Prostate Tumor Volume Measurement with Combined T2-weighted Imaging and Diffusion-weighted MR: Correlation with Pathologic Tumor Volume
Prostate Tumor Volume Measurement with Combined T2-weighted Imaging and Diffusion-weighted MR: Correlation with Pathologic Tumor Volume
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DOI：
10.1148/radiol.2523081423
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发表时间：
2009-08-01
期刊：
影响因子：
19.7
通讯作者：
Koutcher, Jason A.
中科院分区：
文献类型：
--
作者：
Mazaheri, Yousef;Hricak, Hedvig;Koutcher, Jason A.
目的：回顾性评价磁共振弥散加权成像（DW）鉴别前列腺外周区癌的准确性，并以手术病理检查为参考标准，评价t2加权成像及t2加权与DW磁共振联合成像测量肿瘤体积的准确性。材料和方法：机构审查委员会对这项符合hipaa的研究发布了知情同意豁免。42例前列腺癌根治性前列腺切除术前1.5 T行直肠内MR检查，手术病理检查至少有1个大于0.1 cm(3)的PZ肿瘤。在t2加权图像上，一位经验丰富的放射科医生勾勒出疑似PZ肿瘤。利用约登指数和已发表的文献确定了两个表观扩散系数（ADC）截止值。对疑似肿瘤区域内的体素进行图像聚类分析。通过一致性相关系数（CCCs）评估影像学和病理检查的体积测量之间的相关性。计算adc识别恶性PZ体素的敏感性和特异性。结果：在鉴别恶性体素时，ADC截止值分别为0.0014和0.0016 mm(2)/sec，灵敏度分别为82%和95%，特异性分别为85%和65%。病理检查发现大于0.1 cm(3)的PZ癌灶60例；43例被放射科医生发现。t2加权成像与病理肿瘤体积测量之间的CCCs分别为0.36，t2加权和DW MR联合成像分别为0.46和0.60，ADC截止值分别为0.0014和0.0016 mm2/sec；t2加权与DW MR联合成像的CCC （ADC截止值为0.0016 mm2/sec）明显高于单独t2加权成像（P = 0.006）。结论：DW MR联合t2加权成像可显著提高前列腺PZ肿瘤体积测量的准确性。(c) rsna， 2009年
Purpose: To retrospectively determine the accuracy of diffusion-weighted (DW) magnetic resonance (MR) imaging for identifying cancer in the prostate peripheral zone (PZ) and to assess the accuracy of tumor volume measurements made with T2-weighted imaging and combined T2-weighted and DW MR imaging by using surgical pathologic examination as the reference standard.Materials and Methods: The institutional review board issued a waiver of informed consent for this HIPAA-compliant study. Forty-two patients underwent endorectal MR at 1.5 T before undergoing radical prostatectomy for prostate cancer and had at least one PZ tumor larger than 0.1 cm(3) at surgical pathologic examination. On T2-weighted images, an experienced radiologist outlined suspected PZ tumors. Two apparent diffusion coefficient (ADC) cutoff values were identified by using the Youden index and published literature. Image cluster analysis was performed on voxels within the suspected tumor regions. Associations between volume measurements from imaging and from pathologic examination were assessed by using concordance correlation coefficients (CCCs). The sensitivity and specificity of ADCs for identifying malignant PZ voxels were calculated.Results: In identifying malignant voxels, respective ADC cutoff values of 0.0014 and 0.0016 mm(2)/sec yielded sensitivity of 82% and 95% and specificity of 85% and 65%, respectively. Sixty PZ cancer lesions larger than 0.1 cm(3) were found at pathologic examination; 43 were detected by the radiologist. CCCs between imaging and pathologic tumor volume measurements were 0.36 for T2-weighted imaging, and 0.46 and 0.60 for combined T2-weighted and DW MR imaging with ADC cutoffs of 0.0014 and 0.0016 mm2/sec, respectively; the CCC of combined T2-weighted and DW MR imaging (ADC cutoff, 0.0016 mm2/sec) was significantly higher (P = .006) than that of T2-weighted imaging alone.Conclusion: Adding DW MR to T2-weighted imaging can significantly improve the accuracy of prostate PZ tumor volume measurement. (C) RSNA, 2009