Alshehri Sultan Zaher, Alshahrani Omar Safar, Almsaoud Nazal Ahmed, Al-Ghamdi Muhammad Ahmad, Alqahtani Abdulaziz Mohammed, Almurayyi Muath Mohammed, Autwdi Ali Salem, Al-Ghamdi Saeed Ahmed, Zogan Mohammed Mesadef, Alamri Abdulrahim Mohammed
Department of Urology, Aseer Central Hospital, Abha, Saudi Arabia.
Department of Urology, Armed Forces Hospital Southern Region, Khamis Mushait, Saudi Arabia.
Ann Med Surg (Lond). 2020 Jul 17;57:171-178. doi: 10.1016/j.amsu.2020.07.015. eCollection 2020 Sep.
The performance of multiparametric magnetic resonance imaging (mpMRI) and subsequent biopsy in monitoring prostate cancer in men on active surveillance (AS) have not been defined clearly. In this systematic review, we aimed to review current literature about the usage of MRI examination in men with low-risk prostate cancer during active surveillance. For that, we searched seven databases to include all studies reporting magnetic resonance imaging in the AS of low-risk prostate cancer. We finally included 11 studies with 1237 patients included. Our results showed an adequate sensitivity and specificity of both modalities to detect disease progression; including disease upgrading and upstaging. However, the performance in the prediction of unfavorable disease was inferior to the detection of upgrading and upstaging. In terms of MRGB, the previous literature agreed on the superiority of using a combination of different biopsy schemes to get a better progression section. Noteworthy, mp-MRI and MRGB had a good predictive value limited to the first year, with TRUSGB showing a superior role in detecting patients with a GS ≥ 7, after that. In conclusion, both of mpMRI and MRGB have shown an adequate performance on assessing disease progression in the AS of low-risk prostate cancer patients. They can be used for disease staging and grading for successful treatment planning.
多参数磁共振成像（mpMRI）及后续活检在监测接受主动监测（AS）的男性前列腺癌方面的表现尚未明确界定。在这项系统评价中，我们旨在回顾当前关于MRI检查在低风险前列腺癌男性主动监测期间应用的文献。为此，我们检索了七个数据库，纳入所有报告低风险前列腺癌主动监测中磁共振成像的研究。我们最终纳入了11项研究，共1237例患者。我们的结果显示，两种检查方式在检测疾病进展（包括疾病升级和分期升高）方面具有足够的敏感性和特异性。然而，预测不良疾病的表现不如检测升级和分期升高。在磁共振引导活检（MRGB）方面，既往文献一致认为采用不同活检方案的组合能获得更好的进展切片。值得注意的是，mp-MRI和MRGB在第一年具有良好的预测价值，而经直肠超声引导活检（TRUSGB）在此之后在检测GS≥7的患者中显示出更优越的作用。总之，mpMRI和MRGB在评估低风险前列腺癌患者主动监测中的疾病进展方面均表现出足够的性能。它们可用于疾病分期和分级，以制定成功的治疗计划。
