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3T磁共振成像使用相控阵线圈预测前列腺癌放疗后局部复发:初步经验

Prostate MR imaging at 3T using a phased-arrayed coil in predicting locally recurrent prostate cancer after radiation therapy: preliminary experience.

作者信息

Kim Chan Kyo, Park Byung Kwan, Park Won, Kim Sam Soo

机构信息

Department of Radiology, Kangwon National University College of Medicine, Chuncheon, Republic of Korea.

出版信息

Abdom Imaging. 2010 Apr;35(2):246-52. doi: 10.1007/s00261-008-9495-2. Epub 2009 Jan 7.

Abstract

The purpose of this study was to retrospectively assess the diagnostic performance of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced imaging (DCEI) at 3T in predicting locally recurrent prostate cancer after radiation therapy. Twenty-four patients with a rising prostate-specific antigen level after treatment with radiation therapy underwent prostate MR imaging at 3T, followed by transrectal ultrasound-guided biopsy. MRI findings and biopsy results were correlated in six prostate sectors of both peripheral zones. Two radiologists in consensus reviewed the MR images and rated the likelihood of recurrent cancer on a 5-point scale. Out of the 144 prostate sectors, 37 (26%) sectors were positive for cancer in ten patients. For predicting locally recurrent cancer, the sensitivity and specificity of DWI, DCEI, and combined DCEI and DWI were higher than those for T2-weighted imaging (T2WI). The accuracy of DWI, DCEI and combined DCEI and DWI was greater than that of T2WI. A significantly greater Az was determined for combined DCEI and DWI (Az = 0.863, P < 0.05) as compared with T2WI, DCEI, and DWI. For predicting locally recurrent prostate cancer after radiation therapy, our preliminary results suggest that the use of either DWI or DCEI is superior to the use of T2WI.

摘要

本研究的目的是回顾性评估3T磁共振成像中扩散加权成像(DWI)和动态对比增强成像(DCEI)在预测放射治疗后局部复发性前列腺癌方面的诊断性能。24例放射治疗后前列腺特异性抗原水平升高的患者接受了3T前列腺磁共振成像检查,随后进行经直肠超声引导下活检。在两个外周区的六个前列腺区域将MRI表现与活检结果进行关联。两名放射科医生共同对MR图像进行评估,并采用5分制对复发性癌症的可能性进行评分。在144个前列腺区域中,10例患者的37个(26%)区域癌症呈阳性。对于预测局部复发性癌症,DWI、DCEI以及DCEI与DWI联合应用的敏感性和特异性均高于T2加权成像(T2WI)。DWI、DCEI以及DCEI与DWI联合应用的准确性高于T2WI。与T2WI、DCEI和DWI相比,DCEI与DWI联合应用的Az值显著更高(Az = 0.863,P < 0.05)。对于预测放射治疗后的局部复发性前列腺癌,我们的初步结果表明,使用DWI或DCEI均优于使用T2WI。

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