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磁共振弹性成像测量癌症及病理固定对前列腺生物力学的影响,并与T2、T2*及表观扩散系数进行比较。

MR elastography to measure the effects of cancer and pathology fixation on prostate biomechanics, and comparison with T , T and ADC.

作者信息

McGrath Deirdre M, Lee Jenny, Foltz Warren D, Samavati Navid, van der Kwast Theo, Jewett Michael A S, Chung Peter, Ménard Cynthia, Brock Kristy K

机构信息

Radiation Medicine Program, Princess Margaret Hospital, University Health Network, Toronto, Ontario M5G 2M9, Canada.

出版信息

Phys Med Biol. 2017 Feb 7;62(3):1126-1148. doi: 10.1088/1361-6560/aa52f4.

Abstract

MRI is under evaluation for image-guided intervention for prostate cancer. The sensitivity and specificity of MRI parameters is determined via correlation with the gold-standard of histopathology. Whole-mount histopathology of prostatectomy specimens can be digitally registered to in vivo imaging for correlation. When biomechanical-based deformable registration is employed to account for deformation during histopathology processing, the ex vivo biomechanical properties are required. However, these properties are altered by pathology fixation, and vary with disease. Hence, this study employs magnetic resonance elastography (MRE) to measure ex vivo prostate biomechanical properties before and after fixation. A quasi-static MRE method was employed to measure high resolution maps of Young's modulus (E) before and after fixation of canine prostate and prostatectomy specimens (n  =  4) from prostate cancer patients who had previously received radiation therapy. For comparison, T , T and apparent diffusion coefficient (ADC) were measured in parallel. E (kPa) varied across clinical anatomy and for histopathology-identified tumor: peripheral zone: 99(±22), central gland: 48(±37), tumor: 85(±53), and increased consistently with fixation (factor of 11  ±  5; p  <  0.02). T decreased consistently with fixation, while changes in T and ADC were more complex and inconsistent. The biomechanics of the clinical prostate specimens varied greatly with fixation, and to a lesser extent with disease and anatomy. The data obtained will improve the precision of prostate pathology correlation, leading to more accurate disease detection and targeting.

摘要

磁共振成像(MRI)正在接受评估,用于前列腺癌的图像引导干预。MRI参数的敏感性和特异性通过与组织病理学金标准的相关性来确定。前列腺切除标本的全层组织病理学可以进行数字配准,以与体内成像进行相关性分析。当采用基于生物力学的可变形配准来考虑组织病理学处理过程中的变形时,需要离体生物力学特性。然而,这些特性会因病理固定而改变,并随疾病而变化。因此,本研究采用磁共振弹性成像(MRE)来测量固定前后离体前列腺的生物力学特性。采用准静态MRE方法测量了犬前列腺和前列腺癌患者前列腺切除标本(n = 4)固定前后的杨氏模量(E)高分辨率图,这些患者之前接受过放射治疗。作为比较,同时测量了T2、T2和表观扩散系数(ADC)。E(kPa)在不同临床解剖结构和组织病理学确定的肿瘤中有所不同:外周区:99(±22),中央腺体:48(±37),肿瘤:85(±53),并且随着固定一致增加(系数为11 ± 5;p < 0.02)。T2随着固定一致降低,而T2和ADC的变化更为复杂且不一致。临床前列腺标本的生物力学随固定变化很大,在较小程度上随疾病和解剖结构而变化。获得的数据将提高前列腺病理相关性的精度,从而实现更准确的疾病检测和靶向。

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