Prostate Cancer: Comparison of 3D T2-Weighted With Conventional 2D T2-Weighted Imaging for Image Quality and Tumor Detection
Prostate Cancer: Comparison of 3D T2-Weighted With Conventional 2D T2-Weighted Imaging for Image Quality and Tumor Detection
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DOI：
10.2214/ajr.09.3217
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发表时间：
2010-02-01
影响因子：
5
通讯作者：
Taouli, Bachir
中科院分区：
文献类型：
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作者：
Rosenkrantz, Andrew B.;Neil, Jeffry;Taouli, Bachir
OBJECTIVE.本研究的目的是比较三维T2加权成像序列与传统的多平面二维快速自旋回波T2加权序列在肿瘤检测和前列腺癌分期以及图像质量方面的差异。在前列腺切除术前，38名前列腺癌男性（平均年龄60岁）接受了多平面2D快速自旋回波T2加权序列（总采集时间约为11分4秒）和3D T2加权采样完美，应用优化对比序列，不同翻转角演变（SPACE）（采集时间约为3分52秒）的前列腺MRI。两名盲法观察者一致回顾了2D快速自旋回波T2加权图像和SPACE图像，以检测外周区癌、囊外浸润和精囊浸润。观察者还评估了主观图像质量，并测量了正常外周区和肿瘤与外周区对比度的信噪比（SNR）。前列腺切除术用作参考标准。用广义估计方程和McNemar检验评价两种序列的诊断准确性。用Kappa系数评价序列间的一致性。配对Wilcoxon符号秩检验用于比较两个序列的主观图像质量、SNR和肿瘤与外周区对比度。对于肿瘤检测和囊外扩展的诊断，两种序列之间基本一致（kappa = 0.79，kappa = 0.76），在灵敏度、特异性、阳性预测值、阴性预测值、准确度（p = 0.25-1）或图像质量（p = 0.937）方面无差异。2D快速自旋回波序列获得的图像对于正常外周区具有显著更高的SNR比（p = 0.0010），但是SPACE图像具有显著更高的肿瘤与外周区对比度（p < 0.0001）。与传统的前列腺多平面2D快速自旋回波MRI相比，3D T2加权SPACE MRI节省了大量时间（近8分钟），在诊断肿瘤和囊外扩展方面具有相似的图像质量和准确性，并且具有更好的肿瘤明显性。
OBJECTIVE. The purpose of this study was to compare a 3D T2-weighted imaging sequence with a conventional multiplanar 2D turbo spin-echo T2-weighted sequence in terms of tumor detection and staging of prostate cancer, as well as image quality.MATERIALS AND METHODS. Before prostatectomy, 38 men (mean age, 60 years) with prostate cancer underwent MRI of the prostate with multiplanar 2D turbo spin-echo T2-weighted sequences (total acquisition time, approximate to 11 minutes 4 seconds) and a 3D T2-weighted sampling perfection with application optimized contrasts sequence with different flip angle evolutions (SPACE) (acquisition time, approximate to 3 minutes 52 seconds). Two blinded observers in consensus reviewed 2D turbo spin-echo T2-weighted images and SPACE images for detection of peripheral zone cancer, extracapsular extension, and seminal vesicle invasion. The observers also assessed subjective image quality and measured the signal-to-noise ratio (SNR) of normal peripheral zone and tumor-to-peripheral zone contrast. Prostatectomy was used as the reference standard. The diagnostic accuracy of the two sequences was assessed with generalized estimating equations and McNemar tests. The agreement between sequences was assessed with kappa coefficients. A paired Wilcoxon signed rank test was used to compare the subjective image quality, SNR, and tumor-to-peripheral zone contrast of the two sequences.RESULTS. For tumor detection and diagnosis of extracapsular extension, there was substantial agreement between the two sequences (kappa = 0.79, kappa = 0.76) with no difference in sensitivity, specificity, positive predictive value, negative predictive value, accuracy (p = 0.25-1), or image quality (p = 0.937). Images obtained with the 2D turbo spin-echo sequence had a significantly higher SNR ratio for normal peripheral zone (p = 0.0010), but SPACE images had significantly greater tumor-to-peripheral zone contrast (p < 0.0001).CONCLUSION. In comparison with conventional multiplanar 2D turbo spin-echo MRI of the prostate, 3D T2-weighted SPACE MRI was associated with substantial time saving (nearly 8 minutes), had similar image quality and accuracy in the diagnosis of tumor and extracapsular extension, and had better tumor conspicuity.