Fang Andrew M, Gregg Justin R, Pettaway Curtis, Ma Jingfei, Szklaruk Janio, Bathala Tharakeswara K, Surasi Devaki Shilpa S, Chapin Brian F
Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
BJU Int. 2025 Jan;135(1):13-21. doi: 10.1111/bju.16514. Epub 2024 Sep 22.
To present a narrative review regarding the diagnostic accuracy of whole-body magnetic resonance imaging (WBMRI) in staging patients with high-risk prostate cancer (HRPCa) and compare it to established imaging modalities.
A narrative review was carried out using PubMed using the following keywords: 'whole body', 'magnetic resonance imaging', 'MRI', 'prostate cancer', 'risk stratification', and 'staging'. Articles that evaluated WBMRI as the imaging modality to stage patients with HRPCa were included, while studies that solely assessed for biochemical recurrence or metastatic disease progression were excluded.
In the evaluation of lymphatic metastases, WBMRI has demonstrated a comparable, if not improved, sensitivity and specificity compared to conventional imaging of computed tomography (CT). Furthermore, WBMRI demonstrates improved sensitivity and specificity in detecting bone metastases compared to bone scintigraphy (BS). However, with advent of prostate-specific membrane antigen (PSMA) radioligands for positron emission tomography (PET), the diagnostic performance of WBMRI to detect metastatic disease appears inferior.
The diagnostic capabilities of WBMRI exceed that of conventional imaging of CT and BS in detecting metastatic disease in patients with HRPCa. However, WBMRI does not perform as well as PSMA PET/CT. Further study on cost comparisons between WBMRI and PSMA PET/CT are needed, as well as evaluations of combined PSMA PET/MRI are needed.
对全身磁共振成像（WBMRI）在高危前列腺癌（HRPCa）患者分期中的诊断准确性进行叙述性综述，并将其与既定的成像方式进行比较。
使用PubMed进行叙述性综述，关键词如下：“全身”、“磁共振成像”、“MRI”、“前列腺癌”、“风险分层”和“分期”。纳入将WBMRI作为HRPCa患者分期成像方式进行评估的文章，排除仅评估生化复发或转移疾病进展的研究。
在评估淋巴转移方面，与传统的计算机断层扫描（CT）成像相比，WBMRI的敏感性和特异性即使没有提高，也与之相当。此外，与骨闪烁显像（BS）相比，WBMRI在检测骨转移方面显示出更高的敏感性和特异性。然而，随着用于正电子发射断层扫描（PET）的前列腺特异性膜抗原（PSMA）放射性配体的出现，WBMRI检测转移疾病的诊断性能似乎较差。
在检测HRPCa患者的转移疾病方面，WBMRI的诊断能力超过了传统的CT和BS成像。然而，WBMRI的表现不如PSMA PET/CT。需要进一步研究WBMRI与PSMA PET/CT之间的成本比较，以及对PSMA PET/MRI联合检查进行评估。
