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使用定量扩散加权成像和动态对比增强磁共振成像相结合的方法评估前列腺癌的侵袭性

The Assessment of Prostate Cancer Aggressiveness Using a Combination of Quantitative Diffusion-Weighted Imaging and Dynamic Contrast-Enhanced Magnetic Resonance Imaging.

作者信息

Zhu Guangbin, Luo Jinwen, Ouyang Zhongmin, Cheng Zenglan, Deng Yi, Guan Yubao, Du Guoxin, Zhao Fengjin

机构信息

Guangzhou Key Laboratory of Enhanced Recovery after Abdominal Surgery, Department of Radiology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510799, People's Republic of China.

Department of Urology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510799, People's Republic of China.

出版信息

Cancer Manag Res. 2021 Jul 2;13:5287-5295. doi: 10.2147/CMAR.S319306. eCollection 2021.

Abstract

OBJECTIVE

To explore the value of combining dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) quantitative parameters with apparent diffusion coefficient (ADC) values in the diagnosis of prostate cancer.

METHODS

The clinical data of 146 patients with prostate lesions, including 87 patients with prostate cancer (PCa) and 59 with benign prostatic hyperplasia (BPH), were collected. After DCE-MRI and diffusion-weighted imaging (DWI) prostate scans, the magnitude of the DCE-MRI transfer constant ( ), rate constant ( ), the volume of the extravascular extracellular space ( ), and the ADC between the groups were compared, and the correlations between the DCE-MRI parameters and Gleason scores were analyzed. The diagnostic efficacy of these quantitative parameters was assessed by the area under the receiver operating characteristic (ROC) curve.

RESULTS

The DCE-MRI parameters and were significantly greater in the PCa group than in the BPH group ( < 0.05). The ROC curve showed the area under the , and ADC curves to be 0.665, 0.658, and 0.782, respectively. When all three quantitative indicators were combined, the area under the ROC curve was 0.904, with sensitivity and specificity rates of 83.6% and 93.7%, respectively. The Gleason scores were positively correlated with the , and ( = 0.39, 0.572, 0.30, respectively; < 0.05) and negatively correlated with the ADC ( = -0.525; < 0.05).

CONCLUSION

The DCE-MRI quantitative parameters and , as well as the ADC value, provided effective references for the differential diagnosis of PCa and BPH, as well as more precise and reliable quantitative parameters for grading the aggressiveness of PCa.

摘要

目的

探讨动态对比增强磁共振成像(DCE-MRI)定量参数与表观扩散系数(ADC)值相结合在前列腺癌诊断中的价值。

方法

收集146例前列腺病变患者的临床资料,其中前列腺癌(PCa)患者87例,良性前列腺增生(BPH)患者59例。在进行DCE-MRI和扩散加权成像(DWI)前列腺扫描后,比较两组之间DCE-MRI转移常数( )、速率常数( )、血管外细胞外间隙容积( )以及ADC值,并分析DCE-MRI参数与Gleason评分之间的相关性。通过受试者操作特征(ROC)曲线下面积评估这些定量参数的诊断效能。

结果

PCa组的DCE-MRI参数 和 显著高于BPH组( < 0.05)。ROC曲线显示 、 以及ADC曲线下面积分别为0.665、0.658和0.782。当将所有三个定量指标联合使用时,ROC曲线下面积为0.904,敏感性和特异性分别为83.6%和93.7%。Gleason评分与 、 呈正相关(分别为 = 0.39、0.572、0.30; < 0.05),与ADC呈负相关( = -0.525; < 0.05)。

结论

DCE-MRI定量参数 和 以及ADC值为PCa和BPH的鉴别诊断提供了有效参考,也为PCa侵袭性分级提供了更精确可靠的定量参数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63f6/8260110/55e1ecb75c32/CMAR-13-5287-g0001.jpg

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