Prostate cancer: Localization with three-dimensional proton MR spectroscopic imaging - Clinicopathologic study
Prostate cancer: Localization with three-dimensional proton MR spectroscopic imaging - Clinicopathologic study
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DOI：
10.1148/radiology.213.2.r99nv23473
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发表时间：
1999-11-01
期刊：
影响因子：
19.7
通讯作者：
Kurhanewicz, J
中科院分区：
文献类型：
--
作者：
Scheidler, J;Hricak, H;Kurhanewicz, J
目得：为了评估磁共振（MR）成像和三维（3D）质子磁共振波谱成像相结合的检测和定位的前列腺癌的有效性。材料和方法：53例经活检证实的前列腺癌患者行MR成像和3D磁共振波谱成像检查，随后行根治性前列腺癌切除术，并进行阶梯切片组织病理学检查。前列腺被分为六等分。在MR成像时，由不知道3D MR光谱成像和组织病理学检查结果的两名阅片人（阅片人1和2）独立评估每个六分仪外周区是否存在癌症。在3D MR光谱成像中，如果胆碱加肌酸与柠檬酸盐的比率超过人群正常值2 SD，则诊断为可能患有癌症，或者如果该比率超过正常值3 SD，则诊断为可能患有癌症。结果：根据六分仪、灵敏度和特异性，MR成像的诊断符合率分别为77%和61%（阅片人1），81%和46%（阅片人2），阅片人间一致性中等（kappa = 0.43）。3D磁共振波谱成像诊断明确的恶性肿瘤的特异性明显高于其他检查方法（75%，P <0.05），但敏感性低于其他检查方法（63%，P <0.05）。受试者操作特征分析显示，当3D MR光谱成像添加到MR成像中时，两名阅片者的肿瘤定位均得到显著改善（P <0.001）。高特异性（高达91%）时，结合磁共振成像和三维磁共振波谱成像表明癌症，而高灵敏度（高达95%）时，获得任何单独测试表明阳性结果。结论：除了三维磁共振波谱成像的磁共振成像提供了更好的检测和定位前列腺癌的六分仪的前列腺比单独使用磁共振成像。
PURPOSE: To assess the efficacy of combined magnetic resonance (MR) imaging and three-dimensional (3D) proton MR spectroscopic imaging in the detection and localization of prostate cancer.MATERIALS AND METHODS: MR imaging and 3D MR spectroscopic imaging, examinations were performed in 53 patients with biopsy-proved prostate cancer and subsequent radical prostatectomy with step-section histopathologic examination. The prostate was divided into sextants. At MR imaging, the presence or absence of cancer in the peripheral zone of each sextant was assessed independently by two readers (readers 1 and 2) unaware of the findings at 3D MR spectroscopic imaging and histopathologic examination. At 3D MR spectroscopic imaging, cancer was diagnosed as possible if the ratio of choline plus creatine to citrate exceeded 2 SD above population norms or as definite if that ratio exceeded 3 SDs above the norm.RESULTS: On the basis of sextants, sensitivity and specificity, respectively, for MR imaging were 77% and 61% (reader 1) and 81% and 46% (reader 2) with moderate interreader agreement (kappa = 0.43). The 3D MR spectroscopic imaging diagnosis of definite cancer had significantly higher specificity (75%, P < .05) but lower sensitivity (63%, P < .05). Receiver operating characteristic analysis showed significantly (P < .001) improved tumor localization for both readers when 3D MR spectroscopic imaging was added to MR imaging. High specificity (up to 91%) was obtained when combined MR imaging and 3D MR spectroscopic imaging indicated cancer, whereas high sensitivity (up to 95%) was obtained when either test alone indicated a positive result.CONCLUSION: The addition of 3D MR spectroscopic imaging to MR imaging provides better detection and localization of prostate cancer in a sextant of the prostate than does use of MR imaging alone.