Prostate Cancer: Differentiation of Central Gland Cancer from Benign Prostatic Hyperplasia by Using Diffusion-weighted and Dynamic Contrast-enhanced MR Imaging
Prostate Cancer: Differentiation of Central Gland Cancer from Benign Prostatic Hyperplasia by Using Diffusion-weighted and Dynamic Contrast-enhanced MR Imaging
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DOI：
10.1148/radiol.10100021
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发表时间：
2010-12-01
期刊：
影响因子：
19.7
通讯作者：
Stadler, Walter M.
中科院分区：
文献类型：
--
作者：
Oto, Aytekin;Kayhan, Arda;Stadler, Walter M.
目的：分析中央腺（CG）前列腺癌、间质增生（SH）和腺体增生（GH）的弥散和灌注参数，并确定这些参数在CG癌与良性CG增生鉴别中的作用。材料和方法：在这个机构审查委员会批准的（豁免知情同意），符合HIPAA的研究，38个癌灶，38个SH结节，对49例（其中26例为CG癌）术前行直肠内磁共振（MR）成像和根治性直肠癌切除术的CG中的38个GH结节进行了分析。所有癌和增生灶的MR图像定位的基础上，组织病理学相关。计算所有癌、SH和GH病灶的表观扩散系数（ADC）、血液和组织之间的造影剂转移率（K（反式））和血管外细胞外体积分数值。计算每个参数的平均值、标准差、95%置信区间（CI）和范围。结果：CG癌的平均ADC值（3 × 10（-3）mm（2）/sec）为1.05（95%置信区间：0.97，1.11），1.27（95% CI：1.20，1.33）和1.73（95%可信区间：1.64，1.83），差异显著，ROC曲线下面积（AUC）分别为0.99和0.78，用于癌与GH和SH的鉴别。CG癌和SH病灶的灌注参数相似，K（反式）产生最大AUC（分别为0.75和0.58）。在ROC分析中，将K（transs）加入ADC值中，在90%的特异性下，将CG癌与SH的敏感性从38%提高到57%，而AUC（0.79）没有显著增加。结论：CG癌、SH和GH的ADC值差异显著，使用它们可以提高CG癌与SH和GH的鉴别能力。将K transs与ADC组合可以潜在地改善CG癌症的检测。（C）RSNA，2010年
Purpose: To analyze the diffusion and perfusion parameters of central gland (CG) prostate cancer, stromal hyperplasia (SH), and glandular hyperplasia (GH) and to determine the role of these parameters in the differentiation of CG cancer from benign CG hyperplasia.Materials and Methods: In this institutional review board-approved (with waiver of informed consent), HIPAA-compliant study, 38 foci of carcinoma, 38 SH nodules, and 38 GH nodules in the CG were analyzed in 49 patients (26 with CG carcinoma) who underwent preoperative endorectal magnetic resonance (MR) imaging and radical prostatectomy. All carcinomas and hyperplastic foci on MR images were localized on the basis of histopathologic correlation. The apparent diffusion coefficient (ADC), the contrast agent transfer rate between blood and tissue (K(trans)), and extravascular extracellular fractional volume values for all carcinoma, SH, and GH foci were calculated. The mean, standard deviation, 95% confidence interval (CI), and range of each parameter were calculated. Receiver operating characteristic (ROC) and multivariate logistic regression analyses were performed for differentiation of CG cancer from SH and GH foci.Results: The average ADCs (3 10(-3) mm(2)/sec) were 1.05 (95% CI: 0.97, 1.11), 1.27 (95% CI: 1.20, 1.33), and 1.73 (95% CI: 1.64, 1.83), respectively, in CG carcinoma, SH foci, and GH foci and differed significantly, yielding areas under the ROC curve (AUCs) of 0.99 and 0.78, respectively, for differentiation of carcinoma from GH and SH. Perfusion parameters were similar in CG carcinomas and SH foci, with K(trans) yielding the greatest AUCs (0.75 and 0.58, respectively). Adding K(trans) to ADC in ROC analysis to differentiate CG carcinoma from SH increased sensitivity from 38% to 57% at 90% specificity without noticeably increasing the AUC (0.79).Conclusion: ADCs differ significantly between CG carcinoma, SH, and GH, and the use of them can improve the differentiation of CG cancer from SH and GH. Combining K trans with ADC can potentially improve the detection of CG cancer. (C)RSNA, 2010