Department of Radiology, Jichi Medical University Saitama Medical Center.
Department of Urology, Jichi Medical University Saitama Medical Center.
Magn Reson Med Sci. 2022 Jul 1;21(3):477-484. doi: 10.2463/mrms.mp.2020-0182. Epub 2021 May 20.
To assess the diagnostic performance of the tumor contact length (TCL) and apparent diffusion coefficient (ADC) for predicting extraprostatic extension (EPE) of prostate cancer with capsular abutment (CA).
Ninety-three patients with biopsy-proven prostate cancer underwent 3-Tesla MRI, including diffusion-weighted imaging (b value = 0, 2000 s/mm) and radical prostatectomy. Two experienced radiologists, blinded to the clinicopathological data, retrospectively assessed the presence of CA on T2-weighted imaging (T2WI). TCL on T2WI and ADC values were measured on detecting CA in prostate cancer. We used the receiver operating characteristic curves to assess the diagnostic performance of TCL and ADC values for predicting EPE.
CA was present in 58 prostate cancers among 93 patients. The cut-off value for TCL was 6.9 mm, which yielded an area under the curve (AUC) of 0.75. This corresponded to a sensitivity, specificity, and accuracy of 84.2%, 61.5%, and 69.0%, respectively. The cut-off value for ADC was 0.63 × 10 mm/s, which yielded an AUC of 0.76. This, in turn, corresponded to a sensitivity, specificity, and accuracy of 84.2%, 59.0%, and 67.2%, respectively. The combined cut-off value of TCL and ADC yielded an AUC of 0.82. The specificity (84.6%) and accuracy (81.0%) of the combined value were superior to their individual values (P < 0.05).
A combination of TCL and ADC values provided high specificity and accuracy for detecting EPE of prostatic cancer with CA.
评估肿瘤接触长度（TCL）和表观扩散系数（ADC）在预测伴有包膜侵犯（CA）的前列腺癌前列腺外延伸（EPE）中的诊断性能。
93 例经活检证实的前列腺癌患者接受 3.0T MRI 检查，包括弥散加权成像（b 值=0、2000 s/mm）和根治性前列腺切除术。两位有经验的放射科医生在不知道临床病理数据的情况下，对 T2 加权成像（T2WI）上的 CA 存在情况进行了回顾性评估。在检测前列腺癌中的 CA 时，测量 T2WI 上的 TCL 和 ADC 值。我们使用受试者工作特征曲线评估 TCL 和 ADC 值预测 EPE 的诊断性能。
93 例患者中有 58 例前列腺癌存在 CA。TCL 的截断值为 6.9mm，曲线下面积（AUC）为 0.75。这对应于 84.2%、61.5%和 69.0%的敏感性、特异性和准确性。ADC 的截断值为 0.63×10mm/s，AUC 为 0.76。这依次对应于 84.2%、59.0%和 67.2%的敏感性、特异性和准确性。TCL 和 ADC 的联合截断值产生了 0.82 的 AUC。联合值的特异性（84.6%）和准确性（81.0%）优于其各自的值（P<0.05）。
TCL 和 ADC 值的组合可提供高特异性和准确性，用于检测伴有 CA 的前列腺癌的 EPE。
