Polanec Stephan H, Pinker-Domenig Katja, Brader Peter, Georg Dietmar, Shariat Shahrokh, Spick Claudio, Susani Martin, Helbich Thomas H, Baltzer Pascal A
Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, 1090, Vienna, Austria.
Division of Medical Radiation Physics, Department of Radiation Oncology, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, 1090, Vienna, Austria.
World J Urol. 2016 May;34(5):649-56. doi: 10.1007/s00345-015-1670-9. Epub 2015 Sep 25.
The aim of our study was to assess whether multiparametric magnetic resonance imaging (MP-MRI) of the prostate with three parameters (PS3: T2-weighted, DWI, and DCE) benefits from an additional fourth parameter (PS4: including (1)H-MRSI) in the detection and grading of prostate cancer (PCa) at 3 T.
MP-MRI was performed in 64 patients (mean 66.7 years, mean PSA 13 ng/ml). Reference standard was obtained by histopathology. Two readers independently evaluated the images. A summation score of each individual parameter for three parameters (PS3) and for four parameters (PS4) was calculated.
In 52 (81.3 %) of 64 patients, histopathology confirmed a PCa. The diagnostic performance for PCa detection of PS4 (O1: 91.7 %, O2: 91.3 %) equaled that of PS3 (O1: 92.8 %, O2: 92.2 %, P > 0.05). Prediction of high-grade PCa by PS4 (O1: 75.1 %, O2: 74.7 %) was as good as with PS3 (O1: 75.1 %, O2: 72.8 %, P > 0.05). Kappa agreement between the two readers was substantial (0.734 PS4) to moderate (0.558 PS3).
MP-MRI with four parameters including (1)H-MRSI does not increase the detection and grading of prostate cancer at 3 T compared to MP-MRI with three parameters. A sum score accurately detects PCa at 3 T without an endorectal coil and shows potential for the prediction of tumor grade.
我们研究的目的是评估在3T场强下，具有三个参数（PS3：T2加权成像、扩散加权成像和动态对比增强成像）的前列腺多参数磁共振成像（MP-MRI）在前列腺癌（PCa）检测及分级中加入第四个参数（PS4：包括氢磁共振波谱成像（¹H-MRSI））是否更具优势。
对64例患者（平均年龄66.7岁，平均前列腺特异性抗原（PSA）为13 ng/ml）进行MP-MRI检查。通过组织病理学获得参考标准。两名阅片者独立评估图像。计算三个参数（PS3）和四个参数（PS4）各自的总分值。
64例患者中有52例（81.3%）经组织病理学确诊为PCa。PS4对PCa检测的诊断效能（阅片者1：91.7%，阅片者2：91.3%）与PS3相当（阅片者1：92.8%，阅片者2：92.2%，P>0.05）。PS4对高级别PCa的预测效能（阅片者1：75.1%，阅片者2：74.7%）与PS3相同（阅片者1：75.1%，阅片者2：72.8%，P>0.05）。两名阅片者之间的Kappa一致性在PS4时为高度一致（0.734），在PS3时为中度一致（0.558）。
与具有三个参数的MP-MRI相比，包含¹H-MRSI的四个参数的MP-MRI在3T场强下并未提高前列腺癌的检测及分级能力。总分值能够在不使用直肠内线圈的情况下准确检测3T场强下的PCa，并显示出预测肿瘤分级的潜力。
