Lemaitre Laurent, Puech Philippe, Poncelet Edouard, Bouyé Sébastien, Leroy Xavier, Biserte Jacques, Villers Arnauld
Department of Radiology, Centre Hospitalier Régional Universitaire de Lille, 59037 Lille Cedex, France.
Eur Radiol. 2009 Feb;19(2):470-80. doi: 10.1007/s00330-008-1153-0. Epub 2008 Aug 29.
The purpose of the study was to relate morphometric features of prostate cancers in the anterior compartment of the prostate by dynamic contrast-enhanced (DCE) MRI to subsequent histopathologic findings. We prospectively performed DCE-MRI before biopsy in patients with suspected prostate cancer and selected those showing both a suspicious lesion at MRI and positive biopsies in the anterior compartment of the gland. Tumor contours, margins, largest surface areas and volumes were assessed at MRI and histopathology, when available. Anterior compartment tumors were classified according to transition zone (TZ) boundaries with the peripheral zone (PZ) or with the anterior fibromuscular stroma (SFMA). Forty-three patients were included in this study [median PSA 12.7 ng/ml (3.6-72)]. Whole-mount radical prostatectomy specimens were available in 27 cases. Of the anterior cancers, 89% had ill-defined margins at T2-weighted MRI. Cancer location and contour established at MRI agreed well with histopathology in the 27 cases. Median largest surface area and volume were 1.38 cm(2) (0.35-5.82) and 1.01 cc (0.15-7.4) for MRI versus 1.86 cm(2) (0.2-14) and 2.84 cc (0.33-28.92) for histopathology with respective correlation coefficients (r(2)) of 0.73 and 0.69. The site of origin could be accurately determined for the 15 tumors of less than 3 cc. We found a good relationship between DCE-MRI and histopathology for localization, morphologic description and volume assessment of anterior prostate cancers.
本研究的目的是通过动态对比增强（DCE）MRI将前列腺前叶癌的形态学特征与后续的组织病理学结果相关联。我们对疑似前列腺癌患者在活检前前瞻性地进行了DCE-MRI检查，并选择了那些在MRI上显示可疑病变且在腺体前叶活检呈阳性的患者。在MRI和组织病理学检查（如有）时评估肿瘤轮廓、边缘、最大表面积和体积。根据与外周带（PZ）或前纤维肌基质（SFMA）的移行带（TZ）边界对前叶肿瘤进行分类。本研究纳入了43例患者[中位前列腺特异性抗原（PSA）为12.7 ng/ml（3.6 - 72）]。27例患者有完整的根治性前列腺切除术标本。在前叶癌中，89%在T2加权MRI上边界不清。在27例病例中，MRI确定的癌灶位置和轮廓与组织病理学结果高度一致。MRI的中位最大表面积和体积分别为1.38 cm²（0.35 - 5.82）和1.01 cc（0.15 - 7.4），而组织病理学的分别为1.86 cm²（0.2 - 14）和2.84 cc（0.33 - 28.92），相关系数（r²）分别为0.73和0.69。对于15个体积小于3 cc的肿瘤，其起源部位能够准确确定。我们发现DCE-MRI与组织病理学在前叶前列腺癌的定位、形态学描述和体积评估方面存在良好的相关性。
