Kozlowski Piotr, Chang Silvia D, Jones Edward C, Berean Kenneth W, Chen Henry, Goldenberg S Larry
Prostate Centre, Vancouver General Hospital, Vancouver, British Columbia, Canada.
J Magn Reson Imaging. 2006 Jul;24(1):108-13. doi: 10.1002/jmri.20626.
To determine whether the combination of diffusion-weighted (DW) and dynamic contrast-enhanced (DCE) MRI provides higher diagnostic sensitivity for prostate cancer than each technique alone.
Fourteen patients with a clinical suspicion of prostate cancer underwent endorectal MRI on a 1.5T scanner prior to transrectal ultrasound (TRUS)-guided biopsies. The average values of the apparent diffusion coefficient (ADC, calculated from b-values of 0 and 600), K(trans), v(e), maximum gadolinium (Gd) concentration, onset time, mean gradient, and maximum enhancement were determined. Correlation with histology was based on biopsy (six patients) and prostatectomy specimen (eight patients) results. The Tukey-Kramer test was used for statistical analysis.
The average values of all MRI parameters, except v(e) and maximum Gd concentration, showed significant differences between tumor and normal prostate. The sensitivity and specificity values were respectively 54% (35-72%) and 100% (95-100%) for the ADC data, and 59% (39-77%) and 74% (63-83%) for the DCE data. When both ADC and DCE results were combined, the sensitivity increased to 87% (68-95%) and specificity decreased to 74% (62-83%).
All but two DW- and DCE-MRI parameters showed significant differences between tumor and normal prostate. Combining both techniques provides better sensitivity, with a small decrease in specificity.
确定扩散加权（DW）磁共振成像和动态对比增强（DCE）磁共振成像相结合是否比单独使用每种技术对前列腺癌具有更高的诊断敏感性。
14例临床怀疑患有前列腺癌的患者在经直肠超声（TRUS）引导下活检前，于1.5T扫描仪上进行了直肠内磁共振成像检查。测定了表观扩散系数（ADC，根据b值为0和600计算得出）、Ktrans、ve、最大钆（Gd）浓度、起始时间、平均梯度和最大增强的平均值。与组织学的相关性基于活检（6例患者）和前列腺切除标本（8例患者）的结果。采用Tukey-Kramer检验进行统计分析。
除ve和最大Gd浓度外，所有磁共振成像参数的平均值在肿瘤与正常前列腺之间均显示出显著差异。ADC数据的敏感性和特异性值分别为54%（35-72%）和100%（95-100%），DCE数据的敏感性和特异性值分别为59%（39-77%）和74%（63-83%）。当ADC和DCE结果相结合时，敏感性提高到87%（68-95%），特异性降至74%（62-83%）。
除两个DW和DCE磁共振成像参数外，所有参数在肿瘤与正常前列腺之间均显示出显著差异。将两种技术相结合可提供更好的敏感性，特异性略有下降。
