计算机高 b 值全身扩散加权成像对原发性前列腺癌的诊断价值。
Diagnostic value of computed high b-value whole-body diffusion-weighted imaging for primary prostate cancer.
机构信息
Department of Radiology, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; Department of Radiology, Advanced Imaging Center Yaesu Clinic, 2-1-18, Nihonbashi, Chuo-ku, Tokyo, 103-0027, Japan.
Department of Radiology, Advanced Imaging Center Yaesu Clinic, 2-1-18, Nihonbashi, Chuo-ku, Tokyo, 103-0027, Japan; Department of Urology, Tokyo Medical and Dental University Graduate School, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
出版信息
Eur J Radiol. 2021 Apr;137:109581. doi: 10.1016/j.ejrad.2021.109581. Epub 2021 Feb 6.
PURPOSE
To investigate the utility of post-acquisition computed diffusion-weighted imaging (cDWI) for primary prostate cancer (PCa) evaluation in biparametric whole-body MRI (bpWB-MRI).
METHODS
Patients who underwent pelvic MRI for PCa screening and subsequent bpWB-MRI for staging were included. Two radiologists assessed the diagnostic performance of the following datasets for clinically significant PCa diagnosis (grade group ≥2 according to the Prostate Imaging-Reporting and Data System, version 2.1): bpMRI (axial DWI scans with a b-value of 2,000 s/mm + axial T2WI scans from pre-biopsy pelvic MRI), computed bpWB-MRI (computed WB-DWI scans with a b-value of 2,000 s/mm + axial WB-T2WI scans), and native bpWB-MRI (native axial WB-DWI scans with a b-value of 1,000 s/mm + axial WB-T2WI scans). Systemic biopsy was used as reference standard.
RESULTS
Fifty-one patients with PCa were included. The areas under the curve (AUCs) of bpMRI (0.89 for reader 1 and 0.86 for reader 2) and computed bpWB-MRI (0.86 for reader 1 and 0.83 for reader 2) were significantly higher (p < 0.001) than those of native bpWB-MRI (0.67 for both readers). No significant difference was observed between the AUCs of bpMRI and computed bpWB-MRI (p = 0.10 for reader 1 and p = 0.25 for reader 2).
CONCLUSIONS
The diagnostic performance of computed bpWB-MRI was similar to that of dedicated pelvic bpMRI for primary PCa evaluation. cDWI can be recommended for implementation in standard WB-MRI protocols to facilitate a one-step evaluation for concurrent detection of primary and metastatic PCa.
目的
探讨在双参数全身 MRI（bpWB-MRI）中，后处理计算扩散加权成像（cDWI）在原发性前列腺癌（PCa）评估中的应用价值。
方法
纳入接受盆腔 MRI 筛查 PCa 并随后行 bpWB-MRI 分期的患者。两位放射科医生评估了以下数据集对临床显著 PCa 诊断的诊断性能（根据前列腺成像报告和数据系统，版本 2.1，分级组≥2）：bpMRI（术前盆腔 MRI 的轴向 DWI 扫描，b 值为 2,000 s/mm + 轴向 T2WI 扫描）、计算 bpWB-MRI（b 值为 2,000 s/mm 的计算 WB-DWI 扫描+轴向 WB-T2WI 扫描）和原始 bpWB-MRI（b 值为 1,000 s/mm 的原始轴向 WB-DWI 扫描+轴向 WB-T2WI 扫描）。系统活检作为参考标准。
结果
共纳入 51 例 PCa 患者。bpMRI（读者 1 的 AUC 为 0.89，读者 2 的 AUC 为 0.86）和计算 bpWB-MRI（读者 1 的 AUC 为 0.86，读者 2 的 AUC 为 0.83）的曲线下面积（AUC）显著高于原始 bpWB-MRI（读者 1 和读者 2 的 AUC 均为 0.67，p<0.001）。bpMRI 和计算 bpWB-MRI 的 AUC 之间无显著差异（读者 1 的 p 值为 0.10，读者 2 的 p 值为 0.25）。
结论
计算 bpWB-MRI 的诊断性能与专用盆腔 bpMRI 评估原发性 PCa 相似。cDWI 可推荐用于标准 WB-MRI 方案中，以促进原发性和转移性 PCa 的同步检测的一步评估。
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