Pontifical Catholic University of Peru, Engineering Department, Electrical and Electronics Section, Medical Imaging Lab, San Miguel, Lima 32, Peru.
Academic Department of Radiology, Hôpital Pitié-Salpêtrière, AP-HP, UPMC University Paris 06, 75013 Paris, France.
Diagn Interv Imaging. 2017 May;98(5):423-428. doi: 10.1016/j.diii.2017.02.004. Epub 2017 Mar 15.
The purpose of this study was to determine the accuracy of manual semi-automated and volumetric measurements to assess prostate cancer volume on multiparametric magnetic resonance imaging (MP-MRI) using whole-mount histopathology for validation.
We evaluated 30 consecutive men (median age, 65.7 years; interquartile range [IQR], 61.5-70.9 years) with a median prostatic specific antigen of 8.5ng/dL (IQR, 5.5-10.5ng/dL), who underwent MP-MRI before radical prostatectomy. Index tumor volume was determined prospectively and independently on the basis of MRI and whole-mount section volumetric assessment using the maximum histologic diameter (MHD) and the histologic volume (HV). The MRI index tumor volume was determined by two independent radiologists using a single measurement of the maximum tumor dimension (MTD), a simplified MR ellipsoid volume (MREV) calculation and a MR region of interest volume (MROV) segmentation displayed by a commercially available OsiriX. MTD was compared to MHD, whereas MREV and MROV were compared to HV.
Thirty index lesions (median HV, 1.514 cm; IQR, 0.05-3.780 cm) were analyzed. The MREV, MROV and HD were significantly correlated with each other (r>0.5). Inter-observer agreement for measurements was good for each method (r>0.780). The MTD was the best predictor of maximum histologic diameter (r=0.980 and 0.791) and had an excellent inter-variability correlation (P<0.0001).
Prostate cancer histologic volume can be assessed using MREV or MROV with a good accuracy and low inter-observer variability. MTD has the lowest inter-observer variability and provides best degrees of correlation with MHD. MTD should be used on MRI for selecting and following patients for active surveillance and staging before focal treatment of prostate cancer.
本研究旨在确定手动半自动和容积测量法在多参数磁共振成像（MP-MRI）上评估前列腺癌体积的准确性，以全组织切片病理为验证标准。
我们评估了 30 例连续男性患者（中位年龄 65.7 岁；四分位间距 [IQR] 61.5-70.9 岁），中位前列腺特异性抗原为 8.5ng/dL（IQR 5.5-10.5ng/dL），这些患者在根治性前列腺切除术前均接受了 MP-MRI 检查。指数肿瘤体积根据 MRI 和全组织切片体积评估，使用最大组织学直径（MHD）和组织学体积（HV）进行前瞻性、独立的评估。两位独立的放射科医生使用肿瘤最大径（MTD）的单次测量、简化的磁共振椭球体体积（MREV）计算和商业可得的 OsiriX 显示的磁共振感兴趣区体积（MROV）分割，对 MRI 指数肿瘤体积进行了评估。将 MTD 与 MHD 进行比较，而 MREV 和 MROV 与 HV 进行比较。
30 个指数病变（中位 HV 为 1.514cm；IQR 为 0.05-3.780cm）进行了分析。MREV、MROV 和 MHD 之间具有显著相关性（r>0.5）。每种方法的观察者间测量一致性均较好（r>0.780）。MTD 是最大组织学直径的最佳预测因子（r=0.980 和 0.791），且具有极好的变异性相关性（P<0.0001）。
MREV 或 MROV 可用于评估前列腺癌的组织学体积，具有良好的准确性和较低的观察者间变异性。MTD 的观察者间变异性最低，与 MHD 的相关性最佳。MTD 应在 MRI 上用于选择和跟踪接受主动监测和局部治疗前前列腺癌分期的患者。
