体素内不相干运动成像对经内分泌治疗后的前列腺癌患者的临床效果预测

Prediction of Clinical Effect of Voxel Incoherent Motion Imaging in Patients with Prostate Cancer after Endocrine Therapy

目的 探究体素内不相干运动(intravoxel incoherent motion,IVIM)磁共振成像预测经内分泌治疗后前列腺癌患者的临床效果。方法 选取2020年2月—2022年2月上海交通大学附属瑞金医院无锡分院收治的80例经内分泌治疗的前列腺癌患者作为研究对象。治疗前及治疗6个月后均对所有患者行常规核磁共振以及IVIM磁共振成像检查,按治疗效果分组,比较两组前列腺特异抗原(PSA)水平及肿瘤最大径、表观扩散系数(ADC)、真实扩散系数(D)、灌注扩散系数(D*)以及灌注分数(f)差异,并绘制IVIM磁共振相关指标的ROC曲线,分析IVIM的的预测效能。结果 两组前列腺特异抗原(PSA)及肿瘤最大径比较,差异无统计学意义(P>0.05)。治疗前,治疗有效组的ADC、D、f值均高于治疗无效组,差异有统计学意义(P<0.05);治疗有效组的D*值高于治疗无效组,但差异无统计学意义(P>0.05)。ADC、D、f预测前列腺癌内分泌治疗疗效的最佳阈值分别为1.050×10^(-3) mm^(2)/s、6.145×10^(-3) mm^(2)/s、13.815%,曲线下面积(AUC)分别为0.696、0.835、0.920,ADC、D、f灵敏度分别为98.10%、90.60%、96.20%;特异度分别为56.00%、36.00%、8.00%。结论 体素内不相干运动磁共振成像的ADC、D、f值对经内分泌治疗的前列腺癌患者临床效果具有良好的预测价值,有利于对前列腺癌患者的后续治疗。

Objective To explore the clinical effect of voxel incoherent motion(IVIM)magnetic resonance imaging in patients with prostate cancer after endocrine therapy.Methods A total of 80 patients with prostate cancer undergoing endocrine therapy admitted to the Wuxi Branch of Ruijin Hospital Affiliated to Shanghai Jiaotong University from February 2020 to February 2022 were selected as the research objects.Conventional MRI and IVIM magnetic resonance imaging were performed on all patients before treatment and 6 months after treatment,and they were grouped according to treatment effect.Prostate specific antigen(PSA)level,tumor maximum diameter,apparent diffusion coefficient(ADC),true diffusion coefficient(D),perfusion diffusion coefficient(D*)and perfusion fraction(f)were compared between the two groups.And the ROC curve of IVIM magnetic resonance related indicators was draw to analyze the predictive efficiency of IVIM.Results There was no statistically significant difference in prostate specific antigen(PSA)and the maximum diameter of tumor compared to between the two groups(P>0.05).Before treatment,ADC,D and f values of effective treatment group were higher than those of ineffective treatment group,the difference was statistically significant(P<0.05);the D*value of effective treatment group was higher than that of ineffective treatment group,but the difference was not statistically significant(P>0.05).The optimal thresholds for ADC,D and f to predict the efficacy of endocrine therapy for prostate cancer were 1.050×10^(-3) mm^(2)/s,6.145×10^(-3) mm^(2)/s and 13.815%,respectively.The areas under the curve(AUC)were 0.696,0.835 and 0.920,respectively,the sensitivity of ADC,D and f were 98.10%,90.60%and 96.20%,respectively.The specificity were 56.00%,36.00%and 8.00%,respectively.Conclusion The ADC,D and f values of voxel incoherent motion magnetic resonance imaging have good predictive value for the clinical effect of prostate cancer patients undergoing endocrine therapy, which is conducive to the follow-uptreatment of prostate cancer patients.