Schoch Justine, Düring Viola, Wiedmann Michael, Overhoff Daniel, Dillinger Daniel, Waldeck Stephan, Schmelz Hans-Ulrich, Nestler Tim
Department of Urology, Federal Armed Forces Hospital Koblenz, Ruebenacher Strasse 170, 56072 Koblenz, Germany.
Department of Diagnostic and Interventional Radiology, Federal Armed Forces Hospital Koblenz, Ruebenacher Strasse 170, 56072 Koblenz, Germany.
Tomography. 2025 Aug 18;11(8):92. doi: 10.3390/tomography11080092.
This study aimed to investigate the consistency of lesion identification by Prostate Imaging Reporting and Data System (PI-RADS) and the related clinical and histological characteristics in a high-volume tertiary care center.
The analysis used real-world data from 111 patients between 2018 and 2022. Each patient underwent two multiparametric magnetic resonance imaging (MRI) scans of the prostate at different institutions with a median interval of 42 days between the scans, followed by an MRI-fused biopsy conducted 7 days after the second MRI.
The PI-RADS classifications assigned to the index lesions in the in-house prostate MRI were as follows: PI-RADS V, 33.3% (n = 37); PI-RADS IV, 49.5% (n = 55); PI-RADS III, 12.6% (n = 14); and PI-RADS II, 4.5% (n = 5). Cancer detection rates for randomized and/or targeted biopsies were 91.9% (n = 34) for PI-RADS V, 65.5% (n = 36) for PI-RADS IV, 21.4% (n = 3) for PI-RADS III, and 20% (n = 1) for PI-RADS II. Overall, malignant histology was observed in 64.9% (n = 72) of the targeted lesions and 57.7% (n = 64) of the randomized biopsies. In the first performed, external MRI, 18% (n = 20) and 10.8% (n = 12) of the patients were classified in the higher and lower PI-RADS categories, respectively. The biopsy plan was adjusted for 57 patients (51.4%); nevertheless, any cancer could have possibly been identified regardless of the adjustments.
The 6-week interval between the MRI scans did not affect the quality of the biopsy results significantly.
本研究旨在调查在一家大型三级医疗中心中，前列腺影像报告和数据系统（PI-RADS）对病变识别的一致性以及相关的临床和组织学特征。
该分析使用了2018年至2022年间111例患者的真实世界数据。每位患者在不同机构接受了两次前列腺多参数磁共振成像（MRI）扫描，两次扫描的中位间隔时间为42天，随后在第二次MRI扫描7天后进行MRI融合活检。
内部前列腺MRI中对索引病变的PI-RADS分类如下：PI-RADS V，33.3%（n = 37）；PI-RADS IV，49.5%（n = 55）；PI-RADS III，12.6%（n = 14）；PI-RADS II，4.5%（n = 5）。PI-RADS V的随机和/或靶向活检癌症检出率为91.9%（n = 34），PI-RADS IV为65.5%（n = 36），PI-RADS III为21.4%（n = 3），PI-RADS II为20%（n = 1）。总体而言，在64.9%（n = 72）的靶向病变和57.7%（n = 64）的随机活检中观察到恶性组织学。在首次进行的外部MRI中，分别有18%（n = 20）和10.8%（n = 12）的患者被归类为较高和较低的PI-RADS类别。对57例患者（51.4%）的活检计划进行了调整；然而，无论调整如何，任何癌症都有可能被识别出来。
MRI扫描之间6周的间隔时间对活检结果的质量没有显著影响。
