前列腺影像报告和数据系统评价外周带前列腺癌的诊断价值

Diagnostic value of imaging reporting and data system for peripheral zone prostate cancer

目的探讨前列腺影像报告和数据系统(PI-RADSv2)对外周带前列腺癌的诊断应用价值。方法选取2015年6月至2016年12月间苏州大学附属第二医院收治的103例前列腺外周带疾病患者的多参数磁共振成像(mp-MRI)表现。由两位医师对前列腺外周带病变进行PI-RADSv2评分,以病理检查结果作为金标准,分析两位医师诊断的一致性。通过绘制受试者工作特征(ROC)曲线及敏感度和特异度等指标,评估PI-RADSv2对外周带前列腺癌的诊断效能。结果两位医师评估外周带前列腺癌、临床显著癌和非癌病变Kappa值分别为0.75、0.84和0.66。PI-RADSv2诊断外周带前列腺癌的敏感度和特异度分别为80.2%和75.1%。PI-RADSv2诊断外周带前列腺临床显著癌的诊断敏感度和特异度分别为89.7%和84.6%。结论两位医师评估前列腺外周带病变的PIRADS评分有较高一致性,对前列腺外周带临床显著癌的评分一致性高,且PI-RADSv2对外周带前列腺临床显著癌有较高的敏感度和特异度,对前列腺外周带病变诊断具有一定的指导意义。

Objective To evaluate the diagnostic value of the second version of the prostate ima- ging reporting and data system （PI-RADSv2） for peripheral zone prostate cancer. Methods Clinical and multi-parameter magnetic resonance imaging （mp-MRI） data was collected from 103 patients with peripheral zone prostate cancer at The Second Hospital Affiliated to Suzhou University from June 2015 to December 2016. The score of PI-RADSv2 is calculated by two clinicians. The pathologic diagnosis results were consid- ered as the golden rule to analyze the consistence of the diagnosis results between the two clinicians. Receiv- er operator characteristic （ROC） curve was drawn and the indexes including sensitivity and specificity were used to evaluate the diagnostic value PI-RADSv2 for prostate cancer in the peripheral zone. Results Diag- nosis results from the two clinicians revealed that the Kappa values of peripheral zone cancer, clinically signif- icant cancer and non-cancerous lesions were 0. 75, 0. 84, and 0. 66, respectively. The sensitivity and speci- ficity of PI-RADSv2 for peripheral zone prostate cancer was 80. 2% and 75.1%. The sensitivity and specifici- ty of PI-RADSv2 for clinically significant cancer in the peripheral zone was 89.7% and 84. 6%, respectively. Conclusion Threre was high consistency in the scores of PI-RADSv2 for peripheral zone prostate cancer be- tween the two clinicians, especially for clinically significant cancer. PI-RADSv2 score has a high diagnostic sensitivity and specificity in detecting clinically significant prostate cancer in the peripheral zone.