Zabihzadeh Mansour, Fatahi Asl Jafar, Farzanegan Zahra, Hoseini Seyed Mokhtar, Sarkarian Mohsen, Cheraghian Bahman, Dahaz Shapour, Garibvand Mohammad Momen
Cancer Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Department of Medical Physics, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Arch Iran Med. 2020 Feb 1;23(2):104-112.
Considering the non-invasive nature of magnetic resonance spectroscopy (MRS) and its ability to detect prostate lesions, the present study aimed to investigate the accuracy of MRS techniques in distinguishing between prostate cancer (PCa) and prostatitis.
Thirty-three patients (18 patients with PCa and 15 patients with prostatitis) were recruited for this study. Magnetic resonance imaging (MRI) and MRS were performed using 1.5-T system GE- modle Optima 450 Discovery (GE Medical Systems, US). The (Cho+Cr)/Cit ratio of hypointense T2 areas were calculated. The diagnostic accuracy including sensitivity and specificity indices, with 0.95 confidence interval as well as PPV and NPV were calculated for each variable. The receiver operating characteristic (ROC) area under the curve (AUC) was outlined and investigated. The mean quantitative values between the two groups (PCa and Prostatitis) were compared using independent t test.
The mean ratios of Cho+Cr/Cit in PCa was 1.54 ± 0.63 and 0.83 ± 0.48 for PCa and prostatitis, respectively, indicating a significant statistical difference (P = 0.00). A reduction in citrate was seen in both PCa and prostatitis tissue. Significant elevation in choline peak was shown for PCa. Moreover, creatinine level was low in both normal tissue and PCa without significant difference. Sensitivity, specificity, accuracy, PPV and NPV of MRS were 94.4% (95% CI, 74.2-99), 80% (95% CI, 54.8-93), 96%, 85% and 92.4%, respectively.
The results of this study indicate an acceptable level of sensitivity, specificity and accuracy of MRS in the differential diagnosis of PCa and prostatitis.
鉴于磁共振波谱（MRS）具有非侵入性且能够检测前列腺病变，本研究旨在探讨MRS技术在鉴别前列腺癌（PCa）和前列腺炎方面的准确性。
本研究招募了33例患者（18例PCa患者和15例前列腺炎患者）。使用1.5-T系统GE-型号Optima 450 Discovery（美国GE医疗系统公司）进行磁共振成像（MRI）和MRS检查。计算T2低信号区域的（Cho+Cr）/Cit比值。计算每个变量的诊断准确性，包括敏感性和特异性指标、95%置信区间以及阳性预测值（PPV）和阴性预测值（NPV）。绘制并研究受试者工作特征（ROC）曲线下面积（AUC）。使用独立t检验比较两组（PCa组和前列腺炎组）的平均定量值。
PCa组的Cho+Cr/Cit平均比值为1.54±0.63，前列腺炎组为0.83±0.48，差异具有统计学意义（P = 0.00）。在PCa和前列腺炎组织中均观察到柠檬酸盐减少。PCa组胆碱峰显著升高。此外，正常组织和PCa组织中的肌酐水平均较低，无显著差异。MRS的敏感性、特异性、准确性、PPV和NPV分别为94.4%（95%CI，74.2-99）、80%（95%CI，54.8-93）、96%、85%和92.4%。
本研究结果表明，MRS在PCa和前列腺炎的鉴别诊断中具有可接受的敏感性、特异性和准确性水平。
