Diffusion-weighted endorectal MR imaging at 3T for prostate cancer: correlation with tumor cell density and percentage Gleason pattern on whole mount pathology.
Diffusion-weighted endorectal MR imaging at 3T for prostate cancer: correlation with tumor cell density and percentage Gleason pattern on whole mount pathology.
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DOI：
10.1007/s00261-016-0942-1
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发表时间：
2017-03
期刊：
影响因子：
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通讯作者：
Fennessy FM
中科院分区：
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作者：
Glazer DI;Hassanzadeh E;Fedorov A;Olubiyi OI;Goldberger SS;Penzkofer T;Flood TA;Masry P;Mulkern RV;Hirsch MS;Tempany CM;Fennessy FM
确定整体切片病理学（WMP）上所勾画的体积肿瘤感兴趣区域（TROI）内的肿瘤细胞密度和格里森模式百分比是否与术前MRI上所勾画的相应TROI上的ADC值相关。在前列腺切除术前接受多参数MRI（mpMRI）的经活检证实的前列腺腺癌男性患者同意参加本前瞻性研究。使用3D切片器查看WMP和mpMRI图像，并在高b值ADC图（b 0，1400）上勾画WMP的每个TROI。对于WMP上列出的每个TROI，记录TCD（肿瘤细胞密度）和Gleason模式3、4和5的百分比。在每种情况下，还使用3D Slicer根据ADC图计算ADC平均值、ADC第10百分位数、ADC第90百分位数和ADC比率。本研究纳入了19例患者的21个肿瘤。TROI的ADC平均值为944.8 ± 327.4 mm 2/sec，而相邻非肿瘤性前列腺组织的ADC平均值为1329.9 ± 201.6 mm 2/sec（p<0.001）。高级别肿瘤的ADC平均值、ADC第10百分位数和ADC比率值低于低级别肿瘤（平均值：809.71和1176.34 mm 2/sec，p=0.014;第10百分位数：613.83和1018.14 mm 2/sec，p=0.009;比率：0.60和0.94，p=0.005）。TCD与ADC平均值（ρ=-0.61，p=0.005）和ADC第10百分位数（ρ=-0.56，p=0.01）呈负相关。Gleason模式的百分比与ADC值之间没有观察到相关性。DWI MRI可以使用ADC ratio、ADC第10百分位数和ADC mean来表征局灶性前列腺癌，其与病理肿瘤细胞密度相关。
To determine if tumor cell density and percentage of Gleason pattern within an outlined volumetric tumor region of interest (TROI) on whole-mount pathology (WMP) correlate with ADC values on corresponding TROIs outlined on pre-operative MRI. Men with biopsy-proven prostate adenocarcinoma undergoing multiparametric MRI (mpMRI) prior to prostatectomy were consented to this prospective study. WMP and mpMRI images were viewed using 3D Slicer and each TROI from WMP was contoured on the high b-value ADC maps (b0, 1400). For each TROI outlined on WMP, TCD (tumor cell density) and the percentage of Gleason pattern 3, 4, and 5 were recorded. The ADCmean, ADC10th percentile, ADC90th percentile, and ADCratio were also calculated in each case from the ADC maps using 3D Slicer. Nineteen patients with 21 tumors were included in this study. ADCmean values for TROIs were 944.8 ± 327.4 mm2/sec vs. 1329.9 ± 201.6 mm2/sec for adjacent non-neoplastic prostate tissue (p<0.001). ADCmean, ADC10th percentile, and ADCratio values for higher grade tumors were lower than those of lower grade tumors (mean: 809.71 and 1176.34 mm2/sec, p=0.014; 10th percentile: 613.83 and 1018.14 mm2/sec, p=0.009; ratio: 0.60 and 0.94, p=0.005). TCD and ADCmean (ρ= −0.61, p=0.005) and TCD and ADC10th percentile (ρ= −0.56, p=0.01) were negatively correlated. No correlation was observed between percentage of Gleason pattern and ADC values. DWI MRI can characterize focal prostate cancer using ADCratio, ADC10th percentile, and ADCmean, which correlate with pathological tumor cell density.