Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press53710.17650/1726-9776-2016-12-1-81-89DIAGNOSIS AND TREATMENT OF URINARY SYSTEM TUMORS. PROSTATE CANCERДИАГНОСТИКА И ЛЕЧЕНИЕ ОПУХОЛЕЙ МОЧЕПОЛОВОЙ СИСТЕМЫ. Рак предстательной железыA system of a unified approach to interpreting prostate magnetic resonance imaging according to the PI-RADSv2 guidelinesСистема унифицированного подхода к интерпретации магнитно-резонансной томографии предстательной железы согласно руководству PI-RADSv2MishchenkoA. V.МищенкоА. В.
Russian Federation

68, Leningradskaya St., village Pesochny, Saint-Petersburg 197758;

7-9, Universitetskaya naberezhnaya, Saint-Petersburg, 199034

197758, Санкт-Петербург, пос. Песочный, ул. Ленинградская,68;

199034, Санкт-Петербург, Университетская наб., 7–9

RubtsovaN. A.РубцоваН. А.
Russian Federation

3, Second Botkinsky Passage, Moscow 125284

руководитель отдела лучевой диагностики, д.м.н.,

125284, Москва, 2-й Боткинский проезд, 3

rna17@yandex.ruAlekseevB. Ya.АлексеевБ. Я.
Russian Federation

3, Second Botkinsky Passage, Moscow 125284

125284, Москва, 2-й Боткинский проезд, 3

PetrovS. B.ПетровС. Б.
Russian Federation

68, Leningradskaya St., village Pesochny, Saint-Petersburg 197758

197758, Санкт-Петербург, пос. Песочный, ул. Ленинградская, 68

BelyaevA. M.БеляевА. М.
Russian Federation

68, Leningradskaya St., village Pesochny, Saint-Petersburg 197758

197758, Санкт-Петербург, пос. Песочный, ул. Ленинградская, 68

KaprinA. D.КапринА. Д.
Russian Federation

3, Second Botkinsky Passage, Moscow 125284

125284, Москва, 2-й Боткинский проезд, 3

FSBI “N.N. Petrov Cancer Research Institute” of thу Ministry of Health of RussiaФГБУ «НИИ онкологии им. Н.Н. Петрова» Минздрава РоссииThe Scientific Research and Educational Centre “Radiology and Nuclear Medicine” of the Institute of High Medical Technologies the Medical Faculty of the State Educational Institution “St. Petersburg State University”НКОЦ «Лучевая диагностика и ядерная медицина» Института высоких медицинских технологий медицинского факультета ФГБОУ ВО «Санкт-Петербургский государственный университет»P.A. Herzen Moscow Oncology Research Institute, Branch, National Medical Radiology Research Center, Ministry of Health of RussiaМосковский научно-исследовательский онкологический институт им. П.А. Герцена – филиал ФГБУ «Национальный медицинский исследовательский радиологический центр» Минздрава России3003201612181892112201516012016https://oncourology.abvpress.ru/oncur/article/view/537

The experience with magnetic resonance imaging (MRI) used to diagnose prostate cancer (PC) is more than 35 years. Cardinal changes have occurred over that time. The accumulation of experience and the development of technologies have given rise to multiparameter MRI (mpMRI) involving the assessment of both functional and anatomic images. The International MRI Working Group on PC Diagnosis was set up in 2007. The Group has elaborated the basic principles of the standardization and compatibility of MRI studies, which are embodied in the European Society of Urogenital Radiology (ESUR) guidelines as a PI-RADS. The development of this system could create conditions for reducing variations in MRI procedures, interpretation, and mpMRI report forms for PC. The system has realized a scale of rating categories that summarize levels of suspicion or risk and that may be used to select patients for different tactics, such as biopsy or active monitoring. Furthermore, such an optimized approach allows reproducible MRI studies for monitoring during an active follow-up and for the early detection of recurrences. Therefore, PI-RADS enables one to systematize MRI reports and to unify the language of communication between radiologists, urologists, and oncologists.

Owing to the rapid widespread and introduction of the PI-RADS system, it has become possible to analyze its efficiency and to reveal some critical moments. The pooling of the resources of the American College of Radiology (ACR), (ESUR), and the AdMetech Foundation has permitted an Ad Hoc Coordinating Committee, the activity of which is to obtain scientific evidence and to form expert opinions to improve the system, as a result of which an updated PI-RADSv2 was published in 2015. This paper deals with the basic principles of a prostate MRI analysis in accordance with the PI-RADSv2 grades.

Опыт клинического использования магнитно-резонансной томографии (МРТ) в диагностике рака предстательной железы (РПЖ) составляет более 35 лет. За это время произошли кардинальные изменения диагностических возможностей метода. Накопление опыта и развитие технологий привели к созданию мультипараметрической МРТ (мпМРТ), включающей наряду с анатомическими оценку функциональных изображений. В 2007 г. была сформирована Международная рабочая группа МРТ по проблемам диагностики РПЖ. Группой были разработаны основные принципы стандартизации и сопоставимости МРТ-исследований, которые нашли отражение в руководстве Европейского общества урогенитальной радиологии (ESUR) в виде системы PI-RADS. Разработка системы позволила создать условия для снижения вариативности в методике проведения МРТ, интерпретации и формах отчетов мпМРТ при РПЖ. В системе реализована шкала оценочных категорий, которые суммируют уровни подозрения или риска и используются для выбора различных тактик в лечении того или иного пациента, например биопсии или активного наблю- дения. Более того, такой оптимизированный подход позволяет проводить воспроизводимые МРТ-исследования при мониторинге в ходе активного наблюдения, а также для раннего выявления рецидивов. Обладая такими качествами, PI-RADS дает возможность систематизировать отчеты МРТ и унифицировать «язык общения» между рентгенологами, урологами и онкологами. Быстрое распространение и внедрение системы PI-RADS, ее доступность сделали возможным проанализировать ее эффективность и выявить некоторые критические моменты. Кооперация ресурсов American College of Radiology (ACR), European Society of Uroradiology (ESUR) и AdMetech Foundation позволила создать специальный Координационный комитет, работа которого направлена на получение научных доказательств и формирование экспертных мнений по совершенствованию системы, в результате чего в 2015 г. была опубликована обновленная версия – PI-RADSv2. Данная статья посвящена основным принципам анали- за МРТ-исследования предстательной железы в соответствии с градациями, предложенными в системе PI-RADSv2.

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