Transition zone prostate cancers: Features, detection, localization, and staging at endorectal MR imaging
Transition zone prostate cancers: Features, detection, localization, and staging at endorectal MR imaging
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DOI：
10.1148/radiol.2392050949
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发表时间：
2006-06-01
期刊：
影响因子：
19.7
通讯作者：
Hricak, Hedvig
中科院分区：
文献类型：
--
作者：
Akin, Oguz;Sala, Evis;Hricak, Hedvig
目的：以病理分析为参考标准，回顾性评价直肠内磁共振(MR)成像对移行区前列腺癌的发现和局部分期的准确性，并评价其MR成像特征。材料和方法：机构评审委员会批准了这项符合HIPAA标准的回顾性研究，并免除了知情同意的要求。对986名在前列腺癌根治术前接受磁共振成像的患者的机构数据库进行了阶梯切片病理分析，结果显示148名患者连续患有至少一种移行区癌。另随机选择46例非移行带癌患者作为对照组。两位读者独立回顾了MR研究，以确定移行区癌症患者，并确定这些癌症的位置和局部范围。记录了有助于识别移行区癌症的影像特征。结果：阅读器1诊断移行带癌的敏感性和特异度分别为75%和87%，阅读器2分别为80%和78%，阅读器间一致性较好。对于移行区癌的定位，读数1的受试者工作特征曲线下面积为0.75，读数2的受试者工作特征曲线下面积为0.73。随着肿瘤体积的增大，读者发现移行带癌灶的准确率显著提高(P=.001)。在检测移行带癌向前列腺外扩散方面，读数1的灵敏度和特异度分别为56%和94%，读数2的灵敏度和特异度分别为28%和93%。均质低T2信号强度(读数1的P=.001，读数2的P<；.001)和透镜状(读数1的P=0.017)与移行区癌的存在显著相关。结论：MR成像可用于移行区前列腺癌的诊断、定位和分期。
Purpose: To retrospectively evaluate the accuracy of endorectal magnetic resonance (MR) imaging in the detection and local staging of transition zone prostate cancers, with pathologic analysis serving as the reference standard, and to assess MR imaging features of these cancers.Materials and Methods: The institutional review board approved this HIPAA-compliant retrospective study and waived the informed consent requirement. An institutional database of 986 patients who underwent MR imaging before radical prostatectomy yielded 148 consecutive patients with at least one transition zone cancer at step-section pathologic analysis. An additional 46 patients without transition zone cancer were randomly selected as a control group. Two readers independently reviewed MR studies to identify patients with transition zone cancers and determine the location and local extent of these cancers. Imaging features that helped in the identification of transition zone cancers were recorded. Descriptive and kappa statistics, as well as receiver operating characteristic and multivariate logistic regression analyses, were used.Results: For identification of patients with transition zone cancers, sensitivity and specificity were 75% and 87%, respectively, for reader 1 and 80% and 78%, respectively, for reader 2. Interreader agreement was fair. For detection of the location of transition zone cancer, the area under the receiver operating characteristic curve was 0.75 for reader 1 and 0.73 for reader 2. Interreader agreement was fair. The readers' accuracy in detecting transition zone cancer foci increased significantly (P = .001) as tumor volume increased. In the detection of extraprostatic extension of transition zone cancers, sensitivity and specificity were 56% and 94%, respectively, for reader 1 and 28% and 93%, respectively, for reader 2. Homogeneous low T2 signal intensity (P = .001 for reader 1, P < .001 for reader 2) and lenticular shape (P = .017 for reader 1) were significantly associated with the presence of transition zone cancer.Conclusion: MR imaging can be used to detect, localize, and stage transition zone prostate cancers.