Zhengzhou University, The Second Affiliated Hospital of Zhengzhou University, No. 2 Jingba Road, Jinshui District, Zhengzhou, 450014, China.
Sci Rep. 2024 Sep 27;14(1):22278. doi: 10.1038/s41598-024-73605-3.
Magnetic resonance spectroscopy (MRSI) can distinguish between benign and malignant prostate diseases. This study investigated the potential of MRSI for diagnosing prostate cancer and guiding prostate biopsy. We retrospectively reviewed 234 patients with suspected prostate cancer who underwent MRSI with targeted prostate biopsy. Patients were divided into two groups according to their puncture pathology: prostate cancer (n = 103, 44.02%) and benign prostatic disease (n = 131, 55.98%). The t-test, Mann-Whitney U test, or chi-square test was used to compare the groups. The diagnostic abilities of MRSI, prostate-specific antigen level, digital rectal examination, and magnetic resonance imaging without contrast for prostate cancer were compared using the area under the receiver operating characteristic curve (AUC-ROC); the ARC-ROC values were 0.831, 0.768, 0.692, and 0.656, respectively. The AUC-ROC value for diagnosing prostate cancer using the CC/c ratio was 0.853. CC/c ratio > 0.97 was identified as the optimal threshold for diagnosing prostate cancer (sensitivity, 86.5%; specificity, 78.6%; Youden index, 0.651). Spearman correlation analysis revealed a correlation between the CC/c ratio and Gleason score (r = 0.737, p < 0.001). Using the CC/c ratio of MRSI as an adjunct to targeted prostate biopsy can improve the detection rate of positive biopsies and evaluate prostate cancer invasiveness.
磁共振波谱成像（MRSI）可区分良性和恶性前列腺疾病。本研究旨在探讨 MRSI 诊断前列腺癌和指导前列腺活检的潜力。我们回顾性分析了 234 例疑似前列腺癌患者的 MRSI 靶向前列腺活检资料。根据穿刺病理将患者分为两组：前列腺癌组（n=103，44.02%）和良性前列腺疾病组（n=131，55.98%）。采用 t 检验、Mann-Whitney U 检验或卡方检验比较两组。采用受试者工作特征曲线（ROC）下面积（AUC-ROC）比较 MRSI、前列腺特异性抗原水平、直肠指检和无对比磁共振成像对前列腺癌的诊断能力；AUC-ROC 值分别为 0.831、0.768、0.692 和 0.656。CC/c 比值诊断前列腺癌的 AUC-ROC 值为 0.853。CC/c 比值>0.97 被确定为诊断前列腺癌的最佳阈值（灵敏度为 86.5%，特异性为 78.6%，约登指数为 0.651）。Spearman 相关分析显示 CC/c 比值与 Gleason 评分之间存在相关性（r=0.737，p<0.001）。MRSI 的 CC/c 比值作为靶向前列腺活检的辅助手段，可以提高阳性活检的检出率，评估前列腺癌的侵袭性。
