Department of Urology, Ise Red Cross Hospital, Ise, Japan
Department of Urology, Ise Red Cross Hospital, Ise, Japan.
Anticancer Res. 2021 Apr;41(4):2183-2186. doi: 10.21873/anticanres.14992.
BACKGROUND/AIM: The aim of this study was to identify simple and reliable factors to detect clinically insignificant prostate cancer (PC) for avoiding immediate prostate biopsies using biparametric magnetic resonance imaging (MRI), which consists of T2-weighted and diffusion-weighted imaging.
We retrospectively evaluated 427 men with suspected PC, who underwent biparametric MRI and standard 12-core transrectal prostate biopsy. MRI and prostate specific antigen density (PSAD) were analysed. To evaluate the combination of the two parameters, patients were divided into three groups (Group A: MRI negative and PSAD <0.23, Group B: MRI positive or PSAD ≥0.23, Group C: MRI positive and PSAD ≥0.23). A grade of ≥2 was defined as clinically significant PC.
Clinically significant PC was detected in 46.5% of men with positive MRI findings, and 60.0% of men with PSAD ≥0.23. When combining MRI and PSAD, detection rates of clinically significant PC were 10.0%, 28.4% and 65.3% in group A, B and, C, respectively.
Negative biparametric MRI findings with PSAD <0.23 might be a reliable evidence for avoiding immediate prostate biopsies.
背景/目的：本研究旨在通过使用包含 T2 加权和扩散加权成像的双参数磁共振成像（MRI）来确定简单可靠的因素，以识别临床意义不大的前列腺癌（PC），从而避免立即进行前列腺活检。
我们回顾性评估了 427 名疑似 PC 患者，他们均接受了双参数 MRI 和标准的 12 针经直肠前列腺活检。分析了 MRI 和前列腺特异性抗原密度（PSAD）。为了评估这两个参数的组合，将患者分为三组（A 组：MRI 阴性且 PSAD<0.23，B 组：MRI 阳性或 PSAD≥0.23，C 组：MRI 阳性且 PSAD≥0.23）。≥2 级定义为临床显著 PC。
MRI 阳性的男性中，有 46.5%的人检测到临床显著 PC，PSAD≥0.23 的男性中有 60.0%的人检测到临床显著 PC。当将 MRI 和 PSAD 相结合时，A、B 和 C 组的临床显著 PC 检出率分别为 10.0%、28.4%和 65.3%。
PSAD<0.23 且双参数 MRI 阴性可能是避免立即进行前列腺活检的可靠依据。
