Objective To quantitatively evaluate the metabolic changes of benign prostatic hyperplasia(BPH) and prostate cancer in the transitional zone using magnetic resonance spectroscopic imaging(MRSI),and to analyze the char...Objective To quantitatively evaluate the metabolic changes of benign prostatic hyperplasia(BPH) and prostate cancer in the transitional zone using magnetic resonance spectroscopic imaging(MRSI),and to analyze the characteristics and differences of the spectra in this zonal area.Methods Eighteen patients with prostate cancer in the transitional zone underwent magnetic resonance imaging(MRI)/MRSI examinations.The(Choline+Creatine)/Citrate(CC/Ci) ratio and the Choline/Creatine(Cho/Cr) ratio were evaluated in each voxel with cancer or BPH confirmed by pathological results.Discriminant analysis was used to determine the power of the two ratios in differentiation between cancer and BPH.Results The CC/Ci ratio and Cho/Cr ratio for cancer voxels were significantly higher than those in the voxels with BPH in the transitional zone(CC/Ci:2.36±1.31 vs.0.85±0.29,P<0.01;Cho/Cr:4.14±1.79 vs.1.26±0.45,P<0.01).As for the discriminant function with the CC/Ci ratio and the Cho/Cr ratio,the specificity,sensitivity,and accuracy were 98.6%,85.7%,92.9% respectively for the differentiation between cancer and BPH.Conclusions The prostate cancer is characterized by higher CC/Ci ratio and Cho/Cr ratio compared to BPH in the transitional zone.Both CC/Ci ratio and Cho/Cr ratio have high specificity,sensitivity,and accuracy in their discriminative power between cancer and BPH in this zonal area.展开更多
Objective： To explore the application of MR perfusion-weighted imaging （PWI） in the benign and malignant prostate diseases, and evaluate the correlations of PWl features with vascular endothelial growth factor （V...Objective： To explore the application of MR perfusion-weighted imaging （PWI） in the benign and malignant prostate diseases, and evaluate the correlations of PWl features with vascular endothelial growth factor （VEGF） and microvessel density （MVD）. Methods： Seventy-four consecutive patients who were diagnosed clinically for the prostate diseases, including forty-four cases with benign prostate hyperplasia and thirty cases with prostatic cancer proved pathologically, were examined by PWI. MVD and VEGF were stained with immunohistochemical methods. Some parameters of PWl, including the steepest slope of signal intensity-time curve （SSmax） and the change in relaxation rate （ΔR2^＊ peak） at lesions, were analyzed. Correlation analysis was used to determine the relationship between the results of PWl and immunohistochemistry. Results： （1） In the benign prostate hyperplasia （BPH）, SSmax and ΔR2^＊ peak of perfusion curve were 34.2 ± 2.9 and 1.49 ± 0.11, respectively; however, in the prostatic cancer （Pca）, they were 58.6± 4.8 and 3.18 ±0.49 respectively; there were statistical differences （t = 2.16 and 2.31, P 〈 0.05）. （2） The VEGF and MVD expressions of thirty Pca patients were significantly higher than those of forty-four BPH patients （x2 = 28.64, P 〈 0.01; t = 21.2, P 〈 0.01）. MVD expressions of Pca and BPH groups showed positive associations with VEGF expressions （P 〈 0.01）. On MR perfusion-weighted imaging, SSmax and ΔR2^＊ peak showed associations with MVD and VEGF expressions （P 〈 0.01）. Conclusion： On MR perfusion-weighted imaging, SSmax and ΔR2^＊ peak can reflect MVD and VEGF expression levels in the benign and malignant prostate diseases and might be implied the tumor angiogenesis so as to distinguish benign from malignant and provide the important information for the surgeon to diagnose and treat the prostatic diseases.展开更多
Aim: To evaluate KAII/CD82 expression in Chinese patients with benign prostatic hyperplasia (BPH) and late-stage carcinoma of prostate (CaP). Methods: Thirty Chinese patients with benign prostatic hyperplasia and 34 w...Aim: To evaluate KAII/CD82 expression in Chinese patients with benign prostatic hyperplasia (BPH) and late-stage carcinoma of prostate (CaP). Methods: Thirty Chinese patients with benign prostatic hyperplasia and 34 withCaP (adenocarcinoma clinical stage C and D) were analyzed by means of immunohistochemical methods. Results:The KAII/CD82 expression in BPH tissue was all positive, which was uniformly located on the glandular cell mem-brane at the cell-to-cell borders, but KAII/CD82 expression in metastasis CaP tissues was either significantly lower thanthat of BPH or negative, and the immunostaining pattern was not continuous. In late-stage CAP KAII/CD82 expressionwas correlated inversely to the pathological grade ( P < 0.05), but not to clinical stage ( P > 0.05). Conclusion:The authors believe that decreased and negative KAII/CD82 expression in late-stage CaP may be related to tumor pro-gression and metastasis, and appears to be a prognostic marker.展开更多
To assess the role of dynamic contrast-enhanced MRI (DCE-MRI) in thediagnosis and differentiation of prostatic cancer (PC). Methods: Five volunteers, 36 patients withbenign prostatic hyperplasia (BPH) and 13 patients ...To assess the role of dynamic contrast-enhanced MRI (DCE-MRI) in thediagnosis and differentiation of prostatic cancer (PC). Methods: Five volunteers, 36 patients withbenign prostatic hyperplasia (BPH) and 13 patients with biopsy-proven prostate cancer underwentconventional MRI, DCE-MRI and delayed enhancement MRI. The value of the signal intensity in DCE-MRIwas measured and calculated to draw the time-signal intensity curve of the normal peripheral zone(PZ), the prostate cancer and the benign prostatic hyperplasia. Results: In DCE-MRI, the normalperipheral zone was enhanced mildly and slowly and the peak value was located in late phase. Theenhancement of the lesions in 36 patients with the benign prostatic hyperplasia was obvious in earlyphase and strengthened gradually, and then turned to decrease in late phase after peak value. Thelesions in 9 of 13 cases with prostate cancer were enhanced obviously in early phase and washed outrapidly, and the peak value was located in early phase, but the peak value was in mediate and latephase in the other 4 cases with diffuse lesion in the prostate on T_2WI. Conclusion: In DCE-MRI, theenhancement patterns of the normal peripheral zone, the prostate cancer and the benign prostatichyperplasia were significantly different. DCE-MRI was very useful in the diagnosis anddifferentiation of prostate cancer.展开更多
Background： One of the main aims of the updated Prostate Imaging Reporting and Data System Version 2 （PI-RADS v2） is to diminish variation in the interpretation and reporting of prostate imaging, especially among r...Background： One of the main aims of the updated Prostate Imaging Reporting and Data System Version 2 （PI-RADS v2） is to diminish variation in the interpretation and reporting of prostate imaging, especially among readers with varied experience levels. This study aimed to retrospectively analyze diagnostic consistency and accuracy for prostate disease among six radiologists with different experience levels from a single center and to evaluate the diagnostic pcrformance of PI-RADS v2 scores in the detection of clinically significant prostate cancer （PCa）. Methods： From December 2014 to March 2016, 84 PCa patients and 99 benign prostatic shyperplasia patients who underwent 3.0T multiparametric magnetic resonance imaging before biopsy were included in our study. All patients received evaluation according to the PI-RADS v2 scale （1 5 scores） from six blinded readers （with 6 months and 2, 3, 4, 5, or 17 years of experience, respectively, the last reader was a reviewer/contributor for the PI-RADS v2）. The correlation among the readers＇ scores and the Gleason score （GS） was determined with the Kendall test. lntra-/inter-observer agreement was evaluated using K statistics, while receiver operating characteristic curve and area under the curve analyses were performed to evaluate the diagnostic performance of the scores. Results： Based on the PI-RADS v2, the median k score and standard error among all possible pairs of readers were 0.506 and 0.043, respectively： the average correlation between the six readers＇ scores and the GS was positive, exhibiting weak-to-moderate strength （r = 0.391, P = 0.006）. The AUC values of the six radiologists were 0.883, 0.924, 0.927, 0.932, 0.929, and 0.947, respectively. Conclusion： The inter-reader agreement for the PI-RADS v2 among the six readers with different experience is weak to moderate. Different experience levels affect the interpretation of MRI images.展开更多
目的探究不同参数3.0T磁共振成像(MRI)对前列腺疾病诊断的价值,鉴别诊断前列腺癌(PCa)及前列腺增生(BPH),得出不同参数下3.0T磁共振的诊断效能,为临床上PCa早期诊断、早期干预及早期治疗提供影像学依据。方法回顾性分析大理大学第一附...目的探究不同参数3.0T磁共振成像(MRI)对前列腺疾病诊断的价值,鉴别诊断前列腺癌(PCa)及前列腺增生(BPH),得出不同参数下3.0T磁共振的诊断效能,为临床上PCa早期诊断、早期干预及早期治疗提供影像学依据。方法回顾性分析大理大学第一附属医院2019年12月至2022年9月经病理结果证实的98例前列腺疾病患者的临床资料及MRI常规扫描、扩散加权扫描(DWI)的资料,动态增强(DCE)资料,并由2名影像科诊断医师在不知病理结果的前提下根据T_(2)WI、DWI图像及DCE参数对PCa、BPH进行诊断,以病理结果为金标准计算诊断效能。结果PCa在DWI图像上较正常前列腺组织信号明显增高;BPH动态增强扫描(中期),前列腺呈不均匀中等程度强化,SI-T曲线感兴趣区域(region of interest,ROI)呈缓升型为主;PCa动态增强扫描(早期)病灶区呈中等程度不均匀强化,SI-T曲线癌区呈速升型为主;使用T_(2)WI诊断前列腺癌敏感度、特异度和准确度分别为71%、84%、78%;T_(2)WI+DWI诊断前列腺癌,敏感度、特异度和准确度分别为80%、91%、87%;T_(2)WI+DWI+DCE诊断前列腺癌敏感度、特异度及准确度分别是95%、97%、96%。结论PCa与BPH的DWI和ADC值存在差异,使用DWI检查可以有效区别前列腺病变的性质,联合应用常规T_(2)WI、DWI、DCE可以提高BPH和PCa的诊断准确率。展开更多
文摘Objective To quantitatively evaluate the metabolic changes of benign prostatic hyperplasia(BPH) and prostate cancer in the transitional zone using magnetic resonance spectroscopic imaging(MRSI),and to analyze the characteristics and differences of the spectra in this zonal area.Methods Eighteen patients with prostate cancer in the transitional zone underwent magnetic resonance imaging(MRI)/MRSI examinations.The(Choline+Creatine)/Citrate(CC/Ci) ratio and the Choline/Creatine(Cho/Cr) ratio were evaluated in each voxel with cancer or BPH confirmed by pathological results.Discriminant analysis was used to determine the power of the two ratios in differentiation between cancer and BPH.Results The CC/Ci ratio and Cho/Cr ratio for cancer voxels were significantly higher than those in the voxels with BPH in the transitional zone(CC/Ci:2.36±1.31 vs.0.85±0.29,P<0.01;Cho/Cr:4.14±1.79 vs.1.26±0.45,P<0.01).As for the discriminant function with the CC/Ci ratio and the Cho/Cr ratio,the specificity,sensitivity,and accuracy were 98.6%,85.7%,92.9% respectively for the differentiation between cancer and BPH.Conclusions The prostate cancer is characterized by higher CC/Ci ratio and Cho/Cr ratio compared to BPH in the transitional zone.Both CC/Ci ratio and Cho/Cr ratio have high specificity,sensitivity,and accuracy in their discriminative power between cancer and BPH in this zonal area.
文摘Objective： To explore the application of MR perfusion-weighted imaging （PWI） in the benign and malignant prostate diseases, and evaluate the correlations of PWl features with vascular endothelial growth factor （VEGF） and microvessel density （MVD）. Methods： Seventy-four consecutive patients who were diagnosed clinically for the prostate diseases, including forty-four cases with benign prostate hyperplasia and thirty cases with prostatic cancer proved pathologically, were examined by PWI. MVD and VEGF were stained with immunohistochemical methods. Some parameters of PWl, including the steepest slope of signal intensity-time curve （SSmax） and the change in relaxation rate （ΔR2^＊ peak） at lesions, were analyzed. Correlation analysis was used to determine the relationship between the results of PWl and immunohistochemistry. Results： （1） In the benign prostate hyperplasia （BPH）, SSmax and ΔR2^＊ peak of perfusion curve were 34.2 ± 2.9 and 1.49 ± 0.11, respectively; however, in the prostatic cancer （Pca）, they were 58.6± 4.8 and 3.18 ±0.49 respectively; there were statistical differences （t = 2.16 and 2.31, P 〈 0.05）. （2） The VEGF and MVD expressions of thirty Pca patients were significantly higher than those of forty-four BPH patients （x2 = 28.64, P 〈 0.01; t = 21.2, P 〈 0.01）. MVD expressions of Pca and BPH groups showed positive associations with VEGF expressions （P 〈 0.01）. On MR perfusion-weighted imaging, SSmax and ΔR2^＊ peak showed associations with MVD and VEGF expressions （P 〈 0.01）. Conclusion： On MR perfusion-weighted imaging, SSmax and ΔR2^＊ peak can reflect MVD and VEGF expression levels in the benign and malignant prostate diseases and might be implied the tumor angiogenesis so as to distinguish benign from malignant and provide the important information for the surgeon to diagnose and treat the prostatic diseases.
基金The work was supported by a grant from the Guangdong Scientfic and Technologic Committee(No 970750)
文摘Aim: To evaluate KAII/CD82 expression in Chinese patients with benign prostatic hyperplasia (BPH) and late-stage carcinoma of prostate (CaP). Methods: Thirty Chinese patients with benign prostatic hyperplasia and 34 withCaP (adenocarcinoma clinical stage C and D) were analyzed by means of immunohistochemical methods. Results:The KAII/CD82 expression in BPH tissue was all positive, which was uniformly located on the glandular cell mem-brane at the cell-to-cell borders, but KAII/CD82 expression in metastasis CaP tissues was either significantly lower thanthat of BPH or negative, and the immunostaining pattern was not continuous. In late-stage CAP KAII/CD82 expressionwas correlated inversely to the pathological grade ( P < 0.05), but not to clinical stage ( P > 0.05). Conclusion:The authors believe that decreased and negative KAII/CD82 expression in late-stage CaP may be related to tumor pro-gression and metastasis, and appears to be a prognostic marker.
文摘To assess the role of dynamic contrast-enhanced MRI (DCE-MRI) in thediagnosis and differentiation of prostatic cancer (PC). Methods: Five volunteers, 36 patients withbenign prostatic hyperplasia (BPH) and 13 patients with biopsy-proven prostate cancer underwentconventional MRI, DCE-MRI and delayed enhancement MRI. The value of the signal intensity in DCE-MRIwas measured and calculated to draw the time-signal intensity curve of the normal peripheral zone(PZ), the prostate cancer and the benign prostatic hyperplasia. Results: In DCE-MRI, the normalperipheral zone was enhanced mildly and slowly and the peak value was located in late phase. Theenhancement of the lesions in 36 patients with the benign prostatic hyperplasia was obvious in earlyphase and strengthened gradually, and then turned to decrease in late phase after peak value. Thelesions in 9 of 13 cases with prostate cancer were enhanced obviously in early phase and washed outrapidly, and the peak value was located in early phase, but the peak value was in mediate and latephase in the other 4 cases with diffuse lesion in the prostate on T_2WI. Conclusion: In DCE-MRI, theenhancement patterns of the normal peripheral zone, the prostate cancer and the benign prostatichyperplasia were significantly different. DCE-MRI was very useful in the diagnosis anddifferentiation of prostate cancer.
文摘Background： One of the main aims of the updated Prostate Imaging Reporting and Data System Version 2 （PI-RADS v2） is to diminish variation in the interpretation and reporting of prostate imaging, especially among readers with varied experience levels. This study aimed to retrospectively analyze diagnostic consistency and accuracy for prostate disease among six radiologists with different experience levels from a single center and to evaluate the diagnostic pcrformance of PI-RADS v2 scores in the detection of clinically significant prostate cancer （PCa）. Methods： From December 2014 to March 2016, 84 PCa patients and 99 benign prostatic shyperplasia patients who underwent 3.0T multiparametric magnetic resonance imaging before biopsy were included in our study. All patients received evaluation according to the PI-RADS v2 scale （1 5 scores） from six blinded readers （with 6 months and 2, 3, 4, 5, or 17 years of experience, respectively, the last reader was a reviewer/contributor for the PI-RADS v2）. The correlation among the readers＇ scores and the Gleason score （GS） was determined with the Kendall test. lntra-/inter-observer agreement was evaluated using K statistics, while receiver operating characteristic curve and area under the curve analyses were performed to evaluate the diagnostic performance of the scores. Results： Based on the PI-RADS v2, the median k score and standard error among all possible pairs of readers were 0.506 and 0.043, respectively： the average correlation between the six readers＇ scores and the GS was positive, exhibiting weak-to-moderate strength （r = 0.391, P = 0.006）. The AUC values of the six radiologists were 0.883, 0.924, 0.927, 0.932, 0.929, and 0.947, respectively. Conclusion： The inter-reader agreement for the PI-RADS v2 among the six readers with different experience is weak to moderate. Different experience levels affect the interpretation of MRI images.
文摘目的探究不同参数3.0T磁共振成像(MRI)对前列腺疾病诊断的价值,鉴别诊断前列腺癌(PCa)及前列腺增生(BPH),得出不同参数下3.0T磁共振的诊断效能,为临床上PCa早期诊断、早期干预及早期治疗提供影像学依据。方法回顾性分析大理大学第一附属医院2019年12月至2022年9月经病理结果证实的98例前列腺疾病患者的临床资料及MRI常规扫描、扩散加权扫描(DWI)的资料,动态增强(DCE)资料,并由2名影像科诊断医师在不知病理结果的前提下根据T_(2)WI、DWI图像及DCE参数对PCa、BPH进行诊断,以病理结果为金标准计算诊断效能。结果PCa在DWI图像上较正常前列腺组织信号明显增高;BPH动态增强扫描(中期),前列腺呈不均匀中等程度强化,SI-T曲线感兴趣区域(region of interest,ROI)呈缓升型为主;PCa动态增强扫描(早期)病灶区呈中等程度不均匀强化,SI-T曲线癌区呈速升型为主;使用T_(2)WI诊断前列腺癌敏感度、特异度和准确度分别为71%、84%、78%;T_(2)WI+DWI诊断前列腺癌,敏感度、特异度和准确度分别为80%、91%、87%;T_(2)WI+DWI+DCE诊断前列腺癌敏感度、特异度及准确度分别是95%、97%、96%。结论PCa与BPH的DWI和ADC值存在差异,使用DWI检查可以有效区别前列腺病变的性质,联合应用常规T_(2)WI、DWI、DCE可以提高BPH和PCa的诊断准确率。
