A Pilot Study of Multidimensional Diffusion MRI for Assessment of Tissue Heterogeneity in Prostate Cancer.
A Pilot Study of Multidimensional Diffusion MRI for Assessment of Tissue Heterogeneity in Prostate Cancer.
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DOI：
10.1097/rli.0000000000000796
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发表时间：
2021-12-01
影响因子：
6.7
通讯作者：
Fennessy FM
中科院分区：
文献类型：
--
作者：
Langbein BJ;Szczepankiewicz F;Westin CF;Bay C;Maier SE;Kibel AS;Tempany CM;Fennessy FM
本探索性研究的目的是探讨多维弥散磁共振成像（MddMRI）在评估前列腺癌（PCa）的宏观和微观水平的弥散异质性的可行性。在这项机构审查委员会批准的研究中，从接受3.0 T前列腺多参数MRI的46例受试者中获得知情同意书，并补充了基于原型自旋回波的MddMRI序列。使用3D Slicer在表观扩散系数和MddMRI导出的平均扩散率（MD）图（从中导出微观扩散异质性[MKi]和微观扩散各向异性）上描绘每例患者的前列腺癌肿瘤和比较正常组织的轮廓。使用Friedman检验确定MddMRI衍生参数区分PCa与正常组织的区分能力。为了确定肿瘤扩散异质性在宏观和微观尺度上是否相似，使用稳健回归（二次方加权）估计MD的SD和平均MKi之间的线性相关性。假设检验为双尾; P值小于0.05被认为具有统计学显著性。在固定效应分析中，所有MddMRI衍生参数均能区分肿瘤和正常组织（P < 0.0001）。与正常组织相比，肿瘤MKi更高（P < 0.05）（中位数，0.40;四分位距，0.29-0.52 vs 0.20-0.18; 0.25），肿瘤显微扩散各向异性也是如此（0.55; 0.36-0.81 vs 0.20-0.15; 0.28）。MD的SD无法预测MKi（无显著相关性）。肿瘤体积与MD的SD有显著相关性（R2 = 0.50，slope = 0.008 μm2/ms/mm，P < 0.001），但与MKi无相关性。这项探索性研究表明，MddMRI提供了新的信息MKi和微观各向异性，这不同于在宏观层面的措施。MddMRI具有在不同空间尺度上表征肿瘤组织异质性的潜力。
The objectives of this exploratory study were to investigate the feasibility of multidimensional diffusion magnetic resonance imaging (MddMRI) in assessing diffusion heterogeneity at both a macroscopic and microscopic level in prostate cancer (PCa). Informed consent was obtained from 46 subjects who underwent 3.0-T prostate multiparametric MRI, complemented with a prototype spin echo–based MddMRI sequence in this institutional review board–approved study. Prostate cancer tumors and comparative normal tissue from each patient were contoured on both apparent diffusion coefficient and MddMRI-derived mean diffusivity (MD) maps (from which microscopic diffusion heterogeneity [MKi] and microscopic diffusion anisotropy were derived) using 3D Slicer. The discriminative ability of MddMRI-derived parameters to differentiate PCa from normal tissue was determined using the Friedman test. To determine if tumor diffusion heterogeneity is similar on macroscopic and microscopic scales, the linear association between SD of MD and mean MKi was estimated using robust regression (bisquare weighting). Hypothesis testing was 2 tailed; P values less than 0.05 were considered statistically significant. All MddMRI-derived parameters could distinguish tumor from normal tissue in the fixed-effects analysis (P < 0.0001). Tumor MKi was higher (P < 0.05) compared with normal tissue (median, 0.40; interquartile range, 0.29–0.52 vs 0.20–0.18; 0.25), as was tumor microscopic diffusion anisotropy (0.55; 0.36–0.81 vs 0.20–0.15; 0.28). The MKi could not be predicted (no significant association) by SD of MD. There was a significant correlation between tumor volume and SD of MD (R2 = 0.50, slope = 0.008 μm2/ms per millimeter, P < 0.001) but not between tumor volume and MKi. This explorative study demonstrates that MddMRI provides novel information on MKi and microscopic anisotropy, which differ from measures at the macroscopic level. MddMRI has the potential to characterize tumor tissue heterogeneity at different spatial scales.