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系统评价前列腺癌诊断中多参数磁共振成像的健康差异和不平等

A Systematic Review for Health Disparities and Inequities in Multiparametric Magnetic Resonance Imaging for Prostate Cancer Diagnosis.

机构信息

Department of Radiology, Stony Brook University,101 Nicolls Rd., HSC L4, Room 120, Stony Brook, NY 11794-8460.

Department of Radiology, Stony Brook University,101 Nicolls Rd., HSC L4, Room 120, Stony Brook, NY 11794-8460; Department of Pathology, Stony Brook University, Stony Brook, New York.

出版信息

Acad Radiol. 2021 Jul;28(7):953-962. doi: 10.1016/j.acra.2021.03.012. Epub 2021 May 19.

Abstract

RATIONALE AND OBJECTIVES

Multi-parametric Magnetic Resonance Imaging (mpMRI) is a novel procedure recommended by the American Urological Association for Prostate Cancer (PCa) diagnosis. In radiology, differences in utilization of expensive screening techniques are described but never reviewed for mpMRI. Thus, our article aims at summarizing disparities relating to the expensive yet revolutionary mpMRI in United States men with PCa while highlighting needed research areas.

MATERIAL AND METHODS

Eligible articles were gathered via PubMed query, referred publications known to the authors or from the reference lists of the identified publications. We excluded studies that didn't specifically evaluate mpMRI technique, weren't conducted in the United States, or didn't directly assess the relationship between disparities and mpMRI. No date restrictions were applied, resulting articles were published through 2020.

RESULTS

Out of 80 publications, 17 were selected. Two unique themes were identified: 1) disparities in mpMRI utilization, and 2) performance. While demographic factors such as race, age and socioeconomic status played a significant role in utilization, mpMRI demonstrated equal and sometimes superior performance in AAs.

CONCLUSION

Our findings illustrate the importance of disparity awareness in PCa mpMRI and highlight the need to examine additional mpMRI disparities across other races and social determinants. A new area of inequity in PCa was theoretically illustrated, as lower utilization of mpMRI was detected in a group that could potentially benefit from it the most. Major limitation was the selected search terms. Our review is unique as disparities related to mpMRI were found to be multilayered, affecting utilization and performance. Continued research is needed to discover additional areas in efforts to reduce disparity gaps related to mpMRI and PCa.

摘要

背景与目的

多参数磁共振成像(mpMRI)是美国泌尿外科学会推荐用于前列腺癌(PCa)诊断的一种新方法。在放射学领域,昂贵的筛查技术的利用存在差异,但从未对此进行过评估。因此,我们的文章旨在总结美国 PCa 男性中昂贵但具有革命性的 mpMRI 相关差异,并强调需要研究的领域。

材料与方法

通过 PubMed 查询、作者已知的参考出版物或已确定出版物的参考文献收集合格文章。我们排除了未专门评估 mpMRI 技术、未在美国进行或未直接评估差异与 mpMRI 之间关系的研究。未应用日期限制,因此出版的文章时间截止到 2020 年。

结果

从 80 篇文献中,选择了 17 篇。确定了两个独特的主题:1)mpMRI 利用的差异;2)表现。虽然种族、年龄和社会经济地位等人口统计学因素在利用中起重要作用,但 mpMRI 在 AA 中表现出平等,有时甚至更优越。

结论

我们的研究结果表明,在 PCa mpMRI 中,差异意识非常重要,并强调需要检查其他种族和社会决定因素的其他 mpMRI 差异。理论上,PCa 中出现了一个新的不平等领域,因为在最有可能受益于该技术的群体中,mpMRI 的利用率较低。主要的局限性在于选择的搜索词。我们的综述是独特的,因为与 mpMRI 相关的差异是多层次的,影响了利用率和表现。需要进一步研究,以发现与 mpMRI 和 PCa 相关的差异缩小相关的其他领域。

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