使用定量 T1 和 T2 加权成像检测前列腺癌：5-α 还原酶抑制剂对主动监测中男性的影响。
Prostate cancer detection using quantitative T and T -weighted imaging: The effects of 5-alpha-reductase inhibitors in men on active surveillance.
机构信息
Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK.
Division of Surgery & Interventional Science, University College London, London, UK.
出版信息
J Magn Reson Imaging. 2018 Jun;47(6):1646-1653. doi: 10.1002/jmri.25891. Epub 2017 Nov 14.
BACKGROUND
T -weighted imaging (T -WI) information has been used in a qualitative manner in the assessment of prostate cancer. Quantitative derivatives (T relaxation time) can be generated from T -WI. These outputs may be useful in helping to discriminate clinically significant prostate cancer from background signal.
PURPOSE/HYPOTHESIS: To investigate changes in quantitative T parameters in lesions and noncancerous tissue of men on active surveillance for prostate cancer taking dutasteride 0.5 mg or placebo daily for 6 months.
STUDY TYPE
Retrospective.
POPULATION/SUBJECTS: Forty men randomized to 6 months of daily dutasteride (n = 20) or placebo (n = 20).
FIELD STRENGTH/SEQUENCE: Multiparametric 3T MRI at baseline and 6 months. This included a multiecho MR sequence for quantification of the T relaxation times, in three regions of interest (index lesion, noncancerous peripheral [PZ] and transitional [TZ] zones). A synthetic signal contrast (T Q contrast) between lesion and noncancerous tissue was assessed using quantitative T values. Signal contrast was calculated using the T -weighted sequence (T W contrast).
ASSESSMENT
Two radiologists reviewed the scans in consensus according to Prostate Imaging Reporting and Data System (PI-RADS v. 2) guidelines.
STATISTICAL TESTS
Wilcoxon and Mann-Whitney U-tests, Spearman's correlation.
RESULTS
When compared to noncancerous tissue, shorter T values were observed within lesions at baseline (83.5 and 80.5 msec) and 6 months (81.5 and 81.9 msec) in the placebo and dutasteride arm, respectively. No significant differences for T W contrast at baseline and after 6 months were observed, both in the placebo (0.40 [0.29-0.49] vs. 0.43 [0.25-0.49]; P = 0.881) and dutasteride arm (0.35 [0.24-0.47] vs. 0.37 [0.22-0.44]; P = 0.668). There was a significant, positive correlation between the T Q contrast and the T W contrast values (r = 0.786; P < 0.001).
DATA CONCLUSION
The exposure to antiandrogen therapy did not significantly influence the T contrast or the T relaxation values in men on active surveillance for prostate cancer.
LEVEL OF EVIDENCE
4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:1646-1653.
背景
T 加权成像（T -WI）信息已被用于前列腺癌的定性评估。T -WI 可以生成定量衍生物（T 弛豫时间）。这些输出结果可能有助于帮助区分临床上有意义的前列腺癌与背景信号。
目的/假设：研究在接受前列腺癌主动监测的男性中，定量 T 参数在病变和非癌组织中的变化，这些男性每天服用达特昔芬 0.5mg 或安慰剂 6 个月。
研究类型
回顾性研究。
人群/受试者：40 名男性随机分为 6 个月的达特昔芬（n=20）或安慰剂（n=20）组。
磁场强度/序列：基线和 6 个月时进行多参数 3T MRI。该序列包括用于定量 T 弛豫时间的多回波 MR 序列，在三个感兴趣区域（指数病变、非癌性外周区[PZ]和移行区[TZ]）。使用定量 T 值评估病变和非癌性组织之间的合成信号对比（T Q 对比）。使用 T 加权序列（T W 对比）计算信号对比。
评估
两位放射科医生根据前列腺成像报告和数据系统（PI-RADS v.2）指南进行了共识审查。
统计检验
Wilcoxon 和 Mann-Whitney U 检验，Spearman 相关。
结果
与非癌性组织相比，安慰剂和达特昔芬组在基线（83.5 和 80.5msec）和 6 个月（81.5 和 81.9msec）时，病变内的 T 值较短。在安慰剂（0.40[0.29-0.49]与 0.43[0.25-0.49]；P=0.881）和达特昔芬组（0.35[0.24-0.47]与 0.37[0.22-0.44]）中，基线和 6 个月后 T W 对比均无显著差异，P=0.668）。T Q 对比和 T W 对比值之间存在显著的正相关（r=0.786；P<0.001）。
数据结论
在接受抗雄激素治疗的男性中，前列腺癌主动监测的 T 对比或 T 弛豫值无明显影响。
证据水平
4 级 技术效果：2 级 JMRI2018；47：1646-1653。
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