Barone Biagio, Napolitano Luigi, Calace Francesco Paolo, Del Biondo Dario, Napodano Giorgio, Grillo Marco, Reccia Pasquale, De Luca Luigi, Prezioso Domenico, Muto Matteo, Crocetto Felice, Ferro Matteo
Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy.
Unit of Urology, Hospital "Ospedale del Mare", ASL Napoli 1 Centro, 80147 Naples, Italy.
Diagnostics (Basel). 2023 Jun 1;13(11):1939. doi: 10.3390/diagnostics13111939.
: Multiparametric magnetic resonance is an established imaging utilized in the diagnostic pathway of prostate cancer. The aim of this study is to evaluate the accuracy and reliability of multiparametric magnetic resonance imaging (mpMRI) in the detection of clinically significant prostate cancer, defined as Gleason Score ≥ 4 + 3 or a maximum cancer core length 6 mm or longer, in patients with a previous negative biopsy. : The study was conducted as a retrospective observational study at the University of Naples "Federico II", Italy. Overall, 389 patients who underwent systematic and target prostate biopsy between January 2019 and July 2020 were involved and were divided into two groups: Group A, which included biopsy-naïve patients; Group B, which included re-biopsy patients. All mpMRI images were obtained using three Tesla instruments and were interpreted according to PIRADS (Prostate Imaging Reporting and Data System) version 2.0. : 327 patients were biopsy-naïve, while 62 belonged to the re-biopsy group. Both groups were comparable in terms of age, total PSA (prostate-specific antigen), and number of cores obtained at the biopsy. 2.2%, 8.8%, 36.1%, and 83.4% of, respectively, PIRADS 2, 3, 4, and 5 biopsy-naïve patients reported a clinically significant prostate cancer compared to 0%, 14.3%, 39%, and 66.6% of re-biopsy patients ( < 0.0001- = 0.040). No difference was reported in terms of post-biopsy complications. : mpMRI confirms its role as a reliable diagnostic tool prior to performing prostate biopsy in patients who underwent a previous negative biopsy, reporting a comparable detection rate of clinically significant prostate cancer.
多参数磁共振成像（Multiparametric magnetic resonance）是前列腺癌诊断过程中常用的一种成像技术。本研究旨在评估多参数磁共振成像（mpMRI）在检测临床显著性前列腺癌方面的准确性和可靠性，临床显著性前列腺癌定义为Gleason评分≥4 + 3或最大癌灶长度≥6 mm，研究对象为既往活检结果为阴性的患者。本研究在意大利那不勒斯“费德里科二世”大学进行，属于回顾性观察研究。总体而言，纳入了2019年1月至2020年7月期间接受系统性和靶向性前列腺活检的389例患者，并将其分为两组：A组为初次活检患者；B组为再次活检患者。所有mpMRI图像均使用3特斯拉设备获取，并根据前列腺影像报告和数据系统（Prostate Imaging Reporting and Data System，PIRADS）第2.0版进行解读。初次活检患者有327例，再次活检组有62例。两组在年龄、总前列腺特异性抗原（total PSA）以及活检获取的组织条数方面具有可比性。初次活检患者中，PIRADS 2、3、4和5类别的患者分别有2.2%、8.8%、36.1%和83.4%报告患有临床显著性前列腺癌，而再次活检患者中这一比例分别为0%、14.3%、39%和66.6%（P < 0.0001至P = 0.040）。活检后并发症方面未报告有差异。mpMRI证实了其在既往活检结果为阴性的患者进行前列腺活检前作为可靠诊断工具的作用，在检测临床显著性前列腺癌方面具有相似的检出率。
