Parhiala Laura, Knaapila Juha, Jambor Ivan, Verho Janne, Syvänen Kari, Aronen Hannu, Boström Peter, Ettala Otto
Department of Urology, University of Turku, Turku, Finland.
Department of Urology, Turku University Hospital, Turku, Finland.
J Magn Reson Imaging. 2025 Jun;61(6):2425-2432. doi: 10.1002/jmri.29668. Epub 2024 Nov 27.
The long-term prevalence of clinically significant prostate cancer (csPCa) in patients with initial negative prostate biopsy is unknown.
To investigate the rate of csPCa of men with initial negative biopsy.
Retrospective analysis of prospectively collected data.
A total of 197 men (mean age 63 years [SD ±6.98, range 29-79]) without csPCa on initial biopsy and available baseline biparametric prostate MRI (bpMRI).
FIELD STRENGTH/SEQUENCE: 3.0 T, turbo spin-echo T2-weighted (axial and sagittal) and three sets of diffusion-weighted imaging using single-shot spin-echo planar imaging (5 b-values 0-500 seconds/mm; 2 b-values 0 and 1500 seconds/mm, and 2 b-values 0 and 2000 seconds/mm).
BpMRI was read using Prostate Imaging Reporting Data System (PI-RADS) v2.1. Systematic or targeted biopsy results served as reference standard.
Continuous variables were compared using Kruskal-Wallis rank sum test. Categorical variables were compared using either Fisher's exact test or Pearson's chi-square test. Uni- and multivariate regression odds ratios (95% confidence interval) were used to study factors affecting csPCa being diagnosed during follow-up. Time to diagnosis of csPCa is calculated using the Kaplan-Meier method.
Of 197 men, 74 (38%), 57 (29%), and 66 (34%) presented with PI-RADS 1-2, 3, and 4-5 findings in the baseline bpMRI. During the median follow-up of 52 months, 8.1%, 5.3%, and 18.2% of these men were diagnosed with csPCa, respectively. Baseline PI-RADS finding was the only factor that associated with csPCa found during the follow-up.
Baseline bpMRI with PI-RADS scores 1-3 and initial biopsies negative of csPCa had low rate of csPCa during follow-up, which supports more conservative follow-up for them but further research with longer follow-up is warranted.
3 TECHNICAL EFFICACY: Stage 2.
初次前列腺活检结果为阴性的患者中具有临床意义的前列腺癌（csPCa）的长期患病率尚不清楚。
调查初次活检结果为阴性的男性中csPCa的发生率。
对前瞻性收集的数据进行回顾性分析。
共有197名男性（平均年龄63岁[标准差±6.98，范围29 - 79岁]），初次活检时无csPCa且有可用的基线双参数前列腺MRI（bpMRI）。
场强/序列：3.0T，涡轮自旋回波T2加权成像（轴位和矢状位）以及三组扩散加权成像，采用单次激发自旋回波平面成像（5个b值0 - 500秒/毫米；2个b值0和1500秒/毫米，以及2个b值0和2000秒/毫米）。
使用前列腺影像报告和数据系统（PI-RADS）v2.1对bpMRI进行解读。系统活检或靶向活检结果作为参考标准。
连续变量采用Kruskal-Wallis秩和检验进行比较。分类变量采用Fisher精确检验或Pearson卡方检验进行比较。单因素和多因素回归比值比（95%置信区间）用于研究影响随访期间csPCa诊断率的因素。csPCa的诊断时间采用Kaplan-Meier方法计算。
在197名男性中，74名（38%）、57名（29%）和66名（34%）在基线bpMRI中表现为PI-RADS 1 - 2、3和4 - 5结果。在中位随访52个月期间，这些男性中分别有8.1%、5.3%和18.2%被诊断为csPCa。基线PI-RADS结果是随访期间与发现csPCa相关的唯一因素。
基线bpMRI的PI-RADS评分为1 - 3且初次活检csPCa为阴性的患者在随访期间csPCa发生率较低，这支持对他们采取更保守的随访方式，但仍需要进行更长时间随访的进一步研究。
3 技术效能：2级
