Abstract：
OBJECTIVE: There is not yet satisfactory performance data comparing multiparametric MRI (mpMRI) versus biparametric MRI (bpMRI) for detecting prostate cancer (PCa), particularly in high-risk populations. We compared both protocols for detecting overall PCa and clinically significant PCa (CS-PCa; defined as Grade Group ≥ 2) in a multiethnic urban population.
METHODS: We retrospectively reviewed electronic medical record data from men who underwent image-guided fusion prostate biopsy (FB) between 2016 and 2021 at our institution. Patient characteristics, Prostate Imaging Reporting and Data System (PI-RADS) scores, and FB outcomes were analyzed based on MRI protocol. Multivariate mixed-effects logistic regression models were used to examine associations of bpMRI versus mpMRI for detecting overall PCa and CS-PCa in targeted lesions, among all patients and stratified by race/ethnicity.
RESULTS: Overall, 566 men (44.0% Non-Hispanic Black [NHB]; 27.0% Hispanic) with 975 PI-RADS 3-5 lesions on MRI underwent FB. Of these, 312 (55%) men with 497 lesions underwent mpMRI and 254 (45%) men with 478 lesions underwent bpMRI. On multivariate analyses among all men, the odds of detecting overall PCa (OR = 1.18, 95% CI: 1.05-3.11, p = 0.031) and CS-PCa (OR = 2.15, 95% CI: 1.16-4.00, p = 0.014) on FB were higher for lesions identified on bpMRI than mpMRI. When stratified by race/ethnicity, the odds of detecting overall PCa (OR = 1.86; p = 0.15) and CS-PCa (OR = 2.20; p = 0.06) were not statistically different between lesions detected on bpMRI or mpMRI.
CONCLUSIONS: BpMRI has similar diagnostic performance to mpMRI in detecting overall and CS-PCa within a racially/ethnically diverse population. BpMRI can be utilized for evaluating suspected CS-PCa among NHB and Hispanic men.
METHODS: We retrospectively reviewed electronic medical record data from men who underwent image-guided fusion prostate biopsy (FB) between 2016 and 2021 at our institution. Patient characteristics, Prostate Imaging Reporting and Data System (PI-RADS) scores, and FB outcomes were analyzed based on MRI protocol. Multivariate mixed-effects logistic regression models were used to examine associations of bpMRI versus mpMRI for detecting overall PCa and CS-PCa in targeted lesions, among all patients and stratified by race/ethnicity.
RESULTS: Overall, 566 men (44.0% Non-Hispanic Black [NHB]; 27.0% Hispanic) with 975 PI-RADS 3-5 lesions on MRI underwent FB. Of these, 312 (55%) men with 497 lesions underwent mpMRI and 254 (45%) men with 478 lesions underwent bpMRI. On multivariate analyses among all men, the odds of detecting overall PCa (OR = 1.18, 95% CI: 1.05-3.11, p = 0.031) and CS-PCa (OR = 2.15, 95% CI: 1.16-4.00, p = 0.014) on FB were higher for lesions identified on bpMRI than mpMRI. When stratified by race/ethnicity, the odds of detecting overall PCa (OR = 1.86; p = 0.15) and CS-PCa (OR = 2.20; p = 0.06) were not statistically different between lesions detected on bpMRI or mpMRI.
CONCLUSIONS: BpMRI has similar diagnostic performance to mpMRI in detecting overall and CS-PCa within a racially/ethnically diverse population. BpMRI can be utilized for evaluating suspected CS-PCa among NHB and Hispanic men.
摘要：
目的：目前还没有令人满意的性能数据比较多参数MRI（mpMRI）和双参数MRI（bpMRI）检测前列腺癌（PCa），特别是在高危人群中。我们比较了两种在多种族城市人口中检测总体PCa和临床显着PCa（CS-PCa；定义为等级组≥2）的方案。
方法：我们回顾性审查了2016年至2021年在我们机构接受图像引导前列腺融合活检（FB）的男性的电子病历数据。患者特征,前列腺影像报告和数据系统（PI-RADS）评分，和FB结果根据MRI方案进行分析。使用多变量混合效应逻辑回归模型来检查bpMRI与mpMRI的相关性，以检测靶向病变中的总体PCa和CS-PCa。在所有患者中，按种族/民族分层。
结果：总体而言，566名男性（44.0％非西班牙裔黑人[NHB]；27.0％西班牙裔）在MRI上有975个PI-RADS3-5个病变接受了FB。其中,312（55％）例497个病变的男性接受了mpMRI，254（45％）例478个病变的男性接受了bpMRI。在所有男性的多变量分析中，bpMRI确定的病灶在FB上检测到整体PCa(OR=1.18,95%CI:1.05-3.11,p=0.031)和CS-PCa(OR=2.15,95%CI:1.16-4.00,p=0.014)的几率高于mpMRI.当按种族/民族分层时，在bpMRI或mpMRI检测到的病变之间,检测到整体PCa(OR=1.86;p=0.15)和CS-PCa(OR=2.20;p=0.06)的几率无统计学差异.
结论：BpMRI在检测种族/种族不同人群中的总体和CS-PCa方面与mpMRI具有相似的诊断性能。BpMRI可用于评估NHB和西班牙裔男性中可疑的CS-PCa。
方法：我们回顾性审查了2016年至2021年在我们机构接受图像引导前列腺融合活检（FB）的男性的电子病历数据。患者特征,前列腺影像报告和数据系统（PI-RADS）评分，和FB结果根据MRI方案进行分析。使用多变量混合效应逻辑回归模型来检查bpMRI与mpMRI的相关性，以检测靶向病变中的总体PCa和CS-PCa。在所有患者中，按种族/民族分层。
结果：总体而言，566名男性（44.0％非西班牙裔黑人[NHB]；27.0％西班牙裔）在MRI上有975个PI-RADS3-5个病变接受了FB。其中,312（55％）例497个病变的男性接受了mpMRI，254（45％）例478个病变的男性接受了bpMRI。在所有男性的多变量分析中，bpMRI确定的病灶在FB上检测到整体PCa(OR=1.18,95%CI:1.05-3.11,p=0.031)和CS-PCa(OR=2.15,95%CI:1.16-4.00,p=0.014)的几率高于mpMRI.当按种族/民族分层时，在bpMRI或mpMRI检测到的病变之间,检测到整体PCa(OR=1.86;p=0.15)和CS-PCa(OR=2.20;p=0.06)的几率无统计学差异.
结论：BpMRI在检测种族/种族不同人群中的总体和CS-PCa方面与mpMRI具有相似的诊断性能。BpMRI可用于评估NHB和西班牙裔男性中可疑的CS-PCa。
