Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Eur Radiol. 2011 Mar;21(3):616-26. doi: 10.1007/s00330-010-2037-7. Epub 2010 Dec 24.
Dynamic contrast-enhanced MRI enables noninvasive analysis of prostate vascularization as well as tumour angiogenesis and capillary permeability characteristics in prostate cancers. Pharmacokinetic models summarizing the complex information provided by signal intensity-time curves for a few quantitative pharmacokinetic parameters are increasingly being used in the routine clinical setting. This review consists of two parts. The first part discusses the advantages and disadvantages of the MR pulse sequences that can be used for performing DCE-MRI and also of the most widely used pharmacokinetic parameters and models and the parameters they describe. The second part outlines the range of current and potential future clinical applications of DCE-MRI and pharmacokinetic parametric maps in patients with prostate cancer, with reference to the current scientific literature on the topic. The potential clinical applications of DCE-MRI for prostate cancer include detection, localization, and staging, differentiation of recurrent cancer and estimation of the patient's prognosis, as well as monitoring of treatment response.
动态对比增强磁共振成像(DCE-MRI)可无创分析前列腺血管生成以及前列腺癌的毛细血管通透性特征。药代动力学模型可对信号强度-时间曲线提供的复杂信息进行总结,从而得到少数几个定量药代动力学参数,目前已越来越多地应用于常规临床实践中。本文综述分两部分:第一部分讨论了用于 DCE-MRI 的磁共振脉冲序列的优缺点,以及最广泛应用的药代动力学参数和模型及其所描述的参数;第二部分参考目前该主题的科学文献,概述了 DCE-MRI 及其药代动力学参数图在前列腺癌患者中的一系列当前和潜在的临床应用。DCE-MRI 在前列腺癌中的潜在临床应用包括:检测、定位和分期、复发性癌症的鉴别以及患者预后的评估,以及治疗反应的监测。