用于检测前列腺癌的体部磁共振成像（bpMRI）和多参数磁共振成像（mpMRI）：一项回顾性队列研究。
bpMRI and mpMRI for detecting prostate cancer: A retrospective cohort study.
作者信息
Pan Yongsheng, Shen Cheng, Chen Xinfeng, Cao Dongliang, Jiang Jie, Xu Wei, Ji Chen, Pan Xiaodong, Zheng Bing
机构信息
Department of Urology, The Second Affiliated Hospital of Nantong University, Nantong, China.
Medical Research Center, The Second Affiliated Hospital of Nantong University, Nantong, China.
出版信息
Front Surg. 2023 Jan 16;9:1096387. doi: 10.3389/fsurg.2022.1096387. eCollection 2022.
BACKGROUND
We aimed to compare the detection rates of prostate cancer (PCa) and clinically significant prostate cancer(csPCa) by biparametric (bp-) and multiparameter magnetic resonance imaging (mpMRI).
MATERIALS AND METHODS
A total of 699 patients who underwent transperineal prostate biopsy in the Department of Urology, the Second Affiliated Hospital of Nantong University from January 2018 to December 2021 were retrospectively reviewed. Multivariate analysis was used to explore the influencing factors associated with the detection rates of PCa and csPCa. According to MRI examination before biopsy, the patients were divided into bpMRI group and mpMRI group. The detection rates of PCa and csPCa by bpMRI and mpMRI were compared. Furthermore, stratified analysis was performed for patients in these two groups to compare the detection rates of PCa and csPCa at different tPSA intervals, different prostate volume (PV) intervals and different PI-RADS V2 scores.
RESULTS
A total of 571 patients were finally analyzed in this study after exclusion, and the overall detection rate of PCa was 54.5%. Multivariate analysis showed that patient age, tPSA level, prostate volume and PI-RADS V2 score were independent risk factors affecting the detection rates of PCa and csPCa. The detection rates of PCa and csPCa by bpMRI and mpMRI were comparable (51.3% vs. 57.9%, 44.0% vs. 48.0%, both > 0.05), with no statistical significance. In the tPSA 10-20 ng/ml interval, the detection rates of PCa (59.72% vs. 40.35%, = 0.011) and csPCa (51.39% vs. 28.82%, = 0.005) by mpMRI were significantly higher than those by bpMRI, while in other tPSA interval (tPSA < 4 ng/ml, 4-10 ng/ml, 20-100 ng/ml), different PVs (≤30 ml, 30-60 ml, >60 ml) and different PI-RADS V2 scores (3, 4, and 5), the detection rates of PCa and csPCa were comparable between the two groups.
CONCLUSION
For detecting PCa and csPCa, bpMRI and mpMRI had similar diagnostic efficacies, whereas mpMRI detected more PCa and csPCa in the tPSA interval of 10-20 ng/ml.
背景
我们旨在比较双参数（bp-）和多参数磁共振成像（mpMRI）对前列腺癌（PCa）和临床显著前列腺癌（csPCa）的检出率。
材料与方法
回顾性分析2018年1月至2021年12月在南通大学第二附属医院泌尿外科接受经会阴前列腺穿刺活检的699例患者。采用多因素分析探讨影响PCa和csPCa检出率的相关因素。根据穿刺活检前的MRI检查结果，将患者分为bpMRI组和mpMRI组。比较bpMRI和mpMRI对PCa和csPCa的检出率。此外，对两组患者进行分层分析，比较不同总前列腺特异抗原（tPSA）区间、不同前列腺体积（PV）区间和不同前列腺影像报告和数据系统（PI-RADS）V2评分下PCa和csPCa的检出率。
结果
排除后，本研究最终纳入571例患者，PCa的总体检出率为54.5%。多因素分析显示，患者年龄、tPSA水平、前列腺体积和PI-RADS V2评分是影响PCa和csPCa检出率的独立危险因素。bpMRI和mpMRI对PCa和csPCa的检出率相当（51.3%对57.9%，44.0%对48.0%，均>0.05），无统计学意义。在tPSA为10 - 20 ng/ml区间，mpMRI对PCa（59.72%对40.35%，P = 0.011）和csPCa（51.39%对28.82%，P = 0.005）的检出率显著高于bpMRI，而在其他tPSA区间（tPSA < 4 ng/ml、4 - 10 ng/ml、20 - 100 ng/ml）、不同PV（≤30 ml、30 - 60 ml、>60 ml）和不同PI-RADS V2评分（3、4和5）时，两组间PCa和csPCa的检出率相当。
结论
对于PCa和csPCa的检测，bpMRI和mpMRI具有相似的诊断效能，而在tPSA为10 - 20 ng/ml区间，mpMRI能检测出更多的PCa和csPCa。
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