Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
J Urol. 2011 Nov;186(5):1818-24. doi: 10.1016/j.juro.2011.07.013. Epub 2011 Sep 25.
We determined the prostate cancer detection rate of multiparametric magnetic resonance imaging at 3T. Precise one-to-one histopathological correlation with magnetic resonance imaging was possible using prostate magnetic resonance imaging based custom printed specimen molds after radical prostatectomy.
This institutional review board approved prospective study included 45 patients (mean age 60.2 years, range 49 to 75) with a mean prostate specific antigen of 6.37 ng/ml (range 2.3 to 23.7) who had biopsy proven prostate cancer (mean Gleason score of 6.7, range 6 to 9). Before prostatectomy all patients underwent prostate magnetic resonance imaging using endorectal and surface coils on a 3T scanner, which included triplane T2-weighted magnetic resonance imaging, apparent diffusion coefficient maps of diffusion weighted magnetic resonance imaging, dynamic contrast enhanced magnetic resonance imaging and spectroscopy. The prostate specimen was whole mount sectioned in a customized mold, allowing geometric alignment to magnetic resonance imaging. Tumors were mapped on magnetic resonance imaging and histopathology. Sensitivity, specificity, positive predictive value and negative predictive value of magnetic resonance imaging for cancer detection were calculated. In addition, the effects of tumor size and Gleason score on the sensitivity of multiparametric magnetic resonance imaging were evaluated.
The positive predictive value of multiparametric magnetic resonance imaging to detect prostate cancer was 98%, 98% and 100% in the overall prostate, peripheral zone and central gland, respectively. The sensitivity of magnetic resonance imaging sequences was higher for tumors larger than 5 mm in diameter as well as for those with higher Gleason scores (greater than 7, p <0.05).
Prostate magnetic resonance imaging at 3T allows for the detection of prostate cancer. A multiparametric approach increases the predictive power of magnetic resonance imaging for diagnosis. In this study accurate correlation between multiparametric magnetic resonance imaging and histopathology was obtained by the patient specific, magnetic resonance imaging based mold technique.
我们确定了 3T 多参数磁共振成像对前列腺癌的检出率。在根治性前列腺切除术后，使用基于前列腺磁共振成像的定制打印标本模具，可以实现与磁共振成像的精确一对一组织病理学相关性。
这项经机构审查委员会批准的前瞻性研究纳入了 45 名患者（平均年龄 60.2 岁，范围为 49 至 75 岁），他们的前列腺特异性抗原平均为 6.37ng/ml（范围为 2.3 至 23.7），经活检证实患有前列腺癌（平均 Gleason 评分为 6.7，范围为 6 至 9）。在前列腺切除术前，所有患者均在 3T 扫描仪上使用直肠内和表面线圈进行前列腺磁共振成像，包括三轴 T2 加权磁共振成像、扩散加权磁共振成像的表观扩散系数图、动态对比增强磁共振成像和波谱分析。前列腺标本在定制模具中进行整体切片，允许与磁共振成像进行几何对齐。在磁共振成像和组织病理学上对肿瘤进行映射。计算磁共振成像对癌症检测的敏感性、特异性、阳性预测值和阴性预测值。此外，还评估了肿瘤大小和 Gleason 评分对多参数磁共振成像敏感性的影响。
多参数磁共振成像对整个前列腺、外周区和中央区前列腺癌的阳性预测值分别为 98%、98%和 100%。磁共振成像序列的敏感性对于直径大于 5 毫米的肿瘤以及 Gleason 评分较高（大于 7）的肿瘤更高（p<0.05）。
3T 前列腺磁共振成像可检测前列腺癌。多参数方法增加了磁共振成像对诊断的预测能力。在这项研究中，通过患者特异性、基于磁共振成像的模具技术，获得了多参数磁共振成像与组织病理学之间的精确相关性。
