Rectal preparation significantly improves prostate imaging quality: Assessment of the PI-QUAL score with visual grading characteristics
Rectal preparation significantly improves prostate imaging quality: Assessment of the PI-QUAL score with visual grading characteristics
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DOI：
10.1016/j.ejrad.2021.110145
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发表时间：
2022-01-07
影响因子：
3.3
通讯作者：
Baltzer, Pascal A. T.
中科院分区：
文献类型：
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作者：
Arnoldner, Michael A.;Polanec, Stephan H.;Baltzer, Pascal A. T.
目的：探讨由直肠清洁灌肠和直肠内凝胶充填方案组成的直肠准备方案对前列腺成像质量(PI-QUAL)的影响。方法：对150例患者随机分为两组，每组75例。一组接受清洁灌肠和直肠内凝胶填充的直肠准备(中位年龄65.3岁，中位PSA水平6 ng/ml)。另一组患者没有接受这样的制剂(中位年龄岁，中位PSA6 ng/ml)。两位泌尿系放射科医生使用五点序贯等级分别对扩散加权成像(DWI)、T2加权成像(T2w)和动态对比增强(DCE)图像的总体图像质量和病变可见度进行了评估。此外，两名泌尿外科医生使用专用评分表对PI-QUAL进行了评分。结果：视觉分级特征(AUCR1 0.708(0.628-0.779 CI，p<；0.001；AUCR2 0.687(0.606-0.760 CI，p<；0.001)；以及病变可见性(AUCR1 0.729(0.607-0.831CI，p<；0.001)；AUC R2 0.714(0.590-0.818CI，p<；0.001)。对于T2w成像，直肠准备导致两个阅读器的病变可见度显著提高(R1 0.663(0.537-0.774 CI，p=0.014；R2 0.663(0.537-0.774 CI，p=0.014))。平均PI-QUAL评分在直肠准备后显著提高(AUCR3/R4 0.667，CI 0.581-0.754，P<；0.001)。结论：直肠准备显著提高了前列腺成像质量和病变可见度。因此，可以考虑一种由直肠清洁灌肠和直肠内凝胶填充组成的直肠准备方案。
Purpose: To investigate the effects of a rectal preparation regimen, that consisted of a rectal cleansing enema and an endorectal gel filling protocol, on prostate imaging quality (PI-QUAL).Methods: Multiparametric MRI (mpMRI) was performed in 150 consecutive patients divided into two groups of 75 patients. One group received a rectal preparation with a cleansing enema and endorectal gel filling (median age 65.3 years, median PSA level 6 ng/ml). The other patient group did not receive such a preparation (median age 64 years, median PSA level 6 ng/ml). Two uroradiologists independently rated general image quality and lesion visibility on diffusion-weighted imaging (DWI), T2-weighted (T2w), and dynamic contrast-enhanced (DCE) images using a five-point ordinal scale. In addition, two uroradiologists assigned PI-QUAL scores, using the dedicated scoring sheet. Data sets were compared using visual grading characteristics (VGC) and receiver operating characteristics (ROC)/ area under the curve (AUC) analysis.Results: VGC revealed significantly better general image quality for DWI (AUC R1 0.708 (0.628-0.779 CI, p < 0.001; AUC R2 0.687 (0.606-0.760 CI, p < 0.001) and lesion visibility for both readers (AUC R1 0.729 (0.607-0.831 CI, p < 0.001); AUC R2 0.714 (0.590-0.818CI, p < 0.001) in the preparation group. For T2w imaging, rectal preparation resulted in significantly better lesion visibility for both readers (R1 0.663 (0.537-0.774 CI, p = 0.014; R2 0.663 (0.537-0.774 CI, p = 0.014)). Averaged PI-QUAL scores were significantly improved with rectal preparation (AUC R3/R4 0.667, CI 0.581-0.754, p < 0.001).Conclusion: Rectal preparation significantly improved prostate imaging quality (PI-QUAL) and lesion visibility. Hence, a rectal preparation regimen consisting of a rectal cleansing enema and an endorectal gel filling could be considered.