PDF(Pubmed)
Abstract：
UNASSIGNED: Current literature suggests that axial skeleton magnetic resonance imaging (AS-MRI) is more sensitive than Tc 99m bone scintigraphy (BS) for detecting bone metastases (BM) in high-risk prostate cancer (PCa). However, BS is still widely performed. Its diagnostic accuracy has been studied; however, its feasibility and cost implications are yet to be examined.
UNASSIGNED: We reviewed all patients with high risk PCa undergoing AS-MRI over a 5-year period. AS-MRI was performed on patients with histologically confirmed PCa and either PSA > 20 ng/ml, Gleason ≥8, or TNM Stage ≥T3 or N1 disease. All AS-MRI studies were obtained using a 1.5-T AchievaPhilips™MRI scanner. We compared the AS-MRI positivity and equivocal rate with that of BS. Data were analysed according to Gleason score, T-stage and PSA. Multivariate logistic regression analyses were used to quantify the strength of association between positive scans and clinical variables. Feasibility and burden of expenditure was also evaluated.
UNASSIGNED: Five hundred three patients with a median age of 72 and a mean PSA of 34.8 ng/ml were analysed. Eighty-eight patients (17.5%) were positive for BM on AS-MRI (mean PSA 99 [95% CI 69.1-129.9]). Comparatively 409 patients (81.3%) were negative for BM on AS-MRI (mean PSA 24.7 (95% CI [21.7-27.7]) (p = 0.007); 1.2% (n = 6) of patients had equivocal results (mean PSA 33.4 [95% CI 10.5-56.3]). There was no significant difference in age (p = 0.122) between this group and patients with a positive scan, but there was a significant difference in PSA (p = 0.028), T stage (p = 0.006) and Gleason score (p = 0.023). In comparison with BS, AS-MRI detection rate was equivalent or higher compared with the literature. Based on NHS tariff calculations, there would be a minimum cost saving of £8406.89. All patients underwent AS-MRI within 14 days.
UNASSIGNED: The use of AS-MRI to stage BM in high-risk PCa is both feasible and results in a reduced burden of expenditure.
UNASSIGNED: We reviewed all patients with high risk PCa undergoing AS-MRI over a 5-year period. AS-MRI was performed on patients with histologically confirmed PCa and either PSA > 20 ng/ml, Gleason ≥8, or TNM Stage ≥T3 or N1 disease. All AS-MRI studies were obtained using a 1.5-T AchievaPhilips™MRI scanner. We compared the AS-MRI positivity and equivocal rate with that of BS. Data were analysed according to Gleason score, T-stage and PSA. Multivariate logistic regression analyses were used to quantify the strength of association between positive scans and clinical variables. Feasibility and burden of expenditure was also evaluated.
UNASSIGNED: Five hundred three patients with a median age of 72 and a mean PSA of 34.8 ng/ml were analysed. Eighty-eight patients (17.5%) were positive for BM on AS-MRI (mean PSA 99 [95% CI 69.1-129.9]). Comparatively 409 patients (81.3%) were negative for BM on AS-MRI (mean PSA 24.7 (95% CI [21.7-27.7]) (p = 0.007); 1.2% (n = 6) of patients had equivocal results (mean PSA 33.4 [95% CI 10.5-56.3]). There was no significant difference in age (p = 0.122) between this group and patients with a positive scan, but there was a significant difference in PSA (p = 0.028), T stage (p = 0.006) and Gleason score (p = 0.023). In comparison with BS, AS-MRI detection rate was equivalent or higher compared with the literature. Based on NHS tariff calculations, there would be a minimum cost saving of £8406.89. All patients underwent AS-MRI within 14 days.
UNASSIGNED: The use of AS-MRI to stage BM in high-risk PCa is both feasible and results in a reduced burden of expenditure.
摘要：
■目前的文献表明，轴向骨骼磁共振成像（AS-MRI）比Tc99m骨闪烁显像（BS）更敏感地检测高风险前列腺癌（PCa）中的骨转移（BM）。然而,BS仍然广泛执行。已经研究了它的诊断准确性；然而，其可行性和成本影响尚待研究。
■我们回顾了5年期间接受AS-MRI检查的所有高危PCa患者。对组织学证实为PCa且PSA>20ng/ml的患者进行AS-MRI，格里森≥8，或TNM分期≥T3或N1疾病。所有AS-MRI研究均使用1.5-TAchemaPhilips™MRI扫描仪获得。我们将AS-MRI阳性率和模棱两可率与BS进行了比较。根据格里森评分对数据进行分析，T级和PSA。使用多变量逻辑回归分析来量化阳性扫描与临床变量之间的关联强度。还评估了支出的可行性和负担。
■分析了500例患者，中位年龄为72岁，平均PSA为34.8ng/ml。88例患者（17.5%）在AS-MRI上为BM阳性（平均PSA99[95%CI69.1-129.9]）。相比之下，409例患者(81.3%)在AS-MRI上BM阴性(平均PSA24.7(95%CI[21.7-27.7])(p=0.007)；1.2%(n=6)的患者结果不明确(平均PSA33.4[95%CI10.5-56.3])。该组与扫描阳性的患者之间的年龄没有显着差异（p=0.122），但PSA有显著差异（p=0.028），T分期(p=0.006)和Gleason评分(p=0.023)。与BS相比，AS-MRI检出率与文献相当或更高。根据NHS关税计算，最低成本节省8406.89英镑。所有患者均在14天内接受AS-MRI检查。
■在高风险PCa中使用AS-MRI对BM进行分期既可行，又可以减轻支出负担。
■我们回顾了5年期间接受AS-MRI检查的所有高危PCa患者。对组织学证实为PCa且PSA>20ng/ml的患者进行AS-MRI，格里森≥8，或TNM分期≥T3或N1疾病。所有AS-MRI研究均使用1.5-TAchemaPhilips™MRI扫描仪获得。我们将AS-MRI阳性率和模棱两可率与BS进行了比较。根据格里森评分对数据进行分析，T级和PSA。使用多变量逻辑回归分析来量化阳性扫描与临床变量之间的关联强度。还评估了支出的可行性和负担。
■分析了500例患者，中位年龄为72岁，平均PSA为34.8ng/ml。88例患者（17.5%）在AS-MRI上为BM阳性（平均PSA99[95%CI69.1-129.9]）。相比之下，409例患者(81.3%)在AS-MRI上BM阴性(平均PSA24.7(95%CI[21.7-27.7])(p=0.007)；1.2%(n=6)的患者结果不明确(平均PSA33.4[95%CI10.5-56.3])。该组与扫描阳性的患者之间的年龄没有显着差异（p=0.122），但PSA有显著差异（p=0.028），T分期(p=0.006)和Gleason评分(p=0.023)。与BS相比，AS-MRI检出率与文献相当或更高。根据NHS关税计算，最低成本节省8406.89英镑。所有患者均在14天内接受AS-MRI检查。
■在高风险PCa中使用AS-MRI对BM进行分期既可行，又可以减轻支出负担。
