当前位置: X-MOL 学术Clin. Oncol. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Multiparametric Magnetic Resonance Imaging in the Diagnosis of Clinically Significant Prostate Cancer: an Updated Systematic Review
Clinical Oncology ( IF 3.4 ) Pub Date : 2021-08-13 , DOI: 10.1016/j.clon.2021.07.016
M A Haider 1 , J Brown 2 , X Yao 3 , J Chin 4 , N Perlis 5 , N Schieda 6 , A Loblaw 7
Affiliation  

There has been growing utilisation of multiparametric magnetic resonance imaging (MPMRI) as a non-invasive tool to diagnose and localise clinically significant prostate cancer (CSPCa). This updated systematic review examines the use of MPMRI in patients with an elevated risk of CSPCa who have had a prior negative transrectal ultrasound systematic biopsy (TRUS-SB) and who were biopsy naïve. MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews were searched for existing systematic reviews published up to September 2020. The literature search of the electronic databases combined disease-specific terms (prostate cancer, prostate carcinoma, etc.) and treatment-specific terms (magnetic resonance, etc.). Studies were included if they were randomised controlled trials (RCTs) comparing MPMRI to template transperineal mapping biopsy (TPMB) or to TRUS-SB. Thirty-six RCTs were eligible. For biopsy-naïve men, accuracy of diagnosis of CSPCa showed sensitivities from 87 to 96% and specificities ranging from 29 to 45%. Meta-analyses for CSPCa showed increased detection favouring MPMRI-targeted biopsy over TRUS-SB by 3% (95% confidence interval 0–7%, P = 0.03) and decreased detection of clinically insignificant prostate cancer (CISPCa) favouring MPMRI by 8% (95% confidence interval –11 to 5%, P < 0.00001). Accuracy of MPMRI for men with prior negative biopsy showed sensitivities of 78–100% and specificities of 30–100%. Meta-analyses comparing MPMRI to TRUS-SB showed increased detection of 5% (95% confidence interval 3–7%, P < 0.0001) with a reduction of CISPCa detection of 7% (95% confidence interval 4–9%, P < 0.00001). The growing acceptance of MPMRI utilisation internationally and the recent publication of several RCTs regarding MPMRI in reducing CISPCa detection rates, particularly in biopsy-naïve men, without loss of sensitivity for CSPCa necessitates the synthesis of updated evidence examining MPMRI in the diagnosis of CSPCa.



中文翻译:

多参数磁共振成像在临床显着前列腺癌的诊断中:更新的系统评价

越来越多地利用多参数磁共振成像 (MPMRI) 作为非侵入性工具来诊断和定位具有临床意义的前列腺癌 (CSPCa)。这篇更新的系统评价检查了 MPMRI 在 CSPca 风险升高的患者中的使用,这些患者之前进行了阴性经直肠超声系统活检 (TRUS-SB),并且未进行过活检。检索了 MEDLINE、EMBASE 和 Cochrane 系统评价数据库,以查找截至 2020 年 9 月发表的现有系统评价。电子数据库的文献检索结合了疾病特定术语(前列腺癌、前列腺癌等)和治疗特定术语(磁共振等)。纳入比较 MPMRI 与模板经会阴映射活检 (TPMB) 或 TRUS-SB 的随机对照试验 (RCT) 的研究。36 项 RCT 符合条件。对于未进行过活检的男性,CSPCa 诊断的准确性显示敏感性为 87% 至 96%,特异性为 29% 至 45%。CSPCa 的荟萃分析显示,与 TRUS-SB 相比,MPMRI 靶向活检的检测率增加了 3%(95% 置信区间 0-7%,P = 0.03) 并且有利于 MPMRI 的临床无意义前列腺癌 (CISPCa) 的检出率降低了 8%(95% 置信区间 –11 至 5%,P < 0.00001)。MPMRI 对先前活检阴性的男性的准确性显示出 78-100% 的敏感性和 30-100% 的特异性。将 MPMRI 与 TRUS-SB 进行比较的荟萃分析显示,检出率提高了 5%(95% 置信区间 3-7%,P < 0.0001),而 CISPCa 检出率降低了 7%(95% 置信区间 4-9%,P< 0.00001)。国际上越来越多地接受 MPMRI 的使用,以及最近发表的几项关于 MPMRI 降低 CISPCa 检出率的 RCT,特别是在未进行活检的男性中,而不会降低对 CSPCa 的敏感性,因此需要综合检查 MPMRI 在诊断 CSPCa 中的最新证据。

更新日期:2021-08-13
down
wechat
bug