Multiparametric 3T prostate magnetic resonance imaging to detect cancer: histopathological correlation using prostatectomy specimens processed in customized magnetic resonance imaging based molds.
Multiparametric 3T prostate magnetic resonance imaging to detect cancer: histopathological correlation using prostatectomy specimens processed in customized magnetic resonance imaging based molds.
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DOI：
10.1016/j.juro.2011.07.013
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发表时间：
2011-11
期刊：
影响因子：
--
通讯作者：
Pinto PA
中科院分区：
文献类型：
--
作者：
Turkbey B;Mani H;Shah V;Rastinehad AR;Bernardo M;Pohida T;Pang Y;Daar D;Benjamin C;McKinney YL;Trivedi H;Chua C;Bratslavsky G;Shih JH;Linehan WM;Merino MJ;Choyke PL;Pinto PA
确定3 T下多参数（MP）MRI的前列腺癌检出率。在根治性前列腺切除术后，使用基于前列腺MRI的定制打印标本模具，可能与MRI存在精确的一对一组织病理学相关性。该IRB批准的前瞻性研究纳入了45例患者（平均年龄60.2岁，范围49-75岁），平均PSA为6.37 ng/mL（范围2.3- 23.7 ng/mL），经活检证实患有前列腺癌（平均Gleason评分6.7;范围6 - 9）。在前列腺切除术前，所有患者在3 T扫描仪上进行前列腺MRI，包括三平面T2加权MRI、扩散加权MRI的表观扩散系数图、动态对比增强MRI和光谱学。将前列腺标本在模具中进行整体切片，使其与MRI几何对齐。在MRI和组织病理学上绘制肿瘤。计算MRI检测肿瘤的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。此外，评估肿瘤大小和Gleason评分对MP-MRI敏感性的影响。MP-MRI检测前列腺癌的PPV在整个前列腺、外周带和中央腺中分别为98%、98%和100%。MRI序列对直径> 5 mm的肿瘤以及Gleason评分较高（>7）的肿瘤的敏感性较高（p<0.05）。3 T前列腺MRI可用于检测前列腺癌。多参数方法提高了MRI诊断的预测能力。在这项研究中，MP-MRI和组织病理学之间的准确相关性是通过患者特定的MRI为基础的模具技术。
To determine the prostate cancer detection rate of multi-parametric (MP) MRI at 3T. Precise one to one histopathologic correlation with MRI was possible using prostate MRI based custom-printed specimen molds following radical prostatectomy. This IRB approved prospective study included forty-five patients (mean age 60.2 years, range 49–75 years) with a mean PSA of 6.37ng/mL (range 2.3–23.7ng/mL), who had biopsy proven prostate cancer (mean Gleason score of 6.7; range 6 to 9). Prior to prostatectomy, all patients underwent prostate MRI on a 3T scanner which included tri-plane T2 weighted MRI, apparent diffusion coefficient maps of diffusion weighted MRI, dynamic contrast enhanced MRI, and spectroscopy.. The prostate specimen was whole mount sectioned in the mold allowing geometric alignment to MRI. Tumors were mapped on MRI and histopathology.. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of MRI for cancer detection were calculated. Additionally, the effects of tumor size and Gleason score on sensitivity of MP-MRI were evaluated. PPV of MP-MRI to detect prostate cancer was 98%, 98%, and 100% in overall prostate, peripheral zone, and central gland, respectively. Sensitivities of MRI sequences were higher for tumors >5mm in diameter, as well as for tumors with higher Gleason scores (>7) (p<0.05). Prostate MRI at 3T allows for the detection of prostate cancer. A multi-parametric approach increases the predictive power of MRI for diagnosis. In this study, accurate correlation between MP-MRI and histopathology was obtained by the patient specific MRI-based mold technique.
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