Department of Technical Medicine, University of Twente, Enschede, The Netherlands.
Radiology. 2013 Apr;267(1):164-72. doi: 10.1148/radiol.12111683. Epub 2013 Jan 17.
To determine if prostatitis and prostate cancer (PCa) can be distinguished by using apparent diffusion coefficients (ADCs) on magnetic resonance (MR) images, with specimens obtained at MR-guided biopsy as the standard of reference.
The need for institutional review board approval and informed consent was waived. MR-guided biopsies were performed in 130 consecutive patients with cancer-suspicious regions (CSRs) on multiparametric MR images obtained at 3 T. In this retrospective study, 88 patients met the inclusion criteria. During the biopsy procedure, an axial diffusion-weighted sequence was performed and ADC maps were generated (repetition time msec/echo time msec, 2000/67; section thickness, 4 mm; in-plane resolution, 1.8 × 1.8 mm; and b values of 0, 100, 500, and 800 sec/mm(2)). Subsequently, a confirmation image with the needle left in situ was acquired and projected on the ADC map. The corresponding ADCs at the biopsy location were compared with the histopathologic outcomes of the biopsy specimens. Linear mixed-model regression analyses were used to test for ADC differences between the histopathologic groups.
The study included 116 biopsy specimens. Median ADCs of normal prostate tissue, prostatitis, low-grade PCa (Gleason grade components 2 or 3), and high-grade PCa (Gleason grade components 4 or 5) were 1.22 × 10(-3) mm(2)/sec (standard deviation, ± 0.21), 1.08 × 10(-3) mm(2)/sec (± 0.18), 0.88 × 10(-3) mm(2)/sec (± 0.15), and 0.88 × 10(-3) mm(2)/sec (± 0.13), respectively. Although the median ADCs of biopsy specimens with prostatitis were significantly higher compared with low- and high-grade PCa (P < .001), there is a considerable overlap between the tissue types.
Diffusion-weighted imaging is a noninvasive technique that shows differences between prostatitis and PCa in both the peripheral zone and central gland, although its usability in clinical practice is limited as a result of significant overlap in ADCs.
通过磁共振（MR）图像上的表观扩散系数（ADC）来确定前列腺炎和前列腺癌（PCa）是否可以区分，以 MR 引导活检的标本作为参考标准。
本研究获得了机构审查委员会的批准豁免和知情同意。在 3T 多参数 MR 图像上获得癌症可疑区域（CSR）的 130 例连续患者进行了 MR 引导活检。在这项回顾性研究中，88 例患者符合纳入标准。在活检过程中，进行了轴向扩散加权序列并生成 ADC 图（重复时间毫秒/回波时间毫秒，2000/67；层厚 4 毫米；平面分辨率 1.8×1.8 毫米；b 值为 0、100、500 和 800 sec/mm(2)）。随后，采集一个带有原位针尖的确认图像并将其投影到 ADC 图上。将活检部位的相应 ADC 与活检标本的组织病理学结果进行比较。使用线性混合模型回归分析来测试组织病理学组之间的 ADC 差异。
研究包括 116 个活检标本。正常前列腺组织、前列腺炎、低级别 PCa（Gleason 分级成分 2 或 3）和高级别 PCa（Gleason 分级成分 4 或 5）的平均 ADC 值分别为 1.22×10(-3)mm(2)/sec（标准差±0.21）、1.08×10(-3)mm(2)/sec（标准差±0.18）、0.88×10(-3)mm(2)/sec（标准差±0.15）和 0.88×10(-3)mm(2)/sec（标准差±0.13）。尽管前列腺炎活检标本的平均 ADC 值明显高于低级别和高级别 PCa（P<.001），但组织类型之间存在相当大的重叠。
扩散加权成像技术是一种非侵入性技术，可显示前列腺炎和 PCa 在周围区和中央腺体之间的差异，尽管由于 ADC 显著重叠，其在临床实践中的可用性受到限制。
