Fütterer Jurgen J, Engelbrecht Marc R, Jager Gerrit J, Hartman Robert P, King Bernard F, Hulsbergen-Van de Kaa Christina A, Witjes J Alfred, Barentsz Jelle O
Department of Radiology, University Medical Center Nijmegen, Nijmegen, The Netherlands.
Eur Radiol. 2007 Apr;17(4):1055-65. doi: 10.1007/s00330-006-0418-8. Epub 2006 Oct 6.
To compare the visibility of anatomical details and prostate cancer local staging performance of pelvic phased-array coil and integrated endorectal-pelvic phased-array coil MR imaging, with histologic analysis serving as the reference standard. MR imaging was performed in 81 consecutive patients with biopsy-proved prostate cancer, prior to radical prostatectomy, on a 1.5T scanner. T2-weighted fast spin echo images of the prostate were obtained using phased-array coil and endorectal-pelvic phased-array coils. Prospectively, one radiologist, retrospectively, two radiologists and two less experienced radiologists working in consensus, evaluated and scored all endorectal-pelvic phased-array imaging, with regard to visibility of anatomical details and local staging. Receiver operator characteristics (ROC) analysis was performed. Anatomical details of the overall prostate were significantly better evaluated using the endorectal-pelvic phased-array coil setup (P<0.05). The overall local staging accuracy, sensitivity and specificity for the pelvic phased-array coil was 59% (48/81), 56% (20/36) and 62% (28/45), and for the endorectal-pelvic phased-array coils 83% (67/81), 64% (23/36) and 98% (44/45) respectively, for the prospective reader. Accuracy and specificity were significantly better with endorectal-pelvic phased-array coils (P<0.05). The overall staging accuracy, sensitivity and specificity for the retrospective readers were 78-79% (P<0.05), 56-58% and 96%, for the endorectal-pelvic phased-array coils. Area under the ROC curve (Az) was significantly higher for endorectal-pelvic phased-array coils (Az=0.74) compared to pelvic phased-array coil (Az=0.57), for the prospective reader. The use of endorectal-pelvic phased array coils resulted in significant improvement of anatomic details, extracapsular extension accuracy and specificity. Overstaging is reduced significantly with equal sensitivity when an endorectal-pelvic phased-array coil is used.
为比较盆腔相控阵线圈和直肠内-盆腔相控阵集成线圈磁共振成像（MR成像）对解剖细节的显示能力及前列腺癌局部分期的表现，以组织学分析作为参考标准。对81例经活检证实为前列腺癌且即将接受根治性前列腺切除术的患者，在1.5T扫描仪上进行MR成像检查。使用相控阵线圈和直肠内-盆腔相控阵线圈获取前列腺的T2加权快速自旋回波图像。由一名放射科医生前瞻性地、两名放射科医生及两名经验稍欠的放射科医生回顾性地共同对所有直肠内-盆腔相控阵成像的解剖细节显示能力及局部分期进行评估和评分。进行了受试者操作特征（ROC）分析。使用直肠内-盆腔相控阵线圈设置对前列腺整体解剖细节的评估明显更好（P<0.05）。盆腔相控阵线圈的整体局部分期准确性、敏感性和特异性分别为59%（48/81）、56%（20/36）和62%（28/45），而直肠内-盆腔相控阵线圈对前瞻性阅片者而言分别为83%（67/81）、64%（23/36）和98%（44/45）。直肠内-盆腔相控阵线圈的准确性和特异性明显更好（P<0.05）。直肠内-盆腔相控阵线圈对回顾性阅片者的整体分期准确性、敏感性和特异性分别为78 - 79%（P<0.05）、56 - 58%和96%。对于前瞻性阅片者，直肠内-盆腔相控阵线圈的ROC曲线下面积（Az）为0.74，明显高于盆腔相控阵线圈（Az = 0.57）。使用直肠内-盆腔相控阵线圈可显著改善解剖细节、包膜外侵犯的准确性和特异性。使用直肠内-盆腔相控阵线圈时，在敏感性相同的情况下，过度分期显著减少。
