ABSTRACT
BACKGROUND AND OBJECTIVE: Prostate Imaging for Recurrence Reporting (PI-RR) was introduced in 2021 to standardize the interpretation and reporting of multiparametric magnetic resonance imaging (MRI) for prostate cancer following whole-gland treatment. The system scores image on a scale from 1 to 5 and has shown promising results in single-center studies. The aim of our systematic review and meta-analysis was to assess the diagnostic performance of the PI-RR system in predicting the likelihood of local recurrence after whole-gland treatment. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for diagnostic test accuracy were followed. Relevant databases were searched up to December 2023. Primary studies met the eligibility criteria if they reported MRI diagnostic performance in prostate cancer recurrence using PI-RR. Diagnostic performance for MRI was assessed using two different cutoff points (≥3 or ≥4 for positivity according to the PI-RR system). A meta-analysis with a random-effects model was used to estimate pooled sensitivity and specificity values. KEY FINDINGS AND LIMITATIONS: Sixteen articles were identified for full-text reading, of which six were considered eligible, involving a total of 467 patients. Using a cutoff of PI-RR ≥3 (4 studies) for recurrent disease, the sensitivity was 77.8% (95% confidence interval [CI] 69.9-84.1%) and the specificity was 80.2% (95% CI 58.2-92.2%). Using a cutoff of PI-RR ≥4 (4 studies), the sensitivity was 61.9% (95% CI 35.6-82.7%) and the specificity was 86.6% (95% CI 75.1-93.3%). Overall, the inter-rater agreement varied from fair to excellent. CONCLUSIONS AND CLINICAL IMPLICATIONS: PI-RR is accurate in detecting local recurrence after whole-gland treatment for prostate cancer and shows fair-to-good to excellent inter-reader agreement. Overall, a PI-RR cutoff of ≥3 showed high sensitivity and specificity. PATIENT SUMMARY: We reviewed studies that reported on how good MRI scans using a scoring system called PI-RR were in detecting recurrence of prostate cancer. We found that this system shows good performance, with fair to excellent agreement between different radiologists.
ABSTRACT
ABSTRACT COVID-19 started in China on December 31, 2019 and has since been the subject of several studies in medical field. There is not much evidence about the pregnancy and puerperium with the susceptibility of coronavirus infection (COVID-19). The present work reports the laboratory and radiological aspects of a puerperium patient. A positive test for severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) generally confirms the diagnosis of COVID-19, although false-positive and false-negative tests are possible. The test considered the gold standard for the diagnosis of coronavirus infection (COVID-19) is from in vivo or post-mortem polymerase chain reaction (PCR) sample. The purpose of the present case report is to demonstrate the case of a puerperium patient with an unfavorable clinical evolution, giving special attention to laboratory tests that were practically unchanged.
RESUMEN La COVID-19 se originó en China, el 31 de diciembre de 2019, y, desde entonces, ha sido objeto de varios estudios médicos. No hay evidencias sobre la relación del embarazo y del puerperio con la susceptibilidad a la infección por coronavirus. El presente estudio reporta aspectos de laboratorio y radiológicos de una paciente en puerperio. Una prueba positiva para el coronavirus del síndrome respiratorio agudo grave 2 (SARS-CoV-2) por lo general confirma el diagnóstico de COVID-19, a pesar de que falso positivos y falso negativos sean posibles. El método considerado el test de referencia para el diagnóstico de la infección por coronavirus es la muestra in vivo o post mortem por reacción en cadena de la polimerasa (PCR). El objetivo de este reporte es demostrar el caso de una paciente en puerperio con evolución clínica desfavorable, poniendo especial atención a los análisis de laboratorio que estaban prácticamente sin cambios.
RESUMO A COVID-19 teve início na China, em 31 de dezembro de 2019 e, desde então, tem sido alvo de diversos estudos na área médica. Não há muitas evidências sobre a relação da gravidez e do puerpério com a suscetibilidade da infecção pelo coronavírus. O presente estudo relata os aspectos laboratoriais e radiológicos de uma paciente no puerpério. Um teste positivo para a síndrome respiratória aguda severa-coronavírus 2 (SARS-CoV-2) geralmente confirma o diagnóstico de COVID-19, embora testes falso positivos e falso negativos sejam possíveis. O exame considerado padrão-ouro para o diagnóstico da infecção pelo coronavírus é a amostra in vivo ou post-mortem por reação em cadeia da polimerase (PCR). O objetivo deste relato é demonstrar o caso de uma paciente no puerpério com evolução desfavorável do quadro clínico, dando atenção especial para exames laboratoriais que estavam praticamente sem alterações.
