Background：Prostate Imaging Reporting and Data System （PI-RADS） is a globally acceptable standardization for multiparametric magnetic resonance imaging （mp-MRI） in prostate cancer （PCa） diagnosis.The American C...Background：Prostate Imaging Reporting and Data System （PI-RADS） is a globally acceptable standardization for multiparametric magnetic resonance imaging （mp-MRI） in prostate cancer （PCa） diagnosis.The American College of Radiology revised the PI-RADS to address the limitations of version 1 in December 2014.This study aimed to determine whether the PI-RADS version 2 （PI-RADS v2） scoring system improves the diagnostic accuracy of mp-MRI of the prostate compared with PI-RADS v1.Methods：This retrospective study was approved by the institutional review board.A total of 401 consecutive patients,with clinically suspicious Pca undergoing 3.0 T mp-MRI （T2-weighted imaging ＋ diffusion-weighted imaging ＋ DCE） before transrectal ultrasound-guided biopsy between June 2013 and July 2015,were included in the study.All patients were scored using the 5-point PI-RADS scoring system based on either PI-RADS v1 or v2.Receiver operating characteristics were calculated for statistical analysis.Sensitivity,specificity,and diagnostic accuracy were compared using McNemar＇s test.Results：Pca was present in 150 of 401 （37.41%） patients.When we pooled data from both peripheral zone （PZ） and transition zone （TZ）,the areas under the curve were 0.889 for PI-RADS v1 and 0.942 for v2 （P =0.0001）.Maximal accuracy was achieved with a score threshold of 4.At this threshold,in the PZ,similar sensitivity,specificity,and accuracy were achieved with v 1 and v2 （all P 〉 0.05）.In the TZ,sensitivity was higher for v2 than for v1 （96.36% vs.76.36%,P =0.003）,specificity was similar for v2 and v1 （90.24% vs.84.15%,P =0.227）,and accuracy was higher for v2 than for v1 （92.70% vs.81.02%,P =0.002）.Conclusions：Both v1 and v2 showed good diagnostic performance for the detection of Pca.However,in the TZ,the performance was better with v2 than with v1.展开更多
目的初步探讨3.0 T磁共振成像条件下,前列腺影像报告和数据系统第2版(prostate image report and data system version 2,PI-RADS V2)评分诊断方法在前列腺中央腺体癌诊断中的应用价值。材料与方法回顾性分析50例经病理证实的前列腺癌(p...目的初步探讨3.0 T磁共振成像条件下,前列腺影像报告和数据系统第2版(prostate image report and data system version 2,PI-RADS V2)评分诊断方法在前列腺中央腺体癌诊断中的应用价值。材料与方法回顾性分析50例经病理证实的前列腺癌(prostate cancer,Pca)患者的多参数磁共振成像(mutli-parameter magnetic resonance imaging,Mp-MRI)资料和临床资料。根据6分区切割模型进行前列腺中央腺体分区。两位观察者根据PI-RADS V2评分标准及常规阅片,对入组病例Mp-MRI前列腺图像的有效预定义分区进行评分,分析评分结果的一致性。评分结果与该分区相应的病理结果进行对照,分析PI-RADS V2、常规阅片对前列腺中央腺体诊断中的敏感度、特异度、准确度、阳性预测值和阴性预测值,评价PI-RADS V2在前列腺中央腺体癌的诊断效能。结果 50例患者的Mp-MRI前列腺图像共分割为300个前列腺中央腺体分区,获得有效预定义的分区238个。结果显示,2位观察者PI-RADS V2诊断结果一致性极佳(K=0.84)。PI-RADS V2评分"4"分为诊断界值时,诊断结果准确度为79.2%,敏感度为70.4%,特异度为83.8%。常规阅片诊断结果准确度为72.7%,敏感度为49.7%,特异度为92.3%。PI-RADS V2评分诊断效能优于常规阅片。结论在3.0 T磁共振成像系统,Mp-MRI前列腺中央腺体癌诊断中,应用PI-RADS V2进行评分诊断结果的一致性较高,具有较好的诊断效能和临床应用价值。展开更多
目的:分析前列腺多参数核磁共振检查第2版前列腺影像报告与数据系统(prostate imaging-reporting and data system version 2,PI-RADS V2)中低评分患者的临床特征。方法:回顾性分析2015年7月—2019年7月在上海交通大学附属仁济医院行经...目的:分析前列腺多参数核磁共振检查第2版前列腺影像报告与数据系统(prostate imaging-reporting and data system version 2,PI-RADS V2)中低评分患者的临床特征。方法:回顾性分析2015年7月—2019年7月在上海交通大学附属仁济医院行经会阴前列腺穿刺活检,并且术前行多参数核磁共振检查的2588例患者的临床资料,患者年龄25~91岁,平均(67.6±7.9)岁;PSA中位数11.49(7.49,20.74)ng/mL,其中983例PSA位于灰区(4~10ng/mL)。2588例患者中,PI-RADS V2评分2分302例(11.7%),3分238例(9.2%),4分1842例(71.2%),5分206例(7.9%)。采用logistic单因素和卡方检验对中低PI-RADS V2评分(≤3分)患者的临床特征进行分析。结果:2588例经会阴前列腺穿刺活检者中有1259(48.6%)例患者穿刺病理为前列腺癌(prostate cancer,PCa),以PI-RADS V2评分>3分为界,PI-RADS V2中低评分者占6.6%(83/1259),临床分期均≤cT2cN0M0期,其中48.2%(40/83)为临床无显著意义前列腺癌(clinically insignificant prostate cancer,ciPCa)。以PI-RADS V2评分>3分为穿刺指征,可使17.7%(457/2588)的患者避免不必要的穿刺,而且漏诊83例中所有患者均为局限性PCa,其中ciPCa占48.2%;在PSA值位于灰区的983例患者中,穿刺阳性率为33.9%(333/983),以PI-RADS V2评分>3分为穿刺指征,可使20.3%(200/983)的患者避免不必要的穿刺,而且漏诊26例中所有患者均为局限性PCa,其中ciPCa患者占69.2%(18/26)。结论:多参数核磁共振检查对评估患者是否需要进行前列腺穿刺具有指导意义,在PI-RADS V2≤3分的患者中,仍有部分患者穿刺病理为PCa,但是相对于PI-RADS高评分者其临床分期及Gleason评分明显偏低,其中ciPCa占大部分;而对于PSA值位于灰区的患者,采用PIRADS V2对患者进行评估可大幅减少不必要的前列腺穿刺。展开更多
基金This study was supported by a grant of National Natural Science Foundation of China （No. 81171307）.
文摘Background：Prostate Imaging Reporting and Data System （PI-RADS） is a globally acceptable standardization for multiparametric magnetic resonance imaging （mp-MRI） in prostate cancer （PCa） diagnosis.The American College of Radiology revised the PI-RADS to address the limitations of version 1 in December 2014.This study aimed to determine whether the PI-RADS version 2 （PI-RADS v2） scoring system improves the diagnostic accuracy of mp-MRI of the prostate compared with PI-RADS v1.Methods：This retrospective study was approved by the institutional review board.A total of 401 consecutive patients,with clinically suspicious Pca undergoing 3.0 T mp-MRI （T2-weighted imaging ＋ diffusion-weighted imaging ＋ DCE） before transrectal ultrasound-guided biopsy between June 2013 and July 2015,were included in the study.All patients were scored using the 5-point PI-RADS scoring system based on either PI-RADS v1 or v2.Receiver operating characteristics were calculated for statistical analysis.Sensitivity,specificity,and diagnostic accuracy were compared using McNemar＇s test.Results：Pca was present in 150 of 401 （37.41%） patients.When we pooled data from both peripheral zone （PZ） and transition zone （TZ）,the areas under the curve were 0.889 for PI-RADS v1 and 0.942 for v2 （P =0.0001）.Maximal accuracy was achieved with a score threshold of 4.At this threshold,in the PZ,similar sensitivity,specificity,and accuracy were achieved with v 1 and v2 （all P 〉 0.05）.In the TZ,sensitivity was higher for v2 than for v1 （96.36% vs.76.36%,P =0.003）,specificity was similar for v2 and v1 （90.24% vs.84.15%,P =0.227）,and accuracy was higher for v2 than for v1 （92.70% vs.81.02%,P =0.002）.Conclusions：Both v1 and v2 showed good diagnostic performance for the detection of Pca.However,in the TZ,the performance was better with v2 than with v1.
文摘目的初步探讨3.0 T磁共振成像条件下,前列腺影像报告和数据系统第2版(prostate image report and data system version 2,PI-RADS V2)评分诊断方法在前列腺中央腺体癌诊断中的应用价值。材料与方法回顾性分析50例经病理证实的前列腺癌(prostate cancer,Pca)患者的多参数磁共振成像(mutli-parameter magnetic resonance imaging,Mp-MRI)资料和临床资料。根据6分区切割模型进行前列腺中央腺体分区。两位观察者根据PI-RADS V2评分标准及常规阅片,对入组病例Mp-MRI前列腺图像的有效预定义分区进行评分,分析评分结果的一致性。评分结果与该分区相应的病理结果进行对照,分析PI-RADS V2、常规阅片对前列腺中央腺体诊断中的敏感度、特异度、准确度、阳性预测值和阴性预测值,评价PI-RADS V2在前列腺中央腺体癌的诊断效能。结果 50例患者的Mp-MRI前列腺图像共分割为300个前列腺中央腺体分区,获得有效预定义的分区238个。结果显示,2位观察者PI-RADS V2诊断结果一致性极佳(K=0.84)。PI-RADS V2评分"4"分为诊断界值时,诊断结果准确度为79.2%,敏感度为70.4%,特异度为83.8%。常规阅片诊断结果准确度为72.7%,敏感度为49.7%,特异度为92.3%。PI-RADS V2评分诊断效能优于常规阅片。结论在3.0 T磁共振成像系统,Mp-MRI前列腺中央腺体癌诊断中,应用PI-RADS V2进行评分诊断结果的一致性较高,具有较好的诊断效能和临床应用价值。
文摘目的:分析前列腺多参数核磁共振检查第2版前列腺影像报告与数据系统(prostate imaging-reporting and data system version 2,PI-RADS V2)中低评分患者的临床特征。方法:回顾性分析2015年7月—2019年7月在上海交通大学附属仁济医院行经会阴前列腺穿刺活检,并且术前行多参数核磁共振检查的2588例患者的临床资料,患者年龄25~91岁,平均(67.6±7.9)岁;PSA中位数11.49(7.49,20.74)ng/mL,其中983例PSA位于灰区(4~10ng/mL)。2588例患者中,PI-RADS V2评分2分302例(11.7%),3分238例(9.2%),4分1842例(71.2%),5分206例(7.9%)。采用logistic单因素和卡方检验对中低PI-RADS V2评分(≤3分)患者的临床特征进行分析。结果:2588例经会阴前列腺穿刺活检者中有1259(48.6%)例患者穿刺病理为前列腺癌(prostate cancer,PCa),以PI-RADS V2评分>3分为界,PI-RADS V2中低评分者占6.6%(83/1259),临床分期均≤cT2cN0M0期,其中48.2%(40/83)为临床无显著意义前列腺癌(clinically insignificant prostate cancer,ciPCa)。以PI-RADS V2评分>3分为穿刺指征,可使17.7%(457/2588)的患者避免不必要的穿刺,而且漏诊83例中所有患者均为局限性PCa,其中ciPCa占48.2%;在PSA值位于灰区的983例患者中,穿刺阳性率为33.9%(333/983),以PI-RADS V2评分>3分为穿刺指征,可使20.3%(200/983)的患者避免不必要的穿刺,而且漏诊26例中所有患者均为局限性PCa,其中ciPCa患者占69.2%(18/26)。结论:多参数核磁共振检查对评估患者是否需要进行前列腺穿刺具有指导意义,在PI-RADS V2≤3分的患者中,仍有部分患者穿刺病理为PCa,但是相对于PI-RADS高评分者其临床分期及Gleason评分明显偏低,其中ciPCa占大部分;而对于PSA值位于灰区的患者,采用PIRADS V2对患者进行评估可大幅减少不必要的前列腺穿刺。
