使用计算机断层扫描 (CT) 和骨闪烁扫描 (BS) 的传统成像对高危前列腺癌 (HRPCa) 患者进行分期效果不佳。因此，我们的目的是比较全身磁共振成像（WBMRI）与传统成像对 HRPCa 患者分期的准确性。我们前瞻性地入组新诊断 HRPCa 的患者（前列腺特异性抗原≥20ng/ml 和/或分级组） ≥4）。患者在评估后 30 天内接受了 BS、腹部和骨盆 CT 以及 WBMRI。主要终点是 WBMRI 和常规成像检测淋巴结和骨转移性疾病的诊断性能。参考标准由组织病理学或随访 6 个月时所有可用的临床信息定义。为了比较诊断测试，使用了 Exact McNemar 测试和受试者工作特征曲线的曲线下面积 (AUC)。在 92 名入组患者中，15 名 (16.3%) 和 8 名 (8.7%) 患者被发现有淋巴和骨转移， 分别。 WBMRI检测淋巴转移的敏感性、特异性和准确性分别为0.60（95%置信区间0.32-0.84）、0.84（0.74-0.92）和0.80（0.71-0.88），而CT为0.20（0.04-0.48） )、0.92 (0.84-0.97) 和 0.80 (0.71-0.88)。 WBMRI检测骨转移的敏感性、特异性和准确性分别为0.25（0.03-0.65）、0.94（0.87-0.98）和0.88（0.80-0.94），而CT和BS为0.12（0-0.53）。 0.94（0.87-0.98）和0.87（0.78-0.93）。在评估淋巴转移方面，与 CT 相比，WBMRI 表现出更高的敏感性 (p = 0.031) 和辨别力（0.72 对比 0.56，p = 0.019）。对于 HRPCa 患者的分期，WBMRI 在检测淋巴转移方面优于 CT，并且表现与 CT 一样好。 CT和BS在骨转移检测中的应用。需要进一步研究来评估 WBMRI 的成本效益以及 PSMA PET 和 WBMRI 组合的实用性。© 2024。作者，获得 Springer Nature Limited 的独家许可。

Staging patients with high-risk prostate cancer (HRPCa) with conventional imaging of computed tomography (CT) and bone scintigraphy (BS) is suboptimal. Therefore, we aimed to compare the accuracy of whole-body magnetic resonance imaging (WBMRI) with conventional imaging to stage patients with HRPCa.We prospectively enrolled patients with newly diagnosed HRPCa (prostate-specific antigen ≥20 ng/ml and/or Grade Group ≥4). Patients underwent BS, CT of the abdomen and pelvis, and WBMRI within 30 days of evaluation. The primary endpoint was the diagnostic performances of detecting metastatic disease to the lymph nodes and bone for WBMRI and conventional imaging. The reference standard was defined by histopathology or by all available clinical information at 6 months of follow-up. To compare diagnostic tests, Exact McNemar's test and area under the curve (AUC) of the receiver operating characteristics curves were utilized.Among 92 patients enrolled, 15 (16.3%) and 8 (8.7%) patients were found to have lymphatic and bone metastases, respectively. The sensitivity, specificity, and accuracy of WBMRI in detecting lymphatic metastases were 0.60 (95% confidence interval 0.32-0.84), 0.84 (0.74-0.92), and 0.80 (0.71-0.88), respectively, while CT were 0.20 (0.04-0.48), 0.92 (0.84-0.97), and 0.80 (0.71-0.88). The sensitivity, specificity, and accuracy of WBMRI to detect bone metastases were 0.25 (0.03-0.65), 0.94 (0.87-0.98), and 0.88 (0.80-0.94), respectively, while CT and BS were 0.12 (0-0.53), 0.94 (0.87-0.98), and 0.87 (0.78-0.93). For evaluating lymphatic metastases, WBMRI demonstrated a higher sensitivity (p = 0.031) and discrimination compared to CT (0.72 versus 0.56, p = 0.019).For staging patients with HRPCa, WBMRI outperforms CT in the detection of lymphatic metastases and performs as well as CT and BS in the detection of bone metastases. Further studies are needed to assess the cost effectiveness of WBMRI and the utility of combined PSMA PET and WBMRI.© 2024. The Author(s), under exclusive licence to Springer Nature Limited.