Bhanji Yasin, Mamawala Mufaddal, de la Calle Claire M, Landis Patricia, Epstein Jonathan I, Simopoulos Demetrios N, Macura Katarzyna J, Pavlovich Christian P
The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD.
The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD.
Urology. 2023 Oct;180:194-199. doi: 10.1016/j.urology.2023.07.019. Epub 2023 Aug 1.
To determine whether radiological change on serial multiparametric magnetic resonance imaging scored using the Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) Scoring system predicts grade reclassification (GR) at surveillance biopsy in men on active surveillance (AS) with Grade Group 1 (GG1) prostate cancer (PCa).
We retrospectively reviewed records of 255 men with low-risk PCa on AS with magnetic resonance imaging (MRI)-informed diagnostic and confirmatory biopsies and studied the subset who had surveillance biopsies (n = 163) within 6months of an interval MRI.
We studied 309 PRECISE scores in 255 men. 14% demonstrated radiological progression (PRECISE 4-5) on interval MRI performed within 24months, compared to 34% of those whose interval MRI was performed at a >3-year interval (P = .002). 28% (46/163) of men undergoing surveillance biopsy experienced GR to ≥ GG2 PCa. There was no significant increase in the rate of GR with increasing PRECISE score (PRECISE 1-2: 24%, PRECISE 3: 23%, PRECISE 4-5: 38%; P = .11). There was a significant increase in the rate of GR with increasing PI-RADS score (P < .05). On multivariable analysis, a PI-RADS score of 4-5 was significantly associated with GR compared to men who had a highest PI-RADS ≤3 (OR=1.98 [95% CI: 1.45-3.09, P = .01]).
In a low-risk AS cohort with limited follow-up, a patient's highest PI-RADS rather than their PRECISE score on interval MRI was predictive of GR on surveillance biopsy.
确定使用前列腺癌序列评估放射学变化评估（PRECISE）评分系统对连续多参数磁共振成像进行的放射学变化是否能预测接受主动监测（AS）的1级（GG1）前列腺癌（PCa）男性患者在监测活检时的分级重新分类（GR）。
我们回顾性分析了255例接受AS的低风险PCa男性患者的记录，这些患者进行了磁共振成像（MRI）引导下的诊断性和确认性活检，并研究了在间隔MRI后6个月内进行监测活检的亚组（n = 163）。
我们研究了255例男性患者的309个PRECISE评分。在24个月内进行的间隔MRI中，14%表现出放射学进展（PRECISE 4 - 5），而间隔MRI在3年以上进行的患者中这一比例为34%（P = 0.002）。接受监测活检的男性中有28%（46/163）经历了GR至≥GG2 PCa。随着PRECISE评分增加，GR发生率无显著增加（PRECISE 1 - 2：24%，PRECISE 3：23%，PRECISE 4 - 5：38%；P = 0.11）。随着PI - RADS评分增加，GR发生率显著增加（P < 0.05）。多变量分析显示，与最高PI - RADS≤3的男性相比，PI - RADS评分为4 - 5与GR显著相关（OR = 1.98 [95% CI：1.45 - 3.09，P = 0.01]）。
在随访有限的低风险AS队列中，患者间隔MRI上的最高PI - RADS而非PRECISE评分可预测监测活检时的GR。
