Development of a Combined MR Fingerprinting and Diffusion Examination for Prostate Cancer
Development of a Combined MR Fingerprinting and Diffusion Examination for Prostate Cancer
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DOI：
10.1148/radiol.2017161599
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发表时间：
2017-06-01
期刊：
影响因子：
19.7
通讯作者：
Gulani, Vikas
中科院分区：
文献类型：
--
作者：
Yu, Alice C.;Badve, Chaitra;Gulani, Vikas
目的：为了开发和评估的检查组成的磁共振（MR）指纹为基础的T1，T2，和标准的表观扩散系数（ADC）映射的多参数表征的前列腺diseases.Materials和Methods：该机构审查委员会批准，符合健康保险责任法案前瞻性收集的数据包括140例疑似前列腺癌患者的回顾性研究。T1和T2标测采用快速成像和基于稳态旋进的MR指纹和ADC标测。由两名独立的阅片师在临床图像上识别的外周区病变和外观正常的外周区（NPZ）组织中绘制感兴趣区域。记录每个区域的T1、T2和ADC。组织学相关性基于系统性经直肠活检或认知靶向活检结果（如有）。使用广义估计方程logistic回归评估T1、T2和ADC在（a）癌症与NPZ、（B）癌症与前列腺炎、（c）前列腺炎与NPZ和（d）高或中等级别肿瘤与低级别肿瘤的鉴别中的作用。对所有病变进行分析，并在靶向活检亚组中重复分析。结果：共分析了109个病灶，其中39个病灶采用认知靶向采样，所有病灶均采用了不同的检测方法，以受试者工作特征曲线下面积（AUC）作为判别指标。癌症的T1、T2和ADC（平均值分别为1628 msec +/- 344、73 msec +/- 27和0.773 x 10（-3）mm（2）/sec +/- 0.331）显著低于NPZ（平均值，2247 msec 6 450，169 msec +/- 61，和1.711 x 10（-3）mm（2）/sec +/- 0.269）（每个P < .0001），并在这些组之间产生最佳分离（AUC = 0.99）。ADC和T2一起产生了最高的AUC 0.83，用于将高或中等级别肿瘤与低级别癌症分开。前列腺炎患者的T1、T2和ADC值（平均值：1707 msec 6 377、79 msec 6 37和0.911 x 10 - 3 mm 2/sec +/- 0.239）显著低于NPZ患者（均P <0.0005）。Interreader协议是优秀的，与组内相关系数大于0.75的T1和T2 measurement.Conclusion：本研究描述了一个快速的MR指纹和扩散为基础的检查，前列腺组织的定量表征的发展。(C)RSNA，2017
Purpose: To develop and evaluate an examination consisting of magnetic resonance (MR) fingerprinting-based T1, T2, and standard apparent diffusion coefficient (ADC) mapping for multiparametric characterization of prostate disease.Materials and Methods: This institutional review board-approved, HIPAA-compliant retrospective study of prospectively collected data included 140 patients suspected of having prostate cancer. T1 and T2 mapping was performed with fast imaging with steadystate precession-based MR fingerprinting with ADC mapping. Regions of interest were drawn by two independent readers in peripheral zone lesions and normal-appearing peripheral zone (NPZ) tissue identified on clinical images. T1, T2, and ADC were recorded for each region. Histopathologic correlation was based on systematic transrectal biopsy or cognitively targeted biopsy results, if available. Generalized estimating equations logistic regression was used to assess T1, T2, and ADC in the differentiation of (a) cancer versus NPZ, (b) cancer versus prostatitis, (c) prostatitis versus NPZ, and (d) high-or intermediate-grade tumors versus low-grade tumors. Analysis was performed for all lesions and repeated in a targeted biopsy subset. Discriminating ability was evaluated by using the area under the receiver operating characteristic curve (AUC).Results: In this study, 109 lesions were analyzed, including 39 with cognitively targeted sampling. T1, T2, and ADC from cancer (mean, 1628 msec +/- 344, 73 msec +/- 27, and 0.773 x 10(-3) mm(2)/sec +/- 0.331, respectively) were significantly lower than those from NPZ (mean, 2247 msec 6 450, 169 msec +/- 61, and 1.711 x 10(-3) mm(2)/sec +/- 0.269) (P < .0001 for each) and together produced the best separation between these groups (AUC = 0.99). ADC and T2 together produced the highest AUC of 0.83 for separating high-or intermediate-grade tumors from low-grade cancers. T1, T2, and ADC in prostatitis (mean, 1707 msec 6 377, 79 msec 6 37, and 0.911 x 10(-3) mm(2)/sec +/- 0.239) were significantly lower than those in NPZ (P < .0005 for each). Interreader agreement was excellent, with an intraclass correlation coefficient greater than 0.75 for both T1 and T2 measurements.Conclusion: This study describes the development of a rapid MR fingerprinting- and diffusion-based examination for quantitative characterization of prostatic tissue. (C) RSNA, 2017