Negative Multiparametric Magnetic Resonance Imaging of the Prostate Predicts Absence of Clinically Significant Prostate Cancer on 12-Core Template Prostate Biopsy
Negative Multiparametric Magnetic Resonance Imaging of the Prostate Predicts Absence of Clinically Significant Prostate Cancer on 12-Core Template Prostate Biopsy
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DOI：
10.1016/j.urology.2017.01.048
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发表时间：
2017-07-01
期刊：
影响因子：
2.1
通讯作者：
Sprenkle, Preston C.
中科院分区：
文献类型：
--
作者：
Lu, Amanda J.;Syed, Jamil S.;Sprenkle, Preston C.
目的 为了确定多参数磁共振成像 (mpMRI) 的阴性预测价值，我们评估了 mpMRI 未显示可疑区域的男性中通过 12 核模板标测活检检测出前列腺癌的频率。 方法 2012 年 12 月至 2016 年 6 月，670 名患者接受了 mpMRI，随后进行经直肠超声 (TRUS) 引导的系统前列腺活检。在该队列中，100 名患者的 mpMRI 呈阴性。 mpMRI 成像序列包括 T2 加权和扩散加权成像以及动态对比增强序列。 结果 100 名男性的平均年龄、前列腺特异性抗原和前列腺体积分别为 64.3 岁、7.2 ng/mL 和 71 mL。总体癌症检出率为 27%（100 例中有 27 例）。在未接受活检的患者中，有 26.3%（38 名患者中的 10 名）检测出前列腺癌；在先前活检呈阴性的患者中，有 12.1%（33 名患者中的 4 名）检测出前列腺癌；在之前接受过主动监测的患者中，有 44.8%（29 名患者中的 13 名）检测出前列腺癌；总体而言，3% 的患者（100 名患者中有 3 名）检测到格里森分级 >= 7。阴性 mpMRI 对所有前列腺癌的阴性预测值为 73%，对 Gleason >= 7 前列腺癌的阴性预测值为 97%。结论 对于 mpMRI 没有可疑发现的患者，通过系统 TRUS 引导的活检检测出具有临床意义的前列腺癌的机会约为 3%。这些信息应有助于指导患者在 mpMRI 阴性时接受系统 TRUS 引导活检的建议。由爱思唯尔公司出版
OBJECTIVE To determine the negative predictive value of multiparametric magnetic resonance imaging (mpMRI), we evaluated the frequency of prostate cancer detection by 12-core template mapping biopsy in men whose mpMRI showed no suspicious regions.METHODS Six hundred seventy patients underwent mpMRI followed by transrectal ultrasound (TRUS)guided systematic prostate biopsy from December 2012 to June 2016. Of this cohort, 100 patients had a negative mpMRI. mpMRI imaging sequences included T2-weighted and diffusion-weighted imaging, and dynamic contrast enhancement sequences.RESULTS The mean age, prostate-specific antigen, and prostate volume of the 100 men included were 64.3 years, 7.2 ng/mL, and 71 mL, respectively. Overall cancer detection was 27% (27 of 100). Prostate cancer was detected in 26.3% (10 of 38) of patients who were biopsy-naive, 12.1% (4 of 33) of patients who had a prior negative biopsy, and in 44.8% (13 of 29) of patients previously on active surveillance; Gleason grade >= 7 was detected in 3% of patients overall (3 of 100). The negative predictive value of a negative mpMRI was 73% for all prostate cancer and 97% for Gleason >= 7 prostate cancer.CONCLUSION There is an approximately 3% chance of detecting clinically significant prostate cancer with systematic TRUS-guided biopsy in patients with no suspicious findings on mpMRI. This information should help guide recommendations to patients about undergoing systematic TRUS-guided biopsy when mpMRI is negative. Published by Elsevier Inc.