Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.
Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands.
J Magn Reson Imaging. 2018 Feb;47(2):439-448. doi: 10.1002/jmri.25785. Epub 2017 Jun 5.
To investigate the ability of high field ex vivo magnetic resonance imaging (MRI) to localize prostate cancer (PCa) and to predict the margin status in fresh radical prostatectomy (RP) specimens using histology as the reference standard.
This Institutional Review Board (IRB)-approved study had written informed consent. Patients with biopsy-proved PCa and a diagnostic multiparametric 3T MRI examination of the prostate prior to undergoing RP were prospectively included. A custom-made container provided reference between the 7T ex vivo MRI obtained from fresh RP specimens and histological slicing. On ex vivo MRI, PCa was localized and the presence of positive surgical margins was determined in a double-reading session. These findings were compared with histological findings obtained from completely cut, whole-mount embedded, prostate specimens.
In 12 RP specimens, histopathology revealed 36 PCa lesions, of which 17 (47%) and 20 (56%) were correlated with the ex vivo MRI in the first and second reading session, respectively. Nine of 12 (75%) index lesions were localized in the first session, in the second 10 of 12 (83%). Seven and 8 lesions of 11 lesions with Gleason score >6 and >0.5 cc were localized in the first and second session, respectively. In the first session none of the four histologically positive surgical margins (sensitivity 0%) and 9 of 13 negative margins (specificity 69%) were detected. In second session the sensitivity and specificity were 25% and 88%, respectively.
Ex vivo MRI enabled accurate localization of PCa in fresh RP specimens, and the technique provided information on the margin status with high specificity.
1 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:439-448.
利用高场离体磁共振成像（MRI）来定位前列腺癌（PCa），并使用组织学作为参考标准来预测新鲜根治性前列腺切除术（RP）标本的切缘状态。
本研究获得机构审查委员会（IRB）批准，并经患者书面知情同意。前瞻性纳入经活检证实患有 PCa 且在接受 RP 前行前列腺多参数 3T MRI 检查的患者。使用特制容器提供新鲜 RP 标本的 7T 离体 MRI 与组织学切片之间的参考。在离体 MRI 上，对 PCa 进行定位，并在双读会话中确定阳性切缘的存在。这些发现与从完全切割、整体包埋的前列腺标本获得的组织学发现进行比较。
在 12 例 RP 标本中，组织病理学显示 36 个 PCa 病变，其中 17 个（47%）和 20 个（56%）分别在第一次和第二次阅读会话中与离体 MRI 相关。9 个（75%）指数病变在第一次会话中被定位，10 个（83%）在第二次会话中被定位。11 个 Gleason 评分>6 和>0.5 cc 的病变中，有 7 个和 8 个在第一次和第二次会话中被定位。第一次会话中未检测到 4 个组织学阳性切缘（敏感度 0%）和 13 个阴性切缘中的 9 个（特异性 69%）。在第二次会话中，敏感度和特异性分别为 25%和 88%。
离体 MRI 能够准确定位新鲜 RP 标本中的 PCa，该技术具有较高的特异性，可以提供关于切缘状态的信息。
1 技术功效：阶段 1 J. Magn. Reson. Imaging 2018;47:439-448.
