维普中文期刊产品整合服务

Role of multi-parametric MRI of the prostate for screening and staging:Experience with over 1500 cases

查看全文 作　　者：Geoffrey [1]Gaunay;Vinay [1]Patel;Paras [1]Shah;Daniel [2]Moreira;Simon [1]J.Hall;Manish [1]A.Vira;Michael [1]Schwartz;Jessica [1]Kreshover;Eran Ben-[1]Levi;Robert [1]Villani;Ardeshir [3]Rastinehad;Lee [1]Richstone 高影响力作者 机构地区：[1]Department of Urology,The Smith Institute for Urology,Northwell Health,New Hyde Park,NY,USA;[2]Department of Urology,University of Illinois Chicago,Chicago,IL,USA;[3]Department of Urology&Interventional Radiology,Mount Sinai Health System,New York City,NY,USA高影响力机构 出　　处：《Asian Journal of Urology》索引2017年第4卷第1期,共7页高影响力期刊 摘　　要：Objective:Contemporary prostate cancer(PCa)screening modalities such as prostate specific antigen(PSA)and digital rectal examination(DRE)are limited in their ability to predict the detection of clinically significant disease.Multi-parametric magnetic resonance imaging(mpMRI)of the prostate has been explored as a staging modality for PCa.Less is known regarding its utility as a primary screening modality.We examined our experience with mpMRI as both a screening and staging instrument.Methods:mpMRI studies performed between 2012 and 2014 in patients without PCa were cross-referenced with transrectal ultrasonography(TRUS)biopsy findings.Statistical analyses were performed to determine association of mpMRI findings with overall cancer diagnoses and clinically significant(Gleason score≥7)disease.Subgroup analyses were then performed on patients with a history of prior negative biopsy and those without a history of TRUS biopsy.mpMRI studies were also cross-referenced with RP specimens.Statistical analyses determined predictive ability of extracapsular extension(ECE),seminal vesicle involvement(SVI),and pathologic evidence of clinically significant disease(Gleason score7).Results:Four hundred biopsy naive or prior negative biopsy patients had positive mpMRI studies.Overall sensitivity,specificity,positive and negative predictive values were 94%,37%,58%,and 87%,respectively and 95%,31%,42%,and 93%,respectively for overall cancer detection and Gleason score≥7 disease.In patients with no prior biopsy history,mpMRI sensitivity,specificity,positive and negative predictive values were 94%,36%,65%,and 82%,for all cancers,and 95%,30%,50%,and 89%for Gleason score7 lesions,respectively.In those with prior negative biopsy sensitivity,specificity,positive and negative predictive values were 94%,37%,52%,and 90% for all cancers,and 96%,32%,36%,and 96% for Gleason score7 lesions,respectively.Seventy-four patients underwent radical prostatectomy(RP)after mpMRI.Lesion size on mpMRI correlated with the presence of Gleason score7 cancers(p Z 0.005).mpMRI sensitivity,specificity,positive and negative predictive values were 84%,39%,81%,and 44% respectively,for Gleason7 cancer.For ECE and SVI,sensitivity and specificity were 58% and 98% and 44% and 97%,respectively.Conclusion:mpMRI is an accurate predictor of TRUS biopsy and RP outcomes.mpMRI has significant potential to change PCa management,particularly in the screening population,in whom a significant proportion may avoid TRUS biopsy.Further studies are necessary to determine how mpMRI should be incorporated into the current PCa screening and staging paradigms. 关 键 词：Prostate cancer Magnetic resonance imaging STAGING Prostatectomy SCREENING MARGINS Gleason score Novel use
相关文献

参考文献(35)

引证文献(1)

网站首页 | 关于我们 | 联系我们 | 产品服务 | 客服中心 | 广告服务 | 版权声明 | 网站联盟 | 友情链接 | 售卡网点

版权所有© 渝B2-20050021-1　渝公网安备 50019002500403号　违法和不良信息举报中心

互联网出版许可证 新出网证(渝)字10号 全国400电话 - 免长途话费