OVID Medline、EMBASE、PsycInfo 和 Cochrane 对照试验中心注册库（CENTRAL）检索相关文章。对手册搜索和滚雪球技术进行了检索。纳入了测量任何 PCO 的 mpMRI 和 MRI 引导下活检的研究。对研究纳入没有对发表年份、语言或国家进行限制。使用标准化表格独立筛选所有数据库搜索结果，并提取数据。
总体而言，根据标题和摘要筛选了 2762 个数据库搜索结果。其中，有 222 篇全文文章进行了评估，有 10 项研究符合纳入标准。纳入研究中有 2192 名参与者，所有研究均在高收入国家进行。测量了 19 种不同的 PCO，每项研究的中位数为 4 种 PCO（范围 1-11）。尿道出血、疼痛和尿路感染是最常见的测量结果。在将 mpMRI 或 MRI 引导活检与经直肠超声活检进行比较的四项研究中，MRI 相关检测中大多数不良结局发生的频率较低。这四项研究被评估为低偏倚风险。
迄今为止，在 mpMRI 或 MRI 引导活检研究中测量的 PCO 主要是身体结果，有一些证据表明，与经直肠超声活检相比，MRI 检查与较少的不良结局相关。关于 mpMRI 和 MRI 引导活检对情绪、认知、社会或行为结果的影响，证据非常有限。
