Sextant localization of prostate cancer: Comparison of sextant biopsy, magnetic resonance imaging and magnetic resonance spectroscopic imaging with step section histology
Sextant localization of prostate cancer: Comparison of sextant biopsy, magnetic resonance imaging and magnetic resonance spectroscopic imaging with step section histology
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DOI：
10.1016/s0022-5347(05)67370-3
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发表时间：
2000-08-01
影响因子：
6.6
通讯作者：
Kurhanewicz, J
中科院分区：
文献类型：
--
作者：
Wefer, AE;Hricak, H;Kurhanewicz, J
目的：材料与方法：对47例前列腺癌患者行前列腺穿刺活检、MRI、磁共振波谱成像和根治性前列腺切除术，并进行阶梯切片组织学检查，比较MRI、磁共振波谱成像和六分穿刺活检对前列腺癌定位的准确性。对于每个六分仪，我们将活检和成像结果分类为癌症阳性或阴性。阶梯切片组织学作为标准的reference.Results：对于前列腺癌的六分定位MRI和磁共振波谱成像更敏感，但低于活检（67%和76%对50%，69%和68%对82%，分别）的特异性。前列腺尖部六分活检的敏感性显著低于前列腺中部或前列腺底部（分别为38%、52%和62%）。MRI和磁共振波谱成像在整个前列腺中的疗效与仅活检相似，在前列腺尖部的敏感性和特异性更高（分别为60%和75%，86%和68%）。结论：MRI和磁共振波谱成像对前列腺内肿瘤定位的准确性与前列腺穿刺活检相似，但在前列腺尖部肿瘤定位方面，MRI和磁共振波谱成像的准确性高于穿刺活检。这2种成像方式可以通过增加医生在评估前列腺内肿瘤位置时的信心来补充活检结果，这对于规划疾病靶向治疗可能很重要。
Purpose: We compared the accuracy of endorectal magnetic resonance imaging (MRI) and magnetic resonance spectroscopic imaging with that of sextant biopsy for the sextant localization of prostate cancer.Materials and Methods: Sextant biopsy, MRI, magnetic resonance spectroscopic imaging and radical prostatectomy with step section histology were done in 47 patients with prostate cancer. For each sextant we categorized biopsy and imaging results as positive or negative for cancer. Step section histology was used as the standard of reference.Results: For sextant localization of prostate cancer MRI and magnetic resonance spectroscopic imaging were more sensitive but less specific than biopsy (67% and 76% versus 50%, and 69% and 68% versus 82%, respectively). The sensitivity of sextant biopsy was significantly less in the prostate apex than in the mid prostate or prostate base (38% versus 52% and 62%, respectively). MRI and magnetic resonance spectroscopic imaging had similar efficacy throughout the prostate compared with biopsy only as well as better sensitivity and specificity in the prostate apex (60% and 75%, and 86% and 68%, respectively). A positive biopsy or imaging result had 94% sensitivity for cancer and concordant positivity by all 3 tests was highly specific at 98%.Conclusions: Overall MRI and magnetic resonance spectroscopic imaging have accuracy similar to biopsy for intraprostatic localization of cancer and they are more accurate than biopsy in the prostate apex. These 2 imaging modalities may supplement biopsy results by increasing physician confidence when evaluating intraprostatic tumor location, which may be important for planning disease targeted therapy.