Prostate cancer:: Local staging at 3-T endorectal MR imaging -: Early experience
Prostate cancer:: Local staging at 3-T endorectal MR imaging -: Early experience
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DOI：
10.1148/radiol.2381041832
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发表时间：
2006-01-01
期刊：
影响因子：
19.7
通讯作者：
Barentsz, JO
中科院分区：
文献类型：
--
作者：
Fütterer, JJ;Heijmink, SWTPJ;Barentsz, JO
目的：以全切片组织病理学分析为参考标准，前瞻性探讨 3-T 直肠内磁共振 (MR) 成像对前列腺癌局部分期的准确性。 材料与方法：本研究经机构审查委员会批准，并获得所有患者的知情同意。对 35 名连续活检证实患有前列腺癌的患者（中位年龄 62.3 岁）进行了 3-T 直肠内 MR 成像。在三个平面上获得前列腺的高空间分辨率直肠内 T2 加权快速自旋回波图像。两位经验丰富的放射科医生和另一位在局部疾病范围方面经验较少的放射科医生使用五种既定的囊外标准对 MR 图像进行了前瞻性评估。全切片组织病理学分析是参考标准。根据八分圆和患者进行评估。计算敏感性、特异性、阳性和阴性预测值、总体准确性和观察者间一致性。结果：32 名接受根治性前列腺切除术的患者纳入本研究。对于经验丰富的放射科医生来说，局部分期的准确性、敏感性和特异性分别为 94%（32 名中的 30 名）、88%（8 名中的 7 名）和 96%（24 名中的 23 名），而对于经验较少的放射科医生来说，这些值分别为 81%（32 名中的 26 名）、50%（8 名中的 4 名）和 92%（24 名中的 22 名）。对于所有囊外标准，经验丰富的读者之间存在实质性一致性（kappa = 0.42-0.79），而经验不足的读者和经验丰富的读者之间存在中等程度的一致性。对于三例最小包膜侵犯的病例，其中两例是由两位经验丰富的放射科医生检测到的。 结论：在这项研究中，3-T 直肠内 MR 成像对前列腺癌分期的准确性很高，观察者的一致性中等至显着。此外，可以检测到最小的囊膜侵犯。 (c) 北美放射学会，2005 年。
Purpose: To prospectively investigate the local staging accuracy of 3-T endorectal magnetic resonance (MR) imaging for prostate cancer by using whole-mount-section histopathologic analysis as the standard of reference.Materials and Methods: This study was approved by the institutional review board, and informed consent was obtained from all patients. In 35 consecutive patients (median age, 62.3 years) with biopsy-proved prostate cancer, 3-T endorectal MR imaging was performed. High-spatial-resolution endorectal T2-weighted fast spin-echo images of the prostate were obtained in three planes. MR images were prospectively evaluated by two experienced radiologists and a third radiologist who was less experienced with regard to local disease extent by using five established extracapsular criteria. Whole-mount-section histopathologic analysis was the standard of reference. Evaluation was performed according to octant and patient. Sensitivity, specificity, positive and negative predictive values, overall accuracy, and interobserver agreement were calculated.Results: Thirty-two patients who underwent radical prostatectomy were enrolled in this study. Accuracy, sensitivity, and specificity of local staging were 94% (30 of 32), 88% (seven of eight), and 96% (23 of 24), respectively, for both experienced radiologists, and these values were 81% (26 of 32), 50% (four of eight), and 92% (22 of 24), respectively, for the less experienced radiologist. There was substantial agreement between both experienced readers (kappa = 0.42-0.79) and moderate agreement between the less experienced reader and the experienced readers with respect to all extracapsular criteria. In regard to the three cases of minimal capsular invasion, two were detected by both experienced radiologists.Conclusion: In this study, high accuracy for staging of prostate cancer at 3-T endorectal MR imaging, with moderate to substantial observer agreement, was demonstrated. In addition, minimal capsular invasion could be detected. (c) RSNA, 2005.