Combination of signal intensity measurements of lesions PSA level the peripheral zone or prostate with MRI and serum PSA level for differentiating benign disease from prostate cancer
Combination of signal intensity measurements of lesions PSA level the peripheral zone or prostate with MRI and serum PSA level for differentiating benign disease from prostate cancer
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DOI：
10.1007/s003300000524
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发表时间：
2000-01-01
影响因子：
5.9
通讯作者：
Riedl, C
中科院分区：
文献类型：
--
作者：
Engelhard, K;Hollenbach, HP;Riedl, C
本研究的目的是通过定义信号强度比的阈值和血清前列腺特异性抗原（PSA）水平升高的患者中PSA的限值来预测前列腺病变的良性或恶性性质。26例PSA水平升高且超声内镜检查无低回声病变的患者使用1.5 T（Siemans Magnetom Symphony）直肠内体部相控阵线圈进行MR成像。横向应用T2加权快速自旋回波（TSE）脉冲序列。两名放射科医生对图像进行了评估。在存在病理发现的情况下，他们在外周区的可疑病理区域和肌肉中定义了感兴趣区域（ROI）以供参考。计算两个ROI的商，然后与实际PSA水平相关。前列腺活检证实了诊断。肿瘤体积小于4的12例患者中有10例在组织学上显示为癌症。12名经活检证实患有癌症的男性中有9名PSA水平高于10 ng/ml。前列腺癌组与慢性前列腺炎组、前列腺纤维化组、前列腺萎缩组比较，差异有显著性（P < 0.001）。该方法对肿瘤鉴别诊断的准确率为77%。测量前列腺周围区的信号强度，结合PSA水平的定义范围，该技术可能有助于检测前列腺活检的其他癌症区域。标准六分仪活检的假阴性肿瘤结果可以减少。在高PSA值的男性中，该方法在区分需要前列腺活检的患者和需要临床观察的患者方面具有作用。
The aim of this study was to predict the benign or malignant nature of a prostatic lesion by defining a threshold value of signal intensity ratio and a limiting value of serum prostate-specific antigen (PSA) in patients with elevated PSA level. Twenty-six patients with elevated PSA level and no hypoechogenic lesions at endosonography underwent MR imaging using an endorectal body phased-array coil at 1.5 T (Siemans Magnetom Symphony). A T2-weighted turbo-spin-echo (TSE) pulse sequence was applied in a transverse orientation. Two radiologists evaluated the images. In the presence of a pathological finding they defined regions of interest (ROI) in the suspicious pathological area of the peripheral zone and in muscle for reference. The quotient of the two ROIs was calculated and then correlated with the actual PSA level. Diagnosis was confirmed by prostate biopsy. Ten of 12 patients with quotients smaller than 4 showed cancer at histology. Nine of 12 men with cancer proven by biopsy had PSA levels higher than 10 ng/ml. A significant difference (p < 0.001) was found between the quotients of cancer and quotients of chronic prostatitis, fibrosis, or glandular atrophy. The accuracy of tumor differentiation of the method was 77%. Measurement of signal intensity quotients in the peripheral zone of the prostate in combination with knowledge of defined limits of PSA levels the technique could be helpful in detecting additional cancer areas for prostate biopsy. False-negative tumor results of standard sextant biopsy can be reduced. In men with high PSA values the method has a role in differentiating between patients who require prostate biopsy and those of clinical observation.