Multiparametric MRI for prostate cancer localization in correlation to whole-mount histopathology
Multiparametric MRI for prostate cancer localization in correlation to whole-mount histopathology
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DOI：
10.1002/jmri.23938
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发表时间：
2013-06-01
影响因子：
4.4
通讯作者：
Oyen, Raymond
中科院分区：
文献类型：
--
作者：
Isebaert, Sofie;Van den Bergh, Laura;Oyen, Raymond
目的：以整体组织病理学为金标准，前瞻性评价多参数磁共振成像（MRI）对前列腺内肿瘤结节的准确定位。材料与方法：75例经活检证实的中高危前列腺癌患者接受了术前T2加权（T2 w）、动态对比增强（DCE）和1.5T弥散加权（DW）MRI。在不同的MR图像上记录24个标准化感兴趣区域的可疑病变的定位，并与病理结果相关联。广义估计方程（GEE）用于估计每种MRI模式的敏感性，特异性，准确性，阳性和阴性预测值，以及评估Gleason评分和PT分期的影响。组织病理学标本上的肿瘤体积测量值与不同MR模式上的测量值相关（Pearson相关性）。结果如下：DW MRI对肿瘤定位的敏感性最高（T2 w、DCE和DW MRI分别为31.1% vs. 27.4% vs. 44.5%; P < 0.005），该成像模式更容易检测到更具侵袭性或更晚期的肿瘤。T2 w、DCE和DW MRI组合的敏感性值（58.8%）显著高于单独的每种模式或两种模式的任何组合（P < 0.0001）。DWMRI能最准确地估计肿瘤体积（r = 0.75; P < 0.0001）。结论：T2 w、DCE和DW联合成像可显著提高前列腺癌定位。J.磁共振成像2013;37：13921401。(c)2012 Wiley Periodicals，Inc.
Purpose: To prospectively evaluate multiparametric magnetic resonance imaging (MRI) for accurate localization of intraprostatic tumor nodules, with whole-mount histopathology as the gold standard. Materials and Methods: Seventy-five patients with biopsy-proven, intermediate, and high-risk prostate cancer underwent preoperative T2-weighted (T2w), dynamic contrast-enhanced (DCE) and diffusion-weighted (DW) MRI at 1.5T. Localization of suspicious lesions was recorded for each of 24 standardized regions of interest on the different MR images and correlated with the pathologic findings. Generalized estimating equations (GEE) were used to estimate the sensitivity, specificity, accuracy, positive, and negative predictive value for every MRI modality, as well as to evaluate the influence of Gleason score and pT-stage. Tumor volume measurements on histopathological specimens were correlated with those on the different MR modalities (Pearson correlation). Results: DW MRI had the highest sensitivity for tumor localization (31.1% vs. 27.4% vs. 44.5% for T2w, DCE, and DW MRI, respectively; P < 0.005), with more aggressive or more advanced tumors being more easily detected with this imaging modality. Significantly higher sensitivity values were obtained for the combination of T2w, DCE, and DW MRI (58.8%) as compared to each modality alone or any combination of two modalities (P < 0.0001). Tumor volume can most accurately be assessed by means of DW MRI (r = 0.75; P < 0.0001). Conclusion: Combining T2w, DCE, and DW imaging significantly improves prostate cancer localization. J. Magn. Reson. Imaging 2013;37:13921401. (c) 2012 Wiley Periodicals, Inc.