The current role of prostate multiparametric magnetic resonance imaging  

作　　者：Olivier Rouviere Paul Cezar Moldovan 

机构地区：[1]Hospices Civils de Lyon,Department of Urinary and Vascular Imaging,HÔpital Edouard Herriot,Lyon,France [2]Universitéde Lyon,Lyon,France [3]UniversitéLyon 1,facultéde médecine Lyon Est,Lyon,France

出　　处：《Asian Journal of Urology》2019年第2期137-145,共9页亚洲泌尿外科杂志（英文）

摘　　要：Prostate multi-parametric magnetic resonance imaging(mpMRI)has shown excellent sensitivity for Gleason
7 cancers,especially when their volume is
0.5 mL.As a result,performing an mpMRI before prostate biopsy could improve the detection of clinically significant prostate cancer(csPCa)by adding targeted biopsies to systematic biopsies.Currently,there is a consensus that targeted biopsies improve the detection of csPCa in the repeat biopsy setting and at confirmatory biopsy in patients considering active surveillance.Several prospective multicentric controlled trials recently showed that targeted biopsy also improved csPCa detection in biopsy-naǐve patients.The role of mpMRI and targeted biopsy during the follow-up of active surveillance remains unclear.Whether systematic biopsy could be omitted in case of negative mpMRI is also a matter of controversy.mpMRI did show excellent negative predictive values(NPV)in the literature,however,since NPV depends on the prevalence of the disease,negative mpMRI findings should be interpreted in the light of a priori risk for csPCa of the patient.Nomograms combining mpMRI findings and classical risk predictors(age,prostatespecific antigen density,digital rectal examination,etc.)will probably be developed in the future to decide whether a prostate biopsy should be obtained.mpMRI has a good specificity for detecting T3 stage cancers,but its sensitivity is low.It should therefore not be used routinely for staging purposes in low-risk patients.Nomograms combining mpMRI findings and other clinical and biochemical data will also probably be used in the future to better assess the risk of T3 stage disease.

关 键 词：Prostate cancer Magnetic resonance imaging Prostate biopsy Active surveillance NOMOGRAMS 

分 类 号：R73[医药卫生—肿瘤]