MRI在监测1期睾丸精原细胞瘤方面不逊于CT。在6年期间,无论成像方式如何,3扫描计划都不比7扫描计划差。MRI替代CT可减少[1]患者的放射暴露。目前的指南提倡对1期睾丸癌患者行睾丸切除术后进行CT监测。虽然这种癌症有很高的存活率,但由于通过CT扫描反复暴露于辐射,有长期的不良健康影响。第三期trist试验(NCT00589537)的研究旨在证明减少CT或MRI的安全性和有效性监测1期睾丸癌患者的非劣等性。研究人员将669名男性随机分到4组中的1组,其中2组采用CT监测,2组采用MRI监测。每个成像模式臂有两种不同的频率计划:一种是在6、12、18、24、36、48和60个月对患者进行扫描;其他患者分别在6个月、18个月和36个月进行扫描。所有患者随访6年。主要结局指标是皇家马斯登医院分期≥2C的复发患者的比例。669名试验参与者中,82人(12%)复发。82例患者中只有10例分级为≥2C期复发。大多数复发是在预定成像时间诊断的;此外,超过3年的复发是罕见的。 Although there were more events in those who received 3 scans instead of 7, the criteria for non-inferiority were still met. Fewer events were observed in those who received MRI scans compared with CT. No tumor-related deaths occurred and the 5-year disease-free survival and overall survival rates were similar across all groups. Researchers asserted that surveillance is both safe and effective in stage 1 testicular seminoma, regardless of frequency or type of imaging. Furthermore, imaging beyond 3 years may actually be unnecessary, as relapse after 3 years is rare. Finally, they recommend that the standard of care should recommend MRI instead of CT, in an attempt to limit radiation exposure in this young population.
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  1. 监测I期精原细胞瘤睾丸癌的影像学模式和频率:来自一项随机、III期、因子试验(TRISST)的结果。ASCO泌尿生殖系统癌症研讨会,2021年2月11-13日。