Preliminary Results for Characterization of Pelvic Lymph Nodes in Patients With Prostate Cancer by Diffusion-Weighted MR-Imaging
Preliminary Results for Characterization of Pelvic Lymph Nodes in Patients With Prostate Cancer by Diffusion-Weighted MR-Imaging
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DOI：
10.1097/rli.0b013e3181bbdc2f
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发表时间：
2010-01-01
影响因子：
6.7
通讯作者：
Gaa, Jochen
中科院分区：
文献类型：
--
作者：
Eiber, Matthias;Beer, Ambros J.;Gaa, Jochen
目的：探讨弥散加权磁共振成像在前列腺癌盆腔淋巴结诊断中的应用价值。方法与材料：对29例前列腺癌患者行盆腔弥散加权成像，扫描时间1.5T，序列采用非屏气SSEPI序列，采用体相控阵线圈，b值分别为50,300,600 S/mm(2)，附加T2加权序列。通过测量感兴趣多边形区的ADC值，对118个淋巴结(短轴6 mm)进行了分析。通过将自动生成的ADC图(ADC(MR_UNIT))的ADC值与手动计算的ACD值(ADC(计算))进行比较，并使用线性回归模型与ADC值的大小和标准差进行比较，来评估ADC测量的可行性。结果：ADC值与计算的ADC值具有较高的相关性(r=0.8999)，平均百分比偏差为6.33%。恶性(1.07+/-0.23)和良性(1.54+/-0.25)淋巴结的平均ADC值(x10(-3)mm(2)/S)之间有非常显著的差异，即使在亚组分析中，淋巴结小于或大于10 mm也是如此。受检者特征分析显示，以1.30×10~(-3)mm(2)/S为界值，ADC值对良恶性淋巴结的鉴别准确率为85.6%(101/118)；敏感度：86.0%[43/50]；特异度：85.3%[53/68]，优于8min大小分析(准确度：66.1%[78/118]；敏感度：82.0%[41/50]；特异性：54.4%[37/68]；P<；0.01)。结论：DWI有可能成为分析盆腔淋巴结的一种准确技术。此外，我们的初步结果表明，ADC值在区分良、恶性淋巴结方面可能显著优于大小标准。
Objectives: In this retrospective feasibility study diffusion-weighted magnetic resonance imaging (DWI) was evaluated as a potential tool for characterization of pelvic lymph nodes in patients with prostate cancer.Methods and Materials: Twenty-nine patients with prostate cancer underwent DWI of the pelvis at 1.5T by a non breath-hold SSEPI sequence using a body phased array coil with b values of 50, 300, and 600 s/mm(2) and an additional T2-weighted sequence. A total of 118 lymph nodes (>6 mm short axis) were analyzed by measuring the ADC-value with a polygon region of interest. Feasibility for ADC-measurement was assessed by comparing the ADC-value front the automatically created ADC-map (ADC(MR_unit) with a manually calculated ACD-value (ADC(calculated)) and by using a linear-regression model for comparison with size and standard deviation of the ADC-value. Diagnostic performance was estimated by receiver operator characteristic analysis using histologic and/or clinical follow-up as standard of reference.Results: ADC(mR_unit) and ADC(calculated) showed a high correlation (r = 0.8999) with a mean percentual deviation of 6.33%. There was a highly significant difference between the mean ADC-value (x 10(-3) mm(2)/s) of malignant (1.07 +/- 0.23) versus benign (1.54 +/- 0.25) lymph nodes, even in subgroup analysis for lymph nodes smaller versus larger than 10 mm. Receiver operator characteristic-analysis showed a good accuracy of the ADC-value (85.6% [101/118]; sensitivity: 86.0% [43/50]; specificity: 85.3% [53/68]) for differentiation of malignant and benign lymph nodes at a cutoff 1.30 X 10(-3) mm(2)/s. This was superior to a size-based analysis at a cutoff of 8 min (accuracy: 66.1% [78/118]; sensitivity: 82.0% [41/50]; specificity: 54.4% [37/68]; P < 0.01).Conclusions: DWI has the potential of being an accurate technique for analysis of pelvic lymph nodes. Moreover, our preliminary results Suggest that the ADC-value might perform significantly superior to size criteria to discriminate between benign and malignant lymph nodes.