酰胺质子转移可能为前列腺移行区病变提供更准确的特征描述。

Amide Proton Transfer Could Provide More Accurate Lesion Characterization in the Transition Zone of the Prostate.

机构信息

Department of Medical Imaging, Guilin Medical University, Guilin, China.

Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China.

出版信息

J Magn Reson Imaging. 2022 Nov;56(5):1311-1319. doi: 10.1002/jmri.28204. Epub 2022 Apr 16.

DOI:10.1002/jmri.28204

PMID:35429190

Abstract

BACKGROUND

There is an overlap comparing transition zone prostate cancer (TZ PCa) and benign prostatic hyperplasia (BPH) on T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI), creating additional challenges for assessment of TZ tumors on MRI.

PURPOSE

To evaluate whether amide proton transfer-weighted (APTw) imaging provides new diagnostic ideas for TZ PCa.

STUDY TYPE

Prospective.

POPULATION

A total of 51 TZ PCa patients (age, 49-89), 44 stromal BPH (age, 57-92), and 45 glandular BPH patients (age, 56-92).

FIELD STRENGTH/SEQUENCE: A 3 T; T2WI turbo spin echo (TSE), quantitative T2*-weighted imaging, DWI echo planar imaging, 3D APTw TSE.

ASSESSMENT

Differences in APTw, apparent diffusion coefficient (ADC), and T2* among three lesions were compared by one-way analysis of variance (ANOVA). Regions of interest were drawn by two radiologists (X.Q.Z. and X.Y.Q., with 21 and 15 years of experience, respectively).

STATISTICAL TESTS

Multivariable logistic regression analyses; ANOVA with post hoc testing; receiver operator characteristic curve analysis; Delong test. Significance level: P < 0.05.

RESULTS

APTw among TZ PCa, stromal BPH, and glandular BPH (3.48% ± 0.83% vs. 2.76% ± 0.49% vs. 2.72% ± 0.45%, respectively) were significantly different except between stromal BPH and glandular BPH (P > 0.99). Significant differences were found in ADC (TZ PCa 0.76 ± 0.16 × 10 mm /sec vs. stromal BPH 0.91 ± 0.14 × 10 mm /sec vs. glandular BPH 1.08 ± 0.18 × 10 mm /sec) among three lesions. APTw (OR = 12.18, 11.80, respectively) and 1/ADC (OR = 703.87, 181.11, respectively) were independent predictors of TZ PCa from BPH and stromal BPH. The combination of APTw and ADC had better diagnostic performance in the identification of TZ PCa from BPH and stromal BPH.

DATA CONCLUSION

APTw imaging has the potential to be of added value to ADC in differentiating TZ PCa from BPH and stromal BPH.

EVIDENCE LEVEL

2 TECHNICAL EFFICACY: Stage 2.

摘要

背景

在 T2 加权成像（T2WI）和扩散加权成像（DWI）上，移行区前列腺癌（TZ PCa）和良性前列腺增生（BPH）存在重叠，这为 MRI 上评估 TZ 肿瘤增加了额外的挑战。

目的

评估酰胺质子转移加权（APTw）成像是否为 TZ PCa 提供了新的诊断思路。

研究类型

前瞻性。

人群

共 51 例 TZ PCa 患者（年龄 49-89 岁）、44 例基质型 BPH（年龄 57-92 岁）和 45 例腺体型 BPH 患者（年龄 56-92 岁）。

场强/序列：3T；T2WI 涡轮自旋回波（TSE）、定量 T2*-加权成像、DWI 回波平面成像、3D APTw TSE。

评估

采用单因素方差分析（ANOVA）比较三种病变之间的 APTw、表观扩散系数（ADC）和 T2*差异。由两位放射科医生（X.Q.Z.和 X.Y.Q.，分别具有 21 年和 15 年的经验）绘制感兴趣区。

统计学检验

多变量逻辑回归分析；ANOVA 事后检验；受试者工作特征曲线分析；DeLong 检验。显著性水平：P<0.05。

结果

除基质型 BPH 和腺体型 BPH 之间（P>0.99）外，TZ PCa、基质型 BPH 和腺体型 BPH 的 APTw（3.48%±0.83%比 2.76%±0.49%比 2.72%±0.45%）之间差异均有统计学意义。三种病变之间 ADC 差异有统计学意义（TZ PCa 0.76±0.16×10-3mm2/s 比基质型 BPH 0.91±0.14×10-3mm2/s 比腺体型 BPH 1.08±0.18×10-3mm2/s）。APTw（OR=12.18，11.80）和 1/ADC（OR=703.87，181.11）是 TZ PCa 与 BPH 和基质型 BPH 的独立预测因子。APTw 和 ADC 的联合对 TZ PCa 与 BPH 和基质型 BPH 的鉴别具有更好的诊断性能。