Accuracy of multiparametric magnetic resonance imaging in confirming eligibility for active surveillance for men with prostate cancer.
Accuracy of multiparametric magnetic resonance imaging in confirming eligibility for active surveillance for men with prostate cancer.
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DOI：
10.1002/cncr.28216
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发表时间：
2013-09-15
期刊：
影响因子：
6.2
通讯作者：
Pinto PA
中科院分区：
文献类型：
--
作者：
Stamatakis L;Siddiqui MM;Nix JW;Logan J;Rais-Bahrami S;Walton-Diaz A;Hoang AN;Vourganti S;Truong H;Shuch B;Parnes HL;Turkbey B;Choyke PL;Wood BJ;Simon RM;Pinto PA
主动监测（AS）试图避免过度治疗临床上无意义的前列腺癌（PCa），但患者的选择仍然存在争议。多参数前列腺MRI（MP-MRI）可能有助于更好地选择AS候选人。我们回顾了一组接受MP-MRI和MRI/US融合引导前列腺活检的男性，并使用约翰霍普金斯标准在入组时选择了潜在的AS患者。评估MP-MRI结果，包括病变数量、主要病变直径/体积、总病变体积、前列腺体积和“病变密度”（计算为总病变体积/前列腺体积）。通过MRI对病变进行癌症疑似评分。根据确诊活检重新应用AS标准，并评估MP-MRI预测AS候选资格的准确性。Logistic回归模型和卡方统计用于评估MP-MRI解释和活检结果之间的关联。85例患者符合AS标准，平均年龄为60.2岁，平均PSA为4.8 ng/ml。其中，25例患者（29%）根据确证性活检被重新分类为不符合AS标准。病变数量、病变密度和最高MRI病变疑似与确诊活检AS重新分类显著相关。将这些基于MRI的因素结合起来，创建一个列线图，生成确认AS候选资格的概率。当临床医生建议PCa患者时，MP-MRI可能有助于考虑AS时的决策过程。三个基于MRI的因素（病变数量、病变可疑和病变密度）与确诊活检结果和重新分类相关。使用这些因素的诺模图具有很好的预测准确性，未来的验证是必要的。
Active surveillance (AS) attempts to avoid overtreatment of clinically insignificant prostate cancer (PCa), however patient selection remains controversial. Multiparametric prostate MRI (MP-MRI) may help better select AS candidates. We reviewed a cohort of men who underwent MP-MRI with MRI/US fusion-guided prostate biopsy and selected potential AS patients at entry using the Johns Hopkins criteria. MP-MRI findings were assessed including number of lesions, dominant lesion diameter/volume, total lesion volume, prostate volume, and “lesion density” (calculated as total lesion volume/prostate volume). Lesions were assigned a suspicion score for cancer by MRI. AS criteria was reapplied based on the confirmatory biopsy and accuracy of MP-MRI in predicting AS candidacy was assessed. Logistic regression modeling and chi-square statistics were used to assess associations between MP-MRI interpretation and biopsy results. Eighty-five patients qualified for AS with a mean age of 60.2 years and mean PSA of 4.8 ng/ml. Of these, 25 patients (29%) were reclassified as not meeting AS criteria based on confirmatory biopsy. Number of lesions, lesion density, and highest MRI lesion suspicion were significantly associated with confirmatory biopsy AS reclassification. These MRI-based factors were combined to create a nomogram that generates a probability for confirmed AS candidacy. As clinicians counsel patients with PCa, MP-MRI may contribute to the decision-making process when considering AS. Three MRI-based factors (number of lesions, lesion suspicion, and lesion density) were associated with confirmatory biopsy outcome and reclassification. A nomogram using these factors has promising predictive accuracy for which future validation is necessary.
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影响因子：
6.6
作者：
Rastinehad, Ardeshir R.;Baccala, Angelo A., Jr.;Pinto, Peter A.
通讯作者：
Pinto, Peter A.
影响因子：
4.5
作者：
Turkbey B;Xu S;Kruecker J;Locklin J;Pang Y;Bernardo M;Merino MJ;Wood BJ;Choyke PL;Pinto PA
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Pinto PA
影响因子：
23.4
作者：
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通讯作者：
Libertino, John A.
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4.5
作者：
Shukla-Dave A;Hricak H;Akin O;Yu C;Zakian KL;Udo K;Scardino PT;Eastham J;Kattan MW
通讯作者：
Kattan MW
影响因子：
6.6
作者：
Thompson, Ian;Thrasher, James Brantley;Tangen, Catherine M.
通讯作者：
Tangen, Catherine M.