Comparison of PI-RADS 2, ADC histogram-derived parameters, and their combination for the diagnosis of peripheral zone prostate cancer
Comparison of PI-RADS 2, ADC histogram-derived parameters, and their combination for the diagnosis of peripheral zone prostate cancer
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DOI：
10.1007/s00261-016-0826-4
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发表时间：
2016-11-01
影响因子：
2.4
通讯作者：
Muglia, V. F.
中科院分区：
文献类型：
--
作者：
Lin, W. C.;Westphalen, A. C.;Muglia, V. F.
本研究的目的是比较PI-RADS V2评分、ADC直方图衍生参数及其组合用于诊断临床显著的外周区前列腺癌（PCa）。IRB批准了这项对47名接受1.5特斯拉直肠内前列腺磁共振成像（MRI）的男性进行的回顾性研究。放弃知情同意。两名阅片人使用PI-RADS V2识别并评分MRI病变。还计算了其平均值、中位数、第10、第25、第75百分位ADC值和标准化比值。多水平logistic回归和受试者工作特征（ROC）曲线分析评估其诊断性能。临床意义PCa定义为肿瘤体积大于0.5 cc，Gleason分级为4或5，总体和弥散加权成像（DWI）PI-RADS V2评分的ROC曲线下面积（A（z））分别为0.69和0.84（阅片者-1），0.68和0.73（阅片者-2）。两名阅片员的ADC参数的A（z）范围为0.68至0.75。与其他预测因子相比，DWI PI-RADS V2在识别显著癌症方面产生了最高的A（z）;但是，除了读片者-1的75百分位ADC外，差异无统计学意义（P > 0.05）。在PI-RADS V2评分基础上增加ADC值并不能提高其诊断能力，DWI PI-RADS V2评分可能比PI-RADS V2评分更能预测临床意义的PCa，但增加客观ADC值并不能显著提高其诊断能力。
The purpose of this study was to compare the PI-RADS V2 scores, ADC histogram-derived parameters, and their combination for the diagnosis of clinically significant peripheral zone prostate cancer (PCa).The IRB approved this retrospective study of 47 men who underwent 1.5 Tesla endorectal prostate magnetic resonance imaging (MRI). Informed consent was waived. Two readers identified and scored MRI lesions using PI-RADS V2. Their mean, median, 10th, 25th, 75th percentile ADC values, and normalized ratio were also calculated. Multilevel logistic regression and receiver-operating characteristic (ROC) curve analyses assessed their diagnostic performance. Clinically significant PCa was defined as tumor volume over 0.5 cc and Gleason grade of 4 or 5 on prostatectomy.The area under the ROC curve (A (z)) of the overall and diffusion-weighted imaging (DWI) PI-RADS V2 scores were 0.69 and 0.84 (reader-1), and 0.68 and 0.73 (reader-2). The A (z) of ADC parameters ranged from 0.68 to 0.75 for both readers. Compared to other predictors, DWI PI-RADS V2 yielded the highest A (z) for identification of significant cancer; but, except for reader-1 75th percentile ADC, the differences were not statistically significant (P > 0.05). Adding ADC parameters to PI-RADS V2 scores did not improve their diagnostic ability.DWI PI-RADS V2 score may a better predictor of clinically significant PCa than the overall PI-RADS V2 score, but its diagnostic performance was not significantly improved by the addition of objective ADC value measurements.