From the Translational and Molecular Imaging Institute (S.J.H., S.S., S.L., B.T.) and Departments of Radiology (S.J.H., S.S., C.S., S.L., B.T.), Pathology (G.K.H.), and Urology (A.T., A.R.R.), Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY 10029.
Radiology. 2018 Mar;286(3):918-928. doi: 10.1148/radiol.2017170904. Epub 2017 Nov 8.
Purpose To correlate quantitative diffusion-weighted imaging (DWI) parameters derived from conventional monoexponential DWI, stretched exponential DWI, diffusion kurtosis imaging (DKI), and diffusion-tensor imaging (DTI) with quantitative histopathologic tumor tissue composition in prostate cancer in a preliminary hypothesis-generating study. Materials and Methods This retrospective institutional review board-approved study included 24 patients with prostate cancer (mean age, 63 years) who underwent magnetic resonance (MR) imaging, including high-b-value DWI and DTI at 3.0 T, before prostatectomy. The following parameters were calculated in index tumors and nontumoral peripheral zone (PZ): apparent diffusion coefficient (ADC) obtained with monoexponential fit (ADC), ADC obtained with stretched exponential modeling (ADC), anomalous exponent (α) obtained at stretched exponential DWI, ADC obtained with DKI modeling (ADC), kurtosis with DKI, ADC obtained with DTI (ADC), and fractional anisotropy (FA) at DTI. Parameters in prostate cancer and PZ were compared by using paired Student t tests. Pearson correlations between tumor DWI and quantitative histologic parameters (nuclear, cytoplasmic, cellular, stromal, luminal fractions) were determined. Results All DWI parameters were significantly different between prostate cancer and PZ (P < .012). ADC, ADC, and ADC all showed significant negative correlation with cytoplasmic and cellular fractions (r = -0.546 to -0.435; P < .034) and positive correlation with stromal fractions (r = 0.619-0.669; P < .001). ADC and FA showed correlation only with stromal fraction (r = 0.512 and -0.413, respectively; P < .045). α did not correlate with histologic parameters, whereas kurtosis showed significant correlations with histopathologic parameters (r = 0.487, 0.485, -0.422 for cytoplasmic, cellular, and stromal fractions, respectively; P < .040). Conclusion Advanced DWI methods showed significant correlations with histopathologic tissue composition in prostate cancer. These findings should be validated in a larger study. RSNA, 2017 Online supplemental material is available for this article. An earlier incorrect version of this article appeared online. This article was corrected on November 10, 2017.
目的 在初步假设生成研究中，将源于常规单指数弥散加权成像（DWI）、拉伸指数 DWI、弥散峰度成像（DKI）和弥散张量成像（DTI）的定量弥散加权成像（DWI）参数与前列腺癌的定量组织病理学肿瘤组成相关联。
材料与方法 本回顾性机构审查委员会批准的研究纳入了 24 例前列腺癌患者（平均年龄，63 岁），这些患者在前列腺切除术前行 3.0T 磁共振成像（MR）检查，包括高 b 值 DWI 和 DTI。在指数肿瘤和非肿瘤外周带（PZ）中计算了以下参数：单指数拟合获得的表观弥散系数（ADC）（ADC）、拉伸指数建模获得的 ADC（ADC）、拉伸指数 DWI 获得的异常指数（α）、DKI 建模获得的 ADC（ADC）、DKI 获得的峰度、DTI 获得的 ADC（ADC）和分数各向异性（FA）。使用配对学生 t 检验比较前列腺癌和 PZ 中的参数。确定肿瘤 DWI 与定量组织学参数（核、细胞质、细胞、基质、腔隙分数）之间的 Pearson 相关性。
结果 前列腺癌和 PZ 之间的所有 DWI 参数均有显著差异（P <.012）。ADC、ADC 和 ADC 均与细胞质和细胞分数呈显著负相关（r = -0.546 至 -0.435；P <.034），与基质分数呈显著正相关（r = 0.619-0.669；P <.001）。ADC 和 FA 仅与基质分数相关（r = 0.512 和 -0.413，分别；P <.045）。α 与组织学参数无相关性，而峰度与组织病理学参数有显著相关性（r = 0.487、0.485、-0.422 分别对应细胞质、细胞和基质分数；P <.040）。
结论 高级 DWI 方法与前列腺癌的组织病理学组织组成有显著相关性。这些发现应在更大的研究中进行验证。
RSNA，2017 在线补充材料可从本文获得。本文的早期错误版本曾在网上发布。本文于 2017 年 11 月 10 日进行了更正。
