Engelbrecht Marc R, Huisman Henkjan J, Laheij Robert J F, Jager Gerrit J, van Leenders Geert J L H, Hulsbergen-Van De Kaa Christina A, de la Rosette Jean J M C H, Blickman Johan G, Barentsz Jelle O
Department of Radiology, University Medical Center Nijmegen, PO Box 9101, NL 6500 HB Nijmegen, the Netherlands.
Radiology. 2003 Oct;229(1):248-54. doi: 10.1148/radiol.2291020200. Epub 2003 Aug 27.
To evaluate which parameters of dynamic magnetic resonance (MR) imaging and T2 relaxation rate would result in optimal discrimination of prostatic carcinoma from normal peripheral zone (PZ) and central gland (CG) tissues and to correlate these parameters with tumor stage, Gleason score, patient age, and tumor markers.
Of 58 patients with prostatic carcinoma, 36 were included for analysis. Patients underwent MR imaging at 1.5 T with an endorectal-pelvic phased-array coil and subsequently underwent prostatectomy. A T2-weighted turbo spin-echo sequence, an intermediate-weighted sequence, and a fast T1-weighted gradient-echo sequence (seven sections in 2.03 seconds) during bolus injection of 0.1 mmol gadopentetate dimeglumine per kilogram of body weight were performed. Contrast agent concentration-time curves were obtained for prostatic carcinoma and normal PZ and CG tissue by using whole-mount sections to guide placement of regions of interest. Onset time, time to peak, peak enhancement, relative peak enhancement, washout, and T2 relaxation rates were calculated. Multivariate receiver operating characteristic analysis was performed with and without relative peak enhancement.
Results of multivariate receiver operating characteristic analysis showed that relative peak enhancement demonstrated the highest area under the receiver operating characteristic curve (AUC) in the PZ and the CG (AUC = 0.93, 0.82). Results of multivariate analysis without relative peak enhancement showed that relative peak enhancement in the PZ and washout in the CG demonstrated the highest AUC (AUC = 0.9, 0.81). Pearson correlation coefficients between the dynamic parameters or T2 relaxation rates in carcinoma and the tumor stage, Gleason score, patient age, and tumor markers ranged between 0.02 and 0.44.
The optimal parameter for discrimination of prostatic carcinoma in the PZ and CG was relative peak enhancement. If relative peak enhancement was not used, then peak enhancement was optimal in the PZ, and washout was optimal in the CG. Poor-to-moderate correlation was present between the dynamic parameters or T2 relaxation rate in carcinoma and the tumor stage, Gleason score, patient age, tumor volume, and prostate-specific antigen.
评估动态磁共振（MR）成像和T2弛豫率的哪些参数能实现前列腺癌与正常外周带（PZ）和中央腺体（CG）组织的最佳鉴别，并将这些参数与肿瘤分期、Gleason评分、患者年龄和肿瘤标志物相关联。
58例前列腺癌患者中，36例纳入分析。患者采用直肠内盆腔相控阵线圈在1.5T下行MR成像，随后接受前列腺切除术。在静脉团注每千克体重0.1mmol钆喷酸葡胺期间，行T2加权快速自旋回波序列、中等加权序列和快速T1加权梯度回波序列（2.03秒内采集7层）。通过全层切片指导感兴趣区的放置，获得前列腺癌及正常PZ和CG组织的对比剂浓度-时间曲线。计算起始时间、达峰时间、峰值强化、相对峰值强化、廓清率和T2弛豫率。进行有和没有相对峰值强化的多变量受试者操作特征分析。
多变量受试者操作特征分析结果显示，相对峰值强化在PZ和CG中的受试者操作特征曲线下面积（AUC）最高（AUC = 0.93，0.82）。没有相对峰值强化的多变量分析结果显示，PZ中的相对峰值强化和CG中的廓清率的AUC最高（AUC = 0.9，0.81）。癌组织中的动态参数或T2弛豫率与肿瘤分期、Gleason评分、患者年龄和肿瘤标志物之间的Pearson相关系数在0.02至0.44之间。
鉴别PZ和CG中前列腺癌的最佳参数是相对峰值强化。如果不使用相对峰值强化，则PZ中的峰值强化最佳，CG中的廓清率最佳。癌组织中的动态参数或T2弛豫率与肿瘤分期、Gleason评分、患者年龄、肿瘤体积和前列腺特异性抗原之间存在弱至中度的相关性。
