Evaluation of Prostate Imaging Reporting and Data System Classification in the Prediction of Tumor Aggressiveness in Targeted Magnetic Resonance Imaging/Ultrasound-Fusion Biopsy
Evaluation of Prostate Imaging Reporting and Data System Classification in the Prediction of Tumor Aggressiveness in Targeted Magnetic Resonance Imaging/Ultrasound-Fusion Biopsy
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DOI：
10.1159/000477263
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发表时间：
2017-01-01
影响因子：
1.6
通讯作者：
Wirth, Manfred P.
中科院分区：
文献类型：
--
作者：
Borkowetz, Angelika;Platzek, Ivan;Wirth, Manfred P.
目的：本研究旨在评价前列腺成像报告和数据系统（PI-RADS）对磁共振成像（MRI）/超声融合活检（fusPbx）和系统活检（sysPbx）中前列腺癌（PCa）检出率和肿瘤侵袭性的预测。材料和方法：625例接受多参数MRI检查的患者。使用PI-RADS v1或v2对MRI结果进行分类。所有患者均接受了fusPbx联合sysPbx（comP-bx）。PI-RADS最高的病变定义为最大PI-RADS（maxPI-RADS）。Gleason评分≥ 7（3 + 4）定义为显著PCa。结果：总体PCa检出率为51%（n = 321; 39%显著PCa）。fusPbx的检出率为43%（n = 267; 34%显著PCa），sysPbx的检出率为36%（n = 223; 27%显著PCa）。仅通过sysPbx检测到9%的显著PCa。共调查了1，162处病变。PI-RADS 2、3、4和5级病变中显著PCa的检出率分别为9%（18/206）、12%（56/450）、27%（98/358）和61%（90/148）。maxPI-RADS >= 4是检测comPbx中显著PCa的最强预测因子（OR 2.77; 95%CI 1.81-4.24; p < 0.005）。结论：maxPI-RADS是检测comPbx中显著PCa的最强预测因子。由于sysPbx中其他显著PCa的检出率较高，因此fusPbx仍应与sysPbx结合使用。(C)2017 S. Karger AG，巴塞尔
Objectives: The study aimed to evaluate the prediction of Prostate Imaging Reporting and Data System (PI-RADS) with respect to the prostate cancer (PCa) detection rate and tumor aggressiveness in magnetic resonance imaging (MRI)/ultrasound-fusion-biopsy (fusPbx) and in systematic biopsy (sysPbx). Materials and Methods: Six hundred and twenty five patients undergoing multiparametric MRI were investigated. MRI findings were classified using PI-RADS v1 or v2. All patients underwent fusPbx combined with sysPbx (comP-bx). The lesion with the highest PI-RADS was defined as maximum PI-RADS (maxPI-RADS). Gleason Score >= 7 (3 + 4) was defined as significant PCa. Results: The overall PCa detection rate was 51% (n = 321; 39% significant PCa). The detection rate was 43% in fusPbx (n = 267; 34% significant PCa) and 36% in sysPbx (n = 223; 27% significant PCa). Nine percentage of significant PCa were detected by sysPbx alone. A total of 1,162 lesions were investigated. The detection rate of significant PCa in lesions with PI-RADS 2, 3, 4, and 5 were 9% (18/206), 12% (56/450), 27% (98/358), and 61% (90/148) respectively. maxPI-RADS >= 4 was the strongest predictor for the detection of significant PCa in comPbx (OR 2.77; 95% CI 1.81-4.24; p < 0.005). Conclusions: maxPI-RADS is the strongest predictor for the detection of significant PCa in comPbx. Due to a high detection rate of additional significant PCa in sysPbx, fusPbx should still be combined with sysPbx. (C) 2017 S. Karger AG, Basel