MRI衍生的影像组学用于前列腺癌主动监测：一项系统综述。
完整摘要 · 中文译文
目的：系统评价基于MRI的影像组学和人工智能模型预测接受或符合前列腺癌主动监测（AS）条件男性结局的研究，并评估所报告的终点是否允许进行定量合成。方法：遵循PRISMA 2020，我们检索了PubMed、Scopus、Embase和Web of Science（2000年至2026年9月）。两名评价者独立筛选、提取数据，并评估偏倚风险（QUADAS-2、PROBAST）和方法学质量（METRICS）。定义了三个亚组：诊断时AS选择、基线检测临床显著癌症、随访期间进展。预先设定对至少包含四个独立队列的亚组进行合并；评估了终点等效性。结果：共纳入17项研究，涉及12个独特队列。7篇出版物来源于2个队列；重叠消解后保留12个独立队列水平估计（n = 2703）。9篇出版物（4个独立队列）涉及进展（AUC 0.70至0.95），但进展以五种非等效方式定义，从任何分级组增加到复合核心数标准，妨碍了定量合成。17项研究中有16项偏倚风险为高或不明确；METRICS评分中位数为32.3%（范围18.9-52.3%）。无研究报告进展的外部验证或校准。结论：进展终点异质性强，且若干终点的临床相关性有限。需建立AS核心结局集（至少ISUP分级组≥3和/或明确的影像学进展），随后开展多中心e 在考虑临床使用之前，优先需要进行外部验证，并与PRECISE v2（前列腺癌序贯评估变化放射学估计）评分进行头对头比较。
完整摘要 · 英文原文
PURPOSE: To systematically review MRI-derived radiomic and artificial intelligence models predicting outcomes in men on or eligible for active surveillance (AS) for prostate cancer, and whether reported endpoints permit quantitative synthesis. METHOD: Following PRISMA 2020, we searched PubMed, Scopus, Embase, and Web of Science (2000-September 2026). Two reviewers independently screened, extracted data, and assessed risk of bias (QUADAS-2, PROBAST) and methodological quality (METRICS). Three subgroups were defined: AS selection at diagnosis, baseline detection of clinically significant cancer, and progression during follow-up. Pooling was pre-specified for subgroups with at least four independent cohorts; endpoint equivalence was assessed. RESULTS: Seventeen studies across 12 unique cohorts were included. Seven publications derived from two cohorts; 12 independent cohort-level estimates (n = 2703) remained after overlap resolution. Nine publications (four independent cohorts) addressed progression (AUC 0.70 to 0.95), but progression was defined in five non-equivalent ways, from any grade-group increase to composite core-count criteria, precluding quantitative synthesis. Risk of bias was high or unclear in 16 of 17 studies; the median METRICS score was 32.3 % (range 18.9-52.3 %). No study reported external validation or calibration for progression. CONCLUSIONS: Progression endpoints were heterogeneous and several were of limited clinical relevance. A core outcome set for AS (at least ISUP grade group ≥3 and/or unequivocal radiological progression), followed by multi-centre external validation with a head-to-head comparison against the PRECISE v2 (Prostate Cancer Radiological Estimation of Change in Sequential Evaluation) score, is the priority before clinical use can be considered.