Li Liang, Margolis Daniel J A, Deng Ming, Cai Jie, Yuan Ling, Feng Zhaoyan, Min Xiangde, Hu Zhiquan, Hu Daoyu, Liu Jihong, Wang Liang
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Radiology, David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, Los Angeles, California, USA.
J Magn Reson Imaging. 2015 Aug;42(2):460-7. doi: 10.1002/jmri.24813. Epub 2014 Dec 3.
To investigate tumor aggressiveness in peripheral zone prostate cancer (PCa) by correlating Gleason score (GS) with diffusion tensor imaging (DTI) from multiparametric magnetic resonance imaging (MRI) at 3.0 Tesla (T).
Eighty-three patients with pathological proven peripheral zone PCa whose GS in at least one core biopsy met the criteria(GS ≤3+3, GS 3+4, GS 4+3, or GS ≥4+4) were included in this study. DTI was performed using b values of 0 and 800 s/mm(2) with 32 directions in all patients on a 3.0T MRI scanner. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were calculated from the DTI data of patients with the previously mentioned four categories of Gleason scores. An association between DTI measurements(FA, ADC) and GS was tested using the Spearman rank correlation analysis.
FA values in the sextants found to harbor cancer were positively correlated with the GS(r = 0.48; P < 0.001), while the ADC values were negatively correlated with GS(r = -0.54; P < 0.001). Statistical significance(P < 0.05) was found for FA values among different GS groups, with the exception of GS 3+4 versus GS 4+3 (P = 0.105). The differences between the ADC values were statistically significant for all four different scores(all P < 0.05).
Quantitative DTI at 3.0T MRI shows a significant association with GS in the evaluation of tumor aggressiveness in peripheral zone PCa, which may be useful to ensure concordance of biopsy results and therefore make the appropriate decision in the management of patients with PCa.
通过将 Gleason 评分（GS）与 3.0 特斯拉（T）多参数磁共振成像（MRI）的扩散张量成像（DTI）相关联，研究外周带前列腺癌（PCa）的肿瘤侵袭性。
本研究纳入了 83 例经病理证实的外周带 PCa 患者，其至少一次穿刺活检的 GS 符合标准（GS≤3 + 3、GS 3 + 4、GS 4 + 3 或 GS≥4 + 4）。所有患者均在 3.0T MRI 扫描仪上使用 b 值为 0 和 800 s/mm² 且具有 32 个方向进行 DTI 检查。从上述四类 Gleason 评分患者的 DTI 数据中计算出分数各向异性（FA）和表观扩散系数（ADC）值。使用 Spearman 秩相关分析测试 DTI 测量值（FA、ADC）与 GS 之间的关联。
发现存在癌症的扇形区域中的 FA 值与 GS 呈正相关（r = 0.48；P < 0.001），而 ADC 值与 GS 呈负相关（r = -0.54；P < 0.001）。除 GS 3 + 4 与 GS 4 + 3 之间（P = 0.105）外，不同 GS 组之间的 FA 值具有统计学意义（P < 0.05）。所有四个不同评分之间的 ADC 值差异均具有统计学意义（所有 P < 0.05）。
3.0T MRI 的定量 DTI 在评估外周带 PCa 的肿瘤侵袭性方面与 GS 显示出显著关联，这可能有助于确保活检结果的一致性，从而在 PCa 患者的管理中做出适当决策。
