基于 PI-RADS 版本 2.1 的多参数和双参数 MRI 诊断策略在外周带前列腺癌中的比较。

Comparison between biparametric and multiparametric MRI diagnosis strategy for prostate cancer in the peripheral zone using PI-RADS version 2.1.

机构信息

Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Shuaifuyuan No. 1, Wangfujing Street, Dongcheng District, Beijing, 100730, China.

Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Shuaifuyuan No. 1, Wangfujing Street, Dongcheng District, Beijing, 100730, China.

出版信息

Abdom Radiol (NY). 2022 Aug;47(8):2905-2916. doi: 10.1007/s00261-022-03553-x. Epub 2022 May 27.

DOI:10.1007/s00261-022-03553-x

PMID:35622121

Abstract

PURPOSE

To compare and analyse the diagnostic value of PI-RADS v2.1 when used with biparametric MRI (bpMRI) versus multiparametric MRI (mpMRI), DWI versus T2WI to detect peripheral-zone prostate cancer (pzPCa) and clinically significant peripheral-zone prostate cancer (cs-pzPCa).

METHODS

The diagnostic efficiencies of mpMRI and bpMRI as well as DWI and T2WI in pzPCa and cs-pzPCa were compared using a PI-RADS score of ≥ 4 as the positive threshold and prostate biopsy and radical prostatectomy as the reference standards.

RESULTS

A total of 307 prostate cases were included in the study, including 142 in the non-pzPCa group, 165 in the pzPCa group, and 130 in the cs-pzPCa group. The AUCs of mpMRI and bpMRI were 0.717 and 0.733 (P = 0.317), respectively, for the diagnosis of pzPCa (sensitivities: 89.1% and 81.8%; specificities: 54.2% and 64.8%, both P < 0.001) and 0.594 and 0.602 (P = 0.756), respectively, for the diagnosis of cs-pzPCa (sensitivities: 93.1% and 86.2%, P = 0.004; specificities: 25.7% and 34.3%, P = 0.250). The AUCs of DWI and T2WI were 0.733 and 0.749 (P = 0.308), respectively, for the diagnosis of pzPCa (sensitivities: 81.8% and 84.2%; specificities: 64.8% and 66.2%, both P > 0.05) and 0.602 and 0.581 (P = 0.371), respectively, for the diagnosis of cs-pzPCa (sensitivities: 86.2% and 87.7%; specificities: 34.3% and 28.6%, both P > 0.05).

CONCLUSION

mpMRI and bpMRI as well as DWI and T2WI using PI-RADS v2.1 exhibited similar diagnostic efficiency in pzPCa and cs-pzPCa.

摘要

目的

比较并分析 PI-RADS v2.1 联合双参数 MRI（bpMRI）与多参数 MRI（mpMRI）、弥散加权成像（DWI）与 T2 加权成像（T2WI）在诊断外周带前列腺癌（pzPCa）和临床显著外周带前列腺癌（cs-pzPCa）中的诊断效能。

方法

以 PI-RADS 评分≥4 为阳性阈值，以前列腺活检和根治性前列腺切除术为参考标准，比较 mpMRI 和 bpMRI 以及 DWI 和 T2WI 在 pzPCa 和 cs-pzPCa 中的诊断效能。

结果

本研究共纳入 307 例前列腺病例，其中非 pzPCa 组 142 例，pzPCa 组 165 例，cs-pzPCa 组 130 例。mpMRI 和 bpMRI 对 pzPCa 的诊断 AUC 分别为 0.717 和 0.733（P=0.317）（敏感度：89.1%和 81.8%；特异度：54.2%和 64.8%，均 P<0.001），对 cs-pzPCa 的诊断 AUC 分别为 0.594 和 0.602（P=0.756）（敏感度：93.1%和 86.2%，P=0.004；特异度：25.7%和 34.3%，P=0.250）。DWI 和 T2WI 对 pzPCa 的诊断 AUC 分别为 0.733 和 0.749（P=0.308）（敏感度：81.8%和 84.2%；特异度：64.8%和 66.2%，均 P>0.05），对 cs-pzPCa 的诊断 AUC 分别为 0.602 和 0.581（P=0.371）（敏感度：86.2%和 87.7%；特异度：34.3%和 28.6%，均 P>0.05）。