Ueda Yu, Takahashi Satoru, Ohno Naoki, Kyotani Katsusuke, Kawamitu Hideaki, Miyati Tosiaki, Aoyama Nobukazu, Ueno Yoshiko, Kitajima Kazuhiro, Kawakami Fumi, Okuaki Tomoyuki, Tsukamoto Ryuko, Yanagita Emmy, Sugimura Kazuro
Division of Radiology, Kobe University Hospital, Chuo-ku Kobe, Hyogo, Japan.
Department of Radiology, Kobe University Hospital, Chuo-ku Kobe, Hyogo, Japan.
J Magn Reson Imaging. 2016 Jan;43(1):138-48. doi: 10.1002/jmri.24974. Epub 2015 Jun 27.
To evaluate more detailed information noninvasively through on diffusion and perfusion in prostate cancer (PCa) using triexponential analysis of diffusion-weighted imaging (DWI).
Sixty-three prostate cancer patients underwent preoperative 3.0 Tesla MRI including eight b-values DWI. Triexponential analysis was performed to obtain three diffusion coefficients (Dp , Df , Ds ), as well as fractions (Fp , Ff , Fs ). Each diffusion parameter for cancerous lesions and normal tissues was compared and the relationship between diffusion parameters and Gleason score (GS) was assessed. K(trans) , Ve , and the ratios of intracellular components measured in histopathological specimens were compared with diffusion parameters.
Dp was significantly greater for cancerous lesions than normal peripheral zone (PZ) (P < 0.001), whereas Dp in transition zone (TZ) showed no significant difference (P = 0.74, 95% confidence interval (CI) = -4.69-6.48). Ds was significantly smaller for each cancerous lesions in PZ and TZ (P < 0.001, respectively). There was no significant difference in Df between cancerous lesions and normal tissues in PZ and TZ (P = 0.07, 95% CI = -0.29-0.12 and P = 0.53, 95% CI = -3.51-2.29, respectively). D obtained with biexponential analysis were significantly smaller in cancerous lesions than in normal tissue in PZ and TZ (P < 0.001 for both), while D* in PZ and TZ showed no significant difference (P = 0.14, 95% CI = -1.60-0.24 and P = 0.31, 95% CI = -3.43-1.16, respectively). Dp in PZ and TZ showed significant correlation with K(trans) (R = 0.85, P < 0.001; R = 0.81, P < 0.001, respectively), while D(*) in PZ obtained with biexponential analysis showed no such correlation (P = 0.08, 95% CI = -0.14-0.30). Fs was significantly correlated with intracellular space fraction evaluated in histopathological specimens in PZ and TZ cancer (R = 0.41, P < 0.05; R = 0.59, P < 0.001, respectively). Ff and Fs correlated significantly with GS in PZ and TZ cancer (PZ: R = -0.44, P < 0.05; R = 0.37, P < 0.05, TZ: R = -0.59, P < 0.05; R = 0.57, P < 0.05, respectively).
Triexponential analysis is a noninvasive approach that can provide more detailed information regarding diffusion and perfusion of PCa than biexponential analysis.
采用扩散加权成像（DWI）的三指数分析，通过对前列腺癌（PCa）的扩散和灌注进行无创评估，以获取更详细的信息。
63例前列腺癌患者术前行3.0特斯拉MRI检查，包括具有8个b值的DWI。进行三指数分析以获得三个扩散系数（Dp、Df、Ds）以及分数（Fp、Ff、Fs）。比较癌灶和正常组织的每个扩散参数，并评估扩散参数与 Gleason 评分（GS）之间的关系。将组织病理学标本中测得的K(trans)、Ve和细胞内成分的比率与扩散参数进行比较。
癌灶的Dp显著高于正常外周带（PZ）（P < 0.001），而移行带（TZ）的Dp无显著差异（P = 0.74，95%置信区间（CI）= -4.69 - 6.48）。PZ和TZ中每个癌灶的Ds均显著较小（分别为P < 0.001）。PZ和TZ中癌灶与正常组织之间的Df无显著差异（分别为P = 0.07，95% CI = -0.29 - 0.12和P = 0.53，95% CI = -3.51 - 2.29）。双指数分析获得的PZ和TZ中癌灶的D均显著小于正常组织（两者均为P < 0.001），而PZ和TZ中的D无显著差异（分别为P = 0.14，95% CI = -1.60 - 0.24和P = 0.31，95% CI = -3.43 - 1.16）。PZ和TZ中的Dp与K(trans)显著相关（分别为R = 0.85，P < 0.001；R = 0.81，P < 0.001），而双指数分析获得的PZ中的D()无此类相关性（P = 0.08，95% CI = -0.14 - 0.30）。PZ和TZ癌中Fs与组织病理学标本中评估的细胞内空间分数显著相关（分别为R = 0.41，P < 0.05；R = 0.59，P < 0.001）。PZ和TZ癌中Ff和Fs与GS显著相关（PZ：R = -0.44，P < 0.05；R = 0.37，P < 0.05，TZ：R = -0.59，P < 0.05；R = 0.57，P < 0.05）。
三指数分析是一种无创方法，可以比双指数分析提供更多关于PCa扩散和灌注的详细信息。
