Radiology Department, Gemelli Molise Hospital, Campobasso, Italy.
Department of Radiological Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Department of Radiological Sciences, Università Cattolica del Sacro Cuore, Roma, Italy.
Radiography (Lond). 2021 May;27(2):459-463. doi: 10.1016/j.radi.2020.10.011. Epub 2020 Nov 2.
The purpose of our work was to evaluate the feasibility of prostate multiparametric MR imaging at 1.5-T without endorectal coil using an 8 channel pelvic phased array coil.
A total of 154 patients who underwent mp-MRI were retrospectively included. Patients received a standardized mp-MRI, compliant with 2012 European Society of Uro-Radiology guidelines, with 1·5 T magnetic field strength and an 8 channel pelvic phased-array coil. Two blinded readers graded the image quality of mp-MRI on a three-point scale and they scored the prostate lesions according to PI-RADS v2. All PI-RADS of 4 or 5 underwent biopsy. A third radiologist and a pathologist verified the correspondence between the MRI images and the results of the biopsy.
64 (41.6%) patients showed a Pi-rads of 4 or 5. At biopsy, 79.7% showed a Gleason score ≥7, 12.5% showed a Gleason score of 6 and 7.8% showed a negative biopsy. In the group of Pi-rads ≤ 3, 12 patients underwent a biopsy with the following results: negative biopsy in 33.3%, atypical Small Acinar Proliferation in 16.7%, prostatic intraepithelial neoplasia in 25% and indolent PCa 25%. Mp-MRI in the identification of clinically significant cancer provided a low percentage of false positive (7.8%) while in 79.7% of cases it was capable to detect clinically significant prostate cancer. In 92.2% of patients mp-MRI identified a prostate cancer with a Gleason score ≥6. The inter-reader agreement was excellent in defining both the quality of the examination and the PI-RADS category (k = 0.83 and k = 0.70, respectively).
mp-MRI at 1.5-T without endorectal coil using an 8 channel phased array is an appropriate tool for early detection of clinically significant prostate cancer.
8 channel pelvic phased array is still an appropriate tool for early detection of clinically significant prostate cancer and for obtaining a reduction in overdiagnosis of indolent PCa.
我们工作的目的是评估在没有直肠内线圈的情况下，使用 8 通道盆腔相控阵线圈，在 1.5-T 场强下进行前列腺多参数磁共振成像的可行性。
回顾性纳入了 154 例接受 mp-MRI 的患者。患者接受了符合 2012 年欧洲泌尿放射学会指南的标准化 mp-MRI 检查，场强为 1.5T，使用 8 通道盆腔相控阵线圈。两位盲法读者对 mp-MRI 的图像质量进行了三分制评分，并根据 PI-RADS v2 对前列腺病变进行了评分。所有 PI-RADS 为 4 或 5 的患者均接受了活检。第三位放射科医生和病理学家验证了 MRI 图像与活检结果的对应关系。
64 例（41.6%）患者的 PI-RADS 评分为 4 或 5。在活检中，79.7%的患者出现了 Gleason 评分≥7，12.5%的患者出现了 Gleason 评分 6，7.8%的患者出现了阴性活检。在 PI-RADS 评分为≤3 的患者中，12 例接受了活检，结果如下：阴性活检 33.3%，非典型小腺泡增生 16.7%，前列腺上皮内瘤变 25%，惰性前列腺癌 25%。mp-MRI 对临床显著癌的识别率较低（7.8%），但能在 79.7%的病例中检测到临床显著的前列腺癌。在 92.2%的患者中，mp-MRI 检出了 Gleason 评分≥6 的前列腺癌。两位读者在评估检查质量和 PI-RADS 分级方面具有极好的一致性（分别为 k=0.83 和 k=0.70）。
在没有直肠内线圈的情况下，使用 8 通道相控阵线圈，1.5-T 场强下的 mp-MRI 是一种早期检测临床显著前列腺癌的合适工具。
8 通道盆腔相控阵仍是早期检测临床显著前列腺癌和减少惰性前列腺癌过度诊断的合适工具。
