Li Wei, Xu Haibing, Shang Wenwen, Hong Guohui
Department of Medical Imaging, Jiangsu Vocational College of Medicine, Yancheng, China.
Prostate Int. 2024 Dec;12(4):201-206. doi: 10.1016/j.prnil.2024.08.002. Epub 2024 Aug 19.
In this study, we aimed to validate and compare three scoring systems based on biparametric magnetic resonance imaging (bpMRI) for the detection of clinically significant prostate cancer (csPCa) in biopsy-naïve patients.
In this study, we included patients who underwent MRI examinations between January 2018 and December 2022, with MRI-targeted fusion biopsy (MRGB) as the reference standard. The MRI findings were categorized using three bpMRI-based scorings, in all of them the diffusion-weighted imaging (DWI) was the dominant sequence for peripheral zone (PZ) and T2-weighed imaging (T2WI) was the dominant sequence for transition zone (TZ). We also used the Prostate Imaging Reporting and Data System version (PI-RADS) v2.1 to evaluate each lesion. For each scoring, we calculated the sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and area under the receiver operating characteristic (ROC) curves (AUC).
The calculated AUC for three bpMRI-based scorings were 83.2% (95% CI 78.8%-87.6%), 85.0% (95% CI 80.8%-89.3%), 82.9% (95% CI 78.4%-87.5%), and 86.0% (95% CI 81.8%-90.1%), respectively. Scoring 2 exhibited significantly superior performance than scoring 1 ( = 0.01) and scoring 3 ( < 0.001). Moreover, the accuracy of scoring 2 was not decreased significantly as compared to PI-RADS v2.1 ( = 0.05). There was no significant difference between 3 bpMRI-based scorings and with PI-RADS in TZ. However, although scoring 2 yielded the highest AUC, it was still notably inferior to PI-RADS ( = 0.02).
All three bpMRI-based scorings demonstrated favorite diagnostic accuracy, and scoring 2 performed significantly better than the other two bpMRI-based scorings. Notably, scoring 2 was not significantly inferior to the full-sequence PI-RADS v2.1 in terms of sensitivity and specificity.
在本研究中，我们旨在验证和比较基于双参数磁共振成像（bpMRI）的三种评分系统，用于检测未经活检的患者中具有临床意义的前列腺癌（csPCa）。
在本研究中，我们纳入了2018年1月至2022年12月期间接受MRI检查的患者，以MRI靶向融合活检（MRGB）作为参考标准。MRI检查结果使用三种基于bpMRI的评分进行分类，在所有评分中，扩散加权成像（DWI）是外周带（PZ）的主要序列，T2加权成像（T2WI）是移行带（TZ）的主要序列。我们还使用前列腺影像报告和数据系统版本（PI-RADS）v2.1评估每个病变。对于每个评分，我们计算了敏感性、特异性、阴性预测值（NPV）、阳性预测值（PPV）以及受试者操作特征（ROC）曲线下面积（AUC）。
三种基于bpMRI的评分计算出的AUC分别为83.2%（95%CI 78.8%-87.6%）、85.0%（95%CI 80.8%-89.3%）、82.9%（95%CI 78.4%-87.5%）和86.0%（95%CI 81.8%-90.1%）。评分2的表现显著优于评分1（P = 0.01）和评分3（P < 0.001）。此外，与PI-RADS v2.1相比，评分2的准确性没有显著下降（P = 0.05）。在TZ中，三种基于bpMRI的评分与PI-RADS之间没有显著差异。然而，尽管评分2产生了最高的AUC，但仍明显低于PI-RADS（P = 0.02）。
所有三种基于bpMRI的评分都显示出良好的诊断准确性，评分2的表现明显优于其他两种基于bpMRI的评分。值得注意的是，在敏感性和特异性方面，评分2并不显著低于全序列PI-RADS v2.1。
