Prostate cancer （PCa） is one of the most common cancers among men globally. The authors aimed to evaluate the ability of the Prostate Imaging Reporting and Data System version 2 （PI-RADS v2） to classify men with P...Prostate cancer （PCa） is one of the most common cancers among men globally. The authors aimed to evaluate the ability of the Prostate Imaging Reporting and Data System version 2 （PI-RADS v2） to classify men with PCa, clinically significant PCa （CSPCa）, or no PCa, especially among those with serum total prostate-specific antigen （tPSA） levels in the ＂gray zone＂ （4-10 ng ml-1）. A total of 308 patients （355 lesions） were enrolled in this study. Diagnostic efficiency was determined. Univariate and multivariate analyses, receiver operating characteristic curve analysis, and decision curve analysis were performed to determine and compare the predictors of PCa and CSPCa. The results suggested that PI-RADS v2, tPSA, and prostate-specific antigen density （PSAD） were independent predictors of PCa and CSPCa. A PI-RADS v2 score L≥4 provided high negative predictive values （91.39% for PCa and 95.69% for CSPCa）. A model of PI-RADS combined with PSA and PSAD helped to define a high-risk group （PI-RADS score = 5 and PSAD L≥0 15 ng ml-1 cm-3, with tPSA in the gray zone, or PI-RADS score L≥4 with high tPSA level） with a detection rate of 96.1% for PCa and 93.0% for CSPCa while a low-risk group with a detection rate of 6.1% for PCa and 2.2% for CSPCa. It was concluded that the PI-RADS v2 could be used as a reliable and independent predictor of PCa and CSPCa. The combination of PI-RADS v2 score with PSA and PSAD could be helpful in the prediction and diagnosis of PCa and CSPCa and, thus, may help in preventing unnecessary invasive procedures.展开更多
Background：Prostate Imaging Reporting and Data System （PI-RADS） is a globally acceptable standardization for multiparametric magnetic resonance imaging （mp-MRI） in prostate cancer （PCa） diagnosis.The American C...Background：Prostate Imaging Reporting and Data System （PI-RADS） is a globally acceptable standardization for multiparametric magnetic resonance imaging （mp-MRI） in prostate cancer （PCa） diagnosis.The American College of Radiology revised the PI-RADS to address the limitations of version 1 in December 2014.This study aimed to determine whether the PI-RADS version 2 （PI-RADS v2） scoring system improves the diagnostic accuracy of mp-MRI of the prostate compared with PI-RADS v1.Methods：This retrospective study was approved by the institutional review board.A total of 401 consecutive patients,with clinically suspicious Pca undergoing 3.0 T mp-MRI （T2-weighted imaging ＋ diffusion-weighted imaging ＋ DCE） before transrectal ultrasound-guided biopsy between June 2013 and July 2015,were included in the study.All patients were scored using the 5-point PI-RADS scoring system based on either PI-RADS v1 or v2.Receiver operating characteristics were calculated for statistical analysis.Sensitivity,specificity,and diagnostic accuracy were compared using McNemar＇s test.Results：Pca was present in 150 of 401 （37.41%） patients.When we pooled data from both peripheral zone （PZ） and transition zone （TZ）,the areas under the curve were 0.889 for PI-RADS v1 and 0.942 for v2 （P =0.0001）.Maximal accuracy was achieved with a score threshold of 4.At this threshold,in the PZ,similar sensitivity,specificity,and accuracy were achieved with v 1 and v2 （all P 〉 0.05）.In the TZ,sensitivity was higher for v2 than for v1 （96.36% vs.76.36%,P =0.003）,specificity was similar for v2 and v1 （90.24% vs.84.15%,P =0.227）,and accuracy was higher for v2 than for v1 （92.70% vs.81.02%,P =0.002）.Conclusions：Both v1 and v2 showed good diagnostic performance for the detection of Pca.However,in the TZ,the performance was better with v2 than with v1.展开更多
多参数磁共振成像(multiparametric magnetic resonance imaging,mp MRI)是前列腺癌诊断,分期及随访的重要检查手段。本研究以前列腺影像报告和数据系统(Prostate Imaging Reporting and Data System Version 2,PIRADS V2)为基础,结合...多参数磁共振成像(multiparametric magnetic resonance imaging,mp MRI)是前列腺癌诊断,分期及随访的重要检查手段。本研究以前列腺影像报告和数据系统(Prostate Imaging Reporting and Data System Version 2,PIRADS V2)为基础,结合本单位实际临床工作经验,对前列腺mp MRI的技术规范进行介绍,包括MRI检查前准备、设备要求、扫描序列等。展开更多
Imaging study plays a crucial role in the diagnosis of prostate cancer. As early screening and management of prostate cancer has evolved over the past decade, research is now focusing on how to detect clinically signi...Imaging study plays a crucial role in the diagnosis of prostate cancer. As early screening and management of prostate cancer has evolved over the past decade, research is now focusing on how to detect clinically significant prostate cancer and avoid overdiagnosis accurately. This article provides an overview of recent advances in imaging in prostate cancer diagnosis, including new ultrasound imaging techniques, positron emission computed tomography, multiparametric magnetic resonance imaging, and emerging areas such as imaging histology, by systematically reviewing and summarizing the existing literature.展开更多
随着人口老龄化加剧,与年龄相关的脑小血管病(cerebral small vessel disease,CSVD)发病率不断升高。CSVD通常导致患者认知功能障碍,甚至痴呆,已成为亟待解决的重要公共卫生问题。但目前CSVD相关认知功能障碍的发病机制尚未完全阐明,且...随着人口老龄化加剧,与年龄相关的脑小血管病(cerebral small vessel disease,CSVD)发病率不断升高。CSVD通常导致患者认知功能障碍,甚至痴呆,已成为亟待解决的重要公共卫生问题。但目前CSVD相关认知功能障碍的发病机制尚未完全阐明,且缺乏早期诊断和治疗的有效手段。随着神经影像学技术和人工智能的飞速发展,多参数MRI和机器学习在CSVD相关认知功能障碍的辅助诊断和发病机制探索中发挥着越来越重要的作用。本文就近年来相关研究进展作一综述,旨在为阐明CSVD相关认知功能障碍的神经机制及其早期诊断提供全面、客观的影像学依据。展开更多
文摘Prostate cancer （PCa） is one of the most common cancers among men globally. The authors aimed to evaluate the ability of the Prostate Imaging Reporting and Data System version 2 （PI-RADS v2） to classify men with PCa, clinically significant PCa （CSPCa）, or no PCa, especially among those with serum total prostate-specific antigen （tPSA） levels in the ＂gray zone＂ （4-10 ng ml-1）. A total of 308 patients （355 lesions） were enrolled in this study. Diagnostic efficiency was determined. Univariate and multivariate analyses, receiver operating characteristic curve analysis, and decision curve analysis were performed to determine and compare the predictors of PCa and CSPCa. The results suggested that PI-RADS v2, tPSA, and prostate-specific antigen density （PSAD） were independent predictors of PCa and CSPCa. A PI-RADS v2 score L≥4 provided high negative predictive values （91.39% for PCa and 95.69% for CSPCa）. A model of PI-RADS combined with PSA and PSAD helped to define a high-risk group （PI-RADS score = 5 and PSAD L≥0 15 ng ml-1 cm-3, with tPSA in the gray zone, or PI-RADS score L≥4 with high tPSA level） with a detection rate of 96.1% for PCa and 93.0% for CSPCa while a low-risk group with a detection rate of 6.1% for PCa and 2.2% for CSPCa. It was concluded that the PI-RADS v2 could be used as a reliable and independent predictor of PCa and CSPCa. The combination of PI-RADS v2 score with PSA and PSAD could be helpful in the prediction and diagnosis of PCa and CSPCa and, thus, may help in preventing unnecessary invasive procedures.
基金This study was supported by a grant of National Natural Science Foundation of China （No. 81171307）.
文摘Background：Prostate Imaging Reporting and Data System （PI-RADS） is a globally acceptable standardization for multiparametric magnetic resonance imaging （mp-MRI） in prostate cancer （PCa） diagnosis.The American College of Radiology revised the PI-RADS to address the limitations of version 1 in December 2014.This study aimed to determine whether the PI-RADS version 2 （PI-RADS v2） scoring system improves the diagnostic accuracy of mp-MRI of the prostate compared with PI-RADS v1.Methods：This retrospective study was approved by the institutional review board.A total of 401 consecutive patients,with clinically suspicious Pca undergoing 3.0 T mp-MRI （T2-weighted imaging ＋ diffusion-weighted imaging ＋ DCE） before transrectal ultrasound-guided biopsy between June 2013 and July 2015,were included in the study.All patients were scored using the 5-point PI-RADS scoring system based on either PI-RADS v1 or v2.Receiver operating characteristics were calculated for statistical analysis.Sensitivity,specificity,and diagnostic accuracy were compared using McNemar＇s test.Results：Pca was present in 150 of 401 （37.41%） patients.When we pooled data from both peripheral zone （PZ） and transition zone （TZ）,the areas under the curve were 0.889 for PI-RADS v1 and 0.942 for v2 （P =0.0001）.Maximal accuracy was achieved with a score threshold of 4.At this threshold,in the PZ,similar sensitivity,specificity,and accuracy were achieved with v 1 and v2 （all P 〉 0.05）.In the TZ,sensitivity was higher for v2 than for v1 （96.36% vs.76.36%,P =0.003）,specificity was similar for v2 and v1 （90.24% vs.84.15%,P =0.227）,and accuracy was higher for v2 than for v1 （92.70% vs.81.02%,P =0.002）.Conclusions：Both v1 and v2 showed good diagnostic performance for the detection of Pca.However,in the TZ,the performance was better with v2 than with v1.
文摘多参数磁共振成像(multiparametric magnetic resonance imaging,mp MRI)是前列腺癌诊断,分期及随访的重要检查手段。本研究以前列腺影像报告和数据系统(Prostate Imaging Reporting and Data System Version 2,PIRADS V2)为基础,结合本单位实际临床工作经验,对前列腺mp MRI的技术规范进行介绍,包括MRI检查前准备、设备要求、扫描序列等。
文摘Imaging study plays a crucial role in the diagnosis of prostate cancer. As early screening and management of prostate cancer has evolved over the past decade, research is now focusing on how to detect clinically significant prostate cancer and avoid overdiagnosis accurately. This article provides an overview of recent advances in imaging in prostate cancer diagnosis, including new ultrasound imaging techniques, positron emission computed tomography, multiparametric magnetic resonance imaging, and emerging areas such as imaging histology, by systematically reviewing and summarizing the existing literature.
文摘随着人口老龄化加剧,与年龄相关的脑小血管病(cerebral small vessel disease,CSVD)发病率不断升高。CSVD通常导致患者认知功能障碍,甚至痴呆,已成为亟待解决的重要公共卫生问题。但目前CSVD相关认知功能障碍的发病机制尚未完全阐明,且缺乏早期诊断和治疗的有效手段。随着神经影像学技术和人工智能的飞速发展,多参数MRI和机器学习在CSVD相关认知功能障碍的辅助诊断和发病机制探索中发挥着越来越重要的作用。本文就近年来相关研究进展作一综述,旨在为阐明CSVD相关认知功能障碍的神经机制及其早期诊断提供全面、客观的影像学依据。
