管腔水成像：与扩散加权成像（DWI）和 PI-RADS 比较，用于前列腺癌侵袭性特征分析。
Luminal Water Imaging: Comparison With Diffusion-Weighted Imaging (DWI) and PI-RADS for Characterization of Prostate Cancer Aggressiveness.
机构信息
BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
出版信息
J Magn Reson Imaging. 2020 Jul;52(1):271-279. doi: 10.1002/jmri.27050. Epub 2020 Jan 21.
BACKGROUND
Luminal water imaging (LWI), a multicomponent T mapping technique, has shown promise for prostate cancer (PCa) detection and characterization.
PURPOSE
To 1) quantify LWI parameters and apparent diffusion coefficient (ADC) in PCa and benign peripheral zone (PZ) tissues; and 2) evaluate the diagnostic performance of LWI, ADC, and PI-RADS parameters for differentiation between low- and high-grade PCa lesions.
STUDY TYPE
Prospective.
SUBJECTS
Twenty-six PCa patients undergoing prostatectomy (mean age 59 years, range 46-72 years).
FIELD STRENGTH/SEQUENCE: Multiparametric MRI at 3.0T, including diffusion-weighted imaging (DWI) and LWI T mapping.
ASSESSMENT
LWI parameters and ADC were quantified in index PCa lesions and benign PZ.
STATISTICAL TESTS
Differences in MRI parameters between PCa and benign PZ were assessed using Wilcoxon signed tests. Spearman correlation of pathological grade group (GG) with LWI parameters, ADC, and PI-RADS was evaluated. The utility of each of the parameters for differentiation between low-grade (GG ≤2) and high-grade (GG ≥3) PCa was determined by Mann-Whitney U tests and ROC analyses.
RESULTS
Twenty-six index lesions were analyzed (mean size 1.7 ± 0.8 cm, GG: 1 [n = 1; 4%], 2 [n = 14, 54%], 3 [n = 8, 31%], 5 [n = 3, 12%]). LWI parameters and ADC both showed high diagnostic performance for differentiation between benign PZ and PCa (highest area under the curve [AUC] for LWI parameter T [AUC = 0.98, P < 0.001]). The LWI parameters luminal water fraction (LWF) and amplitude of long T component A significantly correlated with GG (r = -0.441, P = 0.024 and r = -0.414, P = 0.036, respectively), while PI-RADS, ADC, and the other LWI parameters did not (P = 0.132-0.869). LWF and A also showed significant differences between low-grade and high-grade PCa (AUC = 0.776, P = 0.008 and AUC = 0.758, P = 0.027, respectively). Maximum diagnostic performance for discrimination of high-grade PCa was found with combined LWI parameters (AUC 0.891, P = 0.001).
DATA CONCLUSION
LWI parameters, in particular in combination, showed superior diagnostic performance for differentiation between low-grade and high-grade PCa compared to ADC and PI-RADS assessment. J. Magn. Reson. Imaging 2020;52:271-279.
背景
腔水成像（LWI）是一种多分量 T 映射技术，已显示出在前列腺癌（PCa）检测和特征描述方面的应用潜力。
目的
1）量化 PCa 和良性外周区（PZ）组织中的 LWI 参数和表观扩散系数（ADC）；2）评估 LWI、ADC 和 PI-RADS 参数在区分低级别和高级别 PCa 病变方面的诊断性能。
研究类型
前瞻性。
受试者
26 名接受前列腺切除术的 PCa 患者（平均年龄 59 岁，范围 46-72 岁）。
磁场强度/序列：3.0T 多参数 MRI，包括扩散加权成像（DWI）和 LWI T 映射。
评估
在指数 PCa 病变和良性 PZ 中量化 LWI 参数和 ADC。
统计学检验
使用 Wilcoxon 符号秩检验评估 MRI 参数在 PCa 和良性 PZ 之间的差异。用 Spearman 相关分析评估病理分级组（GG）与 LWI 参数、ADC 和 PI-RADS 的相关性。使用 Mann-Whitney U 检验和 ROC 分析确定每个参数在区分低级别（GG≤2）和高级别（GG≥3）PCa 中的效用。
结果
分析了 26 个指数病变（平均大小 1.7±0.8cm，GG：1[n=1；4%]，2[n=14；54%]，3[n=8；31%]，5[n=3；12%]）。LWI 参数和 ADC 均显示出在区分良性 PZ 和 PCa 方面的高诊断性能（LWI 参数 T 的最高曲线下面积[AUC]=0.98，P<0.001）。腔水分数（LWF）和长 T 成分 A 的振幅这两个 LWI 参数与 GG 显著相关（r=-0.441，P=0.024 和 r=-0.414，P=0.036），而 PI-RADS、ADC 和其他 LWI 参数则没有（P=0.132-0.869）。LWF 和 A 也在低级别和高级别 PCa 之间有显著差异（AUC=0.776，P=0.008 和 AUC=0.758，P=0.027）。在鉴别高级别 PCa 时，LWI 参数（AUC=0.891，P=0.001）的最大诊断性能。
数据结论
与 ADC 和 PI-RADS 评估相比，LWI 参数，特别是联合使用，在区分低级别和高级别 PCa 方面具有更好的诊断性能。J. Magn. Reson. Imaging 2020；52：271-279。
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