Van As N, Charles-Edwards E, Jackson A, Jhavar S, Reinsberg S, Desouza N, Dearnaley D, Bailey M, Thompson A, Christmas T, Fisher C, Corbishley C, Sohaib S
Academic Unit of Radiotherapy and Oncology, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK.
Br J Radiol. 2008 Jun;81(966):456-62. doi: 10.1259/bjr/29869950.
The purpose of this study was to compare the apparent diffusion coefficient (ADC) of benign central gland (bCG), benign peripheral zone (bPZ) and cancer using diffusion-weighted MRI and whole mount specimens. 11 patients with biopsy-proven prostate cancer underwent diffusion-weighted MRI prior to radical prostatectomy. A single-shot echo planar image technique was used with b-values of 0 s mm(-2), 300 s mm(-2), 500 s mm(-2) and 800 s mm(-2). Whole mount specimens were compared with ADC maps. Areas of cancer, bCG and bPZ were identified, and regions of interest were drawn on ADC maps. Mean ADC values were recorded for all regions of interest, and paired t-tests were performed to compare mean values. Cancer was outlined in nine patients. In two patients, the tumours were too small to correlate with images; bCG was identified in 11 patients and bPZ was identified in 10 patients. Mean ADC values for bCG, bPZ and cancer were, 1.5 x 10(-3) mm(2) s(-1) (standard error (SE) = 0.04), 1.7 x 10(-3) mm(2) s(-1) (SE = 0.1), and 1.3 x 10(-3) mm(2) s(-1) (SE = 0.09), respectively. The most significant difference between benign tissue and cancer existed at b-values of 0-300 s mm(-2) (bCG vs cancer: mean difference = 0. 29, p = 0.001, 95% confidence interval (CI) = 0.17-0.41; bPZ vs cancer: mean difference = 0.34, p = 0.003, 95% CI = 0.18-0.61). In conclusion, we have confirmed, using whole mount verification, a significant difference in the ADC between benign tissue and cancer.
本研究旨在使用扩散加权磁共振成像（MRI）和全层标本比较良性中央腺体（bCG）、良性外周带（bPZ）和癌灶的表观扩散系数（ADC）。11例经活检证实为前列腺癌的患者在根治性前列腺切除术前行扩散加权MRI检查。采用单次激发回波平面成像技术，b值分别为0 s mm(-2)、300 s mm(-2)、500 s mm(-2)和800 s mm(-2)。将全层标本与ADC图进行比较。识别出癌灶、bCG和bPZ区域，并在ADC图上绘制感兴趣区。记录所有感兴趣区的平均ADC值，并进行配对t检验以比较平均值。9例患者的癌灶轮廓清晰。2例患者的肿瘤太小，无法与图像关联；11例患者识别出bCG，10例患者识别出bPZ。bCG、bPZ和癌灶的平均ADC值分别为1.5×10(-3) mm(2) s(-1)（标准误（SE）=0.04）、1.7×10(-3) mm(2) s(-1)（SE = 0.1）和1.3×10(-3) mm(2) s(-1)（SE = 0.09）。良性组织与癌灶之间最显著的差异存在于b值为0 - 300 s mm(-2)时（bCG与癌灶：平均差异 = 0. 29，p = 0.001，95%置信区间（CI）= 0.17 - 0.41；bPZ与癌灶：平均差异 = 0.34，p = 0.003，95% CI = 0.18 - 0.61）。总之，我们通过全层验证证实了良性组织与癌灶之间ADC存在显著差异。
