PI-RADS 3 score: A retrospective experience of clinically significant prostate cancer detection.
PI-RADS 3 score: A retrospective experience of clinically significant prostate cancer detection.
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DOI：
10.1002/bco2.231
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发表时间：
2023-07
期刊：
影响因子：
--
通讯作者：
Fennessy, Fiona M.
中科院分区：
文献类型：
--
作者：
Camacho, Andres;Salah, Fatima;Bay, Camden P.;Waring, Jonathan;Umeton, Renato;Hirsch, Michelle S.;Cole, Alexander P.;Kibel, Adam S.;Loda, Massimo;Tempany, Clare M.;Fennessy, Fiona M.
关键词：
该研究旨在根据一家大型学术医学中心的5年回顾性审查，通过确定用于检测这些男性中具有临床意义的前列腺癌（csPCa）的病理学询问的时间和类型，提出PI‐RADS 3（PR‐3）评估类别（AC）患者的最佳工作流程。这项符合美国健康保险概率和责任法案（HIPAA）、机构审查委员会批准的回顾性研究纳入了既往未诊断为csPCa、在磁共振（MR）成像（MRI）上接受PR-3 AC的男性。记录随后的发生率和至csPCa诊断的时间以及前列腺介入的数量/类型。使用Fisher精确检验比较分类数据，使用ANOVA综合F检验比较连续数据。我们的3238名男性队列确定了332名接受PR-3作为MRI最高AC的男性，其中240名（72.3%）在5年内进行了病理随访。在9.0 ± 10.6个月内，76/240例（32%）患者检测到csPCa，109/240例（45%）患者检测到非csPCa。使用非靶向经直肠超声活检作为初始方法（n = 55），42/55（76.4%）男性需要另一种诊断程序来诊断csPCa，而使用初始MR靶向活检方法（n = 21）的男性为3/21（14.3%）;（p < 0.0001）。与非csPCa/无PCa相比，csPCa患者的中位血清前列腺特异性抗原（PSA）和PSA密度较高，中位前列腺体积较低（p < 0.003）。大多数PR-3 AC患者在5年内接受了前列腺病理学检查，其中32%在MRI后1年内发现有csPCa，最常见的是PSA密度较高和既往非csPCa诊断。增加靶向活检方法最初减少了对第二次活检的需求，以达到csPCa诊断。因此，建议在PR-3和PSA和PSA密度异常并存的男性中结合系统性和靶向活检。
The study aims to propose an optimal workflow in patients with a PI‐RADS 3 (PR‐3) assessment category (AC) through determining the timing and type of pathology interrogation used for the detection of clinically significant prostate cancer (csPCa) in these men based upon a 5‐year retrospective review in a large academic medical center. This United States Health Insurance Probability and Accountability Act (HIPAA)‐compliant, institutional review board‐approved retrospective study included men without prior csPCa diagnosis who received PR‐3 AC on magnetic resonance (MR) imaging (MRI). Subsequent incidence and time to csPCa diagnosis and number/type of prostate interventions was recorded. Categorical data were compared using Fisher's exact test and continuous data using ANOVA omnibus F‐test. Our cohort of 3238 men identified 332 who received PR‐3 as their highest AC on MRI, 240 (72.3%) of whom had pathology follow‐up within 5 years. csPCa was detected in 76/240 (32%) and non‐csPCa in 109/240 (45%) within 9.0 ± 10.6 months. Using a non‐targeted trans‐rectal ultrasound biopsy as the initial approach (n = 55), another diagnostic procedure was required to diagnose csPCa in 42/55 (76.4%) of men, compared with 3/21(14.3%) men with an initial MR targeted‐biopsy approach (n = 21); (p < 0.0001). Those with csPCa had higher median serum prostate‐specific antigen (PSA) and PSA density, and lower median prostate volume (p < 0.003) compared with non‐csPCa/no PCa. Most patients with PR‐3 AC underwent prostate pathology exams within 5 years, 32% of whom were found to have csPCa within 1 year of MRI, most often with a higher PSA density and a prior non‐csPCa diagnosis. Addition of a targeted biopsy approach initially reduced the need for a second biopsy to reach a for csPCa diagnosis. Thus, a combination of systematic and targeted biopsy is advised in men with PR‐3 and a co‐existing abnormal PSA and PSA density.
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影响因子：
2
作者：
Schoots IG
通讯作者：
Schoots IG
DOI：
10.1056/nejmoa1801993
发表时间：
2018-05-10
期刊：
The New England journal of medicine
影响因子：
--
作者：
通讯作者：
--
影响因子：
6.7
作者：
Fedorov A;Vangel MG;Tempany CM;Fennessy FM
通讯作者：
Fennessy FM
影响因子：
8.8
作者：
Simmons, Lucy A. M.;Kanthabalan, Abi;Ahmed, Hashim U.
通讯作者：
Ahmed, Hashim U.
影响因子：
23.4
作者：
Padhani AR;Weinreb J;Rosenkrantz AB;Villeirs G;Turkbey B;Barentsz J
通讯作者：
Barentsz J