Relationship between Apparent Diffusion Coefficients at 3.0-T MR Imaging and Gleason Grade in Peripheral Zone Prostate Cancer
Relationship between Apparent Diffusion Coefficients at 3.0-T MR Imaging and Gleason Grade in Peripheral Zone Prostate Cancer
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DOI：
10.1148/radiol.11091409
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发表时间：
2011-05-01
期刊：
影响因子：
19.7
通讯作者：
Barentsz, Jelle O.
中科院分区：
文献类型：
--
作者：
Hambrock, Thomas;Somford, Diederik M.;Barentsz, Jelle O.
目的：回顾性分析3.0 t弥散加权（DW）磁共振成像（MR）获得的表观扩散系数（adc）与外周带前列腺癌Gleason分级的关系。材料和方法：免除了获得机构审查委员会批准的要求。51例前列腺癌患者在前列腺切除术前接受了MR成像，包括DW MR成像，b值分别为0、50、500和800 sec/mm(2)。在前列腺切除术标本中，根据一级、二级和三级Gleason分级分别逐片测定Gleason分级组。此外，肿瘤被分为定性分级组（低、中、高级别肿瘤）。ADC图与每个肿瘤切片的阶梯切片和感兴趣的区域对齐。采用线性混合模型回归分析，肿瘤中位ADC与定性分级组相关。通过使用受试者工作特征（ROC）曲线下的面积（A(z)）来总结低、中、高恶性肿瘤鉴别中位ADC在最具侵袭性肿瘤成分中的准确性。结果：51例前列腺切除术标本中，发现不同类型肿瘤62例，阶梯切变肿瘤251例。肿瘤中位ADC与Gleason分级组呈负相关，3个定性分级组间差异均有统计学意义（P < 0.001）。总体而言，随着一个定性分级组的增加，中位ADC（+/-标准差）下降0.18 x 10(-3) mm(2)/秒+/- 0.02。低、中、高级别肿瘤的中位ADC分别为1.30 × 10(-3) mm(2)/sec +/- 0.30、1.07 × 10(-3) mm(2)/sec +/- 0.30和0.94 × 10(-3) mm(2)/sec +/- 0.30。ROC分析显示a (z) = 0.90在区分低级别和合并中、高级别病变方面的区别表现。结论：外周血带前列腺癌adc 3.0 T与Gleason分级呈负相关。在鉴别低、中、高级别癌症方面具有很高的歧视性。(c) rsna, 2011
Purpose: To retrospectively determine the relationship between apparent diffusion coefficients (ADCs) obtained with 3.0-T diffusion-weighted (DW) magnetic resonance (MR) imaging and Gleason grades in peripheral zone prostate cancer.Materials and Methods: The requirement to obtain institutional review board approval was waived. Fifty-one patients with prostate cancer underwent MR imaging before prostatectomy, including DW MR imaging with b values of 0, 50, 500, and 800 sec/mm(2). In prostatectomy specimens, separate slice-by-slice determinations of Gleason grade groups were performed according to primary, secondary, and tertiary Gleason grades. In addition, tumors were classified into qualitative grade groups (low-, intermediate-, or high-grade tumors). ADC maps were aligned to step-sections and regions of interest annotated for each tumor slice. The median ADC of tumors was related to qualitative grade groups with linear mixed-model regression analysis. The accuracy of the median ADC in the most aggressive tumor component in the differentiation of low-from combined intermediate-and high-grade tumors was summarized by using the area under the receiver operating characteristic (ROC) curve (A(z)).Results: In 51 prostatectomy specimens, 62 different tumors and 251 step-section tumor lesions were identified. The median ADC in the tumors showed a negative relationship with Gleason grade group, and differences among the three qualitative grade groups were statistically significant (P < .001). Overall, with an increase of one qualitative grade group, the median ADC (+/- standard deviation) decreased 0.18 x 10(-3) mm(2)/sec +/- 0.02. Low-, intermediate-, and high-grade tumors had a median ADC of 1.30 x 10(-3) mm(2)/sec +/- 0.30, 1.07 x 10(-3) mm(2)/sec +/- 0.30, and 0.94 x 10(-3) mm(2)/sec +/- 0.30, respectively. ROC analysis showed a discriminatory performance of A(z) = 0.90 in discerning low-grade from combined intermediate-and high-grade lesions.Conclusion: ADCs at 3.0 T showed an inverse relationship to Gleason grades in peripheral zone prostate cancer. A high discriminatory performance was achieved in the differentiation of low-, intermediate-, and high-grade cancer. (C) RSNA, 2011