Hambrock Thomas, Fütterer Jurgen J, Huisman Henkjan J, Hulsbergen-vandeKaa Christina, van Basten Jean-Paul, van Oort Inge, Witjes J Alfred, Barentsz Jelle O
Department of Radiology, University Medical Centre Nijmegen, Nijmegen, Netherlands.
Invest Radiol. 2008 Oct;43(10):686-94. doi: 10.1097/RLI.0b013e31817d0506.
To test the technique and feasibility of translating tumor suspicious region maps in the prostate, obtained by multimodality, anatomic, and functional 3T magnetic resonance imaging (MRI) data to 32-channel coil, T2-weighted (T2-w), 3T MR images, for directing MR-guided biopsies. Furthermore, to evaluate the practicability of MR-guided biopsy on a 3T MR scanner using a 32-channel coil and a MR-compatible biopsy device.
Twenty-one patients with a high prostate-specific antigen (>4.0 ng/mL) and at least 2 prior negative transrectal ultrasound-guided biopsies of the prostate underwent an endorectal coil 3T MRI, which included T2-w, diffusion weighted and dynamic contrast enhanced MRI. From these multimodality images, tumor suspicious regions (TSR) were determined. The 3D localization of these TSRs within the prostatic gland was translated to the T2-w MR images of a subsequent 32-channel coil 3T MRI. These were then biopsied under 3T MR guidance.
In all patients, TSRs could be identified and accurately translated to subsequent 3T MR images and biopsied under MR guidance. Median MR biopsy procedure time was 35 minutes. Of the 21 patients, 8 (38%) were diagnosed with prostate cancer, 6 (29%) had evidence of prostatitis, 6 (29%) had combined inflammatory and atrophic changes, and only 1 (5%) patient had no identifiable pathology.
Multimodality, 3T MRI determined TSRs could effectively be translated to T2-weighted images, to be used for MR biopsies. 3T MR-guided biopsy based on these translated TSRs was feasible, performed in a clinical useful time, and resulted in a high number of positive results.
测试将通过多模态、解剖学和功能3T磁共振成像(MRI)数据获得的前列腺肿瘤可疑区域图转换为32通道线圈T2加权(T2-w)3T MR图像以指导MR引导活检的技术和可行性。此外,评估使用32通道线圈和MR兼容活检设备在3T MR扫描仪上进行MR引导活检的实用性。
21例前列腺特异性抗原水平高(>4.0 ng/mL)且至少有2次先前经直肠超声引导前列腺活检阴性的患者接受了直肠内线圈3T MRI检查,包括T2-w、扩散加权和动态对比增强MRI。从这些多模态图像中确定肿瘤可疑区域(TSR)。将这些TSR在前列腺内的三维定位转换为随后的32通道线圈3T MRI的T2-w MR图像。然后在3T MR引导下进行活检。
在所有患者中,TSR均可被识别并准确转换为后续的3T MR图像,并在MR引导下进行活检。MR活检的中位操作时间为35分钟。21例患者中,8例(38%)被诊断为前列腺癌,6例(29%)有前列腺炎证据,6例(29%)有炎症和萎缩性改变,只有1例(5%)患者未发现可识别的病理改变。
多模态3T MRI确定的TSR可有效转换为T2加权图像,用于MR活检。基于这些转换后的TSR进行3T MR引导活检是可行的,在临床可用时间内完成,且阳性结果数量较多。