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前列腺癌生长模式如何影响检测和多参数MRI的Interreader协议

Daniel Hausmann¹, N Rupp², B Kuzmanic³

¹Department of Radiology, Kantonsspital Baden, affiliated Hospital for Research and Teaching of the Faculty of Medicine of the University of Zurich, Baden, Switzerland; Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.

Academic radiology

|December 6, 2024

概括

多参数MRI (mpMRI) 可以错过具有透生长的侵袭性前列腺癌 (PCa). 扩张性生长病变显示较低的ADC值和较高的PI-RADS得分,有助于检测.

科学领域:

放射学放射学是一门学科.
病理学病理学病理学
在瘤学瘤学.

背景情况:

多参数MRI (mpMRI) 增强了前列腺癌 (PCa) 检测,而不是系统活检.
具有侵略性的PCa形式,特别是那些具有透生长 (INF) 的形式,可以通过mpMRI错过.
与其他生长模式相比,INF病变的扩散限制较小.

研究的目的:

研究前列腺癌生长模式对使用mpMRI检测病变的影响.
为了将基因病理生长模式 (扩展性与透性) 与mpMRI发现相关联,包括PI-RADS得分和明显扩散系数 (ADC) 值.

主要方法:

对52名急性前列腺切除术患者进行了手术前的mpMRI后期分析.
两个病理学家对病变生长模式 (扩展性/INF) 的独立分类.
独立的PI-RADS v2.1由两名放射科医生根据病理局部进行分类.
测量ADC值与组织病理学相关;使用科恩卡帕评估的读者间一致性.

主要成果:

对于增长模式分类 (κ=0.88) 和PI-RADS评分 (κ=0.90) 的高度一致.
PI-RADS得分与扩张性 (EXP) 增长模式有显著的相关性.
在EXP病变中,ADC值较低 (0.83×10^-3 mm²/s),而不是INF病变 (0.97×10^-3 mm²/s).
透性病变在T2加权成像中更频繁地被遗漏 (29%与4%相比).

结论:

潜入性生长模式的前列腺癌更频繁地被mpMRI遗漏.
扩张性增长模式与较低的ADC值和更高的PI-RADS得分有关.
了解生长模式可以改善对mpMRI的解释,以进行积极的PCa检测.

关键词:

检测检测检测检测检测扩散限制的扩散限制扩张性的增长扩张性的增长潜入式增长是一种潜入式增长.多参数磁共振成像多参数磁共振成像皮拉德斯 (PI-RADS) 是一个前列腺新生体前列腺瘤.

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