前列腺癌检测中术前MRI使用趋势，2007-2022
Trends in pre-biopsy MRI usage for prostate cancer detection, 2007-2022
DOI 原文链接
用sci-hub下载
如无法下载，请从 Sci-Hub 选择可用站点尝试。
发表日期:2025 Jun
作者:
Simon John Christoph Soerensen, Shufeng Li, Marvin E Langston, Richard E Fan, Mirabela Rusu, Geoffrey A Sonn
DOI:
10.1038/s41391-024-00896-y
摘要
临床指南建议在前列腺穿刺活检前使用MRI，以其已被证实的益处。然而，美国不同地区的采用模式尚不明确。本研究利用Merative™ Marketscan®商业及医疗保险数据库，分析2007年至2022年间726,663名男性的872,829例前列腺穿刺活检。主要观察指标为穿检前90天内的盆腔MRI使用情况。采用描述性统计和广义估计方程分析随时间变化、城乡差异及州级变异。结果显示，穿检前MRI的使用率从2007年的0.5%显著增加至2022年的35.5%，城市地区的采用速度更快（2022年为36.1%）对比农村地区（28.3%）。地理差异明显，加州、纽约和明尼苏达的利用率较高，而东南部和山地西部较低。该研究揭示了前列腺癌诊断从传统方式向MRI引导方法的转变，受到指南更新和临床证据的推动。不同地区间的差异提示亟需采取针对性措施，以确保不同地区尤其是农村地区的患者能够平等获得先进的诊断技术。
Abstract
Clinical guidelines favor MRI before prostate biopsy due to proven benefits. However, adoption patterns across the US are unclear.This study used the Merative™ Marketscan® Commercial & Medicare Databases to analyze 872,829 prostate biopsies in 726,663 men from 2007-2022. Pre-biopsy pelvic MRI within 90 days was the primary outcome. Descriptive statistics and generalized estimating equations assessed changes over time, urban-rural differences, and state-level variation.Pre-biopsy MRI utilization increased significantly from 0.5% in 2007 to 35.5% in 2022, with faster adoption in urban areas (36.1% in 2022) versus rural areas (28.3% in 2022). Geographic disparities were notable, with higher utilization in California, New York, and Minnesota, and lower rates in the Southeast and Mountain West.The study reveals a paradigm shift in prostate cancer diagnostics towards MRI-guided approaches, influenced by evolving guidelines and clinical evidence. Disparities in access, particularly in rural areas and specific regions, highlight the need for targeted interventions to ensure equitable access to advanced diagnostic techniques.