比较 PSA 密度和病灶体积策略，以选择在 bpMRI 上 PI-RADS 3 级不确定病变的男性进行活检。
Comparison of PSA density and lesion volume strategies for selecting men with equivocal PI-RADS 3 lesions on bpMRI for biopsies.
机构信息
Department of Radiology, Herlev Gentofte University Hospital, Borgmester Ib Juuls Vej 17, 2730, Herlev, Denmark.
Department of Urological Research, Herlev Gentofte University Hospital, Herlev, Denmark.
出版信息
Abdom Radiol (NY). 2023 Feb;48(2):688-693. doi: 10.1007/s00261-022-03720-0. Epub 2022 Nov 1.
PURPOSE
To compare two strategies: Prostate-specific antigen density (PSAd) and lesion volume measurement in ruling out significant prostate cancer (sPCa) in men with equivocal Prostate Imaging Reporting and Data System (PI-RADS) category 3 index lesions on biparametric magnetic resonance imaging.
METHODS
In total, 130 men from our database had index lesions with PI-RADS scores of 3. Prostate volume was measured using the ellipsoid method, in accordance with PI-RADS version 2.1 criteria. Index lesion volumes were also measured using the ellipsoidal formula on the diffusion-weighted imaging sequence with the highest b-value and sagittal T2 sequences.
RESULTS
Among 130 men with PI-RADS category 3 index lesions, 23 (18%) had sPCa. In total, 6 of the 89 men with PSAd < 0.15 ng/mL (7%) had sPCa, whereas 8 of the 49 men with index lesion volumes < 0.5 mL (16%) had sPCa. The difference was statistically significant (McNemar, p < 0.0001).
CONCLUSION
The PSAd strategy performed better than the lesion volume strategy in ruling out sPCa in men with equivocal PI-RADS category 3 index lesions.
目的
比较两种策略：前列腺特异性抗原密度（PSAd）和病灶体积测量，以排除在前列腺影像报告和数据系统（PI-RADS）评分 3 分的可疑前列腺癌（sPCa）患者中存在的有意义的前列腺癌（sPCa）。
方法
从我们的数据库中共有 130 名患者的可疑 PI-RADS 评分 3 分的指数病变。前列腺体积采用椭圆法测量，符合 PI-RADS 版本 2.1 标准。在弥散加权成像序列中，采用最高 b 值的椭圆公式，以及矢状位 T2 序列测量指数病变体积。
结果
在 130 名 PI-RADS 3 分指数病变患者中，23 名（18%）患有 sPCa。在 PSA d<0.15ng/mL 的 89 名患者中，有 6 名（7%）患有 sPCa，而在指数病变体积<0.5mL 的 49 名患者中，有 8 名（16%）患有 sPCa。差异具有统计学意义（McNemar，p<0.0001）。
结论
在可疑 PI-RADS 3 分指数病变患者中，PSAd 策略在排除 sPCa 方面优于病灶体积策略。
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