Kim Seung Ho, Kim Joo Yeon, Hwang Moon Jung
Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital, Busan 48108, Republic of Korea.
Department of Pathology, Inje University College of Medicine, Haeundae Paik Hospital, Busan 48108, Republic of Korea.
Cancers (Basel). 2024 Oct 15;16(20):3494. doi: 10.3390/cancers16203494.
We investigated the feasibility of magnetic resonance elastography (MRE) using a pelvic acoustic driver for the detection and classification of prostate cancer (PCa). A total of 75 consecutive patients (mean age, 70; range, 56-86) suspected of having PCa and who underwent multi-parametric MRI including MRE and subsequent surgical resection were included. The analyzed regions consisted of cancer (n = 69), benign prostatic hyperplasia (BPH) (n = 70), and normal parenchyma (n = 70). A histopathologic topographic map served as the reference standard for each region. One radiologist and one pathologist performed radiologic-pathologic correlation, and the radiologist measured stiffness values in each region of interest on elastograms automatically generated by dedicated software. Paired t-tests were used to compare stiffness values between two regions. ROC curve analysis was also used to extract a cutoff value between two regions. The stiffness value of PCa (unit, kilopascal (kPa); 4.9 ± 1.1) was significantly different to that of normal parenchyma (3.6 ± 0.3, < 0.0001) and BPH (4.5 ± 1.4, = 0.0454). Under a cutoff value of 4.2 kPa, a maximum accuracy of 87% was estimated, with a sensitivity of 73%, a specificity of 99%, and an AUC of 0.839 for discriminating PCa from normal parenchyma. Between PCa and BPH, a maximum accuracy of 62%, a sensitivity of 70%, a specificity of 56%, and an AUC of 0.598 were estimated at a 4.5 kPa cutoff. The stiffness values tended to increase as the ISUP grade increased. In conclusion, it is feasible to detect and classify PCa using pelvic MRE. Our observations suggest that MRE could be a supplement to multi-parametric MRI for PCa detection.
我们研究了使用盆腔声学驱动器的磁共振弹性成像（MRE）用于前列腺癌（PCa）检测和分类的可行性。纳入了75例连续的疑似患有PCa且接受了包括MRE在内的多参数MRI检查及后续手术切除的患者（平均年龄70岁；范围56 - 86岁）。分析区域包括癌组织（n = 69）、良性前列腺增生（BPH）（n = 70）和正常实质（n = 70）。组织病理学地形图作为每个区域的参考标准。一名放射科医生和一名病理科医生进行放射学 - 病理学相关性分析，放射科医生在由专用软件自动生成的弹性图上的每个感兴趣区域测量硬度值。采用配对t检验比较两个区域之间的硬度值。ROC曲线分析也用于提取两个区域之间的临界值。PCa的硬度值（单位：千帕斯卡（kPa）；4.9±1.1）与正常实质（3.6±0.3，<0.0001）和BPH（4.5±1.4，= 0.0454）的硬度值有显著差异。在临界值为4.2 kPa时，区分PCa与正常实质的最大准确率估计为87%，灵敏度为73%，特异性为99%，AUC为0.839。在PCa和BPH之间，在4.5 kPa临界值时，最大准确率估计为62%，灵敏度为70%，特异性为56%，AUC为0.598。随着国际泌尿病理学会（ISUP）分级增加，硬度值有升高趋势。总之，使用盆腔MRE检测和分类PCa是可行的。我们的观察结果表明，MRE可作为多参数MRI检测PCa的补充手段。
