From INSERM, U1032, LabTau, Lyon, France (A.H.D., R.S., J.L., F.B., S.C., O.R.); CNRS, UMR 5553, BP 53, Grenoble, France (C.M.); Laboratoire d'Ecologie Alpine, Université Joseph Fourier, Grenoble, France (C.M.); Department of Urinary and Vascular Imaging (F.B., O.R.), Department of Pathology (F.M.L.), and Department of Urology (S.C., M.C.), Hospices Civils de Lyon, Hôpital Edouard Herriot, Pavillon P Radio, 5 place d'Arsonval, Lyon 69003, France; Université Lyon 1, Faculté de Médecine Lyon Est, Lyon, France (F.B., S.C., M.C., O.R.); and Department of Urology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre Bénite, France (A.R.).
Radiology. 2016 Jul;280(1):117-27. doi: 10.1148/radiol.2016151406. Epub 2016 Feb 9.
Purpose To assess the intermanufacturer variability of quantitative models in discriminating cancers with a Gleason score of at least 7 among peripheral zone (PZ) lesions seen at 3-T multiparametric magnetic resonance (MR) imaging. Materials and Methods An institutional review board-approved prospective database of 257 patients who gave written consent and underwent T2-weighted, diffusion-weighted, and dynamic contrast material-enhanced imaging before prostatectomy was retrospectively reviewed. It contained outlined lesions found to be suspicious for malignancy by two independent radiologists and classified as malignant or benign after correlation with prostatectomy whole-mount specimens. One hundred six patients who underwent imaging with 3-T MR systems from two manufacturers were selected (data set A, n = 72; data set B, n = 34). Eleven parameters were calculated in PZ lesions: normalized T2-weighted signal intensity, skewness and kurtosis of T2-weighted signal intensity, T2 value, wash-in rate, washout rate, time to peak (TTP), mean apparent diffusion coefficient (ADC), 10th percentile of the ADC, and skewness and kurtosis of the histogram of the ADC values. Parameters were selected on the basis of their specificity for a sensitivity of 0.95 in diagnosing cancers with a Gleason score of at least 7, and the area under the receiver operating characteristic curve (AUC) for the models was calculated. Results The model of the 10th percentile of the ADC with TTP yielded the highest AUC in both data sets. In data set A, the AUC was 0.90 (95% confidence interval [CI]: 0.85, 0.95) or 0.89 (95% CI: 0.82, 0.94) when it was trained in data set A or B, respectively. In data set B, the AUC was 0.84 (95% CI: 0.74, 0.94) or 0.86 (95% CI: 0.76, 0.95) when it was trained in data set A or B, respectively. No third variable added significantly independent information in any data set. Conclusion The model of the 10th percentile of the ADC with TTP yielded accurate results in discriminating cancers with a Gleason score of at least 7 among PZ lesions at 3 T in data from two manufacturers. (©) RSNA, 2016 Online supplemental material is available for this article.
目的 在 3T 多参数磁共振成像中，评估用于区分外周带（PZ）病变中至少 7 分前列腺癌的定量模型在不同制造商之间的可变性。
材料与方法 本研究经机构审查委员会批准，回顾性分析了 257 例患者的前瞻性数据库，这些患者均书面同意并在前列腺切除术前接受了 T2 加权、扩散加权和动态对比增强成像。该数据库包含由 2 位独立放射科医生评估为可疑恶性的病变，并与前列腺切除术后的全切片标本进行对比后，分为恶性或良性病变。从 2 家制造商的 3T MR 系统中选择了 106 例患者（数据集 A，n=72；数据集 B，n=34）。在 PZ 病变中计算了 11 个参数：T2 加权信号强度的归一化值、T2 加权信号强度的偏度和峰度、T2 值、灌注率、洗脱率、达峰时间（TTP）、平均表观扩散系数（ADC）值、ADC 值的第 10 百分位数、ADC 值直方图的偏度和峰度。基于诊断至少 7 分前列腺癌的特异性为 0.95 选择参数，并计算模型的受试者工作特征曲线（AUC）下面积。
结果 在这两个数据集，ADC 值第 10 百分位数与 TTP 的模型产生了最高 AUC。在数据集 A 中，当分别在数据集 A 或 B 中进行训练时，AUC 为 0.90（95%置信区间[CI]：0.85，0.95）或 0.89（95% CI：0.82，0.94）。在数据集 B 中，当分别在数据集 A 或 B 中进行训练时，AUC 为 0.84（95% CI：0.74，0.94）或 0.86（95% CI：0.76，0.95）。在任何数据集，没有第三个变量提供独立的显著信息。
结论 在两个制造商的 3T 数据中，ADC 值第 10 百分位数与 TTP 的模型在区分 PZ 病变中至少 7 分的前列腺癌方面产生了准确的结果。
（©）RSNA，2016 在线补充材料可在本文中获得。
