medvisМедицинская визуализацияMedical Visualization1607-07632408-9516RDS-Media Ltd.10.24835/1607-0763-2019-3-107-125medvis-798Research ArticleМАЛЫЙ ТАЗSMALL PELVISПрактические подходы к использованию системы PI-RADS v2.1 при выполнении магнитно-резонансной томографии предстательной железыUsage of PI-RADS v2.1 system for prostate MRI: a practical approachГромовА. И.GromovA. I.

доктор мед. наук, профессор, профессор кафедры лучевой диагностики; заведующий отделением лучевой диагностики Клинической больницы №2

125284 Москва, 2-й Боткинский проезд, д. 6, корп. 3. Клиническая больница МЕДСИ в Боткинском проезде

Тел.: +7-495-737-61-82, доб. 42021

doct. of med. sci., Professor, Professor of Department of Radiology; Head of Radiology Department of Clinical hospital No.2

6/3, 2nd Botkinski pr., Moscow, 125284, Russia

Phone: +7-495-737-61-82 (42021)

gai8@mail.ruКапустинВ. В.KapustinV. V.

доктор мед. наук, доцент кафедры лучевой диагностики; заведующий отделением ультразвуковой диагностики 

doct. of med. sci., Associated Professor of Department of Radiology, Head of Ultrasound Diagnostics Department

Moscow

ФГБОУ ВО “Московский государственный медико-стоматологический университет имени А.И. Евдокимова” Минздрава России, Клиническая больница №2 АО Группа компаний “Медси”РоссияMoscow State University of Medicine and Dentistry named after A.I. Evdokimov, “Medsi group” Joint Stock CompanyRussian FederationФГБОУ ВО “Московский государственный медико-стоматологический университет имени А.И. Евдокимова” Минздрава России, ГБУЗ “Московская городская онкологическая больница № 62 Департамента здравоохранения города Москвы”РоссияMoscow State University of Medicine and Dentistry named after A. I. Evdokimov; Moscow Municipal Oncology Hospital No.62 of Moscow Healthcare DepartmentRussian Federation20190309201903107125Copyright © Громов А.И., Капустин В.В., 20192019Громов А.И., Капустин В.В.Gromov A.I., Kapustin V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medvis.rdsmedia.ru/jour/article/view/798

В статье представлен подробный анализ положений методических рекомендаций Европейского общества урогенитальной радиологии и Американского радиологического колледжа по МР-диагностике рака предстательной железы PI-RADS v2.1, вышедших в свет в 2019 г. Структурированы отдельные разрозненные положения рекомендаций в разделы, посвященные получению данных, порядку их интерпретации, системе определения категории, определяющей уровень подозрительности на наличие рака предстательной железы у пациента. Статья иллюстрирована оригинальными клиническими наблюдениями, демонстрирующими основные положения классификации. Такая систематизация поможет читателю в изучении и освоении данных рекомендаций. В конце статьи выделены те положения документа, которые отличают его от предыдущей версии – PI-RADS v2.

The detailed an alysis of European Society of Urogenital Radiology (ESUR) and American College of Radiology (ACR) guide-linesforprostatecancer MRI system PI-RADS v.2.1 (2019) was presented. The several scattered theses of this system were structured in suchsectionsas: MRI data acquisition, interpretation, definition of lesion category for prostate cancer probability. This kind of systematization would be helpful for radiologists to master this newest guide-lines version. Finally, the differences between PI-RADS v.2.1 and the previousone were highlighted.

магнитно-резонансная томографиярак предстательной железысистема PI-RADSmagnetic resonance imagingprostate cancerPI-RADS SystemReferencesBarentsz J.O., Richenberg J., Clements R., Choyke P., Verma S., Villeirs G., Rouviere O., Logager V., Fütterer J.J.; European Society of Urogenital Radiology. European Society of Urogenital Radiology. ESUR prostate MR guidelines 2012. Eur. Radiol. 2012; 22 (4): 746–757. http://doi.org/10.1007/s00330-011-2377-y.Barentsz J.O., Richenberg J., Clements R., Choyke P., Verma S., Villeirs G., Rouviere O., Logager V., Fütterer J.J.; European Society of Urogenital Radiology. European Society of Urogenital Radiology. ESUR prostate MR guidelines 2012. Eur. Radiol. 2012; 22 (4): 746–757. http://doi.org/10.1007/s00330-011-2377-y.Weinreb J.C., Barentsz J.O., Choyke P.L., Cornud F., Haider M.A., Macura K.J., Margolis D., Schnall M.D., Shtern F., Tempany C.M., Thoeny H.C., Verma S. PI-RADS Prostate Imaging – Reporting and Data System: 2015, Version 2. Eur. Urol. 2016; 69 (1): 16–40. http://dx.doi.org/10.1016/j.eururo.2015.08.052.Weinreb J.C., Barentsz J.O., Choyke P.L., Cornud F., Haider M.A., Macura K.J., Margolis D., Schnall M.D., Shtern F., Tempany C.M., Thoeny H.C., Verma S. PI-RADS Prostate Imaging – Reporting and Data System: 2015, Version 2. Eur. Urol. 2016; 69 (1): 16–40. http://dx.doi.org/10.1016/j.eururo.2015.08.052.Radtke J.P., Teber D., Hohenfellner M., Hadaschik B.A. The current and future role of magnetic resonance imaging in prostate cancer detection and management. Transl. Androl. Urol. 2015; 3: 326–341. http://doi.org/10.3978/j.issn.2223-4683.2015.06.05.Weinreb J.C., Barentsz J.O., Choyke P.L., Cornud F., Haider M.A., Macura K.J., Margolis D., Schnall M.D., Shtern F., Tempany C.M., Thoeny H.C., Verma S. PI-RADS Prostate Imaging – Reporting and Data System: 2015, Version 2. Eur. Urol. 2016; 69 (1): 16–40. http://dx.doi.org/10.1016/j.eururo.2015.08.052.Boesen L. Multiparametric MRI in detection and staging of prostate cancer. Dan. Med. J. 2017; 64 (2): B5327.Radtke J.P., Teber D., Hohenfellner M., Hadaschik B.A. The current and future role of magnetic resonance imaging in prostate cancer detection and management. Transl. Androl. Urol. 2015; 3: 326–341. http://doi.org/10.3978/j.issn.2223-4683.2015.06.05.Monni F., Fontanella P., Grasso A., Wiklund P., Ou Y.C., Randazzo M., Rocco B., Montanari E., Bianchi G. Magnetic resonance imaging in prostate cancer detection and management: a systematic review. Minerva Urol. Nefrol. 2017; 69 (6): 567–578. http://doi.org/10.23736/S0393-2249.17.02819-3.Radtke J.P., Teber D., Hohenfellner M., Hadaschik B.A. The current and future role of magnetic resonance imaging in prostate cancer detection and management. Transl. Androl. Urol. 2015; 3: 326–341. http://doi.org/10.3978/j.issn.2223-4683.2015.06.05.Ahmed H.U., El-Shater Bosaily A., Brown L.C., Gabe R., Kaplan R., Parmar M.K., Collaco-Moraes Y., Ward K., Hindley R.G., Freeman A., Kirkham A.P., Oldroyd R., Parker C., Emberton M.; PROMIS study group. Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet. 2017; 25; 389 (10071): 815–822. http://doi.org/10.1016/S0140-6736(16)32401-1.Boesen L. Multiparametric MRI in detection and staging of prostate cancer. Dan. Med. J. 2017; 64 (2): B5327.Brown L.C., Ahmed H.U., Faria R., El-Shater Bosaily A., Gabe R., Kaplan R.S., Parmar M., Collaco-Moraes Y., Ward K., Hindley R.G., Freeman A., Kirkham A., Oldroyd R., Parker C., Bott S., Burns-Cox N., Dudderidge T., Ghei M., Henderson A., Persad R., Rosario D.J., Shergill I., Winkler M., Soares M., Spackman E., Sculpher M., Emberton M. Multiparametric MRI to improve detection of prostate cancer compared with transrectal ultrasoundguided prostate biopsy alone: the PROMIS study. Health Technol. Assess. 2018; 22 (39): 1–176. http://doi.org/10.3310/hta22390.Boesen L. Multiparametric MRI in detection and staging of prostate cancer. Dan. Med. J. 2017; 64 (2): B5327.Guidelines of European Association of Urology https://uroweb.org/guideline/prostate-cancer/?type=summaryof-changes.Monni F., Fontanella P., Grasso A., Wiklund P., Ou Y.C., Randazzo M., Rocco B., Montanari E., Bianchi G. Magnetic resonance imaging in prostate cancer detection and management: a systematic review. Minerva Urol. Nefrol. 2017; 69 (6): 567–578. http://doi.org/10.23736/S0393-2249.17.02819-3.Kesch C., Radtke J.P., Distler F., Boxler S., Klein T., Hüttenbrink C., Hees K., Roth W., Roethke M., Schlemmer H.P., Hohenfellner M., Hadaschik B.A. Multiparametric MRI and MRI-TRUS fusion biopsy in patients with prior negative prostate biopsy. Urologe A. 2016; 55 (8): 1071–1077. http://doi.org/10.1007/s00120-016-0093-6.Monni F., Fontanella P., Grasso A., Wiklund P., Ou Y.C., Randazzo M., Rocco B., Montanari E., Bianchi G. Magnetic resonance imaging in prostate cancer detection and management: a systematic review. Minerva Urol. Nefrol. 2017; 69 (6): 567–578. http://doi.org/10.23736/S0393-2249.17.02819-3.Rifkin M.D., Dähnert W., Kurtz A.B. State of the art: endorectal sonography of the prostate gland. Am. J. Roentgenol. 1990; 154 (4): 691–700.Ahmed H.U., El-Shater Bosaily A., Brown L.C., Gabe R., Kaplan R., Parmar M.K., Collaco-Moraes Y., Ward K., Hindley R.G., Freeman A., Kirkham A.P., Oldroyd R., Parker C., Emberton M.; PROMIS study group. Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet. 2017; 25; 389 (10071): 815–822. http://doi.org/10.1016/S0140-6736(16)32401-1.Coakley F.V., Hricak H. Radiologic anatomy of the prostate gland: a clinical approach. Radiol. Clin. N. Am. 2000; 38 (1): 15–30.Ahmed H.U., El-Shater Bosaily A., Brown L.C., Gabe R., Kaplan R., Parmar M.K., Collaco-Moraes Y., Ward K., Hindley R.G., Freeman A., Kirkham A.P., Oldroyd R., Parker C., Emberton M.; PROMIS study group. Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet. 2017; 25; 389 (10071): 815–822. http://doi.org/10.1016/S0140-6736(16)32401-1.McNeal J.E. The Zonal Anatomy of the Prostate. The Prostate. 1981; 2: 35–49.Brown L.C., Ahmed H.U., Faria R., El-Shater Bosaily A., Gabe R., Kaplan R.S., Parmar M., Collaco-Moraes Y., Ward K., Hindley R.G., Freeman A., Kirkham A., Oldroyd R., Parker C., Bott S., Burns-Cox N., Dudderidge T., Ghei M., Henderson A., Persad R., Rosario D.J., Shergill I., Winkler M., Soares M., Spackman E., Sculpher M., Emberton M. Multiparametric MRI to improve detection of prostate cancer compared with transrectal ultrasoundguided prostate biopsy alone: the PROMIS study. Health Technol. Assess. 2018; 22 (39): 1–176. http://doi.org/10.3310/hta22390.Brown L.C., Ahmed H.U., Faria R., El-Shater Bosaily A., Gabe R., Kaplan R.S., Parmar M., Collaco-Moraes Y., Ward K., Hindley R.G., Freeman A., Kirkham A., Oldroyd R., Parker C., Bott S., Burns-Cox N., Dudderidge T., Ghei M., Henderson A., Persad R., Rosario D.J., Shergill I., Winkler M., Soares M., Spackman E., Sculpher M., Emberton M. Multiparametric MRI to improve detection of prostate cancer compared with transrectal ultrasoundguided prostate biopsy alone: the PROMIS study. Health Technol. Assess. 2018; 22 (39): 1–176. http://doi.org/10.3310/hta22390.Brown L.C., Ahmed H.U., Faria R., El-Shater Bosaily A., Gabe R., Kaplan R.S., Parmar M., Collaco-Moraes Y., Ward K., Hindley R.G., Freeman A., Kirkham A., Oldroyd R., Parker C., Bott S., Burns-Cox N., Dudderidge T., Ghei M., Henderson A., Persad R., Rosario D.J., Shergill I., Winkler M., Soares M., Spackman E., Sculpher M., Emberton M. Multiparametric MRI to improve detection of prostate cancer compared with transrectal ultrasoundguided prostate biopsy alone: the PROMIS study. Health Technol. Assess. 2018; 22 (39): 1–176. http://doi.org/10.3310/hta22390.Guidelines of European Association of Urology https://uroweb.org/guideline/prostate-cancer/?type=summaryof-changes.Guidelines of European Association of Urology https://uroweb.org/guideline/prostate-cancer/?type=summaryof-changes.Guidelines of European Association of Urology https://uroweb.org/guideline/prostate-cancer/?type=summaryof-changes.Guidelines of European Association of Urology https://uroweb.org/guideline/prostate-cancer/?type=summaryof-changes.Kesch C., Radtke J.P., Distler F., Boxler S., Klein T., Hüttenbrink C., Hees K., Roth W., Roethke M., Schlemmer H.P., Hohenfellner M., Hadaschik B.A. Multiparametric MRI and MRI-TRUS fusion biopsy in patients with prior negative prostate biopsy. Urologe A. 2016; 55 (8): 1071–1077. http://doi.org/10.1007/s00120-016-0093-6.Kesch C., Radtke J.P., Distler F., Boxler S., Klein T., Hüttenbrink C., Hees K., Roth W., Roethke M., Schlemmer H.P., Hohenfellner M., Hadaschik B.A. Multiparametric MRI and MRI-TRUS fusion biopsy in patients with prior negative prostate biopsy. Urologe A. 2016; 55 (8): 1071–1077. http://doi.org/10.1007/s00120-016-0093-6.Kesch C., Radtke J.P., Distler F., Boxler S., Klein T., Hüttenbrink C., Hees K., Roth W., Roethke M., Schlemmer H.P., Hohenfellner M., Hadaschik B.A. Multiparametric MRI and MRI-TRUS fusion biopsy in patients with prior negative prostate biopsy. Urologe A. 2016; 55 (8): 1071–1077. http://doi.org/10.1007/s00120-016-0093-6.Kesch C., Radtke J.P., Distler F., Boxler S., Klein T., Hüttenbrink C., Hees K., Roth W., Roethke M., Schlemmer H.P., Hohenfellner M., Hadaschik B.A. Multiparametric MRI and MRI-TRUS fusion biopsy in patients with prior negative prostate biopsy. Urologe A. 2016; 55 (8): 1071–1077. http://doi.org/10.1007/s00120-016-0093-6.Rifkin M.D., Dähnert W., Kurtz A.B. State of the art: endorectal sonography of the prostate gland. Am. J. Roentgenol. 1990; 154 (4): 691–700.Rifkin M.D., Dähnert W., Kurtz A.B. State of the art: endorectal sonography of the prostate gland. Am. J. Roentgenol. 1990; 154 (4): 691–700.Rifkin M.D., Dähnert W., Kurtz A.B. State of the art: endorectal sonography of the prostate gland. Am. J. Roentgenol. 1990; 154 (4): 691–700.Rifkin M.D., Dähnert W., Kurtz A.B. State of the art: endorectal sonography of the prostate gland. Am. J. Roentgenol. 1990; 154 (4): 691–700.Coakley F.V., Hricak H. Radiologic anatomy of the prostate gland: a clinical approach. Radiol. Clin. N. Am. 2000; 38 (1): 15–30.Coakley F.V., Hricak H. Radiologic anatomy of the prostate gland: a clinical approach. Radiol. Clin. N. Am. 2000; 38 (1): 15–30.Coakley F.V., Hricak H. Radiologic anatomy of the prostate gland: a clinical approach. Radiol. Clin. N. Am. 2000; 38 (1): 15–30.Coakley F.V., Hricak H. Radiologic anatomy of the prostate gland: a clinical approach. Radiol. Clin. N. Am. 2000; 38 (1): 15–30.McNeal J.E. The Zonal Anatomy of the Prostate. The Prostate. 1981; 2: 35–49.McNeal J.E. The Zonal Anatomy of the Prostate. The Prostate. 1981; 2: 35–49.McNeal J.E. The Zonal Anatomy of the Prostate. The Prostate. 1981; 2: 35–49.McNeal J.E. The Zonal Anatomy of the Prostate. The Prostate. 1981; 2: 35–49.

The authors declare that there are no conflicts of interest present.