Abstract：
BACKGROUND: Prostate cancer (PCa) ranks second among prevalent cancers in men, necessitating effective screening tools such as multiparametric magnetic resonance imaging (mpMRI) with the prostate imaging reporting and data system (PI-RADS) classification. This study explores the impact of lesion volume on clinically significant prostate cancer (csPCa) detection rates in PI-RADS 3-5 lesions, aiming to contribute insights into the underexplored relationship between lesion size and csPCa detection.
METHODS: A retrospective analysis was conducted on data from 754 patients undergoing mpMRI-guided transrectal ultrasound (TRUS) prostate biopsy between January 2016 and 2023. Patients with PI-RADS 3, 4, and 5 lesions were included. Lesion size and PI-RADS categories were assessed through mpMRI, followed by MR fusion biopsy.
RESULTS: Of the patients, 33.7%, 52.3%, and 14.1% had PI-RADS 3, 4, and 5 lesions, respectively. Lesion sizes correlated significantly with csPCa detection in PI-RADS 4 and 5 categories. For PI-RADS 3 lesions, no significant differences in csPCa rates were observed based on lesion size. However, in PI-RADS 4 and 5 groups, larger lesions showed higher csPCa rates.
CONCLUSIONS: This study suggests that subgroup categorizations based on lesion volume could predict clinically significant PCa with high accuracy, potentially reducing unnecessary biopsies and associated overtreatment. Future research should further explore the relationship between lesion size and csPCa, clarifying discussions regarding the inclusion of systematic biopsies in diagnostic protocols.
METHODS: A retrospective analysis was conducted on data from 754 patients undergoing mpMRI-guided transrectal ultrasound (TRUS) prostate biopsy between January 2016 and 2023. Patients with PI-RADS 3, 4, and 5 lesions were included. Lesion size and PI-RADS categories were assessed through mpMRI, followed by MR fusion biopsy.
RESULTS: Of the patients, 33.7%, 52.3%, and 14.1% had PI-RADS 3, 4, and 5 lesions, respectively. Lesion sizes correlated significantly with csPCa detection in PI-RADS 4 and 5 categories. For PI-RADS 3 lesions, no significant differences in csPCa rates were observed based on lesion size. However, in PI-RADS 4 and 5 groups, larger lesions showed higher csPCa rates.
CONCLUSIONS: This study suggests that subgroup categorizations based on lesion volume could predict clinically significant PCa with high accuracy, potentially reducing unnecessary biopsies and associated overtreatment. Future research should further explore the relationship between lesion size and csPCa, clarifying discussions regarding the inclusion of systematic biopsies in diagnostic protocols.
摘要：
背景：前列腺癌（PCa）在男性流行癌症中排名第二，需要有效的筛查工具，例如具有前列腺成像报告和数据系统（PI-RADS）分类的多参数磁共振成像（mpMRI）。这项研究探讨了病变体积对PI-RADS3-5个病变中临床显着前列腺癌（csPCa）检出率的影响，旨在深入了解病变大小与csPCa检测之间的未充分利用关系。
方法：对2016年1月至2023年接受mpMRI引导下经直肠超声（TRUS）前列腺活检的754例患者的数据进行了回顾性分析。包括PI-RADS3、4和5个病变的患者。通过mpMRI评估病变大小和PI-RADS类别，然后进行MR融合活检。
结果：在患者中，33.7%,52.3%,14.1%有PI-RADS3、4和5个病灶，分别。在PI-RADS4和5类别中，病变大小与csPCa检测显着相关。对于PI-RADS3个病变，根据病灶大小,观察到csPCa发生率无显著差异.然而,在PI-RADS4和5组中，较大的病变显示较高的csPCa率。
结论：这项研究表明，基于病变体积的亚组分类可以高精度地预测临床上显著的PCa，可能减少不必要的活检和相关的过度治疗。未来的研究应进一步探讨病变大小与csPCa之间的关系，澄清有关将系统活检纳入诊断方案的讨论。
方法：对2016年1月至2023年接受mpMRI引导下经直肠超声（TRUS）前列腺活检的754例患者的数据进行了回顾性分析。包括PI-RADS3、4和5个病变的患者。通过mpMRI评估病变大小和PI-RADS类别，然后进行MR融合活检。
结果：在患者中，33.7%,52.3%,14.1%有PI-RADS3、4和5个病灶，分别。在PI-RADS4和5类别中，病变大小与csPCa检测显着相关。对于PI-RADS3个病变，根据病灶大小,观察到csPCa发生率无显著差异.然而,在PI-RADS4和5组中，较大的病变显示较高的csPCa率。
结论：这项研究表明，基于病变体积的亚组分类可以高精度地预测临床上显著的PCa，可能减少不必要的活检和相关的过度治疗。未来的研究应进一步探讨病变大小与csPCa之间的关系，澄清有关将系统活检纳入诊断方案的讨论。
