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MP-MRI Helpful to Avoid Prostate Biopsy and Improve Cancer Diagnosis多参数磁共振成像有助于避免前列腺活检并改善癌症诊断

A multicenter, paired-cohort, confirmatory study in UK revealed that multi-parametric magnetic resonance imaging (MP-MRI), used as a triage test before first prostate biopsy, could reduce unnecessary biopsies by a quarter, also reduce over-diagnosis of clinically insignificant prostate cancer and improve detection of clinically significant cancer. Between May 2012 and November 2015, the study enrolled 740 men with prostate-specific antigen concentrations up to 15 ng/mL, with no previous biopsy, 576 of whom underwent 1·5 Tesla MP-MRI followed by both transrectal ultrasound-guided prostate (TRUS)-biopsy and template prostate mapping (TPM)-biopsy. Clinically significant cancer was defined as Gleason score ≥4 + 3 or a maximum cancer core length 6 mm or longer. On TPM-biopsy, 408 (71%) of 576 men had cancer with 230 (40%) clinically significant. For clinically significant cancer, MP-MRI was more sensitive (93%) than TRUS-biopsy (48%) and less specific (41% for MP-MRI vs 96% for TRUS-biopsy). 44 (5·9%) of 740 patients reported serious adverse events, including 8 cases of sepsis. Source: http://www.thelancet.com/

英国的一项多中心,配对群组验证研究表明,多参数磁共振成像,在首次前列腺活检之前用作分诊试验,可以减少四分之一不必要的活检,也减少无显着临床意义的前列腺癌的过度诊断且改善具显着临床意义的癌症的检测。 2012年5月至2015年11月,该研究招募了前列腺特异抗原浓度高达15 豪微克 / 毫升的740名男性,无活检史,其中576名接受了1·5特斯拉多参数磁共振成像,随后是直肠超声活检和模板前列腺标示活检。Gleason评分≥4+ 3或最大癌核心长度6mm或以上被定义为具显着临床意义的癌症。在模板前列腺标示活检中,576名男性中有408名(71%)患有癌症,230名(40%)有显著临床意义。对于临床意义显着的癌症,多参数磁共振成像(93%)比直肠超声活检(48%)更敏感,但特异性(多参数磁共振成像为41%,直肠超声活检为96%)较差。 740例患者中44例(5·9%)报告了严重不良事件,包括8例败血症。来源:http://www.thelancet.com/

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