Department of Radiology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.
Eur J Radiol. 2010 Feb;73(2):352-6. doi: 10.1016/j.ejrad.2008.10.034. Epub 2008 Dec 11.
To investigate the feasibility and diagnostic value of a whole prostate qualitative approach to combined magnetic resonance imaging and spectroscopy (MRI+MRS) in the detection of prostate cancer in patients with elevated PSA.
Three hundred and fifty six subjects (mean serum PSA 11.47ng/ml, range 0.40-133ng/ml) were examined with fast-T2-weighted images (MRI) and 3D-magnetic resonance spectroscopy (MRS). Both modalities were qualitatively analyzed on a whole prostate basis by a single radiologist using a 4-point diagnostic scale. Prostate cancer was histopathologically proven in 220 patients and non-evidence of cancer was determined after at least 12 months clinical follow-up in 136 subjects.
Receiver operating curve analysis revealed a significantly better diagnostic performance of MRI+MRS (A(z)=0.857) than MRI alone (A(z)=0.801) and MRS alone (A(z)=0.810). The sensitivity, specificity and accuracy of MRI+MRS for detection of prostate cancer were 72.3%, 92.6%, and 80.1%, respectively.
Spectral evaluation with a whole prostate qualitative approach is feasible in routine clinical practice. The combination of MRI and MRS yields superior diagnostic results than either modality alone.
探讨在 PSA 升高的患者中，使用基于整个前列腺的磁共振成像和磁共振波谱（MRI+MRS）的整体前列腺定性方法检测前列腺癌的可行性和诊断价值。
对 356 例患者（平均血清 PSA 为 11.47ng/ml，范围为 0.40-133ng/ml）进行快速 T2 加权成像（MRI）和 3D 磁共振波谱（MRS）检查。由一位放射科医生使用 4 分制诊断量表对两种模态进行整体前列腺的定性分析。220 例患者经组织病理学证实为前列腺癌，136 例患者至少经过 12 个月的临床随访后未发现癌症。
受试者工作特征曲线分析显示，MRI+MRS 的诊断性能明显优于 MRI 单独检查（A(z)=0.801）和 MRS 单独检查（A(z)=0.810）（A(z)=0.857）。MRI+MRS 检测前列腺癌的灵敏度、特异度和准确度分别为 72.3%、92.6%和 80.1%。
在常规临床实践中，基于整个前列腺的波谱评估是可行的。MRI 和 MRS 的联合使用比任何单一模态的诊断结果都更优。
