全身MRI在前列腺癌分期中的应用：综述
Whole-body MRI for staging prostate cancer: a narrative review
DOI 原文链接
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影响因子:4.4
分区:医学2区 / 泌尿学与肾脏学2区
发表日期:2025 Jan
作者:
Andrew M Fang, Justin R Gregg, Curtis Pettaway, Jingfei Ma, Janio Szklaruk, Tharakeswara K Bathala, Devaki Shilpa S Surasi, Brian F Chapin
DOI:
10.1111/bju.16514
摘要
本文旨在综述全身磁共振成像（WBMRI）在高危前列腺癌（HRPCa）患者分期中的诊断准确性，并与已建立的影像检测手段进行比较。通过PubMed检索相关文献，关键词包括：‘全身’、‘磁共振成像’、‘MRI’、‘前列腺癌’、‘风险分层’和‘分期’。纳入评估WBMRI用于分期高危前列腺癌的文章，排除仅评估生物化学复发或转移性疾病进展的研究。在淋巴转移的评估中，WBMRI的敏感性和特异性与传统CT影像相当，甚至有所提升。同时，WBMRI在骨转移检测方面优于骨显像（BS），显示出更高的敏感性和特异性。然而，随着前列腺特异性膜抗原（PSMA）放射性配体在正电子发射断层成像（PET）中的应用，WBMRI在检测转移性疾病方面的诊断性能似乎略逊一筹。总体而言，WBMRI在检测HRPCa患者的转移性疾病方面优于传统的CT和BS，但尚不及PSMA PET/CT的性能。未来需进一步开展成本效益分析及融合PSMA PET/MRI的研究，以优化检测策略。
Abstract
To present a narrative review regarding the diagnostic accuracy of whole-body magnetic resonance imaging (WBMRI) in staging patients with high-risk prostate cancer (HRPCa) and compare it to established imaging modalities.A narrative review was carried out using PubMed using the following keywords: 'whole body', 'magnetic resonance imaging', 'MRI', 'prostate cancer', 'risk stratification', and 'staging'. Articles that evaluated WBMRI as the imaging modality to stage patients with HRPCa were included, while studies that solely assessed for biochemical recurrence or metastatic disease progression were excluded.In the evaluation of lymphatic metastases, WBMRI has demonstrated a comparable, if not improved, sensitivity and specificity compared to conventional imaging of computed tomography (CT). Furthermore, WBMRI demonstrates improved sensitivity and specificity in detecting bone metastases compared to bone scintigraphy (BS). However, with advent of prostate-specific membrane antigen (PSMA) radioligands for positron emission tomography (PET), the diagnostic performance of WBMRI to detect metastatic disease appears inferior.The diagnostic capabilities of WBMRI exceed that of conventional imaging of CT and BS in detecting metastatic disease in patients with HRPCa. However, WBMRI does not perform as well as PSMA PET/CT. Further study on cost comparisons between WBMRI and PSMA PET/CT are needed, as well as evaluations of combined PSMA PET/MRI are needed.