医学
前列腺癌
置信区间
前列腺
磁共振成像
泌尿科
逻辑回归
前列腺特异性抗原
回顾性队列研究
内科学
癌症
放射科
作者
Chichen Zhang,Xiang Tu,Jindong Dai,Zilong Zhang,Chenlan Shen,Qiyou Wu,Zhenhua Liu,Tianhai Lin,Shi Qiu,Lu Yang,Ling Yang,Mengni Zhang,Diming Cai,Yige Bao,Hao Zeng,Qiang Wei
摘要
Abstract Background Data on the utilization and effects of prebiopsy prostate multiparametric magnetic resonance imaging (mpMRI) to support its routine use in real‐world setting are still scarce. Objective To evaluate the change of clinical practice of prebiopsy mpMRI over time, and assess its diagnostic accuracy. Design, Setting, and Participants We retrospectively analyzed data from 6168 patients who underwent primary prostate biopsy (PBx) between January 2011 and December 2021 and had prostate‐specific antigen (PSA) values ranging from 3 to 100 ng/mL. Intervention Prebiopsy MRI at the time of PBx. Outcome Measurements and Statistical Analysis We performed general linear regression and to elucidate trends in the annual use of prebiopsy mpMRI and conducted multivariable logistic regression to evaluate the potential benefits of incorporating prebiopsy mpMRI for prostate cancer (PCa) detection. Results and Limitations The utilization of prebiopsy mpMRI significantly increased from 9.2% in 2011 to 75.0% in 2021 ( p < 0.001). In addition, prebiopsy mpMRI significantly reduced negative PBx by 8.6% while improving the detection of clinically significant PCa (csPCa) by 7.0%. Regression analysis showed that the utilization of prebiopsy mpMRI was significantly associated with a 48% (95% confidence interval [CI]: 1.19–1.84) and 36% (95% CI: 1.12–1.66) increased PCa detection rate in the PSA 3–10 ng/mL and 10–20 ng/mL groups, respectively; and a 34% increased csPCa detection rate in the PSA 10–20 ng/mL group (95% CI: 1.09–1.64). The retrospective design and the single center cohort constituted the limitations of this study. Conclusions Our study demonstrated a notable rise in the utilization of prebiopsy mpMRI in the past decade. The adoption of this imaging technique was significantly associated with an increased probability of detecting prostate cancer. Patient Summary From 2011 to 2021, we demonstrated a steady increase in the utilization of prebiopsy mpMRI among biopsy‐naïve men. We also confirmed the positive impact of prebiopsy mpMRI utilization on the detection of prostate cancer.
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