基于三维酰胺质子转移加权和体素内不相干运动成像的前列腺癌骨转移预测：一项初步研究。
Three-dimensional amide proton transfer-weighted and intravoxel incoherent motion imaging for predicting bone metastasis in patients with prostate cancer: A pilot study.
机构信息
Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, 116011, PR China.
Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, 116011, PR China; Dalian Engineering Research Center for Artificial Intelligence in Medical Imaging, Dalian, Liaoning, 116011, PR China.
出版信息
Magn Reson Imaging. 2023 Feb;96:8-16. doi: 10.1016/j.mri.2022.11.004. Epub 2022 Nov 12.
PURPOSE
To explore the value of 3-dimensional amide proton transfer-weighted (APTw) and intravoxel incoherent motion (IVIM) imaging in predicting bone metastasis (BM) of prostate cancer (PCa) in addition to routine diffusion-weighted imaging (DWI).
METHODS
The clinical and imaging data of 39 PCa patients who were pathologically confirmed in our hospital from March 2019 to February 2022 were retrospectively analyzed, and they were divided into BM-negative (27 patients) and BM-positive (12 patients) groups. MR examination included APTw, DWI and IVIM imaging. The IVIM data was fitted by single-exponential IVIM model (IVIM) and double-exponential IVIM model (IVIM), respectively. The APTw, ADC, IVIM (D, D*, and f), and IVIM (D, D*, and f) parameters were independently measured by two radiologists. The synthetic minority oversampling technique (SMOTE) was conducted to balance the minority group. Mann-Whitney U test or Student's t-test was used to compare above values between the BM-negative and BM-positive groups. The diagnostic performance was evaluated with receiver operating characteristic (ROC) analysis of each parameter and their combination. The Delong test was used for ROC curve comparison.The relationship between APTw and IVIM was explored through Spearman's rank correlation analysis.
RESULTS
The APTw and D* values were higher, and the ADC, f, and f values were lower in the BM-positive group than in the BM-negative group (all P < 0.05). Among the individual parameters, the AUC of f was the highest (AUC = 0.865), and AUC (f) was significantly higher than AUC (f), AUC (D*), and AUC (ADC) (all P < 0.05). The AUC (IVIM) was higher than the AUC (IVIM) (P = 0.0068). The combination of APTw and IVIM further improved diagnostic capability, and the AUC of APTw+IVIM was significantly higher than those of APTw and DWI (all P < 0.05). No correlation was found between IVIM-derived parameters and APTw value.
CONCLUSION
Both 3D APTw and IVIM imaging could predict BM of PCa. IVIM showed better performance than APTw and DWI, and the single-exponential IVIM model was superior to the double-exponential IVIM model. The combination of APTw and IVIM could further improve diagnostic performance.
目的
探讨三维酰胺质子转移加权（APTw）和体素内不相干运动（IVIM）成像在常规扩散加权成像（DWI）之外预测前列腺癌（PCa）骨转移（BM）的价值。
方法
回顾性分析 2019 年 3 月至 2022 年 2 月我院经病理证实的 39 例 PCa 患者的临床和影像资料，将其分为 BM 阴性（27 例）和 BM 阳性（12 例）组。MR 检查包括 APTw、DWI 和 IVIM 成像。分别采用单指数 IVIM 模型（IVIM）和双指数 IVIM 模型（IVIM）拟合 IVIM 数据。由两位放射科医生分别独立测量 APTw、ADC、IVIM（D、D和 f）和 IVIM（D、D和 f）参数。采用合成少数过采样技术（SMOTE）平衡少数群体。采用 Mann-Whitney U 检验或 Student's t 检验比较 BM 阴性组和 BM 阳性组之间的上述值。采用每个参数及其组合的受试者工作特征（ROC）分析评估诊断性能。采用 Delong 检验比较 ROC 曲线。采用 Spearman 秩相关分析探讨 APTw 与 IVIM 之间的关系。
结果
BM 阳性组的 APTw 和 D值较高，ADC、f 值较低（均 P<0.05）。在单个参数中，f 的 AUC 最高（AUC=0.865），AUC（f）明显高于 AUC（f）、AUC（D）和 AUC（ADC）（均 P<0.05）。IVIM 的 AUC 高于 IVIM（P=0.0068）。APTw 和 IVIM 的联合进一步提高了诊断能力，APTw+IVIM 的 AUC 明显高于 APTw 和 DWI（均 P<0.05）。IVIM 衍生参数与 APTw 值之间无相关性。
结论
三维 APTw 和 IVIM 成像均可预测 PCa 的 BM。IVIM 比 APTw 和 DWI 具有更好的性能，单指数 IVIM 模型优于双指数 IVIM 模型。APTw 和 IVIM 的联合可进一步提高诊断性能。
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