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bpMRI在前列腺癌中的诊断价值：与mpMRI相比的优势与局限性

The Diagnostic Value of bpMRI in Prostate Cancer: Benefits and Limitations Compared to mpMRI.

作者信息

Iacob Roxana, Manolescu Diana, Stoicescu Emil Robert, Cerbu Simona, Bardan Răzvan, Ghenciu Laura Andreea, Cumpănaș Alin

机构信息

Doctoral School, 'Victor Babes' University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania.

Department of Anatomy and Embriology, 'Victor Babes' University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania.

出版信息

Bioengineering (Basel). 2024 Oct 9;11(10):1006. doi: 10.3390/bioengineering11101006.

DOI:10.3390/bioengineering11101006
PMID:39451382
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11505328/
Abstract

Prostate cancer is the second most common cancer in men and a leading cause of death worldwide. Early detection is vital, as it often presents with vague symptoms such as nocturia and poor urinary stream. Diagnostic tools like PSA tests, ultrasound, PET-CT, and mpMRI are essential for prostate cancer management. The PI-RADS system helps assess malignancy risk based on imaging. While mpMRI, which includes T1, T2, DWI, and dynamic contrast-enhanced imaging (DCE), is the standard, bpMRI offers a contrast-free alternative using only T2 and DWI. This reduces costs, acquisition time, and the risk of contrast-related side effects but has limitations in detecting higher-risk PI-RADS 3 and 4 lesions. This study compared bpMRI's diagnostic accuracy to mpMRI, focusing on prostate volume and PI-RADS scoring. Both methods showed strong inter-rater agreement for prostate volume (ICC 0.9963), confirming bpMRI's reliability in this aspect. However, mpMRI detected more complex conditions, such as periprostatic fat infiltration and iliac lymphadenopathy, which bpMRI missed. While bpMRI offers advantages like reduced cost and no contrast use, it is less effective for higher-risk lesions, making mpMRI more comprehensive.

摘要

前列腺癌是男性中第二常见的癌症，也是全球主要的死亡原因之一。早期检测至关重要，因为它通常表现为夜尿症和尿流不畅等模糊症状。前列腺特异性抗原（PSA）检测、超声、正电子发射断层扫描-计算机断层扫描（PET-CT）和多参数磁共振成像（mpMRI）等诊断工具对前列腺癌的管理至关重要。前列腺影像报告和数据系统（PI-RADS）有助于根据影像学评估恶性风险。虽然包括T1、T2、扩散加权成像（DWI）和动态对比增强成像（DCE）的mpMRI是标准方法，但b值磁共振成像（bpMRI）仅使用T2和DWI提供了一种无需对比剂的替代方法。这降低了成本、采集时间以及与对比剂相关的副作用风险，但在检测高风险的PI-RADS 3和4级病变方面存在局限性。本研究比较了bpMRI与mpMRI的诊断准确性，重点关注前列腺体积和PI-RADS评分。两种方法在前列腺体积方面均显示出很强的评分者间一致性（组内相关系数ICC为0.9963），证实了bpMRI在这方面的可靠性。然而，mpMRI检测到了更多复杂情况，如前列腺周围脂肪浸润和髂淋巴结病，而bpMRI则未检测到。虽然bpMRI具有成本降低和无需使用对比剂等优点，但对于高风险病变的效果较差，这使得mpMRI更为全面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/851c/11505328/ed55368b6b22/bioengineering-11-01006-g008.jpg
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