Weiss Robert E, Egorov Vladimir, Ayrapetyan Suren, Sarvazyan Noune, Sarvazyan Armen
Division of Urology, Department of Surgery, Robert Wood Johnson Medical School/University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey, USA.
Urology. 2008 Mar;71(3):425-9. doi: 10.1016/j.urology.2007.11.021.
To evaluate the ability of prostate mechanical imaging (PMI) technology to provide an objective and reproducible image and to assess the prostate nodularity.
We evaluated the PMI device developed by Artann Laboratories in a pilot clinical study. For the 168 patients (ages 44 to 94) who presented to an urologist for prostate evaluation, PMI-produced images and assessment of prostate size, shape, consistency/hardness, mobility, and nodularity were compared with digital rectal examination (DRE) findings. The PMI and DRE results were further tested for correlation against a transrectal ultrasound of the prostate (TRUS) guided biopsy for a subgroup of 21 patients with an elevated prostate-specific antigen level.
In 84% of the cases, the PMI device was able to reconstruct three-dimensional (3D) and 2D cross-sectional images of the prostate. The PMI System and DRE pretests were able to determine malignant nodules in 10 and 6 patients, respectively, of the 13 patients with biopsy-confirmed malignant inclusions. The PMI System findings were consistent with all 8 biopsy negative cases, whereas the DRE had 1 abnormal reading for this group. The correlation between PMI and DRE detection of palpable nodularity was 81%, as indicated by the area under the receiver operating characteristic curve. Estimates of the prostate size provided by PMI and DRE were statistically significantly correlated.
The PMI has the potential to enable a physician to obtain, examine, and store a 3D image of the prostate based on mechanical and geometrical characteristics of the gland and its internal structures.
评估前列腺机械成像(PMI)技术提供客观且可重复图像以及评估前列腺结节性的能力。
我们在一项初步临床研究中评估了Artann Laboratories公司研发的PMI设备。对于168名(年龄44至94岁)因前列腺问题就诊于泌尿科医生的患者,将PMI生成的图像以及对前列腺大小、形状、质地/硬度、活动度和结节性的评估结果与直肠指检(DRE)结果进行比较。对于21名前列腺特异性抗原水平升高的患者亚组,进一步测试PMI和DRE结果与经直肠超声引导下前列腺穿刺活检结果的相关性。
在84%的病例中,PMI设备能够重建前列腺的三维(3D)和二维横截面图像。在13例经活检证实有恶性病变的患者中,PMI系统和DRE预测试分别在10例和6例患者中检测出恶性结节。PMI系统的结果与所有8例活检阴性病例一致,而DRE在该组中有1例异常读数。如受试者工作特征曲线下面积所示,PMI和DRE对可触及结节性的检测相关性为81%。PMI和DRE对前列腺大小的估计在统计学上具有显著相关性。
PMI有可能使医生能够基于前列腺及其内部结构的机械和几何特征获取、检查并存储前列腺的三维图像。