Abstract：Objective: To investigate the diagnostic role of multiparametric MRI (mpMRI) for clinically significant carcinoma of the prostate, using PI-RADS v2.1 as the diagnostic standard.Methods: A total of 143 cases of suspected prostate cancer were enrolled for mpMRI, including 72 cases of clinically significant cancer confirmed by radical pathology. The films were independently blinded by an experienced imaging physician following PI-RADS v2.1. Accuracy, sensitivity, and specificity were calculated by plotting the ROC curve and calculating the area under the curve (AUC) using puncture/radiological pathology as the gold standard. Results: The AUC of PI-RADS v2.1 score in the diagnosis of csPCa was 0.900 (95% CI: 0.847 ~ 0.952). The accuracy, sensitivity, and specificity of PI-RADS≥3 were 69.7%, 95.7%, and 51.4%, respectively. The accuracy of PI-RADS≥4 (excluding PI-RADS≥3+1 in the peripheral zone [PZ]) was 98.6% (69/70). Conclusion: PI-RADS v2.1 ad high sensitivity in the diagnosis of csPCa, and DCE increased the sensitivity in the detection of PZ cancer. PI-RADS≥4 (excluding PI-RADS≥3+1 in the PZ) indicated that the probability of clinically significant cancer was as high as 9%, providing urologists with strong evidence support for subsequent management.
崔冰, 吴海燕, 陈妍, 刘有为, 许丽丽, 许再超. PI-RADS v2.1在前列腺临床显著癌诊断中的作用[J]. 河北医学, 2022, 28(8): 1295-1297.
CUI Bing, WU Haiyan, CHEN Yan, et al. PI-RADS v2.1 in the Diagnosis of Clinically Significant Cancer of the Prostate. HeBei Med, 2022, 28(8): 1295-1297.
[1] 王慧慧,胡娟,何群,等.前列腺癌体积对PI-RADS v2检出效能的影响:基于逐层切片病理检查[J].放射学实践,2018,33(4):398-402. [2] Mottet N,van den Bergh RCN,Briers E,et al.EAU-EANM-ESTRO-ESUR-SIOG guidelines on prostate cancer-2020 update.Part 1:screening,diagnosis,and local treatment with curative intent[J].Eur Urol,2021,79(2):243-262. [3] Zhang L,TangM,Chen S,et al.A meta-analysis of use of prostate imaging reporting and data system version 2 (PI-RADS V2) with multiparametric MR imaging for the detection of prostate cancer[J].Eur Radiol,2017,27(12):5204-5214. [4] Martin RM,Donovan JL,Turner EL,et al.Effect of a low-intensity PSA-based screening intervention on prostate cancer mortality:the CAP randomized clinical trial[J].JAMA,2018,319(9):883-895. [5] Welch HG,Albertsen PC.Reconsidering prostate cancer mortality - the future of PSA screening[J].N Engl Med.2020,382(16):1557-1563. [6] 杨硕,张彩元,张跃跃,等.第2.1版前列腺影像报告与数据系统对移行带病变的诊断价值[J].中华医学杂志.2020,100(45):3609-3613. [7] Linhares Moreira AS,De Visschere P,Van Praet C,et al.How does PI-RADS v2.1 impact patient classification A head-to-head comparison between PI-RADS v2.0 and v2.1[J].Acta Radiol,2021,62(6):839-847. [8] Byun J,Park KJ,Kim MH,et al.Direct comparison of PI-RADS version 2 and 2.1 in transition zone lesions for detection of prostate cancer:preliminary experience[J].Magn Reson Imaging,2020,52(2):577-586. [9] Bass EJ,Pantovic A,Connor M,et al.A systematic review and meta-analysis of the diagnostic accuracy of biparametric prostate MRI for prostate cancer in men at risk[J].Prostate Cancer Prostatic Dis,2021,24(3):596-611. [10] Tamada T,Kido A,Yamamoto A,et al.Comparison of biparametric and multiparametric MRI for clinically significant prostate cancer detection with PI-RADSVersion 2.1[J].Magn Reson Imaging,2021,53(1):283-291. [11] Chuang RJ,Marks LS.Targeted and systematic biopsy for diagnosis and management of prostate cancer[J].Clin Oncol (R Coll Radiol),2020,32(3):144-148.
2022, Vol. 28 
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