Department of Urology Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Urology Chung, ANG University Hospital, Seoul, Korea.
Scand J Urol. 2021 Feb;55(1):17-21. doi: 10.1080/21681805.2020.1833981. Epub 2020 Dec 21.
To investigate the usefulness of magnetic resonance imaging (MRI) with Prostate Imaging Reporting and Data System version 2 (PI-RADS) and clinical parameters in predicting seminal vesicle invasion (SVI).
In this retrospective study, we identified 569 prostate cancer patients who underwent radical prostatectomy with MRI before surgery. SVI was interpreted with PI-RADS Clinical parameters such as the prostate-specific antigen (PSA) and Gleason score (GS) were analyzed for the prediction of SVI. Logistic regression models and receiver operating characteristic (ROC) curves were used to evaluate SVI based on clinical parameters and MRI with PI-RADS.
The median age at presentation was 67 years (43-85 years). The median PSA level was 6.1 ng/mL (2.2-72.8 ng/mL). There were 113 patients with a biopsy GS of ≥ 8. A total of 34 patients (6.0%) were interpreted to have SVI by MRI of which 20 were true positive, and 52 patients (9.1%) had true SVI in the final pathologic analysis. In multivariable analysis, PSA (HR: 1.03, 95% CI: 1.00-1.07), biopsy GS ≥ 8 (HR: 4.14, 95% CI: 2.12-8.09), and MRI with PI-RADS (HR: 14.67, 95% CI: 6.34-33.93) were significantly associated with pathologic SVI. The area under the curve of the model based on the clinical parameters PSA and GS plus MRI (0.862) was significantly larger than that of the model based on clinical parameters alone (0.777, < 0.001).
MRI with PI-RADS using the clinical parameters PSA and GS was effective in predicting SVI.
探讨磁共振成像（MRI）结合前列腺影像报告和数据系统（PI-RADS）版本 2 （PI-RADSv2）与临床参数在预测精囊侵犯（SVI）中的作用。
本回顾性研究纳入了 569 例行根治性前列腺切除术且术前接受 MRI 检查的前列腺癌患者。采用 PI-RADS 对 SVI 进行解读，分析前列腺特异性抗原（PSA）和 Gleason 评分（GS）等临床参数对 SVI 的预测作用。采用逻辑回归模型和受试者工作特征（ROC）曲线评估基于临床参数和 MRI 联合 PI-RADS 的 SVI。
患者中位年龄为 67 岁（43-85 岁），中位 PSA 水平为 6.1ng/ml（2.2-72.8ng/ml），224 例患者活检 GS≥8。MRI 诊断有 34 例 SVI（6.0%），其中 20 例为真阳性，术后病理分析证实有 52 例（9.1%）存在真正的 SVI。多变量分析显示，PSA（HR：1.03，95%CI：1.00-1.07）、活检 GS≥8（HR：4.14，95%CI：2.12-8.09）和 MRI 联合 PI-RADS（HR：14.67，95%CI：6.34-33.93）与病理 SVI 显著相关。基于 PSA 和 GS 联合 MRI 的模型曲线下面积（0.862）显著大于仅基于临床参数的模型（0.777， < 0.001）。
基于 PSA 和 GS 的 MRI 联合 PI-RADS 可有效预测 SVI。
