Abstract：
Background Biparametric MRI (bpMRI) of the prostate is an alternative to multiparametric MRI (mpMRI), with lower cost and increased accessibility. Studies investigating the positive predictive value (PPV) of bpMRI-directed compared with mpMRI-directed targeted biopsy are lacking in the literature. Purpose To compare the PPVs of bpMRI-directed and mpMRI-directed targeted prostate biopsies. Materials and Methods This retrospective cross-sectional study evaluated men who underwent bpMRI-directed or mpMRI-directed transrectal US (TRUS)-guided targeted prostate biopsy at a single institution from January 2015 to December 2022. The PPVs for any prostate cancer (PCa) and clinically significant PCa (International Society of Urological Pathology grade ≥2) were calculated for bpMRI and mpMRI using mixed-effects logistic regression modeling. Results A total of 1538 patients (mean age, 67 years ± 8 [SD]) with 1860 lesions underwent bpMRI-directed (55%, 849 of 1538) or mpMRI-directed (45%, 689 of 1538) prostate biopsy. When adjusted for the number of lesions and Prostate Imaging Reporting and Data System (PI-RADS) score, there was no difference in PPVs for any PCa or clinically significant PCa (P = .61 and .97, respectively) with bpMRI-directed (55% [95% CI: 51, 59] and 34% [95% CI: 30, 38], respectively) or mpMRI-directed (56% [95% CI: 52, 61] and 34% [95% CI: 30, 39], respectively) TRUS-guided targeted biopsy. PPVs for any PCa and clinically significant PCa stratified according to clinical indication were as follows: biopsy-naive men, 64% (95% CI: 59, 69) and 43% (95% CI: 39, 48) for bpMRI, 67% (95% CI: 59, 75) and 51% (95% CI: 43, 59) for mpMRI (P = .65 and .26, respectively); and active surveillance, 59% (95% CI: 49, 69) and 30% (95% CI: 22, 39) for bpMRI, 73% (95% CI: 65, 89) and 38% (95% CI: 31, 47) for mpMRI (P = .04 and .23, respectively). Conclusion There was no evidence of a difference in PPV for clinically significant PCa between bpMRI- and mpMRI-directed TRUS-guided targeted biopsy. © RSNA, 2024 Supplemental material is available for this article.
摘要：
背景技术前列腺的双参数MRI(bpMRI)是多参数MRI(mpMRI)的替代方法,更低的成本和增加的可访问性。文献中缺乏研究bpMRI定向与mpMRI定向靶向活检的阳性预测值（PPV）的研究。目的比较bpMRI定向和mpMRI定向靶向前列腺活检的PPV。材料和方法这项回顾性横断面研究评估了2015年1月至2022年12月在单个机构接受bpMRI定向或mpMRI定向经直肠US（TRUS）引导的靶向前列腺活检的男性。使用混合效应逻辑回归模型计算bpMRI和mpMRI的任何前列腺癌（PCa）和临床上有意义的PCa（国际泌尿外科病理学学会≥2级）的PPV。结果1538例患者(平均年龄,67岁±8[SD]），1860个病灶接受bpMRI指导（55%，1538年中的849个)或MPMRI指导的(45%，1538的689）前列腺活检。当调整病灶数量和前列腺影像报告和数据系统（PI-RADS）评分时，任何PCa或临床显著PCa的PPV无差异（分别为P=.61和.97），在bpMRI指导下（55%[95%CI：51,59]和34%[95%CI：30,38]，分别）或MPMRI定向（56%[95%CI：52，61]和34%[95%CI：30，39]，分别）TRUS引导的靶向活检。根据临床适应症分层的任何PCa和临床上有意义的PCa的PPV如下：活检幼稚的男性，bpMRI为64%(95%CI:59,69)和43%(95%CI:39,48)，67%（95%CI：59，75）和51%（95%CI：43，59）的MPMRI（分别为P=.65和.26）；和积极监测，bpMRI为59%（95%CI：49，69）和30%（95%CI：22，39），mpMRI为73%（95%CI：65，89）和38%（95%CI：31，47）（P分别为.04和.23）。结论在bpMRI和mpMRI引导的TRUS引导的靶向活检之间，没有证据表明有临床意义的PCa的PPV存在差异。©RSNA,2024补充材料可用于本文。
