Prostate Cancer: Feasibility and Preliminary Experience of a Diffusional Kurtosis Model for Detection and Assessment of Aggressiveness of Peripheral Zone Cancer
Prostate Cancer: Feasibility and Preliminary Experience of a Diffusional Kurtosis Model for Detection and Assessment of Aggressiveness of Peripheral Zone Cancer
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DOI：
10.1148/radiol.12112290
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发表时间：
2012-07-01
期刊：
影响因子：
19.7
通讯作者：
Jensen, Jens H.
中科院分区：
文献类型：
--
作者：
Rosenkrantz, Andrew B.;Sigmund, Eric E.;Jensen, Jens H.
目的：评估扩散峰度（DK）成像与标准扩散加权（DW）成像相比，在前列腺外周区（PZ）内区分良性和恶性区域以及低恶性和高恶性区域的可行性。材料和方法：机构审查委员会批准了这项符合hipaa的回顾性研究，并放弃了知情同意。47例前列腺癌患者行骨盆相控阵线圈3-T磁共振成像和DW成像（最大b值为2000 sec/mm(2)）。得到表观扩散系数（ADC）的参数化图；度量DK (K)，表示非高斯扩散行为；和校正的扩散(D)，它解释了这种非高斯性。两名放射科医生回顾了这些地图，并在活检中检测出癌症阳性的六分仪中测量了ADC、D和K。采用混合模型方差分析和受试者工作特征曲线对数据进行分析。结果：70位六分仪的Gleason评分为6分；51人的Gleason评分为7或8分。K在癌性六分仪中显著高于良性PZ (0.96 +/- 0.24 vs 0.57 +/- 0.07, P < 0.001)，在Gleason评分较高的癌性六分仪中显著高于低Gleason评分（1.05 +/- 0.26 vs 0.89 +/- 0.20, P < 0.001）。K在区分癌性六分仪与良性PZ方面的敏感性显著高于ADC或D（分别为93.3% vs 78.5%和83.5%,P < 0.001），两者的特异性相同（95.7%,P < .99）。与ADC或D相比，K在鉴别低级别和高级别癌症的六分仪上表现出更高的敏感性（分别为68.6%比51.0%和49.0%,P < 0.004），但特异性较低(分别为70.0%比81.4%和82.9%
Purpose: To assess the feasibility of diffusional kurtosis (DK) imaging for distinguishing benign from malignant regions, as well as low-from high-grade malignant regions, within the peripheral zone (PZ) of the prostate in comparison with standard diffusion-weighted (DW) imaging.Materials and Methods: The institutional review board approved this retrospective HIPAA-compliant study and waived informed consent. Forty-seven patients with prostate cancer underwent 3-T magnetic resonance imaging by using a pelvic phased-array coil and DW imaging (maximum b value, 2000 sec/mm(2)). Parametric maps were obtained for apparent diffusion coefficient (ADC); the metric DK (K), which represents non-Gaussian diffusion behavior; and corrected diffusion (D) that accounts for this non-Gaussianity. Two radiologists reviewed these maps and measured ADC, D, and K in sextants positive for cancer at biopsy. Data were analyzed by using mixed-model analysis of variance and receiver operating characteristic curves.Results: Seventy sextants exhibited a Gleason score of 6; 51 exhibited a Gleason score of 7 or 8. K was significantly greater in cancerous sextants than in benign PZ (0.96 +/- 0.24 vs 0.57 +/- 0.07, P < .001), as well as in cancerous sextants with higher rather than lower Gleason score (1.05 +/- 0.26 vs 0.89 +/- 0.20, P < .001). K showed significantly greater sensitivity for differentiating cancerous sextants from benign PZ than ADC or D (93.3% vs 78.5% and 83.5%, respectively; P < .001), with equal specificity (95.7%, P < .99). K exhibited significantly greater sensitivity for differentiating sextants with low-and high-grade cancer than ADC or D (68.6% vs 51.0% and 49.0%, respectively; P < .004) but with decreased specificity (70.0% vs 81.4% and 82.9%, respectively; P