PDF(Pubmed)
Abstract：
Purpose: The accuracy of multiparametric magnetic resonance imaging (mpMRI) heavily relies on image quality, as evidenced by the evolution of the prostate imaging quality (PI-QUAL) scoring system for the evaluation of clinically significant prostate cancer (csPC). This study aims to evaluate the impact of PI-QUAL scores in detecting csPC within PI-RADS 4 and 5 lesions. Methods: We retrospectively selected from our database all mpMRI performed from January 2019 to March 2022. Inclusion criteria were as follows: (1) mpMRI acquired in our institution according to the technical requirements from the PI-RADS (v2.1) guidelines; (2) single lesion scored as PI-RADS (v2.1) 4 or 5; (3) MRI-TBx performed in our institution; (4) complete histology report; and (5) complete clinical record. Results: A total of 257 male patients, mean age 70.42 ± 7.6 years, with a single PI-RADS 4 or 5 lesion undergoing MRI-targeted biopsy, were retrospectively studied. Of these, 61.5% were PI-RADS 4, and 38.5% were PI-RADS 5, with 84% confirming neoplastic cells. In high-quality image lesions (PI-QUAL ≥ 4), all PI-RADS 5 lesions were accurately identified as positive at the final histological examination (100% of CDR). For PI-RADS 4 lesions, 37 (23%) were negative, resulting in a cancer detection rate of 77% (95% CI: 67.51-84.83). Conclusions: The accuracy of mpMRI, independently of the PI-RADS score, progressively decreased according to the decreasing PI-QUAL score. These findings emphasize the crucial role of the PI-QUAL scoring system in evaluating PI-RADS 4 and 5 lesions, influencing mpMRI accuracy.
摘要：
目的：多参数磁共振成像（mpMRI）的准确性在很大程度上取决于图像质量，用于评估有临床意义的前列腺癌（csPC）的前列腺成像质量（PI-QUAL）评分系统的演变证明了这一点。本研究旨在评估PI-QUAL评分在检测PI-RADS4和5病变中的csPC的影响。方法：我们从我们的数据库中回顾性选择2019年1月至2022年3月进行的所有mpMRI。纳入标准如下：（1）根据PI-RADS（v2.1）指南的技术要求在我们机构获得的mpMRI；（2）单个病灶评分为PI-RADS（v2.1）4或5；（3）在我们机构进行的MRI-TBx；（4）完整的组织学报告；（5）完整的临床记录。结果:共257例男性患者,平均年龄70.42±7.6岁，单个PI-RADS4或5个病灶接受MRI靶向活检，进行了回顾性研究。其中,PI-RADS4占61.5％，PI-RADS5占38.5％，其中84％确认了肿瘤细胞。在高质量图像病变（PI-QUAL≥4）中，所有PI-RADS5个病变在最后一次组织学检查中被准确鉴定为阳性(CDR的100%).对于PI-RADS4病变，37（23％）为阴性，导致癌症检出率为77%（95%CI：67.51-84.83）。结论:MPMRI的准确性,独立于PI-RADS评分，随着PI-QUAL评分的降低而逐渐降低。这些发现强调了PI-QUAL评分系统在评估PI-RADS4和5病变中的关键作用。影响MPMRI准确性。
