From the Department of Radiology (D.J.W., T.J.H., M.R.B., C.G.G., D.T.B.), Department of Urology (C.W.), and Institute of Pathology (L.B.), University Hospital of Basel, 4031 Basel, Switzerland; and Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY (T.K.B.).
Radiology. 2019 Mar;290(3):702-708. doi: 10.1148/radiol.2018180556. Epub 2019 Jan 1.
Purpose To investigate the diagnostic performance of a dual-parameter approach by combining either volumetric interpolated breath-hold examination (VIBE)- or golden-angle radial sparse parallel (GRASP)-derived dynamic contrast agent-enhanced (DCE) MRI with established diffusion-weighted imaging (DWI) compared with traditional single-parameter evaluations on the basis of DWI alone. Materials and Methods Ninety-four male participants (66 years ± 7 [standard deviation]) were prospectively evaluated at 3.0-T MRI for clinical suspicion of prostate cancer. Included were 101 peripheral zone prostate cancer lesions. Histopathologic confirmation at MRI transrectal US fusion biopsy was matched with normal contralateral prostate parenchyma. MRI was performed with diffusion weighting and DCE by using GRASP (temporal resolution, 2.5 seconds) or VIBE (temporal resolution, 10 seconds). Perfusion (influx forward volume transfer constant [K] and rate constant [K]) and apparent diffusion coefficient (ADC) parameters were determined by tumor volume analysis. Areas under the receiver operating characteristic curve were compared for both sequences. Results Evaluated were 101 prostate cancer lesions (GRASP, 61 lesions; VIBE, 40 lesions). In a combined analysis, diffusion and perfusion parameters ADC with K or K acquired with GRASP had higher diagnostic performance compared with diffusion characteristics alone (area under the curve, 0.97 ± 0.02 [standard error] vs 0.93 ± 0.03; P < .006 and .021, respectively), whereas ADC with perfusion parameters acquired with VIBE had no additional benefit (area under the curve, 0.94 ± 0.03 vs 0.93 ± 0.04; P = .18and .50, respectively, for combination of ADC with K and K). Conclusion If used in a dual-parameter model, incorporating diffusion and perfusion characteristics, the golden-angle radial sparse parallel acquisition technique improves the diagnostic performance of multiparametric MRI examinations of the prostate. This effect could not be observed combining diffusing with perfusion parameters acquired with volumetric interpolated breath-hold examination. © RSNA, 2018.
目的 本研究旨在对比传统单参数评估方法，探讨基于体素内不相干运动（IVIM）扩散加权成像（DWI）联合容积内插屏气检查（VIBE）或角度优化径向稀疏并行采集（GRASP）衍生的双参数动态对比增强磁共振成像（DCE-MRI）的诊断效能。
材料与方法 本前瞻性研究纳入 94 例有前列腺癌临床疑似症状的男性患者（年龄 66 岁±7 岁），在 3.0T MRI 上进行检查。纳入研究的 101 个外周带前列腺癌病灶均经 MRI 经直肠超声融合活检病理证实，与对侧正常前列腺组织相对照。DCE-MRI 采用 GRASP（时间分辨率 2.5 秒）或 VIBE（时间分辨率 10 秒）序列进行采集，同时行 DWI 检查。通过肿瘤容积分析，获得灌注参数（流入正向体积转移常数 [K]和速率常数 [K]）和表观扩散系数（ADC）参数。比较两种序列的受试者工作特征曲线下面积。
结果 本研究共纳入 101 个前列腺癌病灶（GRASP 序列 61 个病灶，VIBE 序列 40 个病灶）。在联合分析中，与单纯扩散特征相比，GRASP 序列获得的 ADC 与 K 或 K 的联合扩散和灌注参数（曲线下面积：0.97±0.02[标准误差]比 0.93±0.03；P<.006 和.021），以及 VIBE 序列获得的 ADC 与灌注参数的联合（曲线下面积：0.94±0.03 比 0.93±0.04；P=.18 和.50）具有更高的诊断效能。
结论 若将扩散和灌注特征纳入双参数模型，角度优化径向稀疏并行采集技术可提高多参数 MRI 前列腺检查的诊断效能。但在联合分析中，将 VIBE 序列获得的扩散与灌注参数进行组合时，并未观察到这种效果。
