Endorectal magnetic resonance imaging and spectroscopy for the detection of tumor foci in men with prior negative transrectal ultrasound prostate biopsy
Endorectal magnetic resonance imaging and spectroscopy for the detection of tumor foci in men with prior negative transrectal ultrasound prostate biopsy
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DOI：
10.1097/01.ju.0000118380.90871.ef
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发表时间：
2004-04-01
影响因子：
6.6
通讯作者：
Cheng, CWS
中科院分区：
文献类型：
--
作者：
Yuen, JSP;Thng, CH;Cheng, CWS
目的：我们确定了直肠内磁共振成像（MRI）和磁共振波谱成像（MRSI）相结合的能力，以前瞻性地检测先前经直肠超声（TRUS）前列腺活检阴性的男性中的前列腺癌病灶。对24名先前接受过1次或多次TRUS前列腺活检的前列腺特异性抗原持续升高和/或前列腺特异性抗原持续升高的患者进行了直肠内MRI波谱检查。或直肠指检异常所有研究均由专门的放射科医生进行解释，该放射科医生分别在MRI和MRSI上将外周区中的感兴趣区域报告为正常、可疑或可疑。然后将可疑和可疑区域与三维前列腺模型相关联。所有患者进行了标准的TRUS 10芯外周区活检，最多4个额外的活检针对可疑或可疑sites.Results：前列腺癌被检测到7 24例（29.2%）。考虑到可疑类别为测试阴性，MRI、MRSI和MRI/MRSI联合检测前列腺癌的敏感性、特异性、阳性预测值和阴性预测值以及准确性分别为57.1%、57。1%和100.0%，88.2%，82.4%和70.6%，（36.7%，57。1%和58.3%、83.3%、82. 1%和100%，分别为79.2%、75.0%和79.2%。阳性活检的网站正确相关的MRI和MRSI标记可疑核心，分别为50%和28.6%.Conclusions：MRI和MRSI有可能确定癌灶和直接TRUS患者先前负TRUS活检。此外，需要进行更大规模的研究，以量化效益的数量。
Purpose: We determined the ability of combined endorectal magnetic resonance imaging (MRI) and magnetic resonance spectroscopic imaging (MRSI) to detect prostate cancer foci prospectively in men with prior negative transrectal ultrasound (TRUS) prostate biopsy.Materials and Methods: Endorectal MRI with spectroscopy was performed in 24 consecutive patients with I or more prior negative TRUS prostatic biopsies for persistently increased prostate specific antigen and/or abnormal digital rectal examination. All studies were interpreted by a dedicated radiologist who reported areas of interest in the peripheral zone as normal, equivocal or suspicious on MRI and MRSI separately. Equivocal and suspicious areas were then correlated with a 3-dimensional prostate model. All patients underwent a standard TRUS 10-core peripheral zone biopsy with up to 4 additional biopsies targeted at the equivocal or suspected sites.Results: Prostate cancer was detected in 7 of 24 subjects (29.2%). Considering the equivocal category as test negative the sensitivity, specificity, positive and negative predictive values, and the accuracy of MRI, MRSI and combined MRI/MRSI for the detection of prostate cancer were 57.1%, 57. 1% and 100.0%, 88.2%, 82.4% and 70.6%, (36.7%, 57. 1% and 58.3%, 83.3%, 82. 1% and 100%, and 79.2%, 75.0% and 79.2%, respectively. The site of positive biopsy correlated correctly in 50% and 28.6% of MRI and MRSI labeled suspicious cores, respectively.Conclusions: MRI and MRSI have the potential to identify cancer foci and direct TRUS in patients with a previous negative TRUS biopsy. Further, larger studies are required to quantify the amount of benefit.