加载中…前列腺MRI：为何漏诊临床显著性癌？
(2022-12-01 15:25:47) RSNA2021（039）：前列腺MRI：为何漏诊临床显著性癌？
医学影像学英语 2022-10-24 00:00 发表于广东
KEY POINTS
Clinically significant prostate cancer - CSPCa - can be missed
in 2-10% of MRl exams
Most common causes:
Biopsy targeting errors: undersampling
Invisible cancer: histopathologic-MRI correlation
Non optimal acquisition technique: MRl parameters/equipment–
patient related factors
Atypical prostate cancer: other neoplasm
beyondadenocarcinoma
Interpretation: PI-RADS ambiguities-limitations, reader
experience
Invisible prostate cancer can be due to: cell density, Gleason
grade, pattern,microvessel density, size, PSA
It is important to know why CSPCa is missed to reduce the
false negative ratesand improve PCa detection
要点
在2-10%的MRl检查中，可漏诊具有临床意义的前列腺癌（CSPCa）
最常见的原因：
活检靶向错误：采样不足
隐形癌：组织病理学MRI相关性
非最佳采集技术：MRl参数/设备–患者相关因素
非典型前列腺癌：腺癌以外的其他肿瘤
解释：PI-RADS歧义限制、读者体验
隐形前列腺癌可归因于：细胞密度、Gleason分级、模式、微血管密度、大小、PSA
了解CSPCa缺失的原因对于降低假阴性率和改善PCa检测非常重要
Prostate MRl has a high negative predictive value to detect
clinically significant prostate cancer (CSPCa)> >90%
·Prostate MRI misses approximately 2-10% of CSPCa
•Positive MRl by visible Pca could be related:· Larger tumor,
aggressive (pattern), cell density
·Prostate MRI dominant sequences are T2WI and
DWI-ADC
T2: high resolution – 3mm/0 gap
DWI+ ADC:high b value (> 1400 s/mm2)
DCE: <15s/acquisition
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