Department of Radiologial Sciences, Policlinico Umberto I, University Sapienza, Viale Regina Elena 324, Rome, Italy.
Radiol Med. 2010 Dec;115(8):1314-29. doi: 10.1007/s11547-010-0575-3. Epub 2010 Sep 17.
The purpose of this study was to evaluate the role of magnetic resonance spectroscopic imaging (MRSI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in detecting tumour foci in patients with elevated prostate-specific antigen (PSA) and negative transrectal ultrasonography (TRUS)-guided biopsy.
This prospective randomised trial was conducted on 150 patients who underwent [¹H]MRSI and DCE-MRI and targeted biopsies of suspicious areas on MRI associated with random biopsies.
After the second biopsy, the diagnosis of prostate adenocarcinoma was made in 64/150 cases. On a per-patient basis, MRSI had 82.8% sensitivity, 91.8% specificity, 88.3% positive predictive value (PPV), 87.8% negative predictive value (NPV) and 85.7% diagnostic accuracy. The sensitivity, specificity, PPV, NPV and accuracy for DCE-MRI was 76.5%, 89.5%, 84.5%, 83.7% and 82%, respectively. The combination of MRSI and DCE-MRI yielded 93.7% sensitivity, 90.7% specificity, 88.2% PPV, 95.1% NPV and 90.9% accuracy in detecting prostate carcinoma.
The combined study with [¹H]MRSI and DCE-MRI showed promising results in guiding the biopsy of cancer foci in patients with an initial negative TRUS-guided biopsy.
本研究旨在评估磁共振波谱成像（MRSI）和动态对比增强磁共振成像（DCE-MRI）在检测前列腺特异性抗原（PSA）升高且经直肠超声（TRUS）引导活检阴性患者肿瘤病灶中的作用。
本前瞻性随机试验纳入了 150 例接受 [¹H]MRSI 和 DCE-MRI 检查以及可疑 MRI 区域靶向活检和随机活检的患者。
在二次活检后，150 例患者中有 64 例被诊断为前列腺腺癌。基于每位患者，MRSI 的敏感性为 82.8%，特异性为 91.8%，阳性预测值（PPV）为 88.3%，阴性预测值（NPV）为 87.8%，诊断准确性为 85.7%。DCE-MRI 的敏感性、特异性、PPV、NPV 和准确性分别为 76.5%、89.5%、84.5%、83.7%和 82%。MRSI 和 DCE-MRI 联合检查在检测前列腺癌方面的敏感性、特异性、PPV、NPV 和准确性分别为 93.7%、90.7%、88.2%、95.1%和 90.9%。
[¹H]MRSI 和 DCE-MRI 的联合研究在指导初始 TRUS 引导活检阴性患者的癌灶活检方面显示出良好的结果。
