da Cruz Fagundes Marília, Coelho Fernando Morbeck Almeida, Naves Guilherme Gotti, Torre Giovanna Sawaya, de Macêdo Gusmão Marcelo, Schuch Alice, Mussi Thaís Caldara, Zapparoli Mauricio, Baroni Ronaldo Hueb
Hospital Alemão Oswaldo Cruz, São Paulo, Brazil.
Hospital Israelita Albert Einstein, São Paulo, Brazil.
Abdom Radiol (NY). 2025 Jun 27. doi: 10.1007/s00261-025-05042-3.
Advancements in prostate imaging, particularly multiparametric magnetic resonance imaging (mpMRI), have transformed the diagnosis and monitoring paradigms for prostate cancer (PCa). However, considerable interobserver variability has been reported,emphasizing the importance of standardized scoring and reporting systems. The Prostate Imaging Reporting and Data System (PI-RADS), along with quality assurance protocols such as Prostate Imaging Quality (PI-QUAL), has enhanced the diagnostic accuracy of mpMRI. While mpMRI effectively identifies extraprostatic extension, emerging hybrid positron emission tomography/magnetic resonance imaging (PET/MRI) and radio labeled prostate-specific membrane antigen (PSMA) tracers have improved metastasis detection. In active surveillance settings, the Prostate Cancer Radiologic Estimation of Change in Sequential Evaluation (PRECISE) recommendations enable the assessment of longitudinal PCa changes. Post-treatment evaluation can also employ dedicated frameworks, such as the Prostate Imaging for Recurrence Reporting (PI-RR) after radical prostatectomy, and either the Prostate Imaging after Focal Ablation (PI-FAB) or the Transatlantic Recommendations for Prostate Gland Evaluation with MRI after Focal Therapy (TARGET). This article reviews key aspects of mpMRI, including structured interpretation frameworks beyond the widely recognized PI-RADS.
前列腺成像技术的进步，尤其是多参数磁共振成像（mpMRI），已经改变了前列腺癌（PCa）的诊断和监测模式。然而，据报道观察者之间存在相当大的变异性，这凸显了标准化评分和报告系统的重要性。前列腺成像报告和数据系统（PI-RADS）以及诸如前列腺成像质量（PI-QUAL）等质量保证协议提高了mpMRI的诊断准确性。虽然mpMRI能有效识别前列腺外侵犯，但新兴的正电子发射断层扫描/磁共振成像（PET/MRI）混合技术和放射性标记的前列腺特异性膜抗原（PSMA）示踪剂改善了转移灶的检测。在主动监测环境中，前列腺癌连续评估放射学变化估计（PRECISE）建议有助于评估前列腺癌的纵向变化。治疗后评估也可采用专门的框架，如根治性前列腺切除术后的复发报告前列腺成像（PI-RR），以及聚焦消融后的前列腺成像（PI-FAB）或聚焦治疗后前列腺MRI评估的跨大西洋建议（TARGET）。本文回顾了mpMRI的关键方面，包括除了广泛认可的PI-RADS之外的结构化解读框架。
