3T 直肠内磁共振弥散加权成像在前列腺癌中的应用：与全切片病理肿瘤细胞密度和 Gleason 模式百分比的相关性。
Diffusion-weighted endorectal MR imaging at 3T for prostate cancer: correlation with tumor cell density and percentage Gleason pattern on whole mount pathology.
机构信息
Department of Radiology, Brigham and Women's Hospital, Boston, MA, 02115, USA.
Department of Radiology, Charité University Hospital, Berlin, Germany.
出版信息
Abdom Radiol (NY). 2017 Mar;42(3):918-925. doi: 10.1007/s00261-016-0942-1.
OBJECTIVE
To determine if tumor cell density and percentage of Gleason pattern within an outlined volumetric tumor region of interest (TROI) on whole-mount pathology (WMP) correlate with apparent diffusion coefficient (ADC) values on corresponding TROIs outlined on pre-operative MRI.
METHODS
Men with biopsy-proven prostate adenocarcinoma undergoing multiparametric MRI (mpMRI) prior to prostatectomy were consented to this prospective study. WMP and mpMRI images were viewed using 3D Slicer and each TROI from WMP was contoured on the high b-value ADC maps (b0, 1400). For each TROI outlined on WMP, TCD (tumor cell density) and the percentage of Gleason pattern 3, 4, and 5 were recorded. The ADC, ADC, ADC, and ADC were also calculated in each case from the ADC maps using 3D Slicer.
RESULTS
Nineteen patients with 21 tumors were included in this study. ADC values for TROIs were 944.8 ± 327.4 vs. 1329.9 ± 201.6 mm/s for adjacent non-neoplastic prostate tissue (p < 0.001). ADC, ADC, and ADC values for higher grade tumors were lower than those of lower grade tumors (mean 809.71 and 1176.34 mm/s, p = 0.014; 10th percentile 613.83 and 1018.14 mm/s, p = 0.009; ratio 0.60 and 0.94, p = 0.005). TCD and ADC (ρ = -0.61, p = 0.005) and TCD and ADC (ρ = -0.56, p = 0.01) were negatively correlated. No correlation was observed between percentage of Gleason pattern and ADC values.
CONCLUSION
DWI MRI can characterize focal prostate cancer using ADC, ADC, and ADC, which correlate with pathological tumor cell density.
目的
确定在全组织病理（WMP）中勾画的感兴趣区（TROI）内的肿瘤细胞密度和格里森模式百分比是否与术前磁共振成像（mpMRI）上勾画的相应 TROI 的表观扩散系数（ADC）值相关。
方法
对经活检证实患有前列腺腺癌并在前列腺切除术前行多参数 MRI（mpMRI）的男性患者进行了这项前瞻性研究。使用 3D Slicer 查看 WMP 和 mpMRI 图像，然后在高 b 值 ADC 图（b0、1400）上对 WMP 中的每个 TROI 进行勾画。在 WMP 上勾画的每个 TROI 中，记录肿瘤细胞密度（TCD）和格里森模式 3、4 和 5 的百分比。还使用 3D Slicer 从 ADC 图中计算每个 TROI 的 ADC、ADC、ADC 和 ADC 值。
结果
本研究纳入了 19 名患者的 21 个肿瘤。TROI 的 ADC 值为 944.8±327.4 与相邻非肿瘤性前列腺组织的 1329.9±201.6mm/s（p<0.001）。高级别肿瘤的 ADC、ADC 和 ADC 值低于低级别肿瘤（平均值分别为 809.71 和 1176.34mm/s，p=0.014；10 分位数分别为 613.83 和 1018.14mm/s，p=0.009；比值分别为 0.60 和 0.94，p=0.005）。TCD 和 ADC（ρ=-0.61，p=0.005）以及 TCD 和 ADC（ρ=-0.56，p=0.01）呈负相关。格里森模式百分比与 ADC 值之间无相关性。
结论
DWI MRI 可以使用 ADC、ADC 和 ADC 来描述局灶性前列腺癌，这些参数与肿瘤细胞密度的病理结果相关。
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