Use of prostate systematic and targeted biopsy on the basis of multiparametric MRI in biopsy-naive patients (MRI-FIRST): a prospective, multicentre, paired diagnostic study
Use of prostate systematic and targeted biopsy on the basis of multiparametric MRI in biopsy-naive patients (MRI-FIRST): a prospective, multicentre, paired diagnostic study
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DOI：
10.1016/s1470-2045(18)30569-2
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发表时间：
2019-01-01
期刊：
影响因子：
51.1
通讯作者：
Grenier, Nicolas
中科院分区：
文献类型：
--
作者：
Rouviere, Olivier;Puech, Philippe;Grenier, Nicolas
背景：多参数MRI是否能提高对临床意义的前列腺癌的检测，并避免对未接受活检的患者进行系统活检仍有争议。我们的目的是研究在活检前使用这种方法是否会提高对未进行活检的患者的临床意义的前列腺癌的检测。在这项前瞻性、多中心、配对诊断研究中，我们在法国的16个中心进行了研究，招募了年龄在18-75岁、前列腺特异性抗原浓度为20 ng/mL或更低、T2c期或更低水平前列腺癌的患者。符合条件的患者在第一次前列腺活检前接受前列腺多参数MRI检查，MRI和活检之间的计划间隔不超过3个月。对多参数MRI结果不知情的操作人员通过获得12个系统核心和最多两个针对低回声病变的核心进行了系统活检。在同一例患者中，另一名操作员使用基于多参数MRI结果的靶向活检，针对MRI上看到的两个病灶，其like评分为3分或更高（每个病灶三个核心）。多参数MRI （Likert评分）阴性患者
Background Whether multiparametric MRI improves the detection of clinically significant prostate cancer and avoids the need for systematic biopsy in biopsy-naive patients remains controversial. We aimed to investigate whether using this approach before biopsy would improve detection of clinically significant prostate cancer in biopsy-naive patients.Methods In this prospective, multicentre, paired diagnostic study, done at 16 centres in France, we enrolled patients aged 18-75 years with prostate-specific antigen concentrations of 20 ng/mL or less, and with stage T2c or lower prostate cancer. Eligible patients had been referred for prostate multiparametric MRI before a first set of prostate biopsies, with a planned interval of less than 3 months between MRI and biopsies. An operator masked to multiparametric MRI results did a systematic biopsy by obtaining 12 systematic cores and up to two cores targeting hypoechoic lesions. In the same patient, another operator targeted up to two lesions seen on MRI with a Liked score of 3 or higher (three cores per lesion) using targeted biopsy based on multiparametric MRI findings. Patients with negative multiparametric MRI (Likert score