前列腺癌的非高斯水扩散峰度成像
Non-Gaussian water diffusion kurtosis imaging of prostate cancer.
作者信息
Suo Shiteng, Chen Xiaoxi, Wu Lianming, Zhang Xiaofei, Yao Qiuying, Fan Yu, Wang He, Xu Jianrong
机构信息
Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
Global Applied Science Laboratory, GE Healthcare, Shanghai 201203, China.
出版信息
Magn Reson Imaging. 2014 Jun;32(5):421-7. doi: 10.1016/j.mri.2014.01.015. Epub 2014 Jan 30.
PURPOSE
To evaluate the non-Gaussian water diffusion properties of prostate cancer (PCa) and determine the diagnostic performance of diffusion kurtosis (DK) imaging for distinguishing PCa from benign tissues within the peripheral zone (PZ), and assessing tumor lesions with different Gleason scores.
MATERIALS AND METHODS
Nineteen patients who underwent diffusion weighted (DW) magnetic resonance imaging using multiple b-values and were pathologically confirmed with PCa were enrolled in this study. Apparent diffusion coefficient (ADC) was derived using a monoexponential model, while diffusion coefficient (D) and kurtosis (K) were determined using a DK model. Differences between the ADC, D and K values of benign PZ and PCa, as well as those of tumor lesions with Gleason scores of 6, 7 and ≥8 were assessed. Correlations between parameters D and K in PCa were analyzed using Pearson's correlation coefficient. ADC, D and K values were correlated with Gleason scores of 6, 7 and ≥8, respectively.
RESULTS
ADC and D values were significantly (p<0.001) lower in PCa (0.79±0.14μm(2)/ms and 1.56±0.23μm(2)/ms, respectively) compared to benign PZ (1.23±0.19μm(2)/ms and 2.54±0.24μm(2)/ms, respectively). K values were significantly (p<0.001) greater in PCa (0.96±0.20) compared to benign PZ (0.59±0.08). D and K showed fewer overlapping values between benign PZ and PCa compared to ADC. There was a strong negative correlation between D and K values in PCa (Pearson correlation coefficient r=-0.729; p<0.001). ADC and K values differed significantly in tumor lesions with Gleason scores of 6, 7 and ≥8 (p<0.001 and p=0.001, respectively), although no significant difference was detected for D values (p=0.325). Significant correlations were found between the ADC value and Gleason score (r=-0.828; p<0.001), as well as the K value and Gleason score (r=0.729; p<0.001).
CONCLUSION
DK model may add value in PCa detection and diagnosis. K potentially offers a new metric for assessment of PCa.
目的
评估前列腺癌（PCa）的非高斯水扩散特性，确定扩散峰度（DK）成像在区分外周带（PZ）内的PCa与良性组织以及评估不同Gleason评分的肿瘤病变方面的诊断性能。
材料与方法
本研究纳入了19例接受多b值扩散加权（DW）磁共振成像且经病理证实为PCa的患者。使用单指数模型得出表观扩散系数（ADC），同时使用DK模型确定扩散系数（D）和峰度（K）。评估良性PZ与PCa的ADC、D和K值之间的差异，以及Gleason评分为6、7和≥8的肿瘤病变之间的差异。使用Pearson相关系数分析PCa中参数D和K之间的相关性。ADC、D和K值分别与Gleason评分为6、7和≥8相关。
结果
与良性PZ（分别为1.23±0.19μm²/ms和2.54±0.24μm²/ms）相比，PCa的ADC和D值显著更低（分别为0.79±0.14μm²/ms和1.56±0.23μm²/ms，p<0.001）。与良性PZ（0.59±0.08）相比，PCa的K值显著更高（0.96±0.20，p<0.001）。与ADC相比，D和K在良性PZ与PCa之间的重叠值更少。PCa中D和K值之间存在强负相关（Pearson相关系数r=-0.729；p<0.001）。Gleason评分为6、7和≥8的肿瘤病变中，ADC和K值存在显著差异（分别为p<0.001和p=），尽管D值未检测到显著差异（p=0.325）。ADC值与Gleason评分之间存在显著相关性（r=-0.828；p<0.001），K值与Gleason评分之间也存在显著相关性（r=0.729；p<0.001）。
结论
DK模型可能在PCa检测和诊断中具有附加价值。K可能为PCa评估提供一种新的指标。
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