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比较群体平均与实验测量的动脉输入函数在预测前列腺癌活检结果中的应用。

Comparison between population average and experimentally measured arterial input function in predicting biopsy results in prostate cancer.

机构信息

MRI Research Centre, University of British Columbia, Vancouver, BC, Canada.

出版信息

Acad Radiol. 2010 Apr;17(4):520-5. doi: 10.1016/j.acra.2009.11.006. Epub 2010 Jan 13.

Abstract

RATIONALE AND OBJECTIVES

To test whether individually measured arterial input function (AIF) provides more accurate prostate cancer diagnosis then population average AIF when dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) data are acquired with limited temporal resolution.

MATERIALS AND METHODS

Twenty-six patients with a high clinical suspicion for prostate cancer and no prior treatment underwent DCE MRI examination at 3.0 T before biopsy. DCE MRI data were fitted to a pharmacokinetic model using three forms of AIF: an individually measured, a local population average, and a literature double exponential population average. Receiver operating characteristic (ROC) analysis was used to correlate MRI with the biopsy results. Goodness of fit (chi(2)) for the three AIFs was compared using nonparametric Mann-Whitney test.

RESULTS

Average volume transfer constant (K(trans)) values were significantly higher in tumor than in normal peripheral zone for all three AIFs. The individually measured and the local population average AIFs had the highest sensitivity (76%), whereas the double exponential AIF had the highest specificity (82%). The areas under the ROC curves were not significantly different between any of the AIFs (0.81, 0.76, and 0.81 for the individually measured, local population average, and double exponential AIFs, respectively). chi(2) was not significantly different for the three AIFs; however, it was significantly higher in enhancing than in nonenhancing regions for all three AIFs.

CONCLUSIONS

These results suggest that, when DCE MRI data are acquired with limited temporal resolution, experimentally measured individual AIF is not significantly better than population average AIF in predicting the biopsy results in prostate cancer.

摘要

背景与目的

通过检测动态对比增强磁共振成像(DCE-MRI)数据获取时的时间分辨率有限,探究个体化测量的动脉输入函数(AIF)是否比群体平均 AIF 更能准确诊断前列腺癌。

材料与方法

26 例高度怀疑前列腺癌且未经治疗的患者在 3.0T 磁共振扫描仪上行 DCE-MRI 检查,之后行前列腺穿刺活检。使用三种 AIF(个体测量的 AIF、局部群体平均 AIF 和文献双指数群体平均 AIF)拟合药代动力学模型。采用接受者操作特征(ROC)分析将 MRI 与活检结果相关联。使用非参数 Mann-Whitney 检验比较三种 AIF 的拟合优度(chi(2))。

结果

三种 AIF 的平均容积转移常数(K(trans))值在肿瘤区均显著高于正常外周带。个体测量的 AIF 和局部群体平均 AIF 的灵敏度最高(76%),而双指数 AIF 的特异性最高(82%)。ROC 曲线下面积在三种 AIF 之间无显著差异(个体测量的 AIF、局部群体平均 AIF 和双指数 AIF 的面积分别为 0.81、0.76 和 0.81)。三种 AIF 的 chi(2)无显著差异,但在三种 AIF 中,增强区域的 chi(2)均显著高于非增强区域。

结论

这些结果表明,当 DCE-MRI 数据获取的时间分辨率有限时,实验测量的个体 AIF 并不比群体平均 AIF 更能显著提高预测前列腺癌活检结果的准确性。

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