前列腺癌检测中术前MRI使用趋势，2007-2022年
Trends in pre-biopsy MRI usage for prostate cancer detection, 2007-2022
影响因子:5.80000
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
摘要
临床指南建议在前列腺活检前使用MRI，因其具有明确的益处。然而，美国各地的采用模式尚不清楚。本研究利用Merative™ Marketscan® 商业及医疗保险数据库，分析了2007年至2022年间726,663名男性的872,829例前列腺活检。主要观察指标为活检前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评估随时间变化、城乡差异和各州差异。术前MRI的利用率从2007年的0.5%显著增加到2022年的35.5%，城市地区的采纳速度较快（2022年为36.1%）而农村地区为28.3%。地理差异明显，加州、纽约和明尼苏达州的利用率较高，东南部和山区州较低。研究显示，受指南变化及临床证据影响，前列腺癌诊断逐渐向MRI引导的方式转变。城乡和地区差异突显了确保公平获得先进诊断技术的需求，需采取有针对性的干预措施。
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.