CRUK Cambridge Institute, Cambridge United Kingdom.
General Electric Healthcare, Waukesha, WI.
Invest Radiol. 2018 Aug;53(8):450-456. doi: 10.1097/RLI.0000000000000470.
The aim of this study was to measure the tissue sodium concentration (TSC) within tumors and normal prostate in prostate cancer patients, using prostatectomy as pathological criterion standard.
Fifteen patients with biopsy-proven, magnetic resonance imaging (MRI) visible, intermediate- or high-risk prostate cancer underwent a dedicated research sodium MRI, before treatment with radical prostatectomy. All participants signed written informed consent for this institutional review board-approved prospective study. 3 T MRI acquired using a dedicated multinuclear clamshell transmit coil and a bespoke dual-tuned H/Na endorectal receive coil, with intracellular-sodium imaging acquired using inversion recovery sequences; a phantom-based calibration enabled quantitative sodium maps. Regions of interest were defined for normal peripheral zone (PZ) and transition zone (TZ) and tumor regions, referenced from histopathology maps. A 1-way analysis of variance compared normal and tumor tissue, using Tukey test for multiple comparisons.
Two patients were excluded due to artifact; software error resulted in 1 further intracellular-sodium failure. Fifteen tumors were detected (13 PZ, 2 TZ) in 13 patients: Gleason 3 + 3 (n = 1), 3 + 4 (6), 3 + 5 (2), 4 + 3 (5), 4 + 5 (1). Both mean TSC and intracellular-sodium were significantly higher in normal PZ (39.2 and 17.5 mmol/L, respectively) versus normal TZ (32.9 and 14.7; P < 0.001 and P = 0.02). Mean TSC in PZ tumor (45.0 mmol/L) was significantly higher than both normal PZ and TZ tissue (P < 0.001). Intracellular sodium in PZ tumors (19.9 mmol/L) was significantly higher than normal TZ (P < 0.001) but not normal PZ (P = 0.05). Mean TSC and intracellular-sodium was lower in Gleason ≤3 + 4 tumors (44.4 and 19.5 mmol/L, respectively) versus ≥4 + 3 (45.6 and 20.2), but this was not significant (P = 0.19 and P = 0.29).
Tissue sodium concentration and intracellular sodium concentrations of prostate tumors were quantified, with PZ tumors demonstrating a significantly increased TSC.
本研究旨在通过前列腺切除术作为病理标准，测量前列腺癌患者肿瘤和正常前列腺组织中的组织钠浓度（TSC）。
15 名经活检证实、磁共振成像（MRI）可见、中高危前列腺癌患者在接受根治性前列腺切除术前行专门的研究性钠 MRI 检查。所有参与者均签署了机构审查委员会批准的这项前瞻性研究的书面知情同意书。使用专用多核贝壳式发射线圈和定制的双调谐 H/Na 腔内接收线圈在 3T MRI 上采集，使用反转恢复序列采集细胞内钠成像；基于体模的校准可实现定量钠图。参考组织病理学图谱，为正常外周区（PZ）和移行区（TZ）以及肿瘤区域定义感兴趣区。使用方差分析（ANOVA）比较正常组织和肿瘤组织，采用 Tukey 检验进行多重比较。
由于伪影，有 2 名患者被排除在外；软件错误导致 1 例细胞内钠失败。在 13 名患者中检测到 15 个肿瘤（13 个 PZ，2 个 TZ）：Gleason 3+3（n=1），3+4（6），3+5（2），4+3（5），4+5（1）。正常 PZ 的平均 TSC 和细胞内钠分别为 39.2mmol/L 和 17.5mmol/L，均显著高于正常 TZ 的 32.9mmol/L 和 14.7mmol/L（P<0.001 和 P=0.02）。PZ 肿瘤的平均 TSC（45.0mmol/L）明显高于正常 PZ 和 TZ 组织（P<0.001）。PZ 肿瘤的细胞内钠（19.9mmol/L）也明显高于正常 TZ（P<0.001），但与正常 PZ 无显著差异（P=0.05）。Gleason≤3+4 肿瘤的平均 TSC 和细胞内钠分别为 44.4mmol/L 和 19.5mmol/L，明显低于≥4+3 肿瘤（分别为 45.6mmol/L 和 20.2mmol/L），但差异无统计学意义（P=0.19 和 P=0.29）。
定量测量了前列腺肿瘤的组织钠浓度和细胞内钠浓度，PZ 肿瘤的 TSC 显著升高。
