Department of Radiology, West China Hospital, Sichuan University, Sichuan, China.
Department of Pathology, West China Hospital, Sichuan University, Sichuan, China.
Korean J Radiol. 2023 Jul;24(7):668-680. doi: 10.3348/kjr.2022.1022.
To compare multiparametric magnetic resonance imaging (MRI) features of intraductal carcinoma of the prostate (IDC-P) with those of prostatic acinar adenocarcinoma (PAC) and develop prediction models to distinguish IDC-P from PAC and IDC-P with a high proportion (IDC ≥ 10%, hpIDC-P) from IDC-P with a low proportion (IDC < 10%, lpIDC-P) and PAC.
One hundred and six patients with hpIDC-P, 105 with lpIDC-P and 168 with PAC, who underwent pretreatment multiparametric MRI between January 2015 and December 2020 were included in this study. Imaging parameters, including invasiveness and metastasis, were evaluated and compared between the PAC and IDC-P groups as well as between the hpIDC-P and lpIDC-P subgroups. Nomograms for distinguishing IDC-P from PAC, and hpIDC-P from lpIDC-P and PAC, were made using multivariable logistic regression analysis. The discrimination performance of the models was assessed using the receiver operating characteristic area under the curve (ROC-AUC) in the sample, where the models were derived from without an independent validation sample.
The tumor diameter was larger and invasive and metastatic features were more common in the IDC-P than in the PAC group ( < 0.001). The distribution of extraprostatic extension (EPE) and pelvic lymphadenopathy was even greater, and the apparent diffusion coefficient (ADC) ratio was lower in the hpIDC-P than in the lpIDC-P group ( < 0.05). The ROC-AUCs of the stepwise models based solely on imaging features for distinguishing IDC-P from PAC and hpIDC-P from lpIDC-P and PAC were 0.797 (95% confidence interval, 0.750-0.843) and 0.777 (0.727-0.827), respectively.
IDC-P was more likely to be larger, more invasive, and more metastatic, with obviously restricted diffusion. EPE, pelvic lymphadenopathy, and a lower ADC ratio were more likely to occur in hpIDC-P, and were also the most useful variables in both nomograms for predicting IDC-P and hpIDC-P.
比较前列腺导管内癌（IDC-P）与前列腺腺癌（PAC）的多参数磁共振成像（MRI）特征，建立预测模型，以区分 IDC-P 与 PAC，并区分高比例 IDC-P（IDC≥10%，hpIDC-P）与低比例 IDC-P（IDC<10%，lpIDC-P）和 PAC。
本研究纳入了 2015 年 1 月至 2020 年 12 月期间接受术前多参数 MRI 检查的 106 例 hpIDC-P、105 例 lpIDC-P 和 168 例 PAC 患者。评估并比较了 PAC 与 IDC-P 组以及 hpIDC-P 与 lpIDC-P 亚组之间的侵袭性和转移相关的影像学参数。使用多变量逻辑回归分析建立了鉴别 IDC-P 与 PAC、hpIDC-P 与 lpIDC-P 和 PAC 的列线图。使用样本中的接收者操作特征曲线（ROC-AUC）评估模型的鉴别性能，模型在没有独立验证样本的情况下得出。
与 PAC 组相比，IDC-P 组的肿瘤直径更大，侵袭性和转移性特征更常见（<0.001）。HPIDC-P 组的前列腺外延伸（EPE）和盆腔淋巴结病变分布更为广泛，表观扩散系数（ADC）比值更低（<0.05）。仅基于影像学特征的逐步模型用于鉴别 IDC-P 与 PAC 以及 hpIDC-P 与 lpIDC-P 和 PAC 的 ROC-AUC 分别为 0.797（95%置信区间，0.750-0.843）和 0.777（0.727-0.827）。
IDC-P 更有可能体积更大、侵袭性更强、转移性更高，扩散受限明显。HPIDC-P 更有可能出现 EPE、盆腔淋巴结病变和 ADC 比值较低，这也是两个列线图预测 IDC-P 和 hpIDC-P 中最有用的变量。
