Diffusion-Weighted and Dynamic Contrast-Enhanced MRI of Prostate Cancer: Correlation of Quantitative MR Parameters With Gleason Score and Tumor Angiogenesis
Diffusion-Weighted and Dynamic Contrast-Enhanced MRI of Prostate Cancer: Correlation of Quantitative MR Parameters With Gleason Score and Tumor Angiogenesis
复制标题
DOI：
10.2214/ajr.11.6861
复制
发表时间：
2011-12-01
影响因子：
5
通讯作者：
Stadler, Walter M.
中科院分区：
文献类型：
--
作者：
Oto, Aytekin;Yang, Cheng;Stadler, Walter M.
objective.本研究的目的是探讨弥散加权成像（DWI）和动态增强MRI（DCE-MRI）的定量参数是否与前列腺癌的Gleason评分和血管生成相关。我们的研究包括了73名术前接受MRI和根治性直肠癌切除术的患者。放射科医生和病理学家根据组织病理学相关性在MR图像上定位优势肿瘤。对于每个优势肿瘤，表观扩散系数（ADC）值和定量DCE-MRI参数（即，计算血液和组织之间的造影剂转移速率[K-transs]、血管外细胞外分数体积[v（e）]、造影剂回流速率常数[k（ep）]和基于逐个体素的血浆分数体积[v（p）]），并记录Gleason评分。使用CD31、CD34和VEGF抗体染色确定优势肿瘤的平均血管计数、平均血管面积分数和血管内皮生长因子（VEGF）表达。将MR与病理参数进行斯皮尔曼相关分析。平均肿瘤直径为15.2 mm（范围，5 - 28 mm）。在73例前列腺癌肿瘤中，5例（6.8%）的Gleason评分为6，46例（63%）的Gleason评分为7，22例（30.1%）的Gleason评分大于7。ADC值与Gleason评分呈中度负相关（r =-0.376，p = 0.001），但与肿瘤血管生成参数无关。定量DCE-MRI参数与Gleason评分或VEGF表达无显著相关性（p> 0.05）。前列腺癌的平均血管计数和平均血管面积分数参数与k（ep）呈正相关（r分别为0.440和0.453; p均为0.001）。前列腺癌的ADC值与Gleason评分、k（ep）与微血管密度呈中度相关。虽然强度的相关性是不够的即时诊断效用，这些结果值得进一步调查的潜力，多参数MRI，以促进非侵入性评估前列腺癌的侵袭性和血管生成。
OBJECTIVE. The objective of our study was to investigate whether quantitative parameters derived from diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MRI (DCE-MRI) correlate with Gleason score and angiogenesis of prostate cancer.MATERIALS AND METHODS. Seventy-three patients who underwent preoperative MRI and radical prostatectomy were included in our study. A radiologist and pathologist located the dominant tumor on the MR images based on histopathologic correlation. For each dominant tumor, the apparent diffusion coefficient (ADC) value and quantitative DCE-MRI parameters (i.e., contrast agent transfer rate between blood and tissue [K-trans], extravascular extracellular fractional volume [v(e)], contrast agent backflux rate constant [k(ep)], and blood plasma fractional volume on a voxel-by-voxel basis [v(p)]) were calculated and the Gleason score was recorded. The mean blood vessel count, mean vessel area fraction, and vascular endothelial growth factor (VEGF) expression of the dominant tumor were determined using CD31, CD34, and VEGF antibody stains. Spearman correlation analysis between MR and histopathologic parameters was conducted.RESULTS. The mean tumor diameter was 15.2 mm (range, 5-28 mm). Of the 73 prostate cancer tumors, five (6.8%) had a Gleason score of 6, 46 (63%) had a Gleason score of 7, and 22 (30.1%) had a Gleason score of greater than 7. ADC values showed a moderate negative correlation with Gleason score (r = -0.376, p = 0.001) but did not correlate with tumor angiogenesis parameters. Quantitative DCE-MRI parameters did not show a significant correlation with Gleason score or VEGF expression (p > 0.05). Mean blood vessel count and mean vessel area fraction parameters estimated from prostate cancer positively correlated with k(ep) (r = 0.440 and 0.453, respectively; p = 0.001 for both).CONCLUSION. There is a moderate correlation between ADC values and Gleason score and between k(ep) and microvessel density of prostate cancer. Although the strength of the correlations is insufficient for immediate diagnostic utility, these results warrant further investigation on the potential of multiparametric MRI to facilitate noninvasive assessment of prostate cancer aggressiveness and angiogenesis.