Correlation of magnetic resonance imaging tumor volume with histopathology.
Correlation of magnetic resonance imaging tumor volume with histopathology.
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DOI：
10.1016/j.juro.2012.06.011
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发表时间：
2012-10
期刊：
影响因子：
--
通讯作者：
Pinto PA
中科院分区：
文献类型：
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作者：
Turkbey B;Mani H;Aras O;Rastinehad AR;Shah V;Bernardo M;Pohida T;Daar D;Benjamin C;McKinney YL;Linehan WM;Wood BJ;Merino MJ;Choyke PL;Pinto PA
前列腺癌的生物学可能受到指数病变的影响。指数病变体积的定义对于适当的决策非常重要，特别是对于图像引导的病灶治疗。我们确定了磁共振成像确定指标肿瘤体积的准确性与组织病理学得出的体积相比较。我们评估了135例平均前列腺特异性抗原为6.74 ng/dl的患者（平均年龄59.3岁），他们接受了多参数3T直肠内线圈前列腺磁共振成像和随后的根治前列腺切除术。通过磁共振成像和组织病理学前瞻性独立测定指标肿瘤体积。采用椭球公式确定组织病理学肿瘤体积，采用人工肿瘤分割确定磁共振肿瘤体积。组织病理学肿瘤体积与年龄和前列腺特异性抗原相关，而磁共振肿瘤体积采用Pearson相关和线性回归方法。此外，采用ROC分析评估磁共振肿瘤体积、前列腺特异性抗原和年龄对组织病理学肿瘤体积（大于0.5 cm3）的预测能力。对1.15收缩因子校正后的组织病理学数据集也进行了相同的分析。组织病理肿瘤体积与磁共振肿瘤体积呈正相关（Pearson系数0.633,p <0.0001），前列腺特异性抗原与组织病理肿瘤体积呈弱相关（Pearson系数0.237,p=0.003）。经线性回归分析，组织病理学肿瘤体积与磁共振肿瘤体积相关（r2=0.401, p <0.00001）。在ROC分析中，磁共振肿瘤体积、前列腺特异性抗原和年龄在组织病理学上估计大于0.5 cm3肿瘤的AUC值分别为0.949 （p <0.0000001）、0.685 （p=0.001）和0.627 （p=0.02）。在组织病理学上用收缩因子校正肿瘤体积的分析也发现了类似的结果。磁共振成像可以准确估计指标肿瘤体积，由组织学决定。对于大于0.5 cm3的肿瘤，磁共振成像预测组织病理学肿瘤体积的准确性优于前列腺特异性抗原和年龄。由磁共振成像确定的肿瘤体积指数可能有助于规划治疗，特别是在识别肿瘤边缘以进行图像引导的局灶治疗，并可能选择更好的主动监测候选人。
The biology of prostate cancer may be influenced by the index lesion. The definition of index lesion volume is important for appropriate decision making, especially for image guided focal treatment. We determined the accuracy of magnetic resonance imaging for determining index tumor volume compared with volumes derived from histopathology. We evaluated 135 patients (mean age 59.3 years) with a mean prostate specific antigen of 6.74 ng/dl who underwent multiparametric 3T endorectal coil magnetic resonance imaging of the prostate and subsequent radical prostatectomy. Index tumor volume was determined prospectively and independently by magnetic resonance imaging and histopathology. The ellipsoid formula was applied to determine histopathology tumor volume, whereas manual tumor segmentation was used to determine magnetic resonance tumor volume. Histopathology tumor volume was correlated with age and prostate specific antigen whereas magnetic resonance tumor volume involved Pearson correlation and linear regression methods. In addition, the predictive power of magnetic resonance tumor volume, prostate specific antigen and age for estimating histopathology tumor volume (greater than 0.5 cm3) was assessed by ROC analysis. The same analysis was also conducted for the 1.15 shrinkage factor corrected histopathology data set. There was a positive correlation between histopathology tumor volume and magnetic resonance tumor volume (Pearson coefficient 0.633, p <0.0001), but a weak correlation between prostate specific antigen and histopathology tumor volume (Pearson coefficient 0.237, p=0.003). On linear regression analysis histopathology tumor volume and magnetic resonance tumor volume were correlated (r2=0.401, p <0.00001). On ROC analysis AUC values for magnetic resonance tumor volume, prostate specific antigen and age in estimating tumors larger than 0.5 cm3 at histopathology were 0.949 (p <0.0000001), 0.685 (p=0.001) and 0.627 (p=0.02), respectively. Similar results were found in the analysis with shrinkage factor corrected tumor volumes at histopathology. Magnetic resonance imaging can accurately estimate index tumor volume as determined by histology. Magnetic resonance imaging has better accuracy in predicting histopathology tumor volume in tumors larger than 0.5 cm3 than prostate specific antigen and age. Index tumor volume as determined by magnetic resonance imaging may be helpful in planning treatment, specifically in identifying tumor margins for image guided focal therapy and possibly selecting better active surveillance candidates.