外周带前列腺癌多参数MRI与前列腺临床显著癌及Gleason评分的相关性

目的探讨基于第2版前列腺影像报告和数据系统(PI-RADS v2)评分的外周带前列腺癌多参数MRI(mp-MRI)与前列腺临床显著癌及Gleason评分的相关性。方法回顾性分析T2WI、扩散加权成像(DWI)和动态增强MRI(DCE-MRI)诊断且经穿刺病理证实的91例外周带前列腺癌(阳性组)、70例前列腺增生和21例前列腺炎(阴性组)患者,采用PI-RADS v2评分标准进行盲法评分,分析其结果与外周带前列腺临床显著癌及Gleason评分的相关性,并以受试者工作特征(ROC)曲线分析PI-RADS v2评分诊断外周带前列腺临床显著癌的敏感度、特异度和准确率。结果 PI-RADS v2评分诊断外周带前列腺临床显著癌的曲线下面积(AUC)为0.965[95%CI(0.930,1.000),P<0.01];评分为4分时约登指数最大(0.877),诊断前列腺临床显著癌的敏感度、特异度和准确率分别为98.61%、89.09%和92.86%。以PI-RADS v2评分3分为穿刺指征,使36.26%(66/182)患者免于不必要的穿刺,但漏诊2例非临床显著前列腺癌。PI-RADS v2评分与...

Correlation of multi-parametric MRI of peripheral prostate cancer with clinically significant prostate cancer and Gleason score

Objective To explore the correlation of multi-parametric MRI (mp-MRI) of peripheral prostate cancer based on prostate imaging reporting and data system version 2 (PI-RADS v2) scoring with clinically significant prostate cancer and Gleason score. Methods Clinical and MRI data, including T2WI, diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MRI (DCE-MRI) of 91 cases of peripheral prostate cancer (positive group), 70 of benign prostatic hyperplasia (BPH) and 21 cases of prostatitis (negative group) confirmed with prostate biopsy pathology were retrospectively analyzed. PI-RADS v2 scoring was performed blindly, then the correlations with clinically significant prostate cancer and Gleason score were analyzed. The sensitivity, specificity and accuracy of PI-RADS v2 scoring were analyzed using receiver operating characteristic (ROC) curve. Results The area under the curve (AUC) for the detection of clinically significant prostate cancer of PI-RADS v2 scoring was 0.965 (95%CI, P<0.01). Taken PI-RADS v2 scoring 4 as the cutoff value, Youden index was maximum (0.877),the sensitivity, specificity and accuracy of diagnosis of clinically significant prostate cancer was 98.61%, 89.09% and 92.86%, respectively. Taken PI-RADS v2 scoring 3 as the cut-off point, unnecessary prostate biopsy could be avoided in 36.26% (66/182) patients, but 2 patients with non-significant prostate cancer would be misdiagnosed. PI-RADS v2 scoring was highly positively correlated with clinically significant prostate cancer (r=0.853, P<0.01) and Gleason score (r=0.816, P<0.01). Conclusion PI-RADS v2 scoring was positively correlated with clinically significant peripheral prostate cancer and Gleason score, which had high diagnostic accuracy in clinically significant prostate cancer and Preliminarily evaluation on tumor differentiation, therefore being helpful to avoiding unnecessary biopsy.