Franiel T, Lüdemann L, Taupitz M, Rost J, Asbach P, Beyersdorff D
Institut für Radiologie CCM, Charité - Universitätsmedizin Berlin.
Rofo. 2009 Jun;181(6):536-42. doi: 10.1055/s-0028-1109168. Epub 2009 Apr 7.
To investigate whether pharmacokinetic MRI parameters "perfusion, blood volume, mean transit time (MTT), interstitial volume, permeability, extraction coefficient, delay, and dispersion" allow the differentiation of low-grade (Gleason score < or = 6) and high-grade (Gleason score > or = 7) prostate cancer.
Forty-two patients with prostate cancer verified by biopsy (PSA 2.7 to 31.4 ng/ml) and scheduled for prostatectomy underwent MRI at 1.5 Tesla using the dynamic contrast-enhanced inversion-prepared dual-contrast gradient echo sequence (temporal resolution, 1.65 s) and a combined endorectal body phased array coil. Parametric maps were computed using a sequential 3-compartment model and the corresponding post-processing algorithms. A total of 41 areas of prostate cancer (15 low-grade, 26 high-grade cancers) in 32 patients were able to be correlated with the prostatectomy specimens and were included in the analysis.
Low-grade prostate cancers had a higher mean blood volume (1.76 % vs. 1.64 %, p = 0.039), longer MTT (6.39 s vs. 3.25 s, p < 0.001), and lower mean permeability (2.57 min (-1) vs. 3.86 min (-1), p = 0.011) than high-grade cancers. No statistically significant difference was found for perfusion (p = 0.069), interstitial volume (p = 0.849), extraction coefficient (p = 0.615), delay (p = 0.489), and dispersion (p = 0.306).
Blood volume, MTT, and permeability allow the differentiation of low-grade and high-grade prostate cancer. They may be used to detect cancer progression by MRI in patients managed by active surveillance.
研究药代动力学磁共振成像参数“灌注、血容量、平均通过时间（MTT）、组织间隙容积、通透性、提取系数、延迟和弥散”是否能够区分低级别（Gleason评分≤6）和高级别（Gleason评分≥7）前列腺癌。
42例经活检证实患有前列腺癌（前列腺特异抗原2.7至31.4 ng/ml）且计划接受前列腺切除术的患者，使用动态对比增强反转预饱和双对比梯度回波序列（时间分辨率为1.65秒）和联合直肠内体部相控阵线圈，在1.5特斯拉场强下进行磁共振成像检查。使用序贯三室模型和相应的后处理算法计算参数图。32例患者中总共41个前列腺癌区域（15个低级别癌、26个高级别癌）能够与前列腺切除标本相关联，并纳入分析。
低级别前列腺癌的平均血容量较高（1.76%对1.64%，p = 0.039），MTT较长（6.39秒对3.25秒，p < 0.001），平均通透性较低（2.57分钟⁻¹对3.86分钟⁻¹，p = 0.011），高于高级别癌。在灌注（p = 0.069）、组织间隙容积（p = 0.849）、提取系数（p = 0.615）、延迟（p = 0.489）和弥散（p = 0.306）方面未发现统计学显著差异。
血容量、MTT和通透性能够区分低级别和高级别前列腺癌。它们可用于在接受主动监测的患者中通过磁共振成像检测癌症进展。
