Department of Radiology, NYU Langone Medical Center, New York, NY 10016, USA.
Clin Radiol. 2012 Dec;67(12):e83-90. doi: 10.1016/j.crad.2012.08.014. Epub 2012 Sep 13.
To assess impact of haemorrhage and delay after biopsy on prostate tumour detection using multi-parametric (MP) magnetic resonance imaging (MRI) assessment.
Forty-four patients underwent prostate MRI at 1.5 T using a pelvic phased-array coil, including T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and dynamic contrast-enhanced (DCE) imaging, before prostatectomy. Three radiologists independently reviewed images during four sessions [T2WI, DWI, DCE, and all parameters combined (MP-MRI)] to assess for tumour in each sextant. In a separate session, readers reviewed T1WI to score the extent of haemorrhage per sextant. Accuracy was assessed using logistic regression for correlated data.
There was no significant difference in accuracy between readers for any session (p ≥ 0.166), and results were averaged across the three readers for remaining comparisons. Accuracy was significantly greater for MP-MRI than for any parameter alone (p ≤ 0.020). For T2WI alone, there was a trend toward decreased sensitivity in sextants with extensive haemorrhage (p = 0.072). However, accuracy, sensitivity, and specificity were otherwise similar for sextants with and without extensive haemorrhage for all sessions (p = 0.192-0.934). No session showed a significant improvement in accuracy, sensitivity, or specificity in cases with delay after biopsy of over 4 weeks compared with shorter delay.
Extensive haemorrhage and short delay after biopsy did not negatively impact accuracy for tumour detection using MP-MRI. Further studies using MP-MRI protocols and interpretation schemes from other institutions are required to confirm these observations.
评估使用多参数（MP）磁共振成像（MRI）评估在活检后出血和延迟对前列腺肿瘤检测的影响。
44 例患者在 1.5T 下使用盆腔相控阵线圈进行前列腺 MRI 检查，包括 T1 加权成像（T1WI）、T2 加权成像（T2WI）、扩散加权成像（DWI）和动态对比增强（DCE）成像，然后进行前列腺切除术。三位放射科医生在四个阶段[T2WI、DWI、DCE 和所有参数组合（MP-MRI）]独立评估图像，以评估每个六分区的肿瘤。在单独的阶段，读者评估 T1WI 以按六分区评分出血程度。使用逻辑回归对相关数据进行准确性评估。
对于任何阶段，读者之间的准确性都没有显著差异（p≥0.166），并且在剩余的比较中，结果在三位读者之间平均。MP-MRI 的准确性明显高于任何单独参数（p≤0.020）。对于 T2WI 单独使用，在广泛出血的六分区中，敏感性呈下降趋势（p=0.072）。然而，对于所有阶段，广泛出血和无广泛出血的六分区的准确性、敏感性和特异性相似（p=0.192-0.934）。在活检后延迟超过 4 周的病例中，与较短的延迟相比，没有一个阶段在准确性、敏感性或特异性方面显示出明显的改善。
使用 MP-MRI 检测肿瘤时，广泛出血和活检后短时间延迟不会对准确性产生负面影响。需要使用来自其他机构的 MP-MRI 协议和解释方案进行进一步研究，以证实这些观察结果。
