Zakian Kristen L, Sircar Kanishka, Hricak Hedvig, Chen Hui-Ni, Shukla-Dave Amita, Eberhardt Steven, Muruganandham Manickam, Ebora Lanie, Kattan Michael W, Reuter Victor E, Scardino Peter T, Koutcher Jason A
Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021, USA.
Radiology. 2005 Mar;234(3):804-14. doi: 10.1148/radiol.2343040363.
To determine whether hydrogen 1 magnetic resonance (MR) spectroscopic imaging can be used to predict aggressiveness of prostate cancer.
All patients gave informed consent according to an institutionally approved research protocol. A total of 123 patients (median age, 58 years; age range, 40-74 years) who underwent endorectal MR imaging and MR spectroscopic imaging between January 2000 and December 2002 were included. MR imaging and spectroscopy were performed by using combined pelvic phased-array and endorectal probe. Water and lipids were suppressed, and phase-encoded data were acquired with 6.2-mm resolution. Voxels in the peripheral zone were considered suspicious for cancer if (Cho + Cr)/Cit was at least two standard deviations above the normal level, where Cho represents choline-containing compounds, Cr represents creatine and phosphocreatine, and Cit represents citrate. Correlation between metabolite ratio and four Gleason score groups identified at step-section pathologic evaluation (3 + 3, 3 + 4, 4 + 3, and > or =4 + 4) was assessed with generalized estimating equations.
Data from 94 patients were included. Pathologic evaluation was used to identify 239 lesions. Overall sensitivity of MR spectroscopic imaging was 56% for tumor detection, increasing from 44% in lesions with Gleason score of 3 + 3 to 89% in lesions with Gleason score greater than or equal to 4 + 4. There was a trend toward increasing (Cho + Cr)/Cit with increasing Gleason score in lesions identified correctly with MR spectroscopic imaging. Tumor volume assessed with MR spectroscopic imaging increased with increasing Gleason score.
MR spectroscopic imaging measurement of prostate tumor (Cho + Cr)/Cit and tumor volume correlate with pathologic Gleason score. There is overlap between MR spectroscopic imaging parameters at various Gleason score levels, which may reflect methodologic and physiologic variations. MR spectroscopic imaging has potential in noninvasive assessment of prostate cancer aggressiveness.
确定氢1磁共振（MR）波谱成像是否可用于预测前列腺癌的侵袭性。
所有患者均根据机构批准的研究方案给予知情同意。纳入2000年1月至2002年12月期间接受直肠内MR成像和MR波谱成像的123例患者（中位年龄58岁；年龄范围40 - 74岁）。MR成像和波谱分析采用盆腔相控阵和直肠内探头联合进行。水和脂质被抑制，并以6.2毫米分辨率采集相位编码数据。如果外周区体素的（胆碱+肌酸）/枸橼酸盐至少比正常水平高两个标准差，则认为该体素可疑为癌，其中胆碱代表含胆碱化合物，肌酸代表肌酸和磷酸肌酸，枸橼酸盐代表枸橼酸。使用广义估计方程评估代谢物比率与在病理切片评估中确定的四个Gleason评分组（3 + 3、3 + 4、4 + 3和≥4 + 4）之间的相关性。
纳入94例患者的数据。病理评估用于识别239个病变。MR波谱成像检测肿瘤的总体敏感性为56%，从Gleason评分为3 + 3的病变中的44%增加到Gleason评分大于或等于4 + 4的病变中的89%。在通过MR波谱成像正确识别的病变中，随着Gleason评分增加，（胆碱+肌酸）/枸橼酸盐有增加趋势。通过MR波谱成像评估的肿瘤体积随Gleason评分增加而增大。
前列腺肿瘤的MR波谱成像测量值（胆碱+肌酸）/枸橼酸盐和肿瘤体积与病理Gleason评分相关。在不同Gleason评分水平的MR波谱成像参数之间存在重叠，这可能反映了方法学和生理学变异。MR波谱成像在前列腺癌侵袭性的无创评估中具有潜力。
