Biparametric vs Multiparametric MRI for Prostate Cancer Diagnosis

作者：Alexander Ng, Aqua Asif, Ridhi Agarwal, Valeria Panebianco, Rossano Girometti, Sangeet Ghai, Enrique Gómez‐Gómez, Lars Budäus, Tristan Barrett, Jan Philipp Radtke, Claudia Kesch, Francesco DE COBELLI, Tho Pham, Samir S. Taneja, Jim C. Hu, Ash Tewari, M.A. Rodríguez Cabello, Adriano Basso Dias, Lance A. Mynderse, Marcelo Borghi, Lars Boesen, Paras Bikram Singh, Raphaële Renard‐Penna, Jeffrey Jia Jun Leow, Fabian Falkenbach, Martina Pecoraro, Gianluca Giannarini, Nathan Perlis, Daniel José López-Ruiz, Christof Kastner, Lars Schimmöller, Marimo Rossiter, Arjun Nathan, Pramit Khetrapal, Vinson Wai‐Shun Chan, Aiman Haider, Caroline Sarah Clarke, Shonit Punwani, Chris Brew‐Graves, Louise Dickinson, Anita Mitra, Giorgio Brembilla, Daniel Margolis, Yemisi Takwoingi, Mark Emberton, Clare Allen, Francesco Giganti, Caroline M. Moore, Veeru Kasivisvanathan, PRIME Study Group Collaborators, Alberto Briganti, Alessandro Crestani, Alessandro Sciarra, Alex Evangelista, Alex Freeman, Alex P. S. Kirkham, Alexandre R. Zlotta, Alistair Grey, Ana Blanca, Anders S Bjartell, Andrew Ryan, Angela Y. Tong, Anne Yvonne Warren, Antonella Borrelli, Antonette Andrews, Antonio Finelli, Antonio Ciardi, Antti Sakari Rannikko, Armando Stabile, Arnauld A. Villers, Arturo Platas Sancho, Ashley Baring, Ashoke Roy, Balqiisa Issa, Bas Israël, Boris Alexander Hadaschik, Carolina Aulló González, Caroline L. English, Chau Hung Lee, Chiara Zuiani, Christien T.M. Caris, Conrad Brice von Stempel, Cristina Amate, Daniel Z. P. Yong, Davide Rozze, Derek J. Lomas, Donato Cannoletta, Eileen Wang Chang, Emanuele Messina, Felix Chun, Gaia Zussino, Gerald Antoch, Giorgio Gandaglia, G. Robert, Guido Sauter, Harini Thevarajah, Harriet Sorrell, Hazel McBain, Henning Reis, Hernando Ríos Pita, Ingrid Potyka, Iztok Caglič, Jeanlou Collavino, Jens Matthias Theysohn, Jeremy Grummet, Jincy Koshy, Jing Yi Weng, John C. Wilkinson, John Withington, Joke van Egmond, Jon Piper, Jonathan J Deeks, Jonathan Paul O'Brien, José Valero Rosa, Juan Luis Sanz, Juan Mesa Quesada, Kai Jannusch, Kateri Corr, Kenneth Haines, Lale Umutlu, Leonardo Quarta, Letizia Casarotto, Linda Gimeno, Luca Orecchia, Lucas Moretti, Ludovica Laschena, Lukas Drewes, Maarten de Rooij, Manuel Sanchez Ostos, Marco Bicchetti, Marco Gatti, M. Peris, Mariano M. Volpacchio, Mark Prentice, Markus Graefen, Matteo Soligo, Matthias Boschheidgen, Matthias Claudius Roethke, Maurizio Del Monte, Mausam Singhera, Mike Wenzel, Monali Fatterpekar, Mulham Al‐Nader, Mykyta Kachanov, Nadeem Shaida, Naoki Takahashi, Neil Eric Fleshner, Nicola Muirhead, Nikhil Vasdev, Nimalan Sanmugalingam, Nis Nørgaard, Pete Vicente, Peter Albers, Peter F. Incze, Philip Ryan, Philippe Rouvier, Phoebe Mead, Pierre Mozer, Pieter De Visschere, Públio César Cavalcante Viana, Rafael E. Jiménez, Réka Novotta, Richard Huang, Richard O’Sullivan, Rikke Karlin Jepsen, Robert Frese, Rosemary Clow, Rouvier Al‐Monajjed, Sara C. Lewis, Sophia Cashman, Stefano Pizzolitto, Steven Lelie, Sydney Lindner, Syed Ahmar Shah, Tarek Al‐Hammouri, Teresa González Sánchez, Tharakeswara Kumar Bathala, Theodorus van der Kwast, Thomas Reid, Timothy McClure, Tobias Maurer, Valeria Peruzzi, Vibeke Løgager, Vinay Prabhu, Vinayak Gorakhnath Wagaskar, Wei Phin Tan, William Carlos Nahas, Wim P.J. Witjes, Yew Lam Chong · 发表于：JAMA · 年份：2025 · DOI：10.1001/jama.2025.13722 · 被引用次数：74 · 研究领域：Prostate Cancer Diagnosis and Treatment、MRI in cancer diagnosis、Prostate Cancer Treatment and Research

Importance: Multiparametric magnetic resonance imaging (MRI), with or without prostate biopsy, has become the standard of care for diagnosing clinically significant prostate cancer. Resource capacity limits widespread adoption. Biparametric MRI, which omits the gadolinium contrast sequence, is a shorter and cheaper alternative offering time-saving capacity gains for health systems globally. Objective: To assess whether biparametric MRI is noninferior to multiparametric MRI for diagnosis of clinically significant prostate cancer. Design, Setting, and Participants: A prospective, multicenter, within-patient, noninferiority trial of biopsy-naive men from 22 centers (12 countries) with clinical suspicion of prostate cancer (elevated prostate-specific antigen [PSA] level and/or abnormal digital rectal examination findings) from April 2022 to September 2023, with the last follow-up conducted on December 3, 2024. Interventions: Participants underwent multiparametric MRI, comprising T2-weighted, diffusion-weighted, and dynamic contrast-enhanced (DCE) sequences. Radiologists reported abbreviated biparametric MRI first (T2-weighted and diffusion-weighted), blinded to the DCE sequence. After unblinding, radiologists reported the full multiparametric MRI. Patients underwent a targeted biopsy with or without systematic biopsy if either biparametric MRI or multiparametric MRI was suggestive of clinically significant prostate cancer. Main outcomes and measures: The primary outcome was the p...