Kim Chan Kyo, Park Byung Kwan, Han Jae Joon, Kang Tae Wook, Lee Hyun Moo
Departments of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Comput Assist Tomogr. 2007 May-Jun;31(3):449-54. doi: 10.1097/01.rct.0000243456.00437.59.
To evaluate prospectively the use of apparent diffusion coefficients (ADCs) for the differentiation of malignant and benign tissue in the transition (TZ) and peripheral (PZ) zones of the prostate diffusion-weighted imaging (DWI) at 3 T magnetic resonance imaging (MRI) using a phased-array coil.
The DWI at 3-T MRI was performed on a total of 35 patients before radical prostatectomy. A single-shot echo-planar imaging DWI technique with b = 0 and b = 1000 s/mm2 was used. The ADC values were measured in both benign and malignant tissues in the PZ and TZ using regions of interest. Differences between PZ and TZ ADC values were estimated using a paired Student t test. Presumed ADC cutoff values in the PZ and TZ for the diagnosis of cancer were assessed by receiver operating characteristic analysis.
The ADC values of malignant tissues were significantly lower than those of benign tissues in the PZ and TZ (P < 0.001; 1.32 +/- 0.24 x 10(-3) mm2/s vs 1.97 +/- 0.25 x 10(-3) mm2/s, and 1.37 +/- 0.29 x 10(-3) mm2/s vs 1.79 +/- 0.19 x 10(-3) mm2/s, respectively). For tumor diagnosis, cutoff values of 1.67 x 10(-3) mm2/s (PZ) and 1.61 x 10(-3) mm2/s (TZ) resulted in sensitivities and specificities of 94% and 91% and 90% and 84%, respectively.
The DWI of the prostate at 3T MRI using a phased-array coil was useful for the differentiation of malignant and benign tissues in the TZ and PZ.
前瞻性评估在3T磁共振成像（MRI）中使用相控阵线圈进行前列腺扩散加权成像（DWI）时，表观扩散系数（ADC）在前列腺移行区（TZ）和外周区（PZ）鉴别恶性和良性组织的应用价值。
对35例患者在根治性前列腺切除术前行3T MRI的DWI检查。采用单次激发回波平面成像DWI技术，b值分别为0和1000 s/mm²。利用感兴趣区测量PZ和TZ中良性和恶性组织的ADC值。采用配对t检验评估PZ和TZ的ADC值差异。通过受试者工作特征分析评估PZ和TZ中诊断癌症的假定ADC临界值。
PZ和TZ中恶性组织的ADC值显著低于良性组织（P<0.001；分别为1.32±0.24×10⁻³mm²/s对1.97±0.25×10⁻³mm²/s，以及1.37±0.29×10⁻³mm²/s对1.79±0.19×10⁻³mm²/s）。对于肿瘤诊断，1.67×10⁻³mm²/s（PZ）和1.61×10⁻³mm²/s（TZ）的临界值分别产生了94%和91%以及90%和84%的敏感性和特异性。
3T MRI使用相控阵线圈进行前列腺DWI有助于鉴别TZ和PZ中的恶性和良性组织。
