Ream Justin M, Doshi Ankur M, Dunst Diane, Parikh Nainesh, Kong Max X, Babb James S, Taneja Samir S, Rosenkrantz Andrew B
Department of Radiology, NYU Langone Medical Center, New York, New York, USA.
Department of Pathology, NYU Langone Medical Center, New York, New York, USA.
J Magn Reson Imaging. 2017 May;45(5):1464-1475. doi: 10.1002/jmri.25451. Epub 2016 Sep 20.
To assess the effects of temporal resolution (R ) in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) on qualitative tumor detection and quantitative pharmacokinetic parameters in prostate cancer.
This retrospective Institutional Review Board (IRB)-approved study included 58 men (64 ± 7 years). They underwent 3T prostate MRI showing dominant peripheral zone (PZ) tumors (24 with Gleason ≥ 4 + 3), prior to prostatectomy. Continuously acquired DCE utilizing GRASP (Golden-angle RAdial Sparse Parallel) was retrospectively reconstructed at R of 1.4 sec, 3.7 sec, 6.0 sec, 9.7 sec, and 14.9 sec. A reader placed volumes-of-interest on dominant tumors and benign PZ, generating quantitative pharmacokinetic parameters (k , v ) at each R . Two blinded readers assessed each R for lesion presence, location, conspicuity, and reader confidence on a 5-point scale. Data were assessed by mixed-model analysis of variance (ANOVA), generalized estimating equation (GEE), and receiver operating characteristic (ROC) analysis.
R did not affect sensitivity (R1 : 69.0%-72.4%, all P = 1.000; R1 : 83.3-91.7%, all P = 1.000; R2 : 60.3-69.0%, all P = 1.000; R2 : 58.3%-79.2%, all P = 1.000). R1 reported greater conspicuity of GS ≥ 4 + 3 tumors at R of 1.4 sec vs. 14.9 sec (4.29 ± 1.23 vs. 3.46 ± 1.44; P = 0.029). No other tumor conspicuity pairwise comparison reached significance (R1 : 2.98-3.43, all P ≥ 0.205; R2 : 2.57-3.19, all P ≥ 0.059; R1 : 3.46-4.29, all other P ≥ 0.156; R2 : 2.92-3.71, all P ≥ 0.439). There was no effect of R on reader confidence (R1 : 3.17-3.34, all P = 1.000; R2 : 2.83-3.19, all P ≥ 0.801; R1 : 3.79-4.21, all P = 1.000; R2 : 3.13-3.79, all P = 1.000). k and v of tumor and benign tissue did not differ across R (all adjusted P values [P ] = 1.000). R did not significantly affect area under the curve (AUC) of K or v for differentiating tumor from benign (all P = 1.000).
Current PI-RADS recommendations for R of 10 seconds may be sufficient, with further reduction to the stated PI-RADS preference of R ≤ 7 seconds offering no benefit in tumor detection or quantitative analysis.
3 J. MAGN. RESON. IMAGING 2017;45:1464-1475.
评估动态对比增强磁共振成像（DCE-MRI）中的时间分辨率（R）对前列腺癌定性肿瘤检测和定量药代动力学参数的影响。
这项经机构审查委员会（IRB）批准的回顾性研究纳入了58名男性（64±7岁）。他们在前列腺切除术前接受了3T前列腺MRI检查，显示主要为外周带（PZ）肿瘤（24例Gleason评分≥4+3）。利用GRASP（黄金角径向稀疏并行）连续采集的DCE在1.4秒、3.7秒、6.0秒、9.7秒和14.9秒的R值下进行回顾性重建。一名阅片者在主要肿瘤和良性PZ上放置感兴趣区，在每个R值下生成定量药代动力学参数（k，v）。两名盲法阅片者以5分制评估每个R值下病变的存在、位置、清晰度和阅片者信心。数据通过方差分析（ANOVA）的混合模型分析、广义估计方程（GEE）和受试者操作特征（ROC）分析进行评估。
R值不影响敏感性（R1：69.0%-72.4%，所有P=1.000；R1：83.3-91.7%，所有P=1.000；R2：60.3-69.0%，所有P=1.000；R2：58.3%-79.2%，所有P=1.000）。R1报告在1.4秒的R值下，GS≥4+3肿瘤比14.9秒时更清晰（4.29±1.23对3.46±1.44；P=0.029）。没有其他肿瘤清晰度的成对比较达到显著差异（R1：2.98-3.43，所有P≥0.205；R2：2.57-3.19，所有P≥0.059；R1：3.46-4.29，所有其他P≥0.156；R2：2.92-3.71，所有P≥0.439）。R值对阅片者信心没有影响（R1：3.17-3.34，所有P=1.000；R2：2.83-3.19，所有P≥0.801；R1：3.79-4.21，所有P=1.000；R2：3.13-3.79，所有P=1.000）。肿瘤和良性组织的k和v在不同R值下没有差异（所有校正P值[P] = 1.000）。R值对区分肿瘤与良性的K或v曲线下面积（AUC）没有显著影响（所有P=1.000）。
目前前列腺影像报告和数据系统（PI-RADS）推荐的10秒R值可能就足够了，进一步降低到PI-RADS规定的首选R≤7秒对肿瘤检测或定量分析没有益处。
3 J.MAGN.RESON.IMAGING 2017；45：1464-1475。
