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Objective:To evaluate the value of integrated PET/MR in assessing myocardial viability in ischemic heart disease.Methods:A total of 39 patients (28 males, 11 females; age (60.1±12.0) years) diagnosed with ischemic heart disease in Xuanwu Hospital, Capital Medical University were retrospectively enrolled from September 2020 to December 2021. All patients underwent cardiac 13N-NH 3·H 2O and 18F-FDG PET/MR examinations. Late gadolinium enhancement (LGE) sequence was included in MRI scan. PET and MRI images were analyzed and myocardial viability of each myocardial segment was evaluated according to the American Heart Association (AHA) 17 segment method. The extent of left ventricular infarcted myocardium was measured based on PET and MRI images. Weighted Kappa test was used to evaluate the agreement of PET and MRI in assessing myocardial viability. The extent of infarcted myocardium measured by PET and MRI was compared by paired- t test, and Pearson correlation analysis was used to assess the correlation between them. Results:There was a moderate agreement between PET and MRI in assessing myocardial viability ( Kappa=0.532, P<0.001), with the agreement rate of 69.83%(463/663). There was no significant difference but strong correlation between the extents of infarcted myocardium measured by PET and MRI ((23.89±14.23)% vs (23.55±11.90)%; t=-0.24, P=0.809; r=0.79, P<0.001). In segments with normal perfusion and metabolism on PET, 22.52% (100/444) showed abnormal enhancement on MRI. On the other hand, 39.89% (73/183) of the segments classified as non-viable on MRI showed normal or viable on PET. Conclusion:Integrated PET/MR is able to take full advantage of the complementary nature of PET and MRI, achieving the comprehensive and accurate evaluation of myocardial viability.
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Objective:To investigate the diagnostic value of quantitative parameters of synthetic MRI in patients with prostate cancer (PCa).Methods:From April 2018 to April 2019, 25 PCa patients confirmed by whole-mount pathology were prospectively enrolled in Beijing Hospital. All patients underwent prostate MRI examinations including DWI and synthetic MRI. Four kinds of tissue types were identified in pathology, including PCa, stromal hyperplasia (SH), glandular hyperplasia (GH) and prostatitis. According to the pathological results, quantitative parameters including ADC, T 1, T 2 and proton density (PD) values were measured on DWI and synthetic MRI. One-way analysis of variance or Kruskal-Wallis H test was performed to compare the difference of each parameter among PCa, SH or GH in the transitional zone (TZ). The difference of each parameter between PCa and prostatitis in the peripheral zone (PZ) was evaluated by using independent sample t test or Mann-Whitney U test. The diagnostic performance of each parameter in discriminating PCa from other benign conditions was evaluated by using ROC curve. Area under the curve (AUC) of each parameter was compared by using DeLong test. Results:The overall differences of T 1, T 2 PD and ADC values were statistically significant among PCa and other benign conditions. The T 1, T 2 and ADC values of PCa in the TZ were lower than those in the SH ( P=0.041, 0.030,<0.001) and GH (all P<0.001). The PD value of PCa in the TZ was lower than that in the GH ( P=0.040). The differences of T 1, T 2, PD and ADC values between PCa and prostatitis in the PZ were significant ( P<0.05). The AUC of ADC value (0.943) was higher than that of T 1 (0.691, P=0.001), PD (0.555, P=0.002) and T 2 (0.754, P=0.016) values in differentiating PCa from SH. For discriminating PCa and GH, T 1, T 2 and ADC showed similar AUC ( P>0.05), which were higher than AUC of PD value ( P=0.001). For discriminating PCa and prostatitis, T 1, T 2, PD and ADC values showed similar AUC ( P>0.05). Conclusions:Quantitative parameters of synthetic MRI were practical tools for discriminating PCa from other benign pathologies.
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Objective:To investigate the features of volume, distribution, grading and staging of prostate cancer(PCa)examined via whole-mount histopathology in transitional PCa.Methods:A total of 129 PCa patients undergone radical prostatectomy(RP)between July 2017 and March 2020 whose whole-mount prostate specimens were prepared after surgery were retrospectively studied.Pathological data on tumor locations, diameters and classification of the International Society of Urologic Pathology(ISUP), radiological data on regions of interest(ROI)and scores of the Prostate Imaging and Reporting Data System(PI-RADS v2)were recorded.The results of pathological whole-mount sections and prostate imaging were compared, and the characteristics and detection rates of lesions in different prostate regions were analyzed.Results:Of all 129 prostate specimens from RP, a total of 213 PCa lesions were detected through whole-mount histopathology.There were 21(9.9%)lesions involving both the peripheral zone(PZ)and the transition zone(TZ), with an average diameter of(2.82±0.71)cm.Of all lesions, 85(39.9%)involved PZ and 107(50.2%)involved TZ, with an average diameter of(1.36±0.81)cm and of(1.60±0.94)cm, respectively.The percentage of lesions involving TZ was higher than that lesions involving PZ, with larger diameters( P<0.05). Of 64 patients with complete MRI data, 105 PCa lesions were detected histopathologically by using whole mount sections, while 75 PCa lesions were detected by MRI, with a statistical difference( P<0.05). For lesions≥1.0 cm or lesions with an ISUP grade group≥2, the detection rate of MRI was lower in TZ lesions( P<0.05). Conclusions:PCa lesions within TZ account for a large proportion and have a relatively large tumor dimeter.PCa lesions within TZ are more likely to be missed in clinical examinations and on MRI, and clinicians should pay close attention during diagnosis and treatment.
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Objective:To investigate the detection rate and the characteristics of detected prostate cancer foci on multi-parametric MRI (mp-MRI) and to evaluate the potential influence factors.Methods:A total of 66 patients undergoing radical prostatectomy (RP) from August 2017 to July 2019 in Beijing Hospital were retrospectively studied. The median age was 67(56-80)years, with the median preoperative PSA level of 8.73 (1.22-72.46)ng/ml, and median prostate volume of 35.9(16.8-131.8) ml. All patients underwent mp-MRI before surgery and the whole mount section of RP specimens was prepared. Two radiologists reviewed all the foci independently and then matched each foci with an urological pathologist. The primary outcome was the detection rate of prostate cancer. The potential influence factors were also investigated.Results:Of all 66 patients, a total of 62(93.9%) patients were diagnosed with prostate cancer on a preoperative mp-MRI. On whole mount section, 109 prostate cancer foci were detected, of which 77 foci were correctly diagnosed on mp-MRI, with the overall sensitivity of 70.6%. For all the foci detected, 53(48.6%) were grade group 1 disease of International Society of Urological pathology (ISUP), 31(27.5%) were ISUP grade group 2 disease, 19(17.4%) were ISUP grade group 3 disease, and 6(5.5%) were ≥ISUP grade group 4 disease. Mp-MRI detected 62/67(92.5%) lesions with tumor diameter ≥1 cm, 49/56(87.5%) lesions with tumor Gleason score ≥7, and 59/66(89.4%) index lesions. The tumor diameter( OR=3.183, 95% CI 1.580-6.411, P=0.001)and index lesion status( OR=4.042, 95% CI 1.127-14.503, P=0.032)were independently associated with the detection of prostate cancer foci on mp-MRI. Conclusions:mp-MRI is an effective technique for prostate cancer detection. Sensitivity increased with increased tumor size and index lesion status. The tumor diameter and index lesion status were independently associated with the detection of prostate cancer foci on mp-MRI.
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Objective@#To explore the value of diffusion kurtosis imaging (DKI) histogram analysis for differential diagnosis of prostate cancer and noncancerous foci and the correlation between histogram parameters and Gleason score.@*Methods@#Twenty-one patients were retrospectively enrolled in Beijing Hospital from May 2017 to May 2018. All subjects underwent Philips 3.0 T MR scanning. The pathologies were confirmed by in-bore MR-guided biopsy. Finally, 31 lesions were collected (two lesions each from 10 patients), including 15 prostate cancer and 16 noncancerous foci (benign prostatic hyperplasia and prostatitis). ROI was drawn manually by two experienced radiologists. All the lesions were measured mean apparent diffusion coefficient (Dapp), mean apparent kurtosis coefficient (Kapp) and their histogram parameters, the averages of two measurements were used to be calculated. The values of these parameters in cancer and noncancerous foci were compared using independent-samples t test. The Spearman test was used to evaluate the correlation of these parameters and Gleason scores of prostate cancer.@*Results@#Mean Dapp, 10th Dapp, 25th Dapp, 50th Dapp, 75th Dapp, 90th Dapp, minimum Dapp, maximum Dapp, mean Kapp, 50th Kapp, 75th Kapp, 90th Kapp, maximum Kapp between prostate cancer and noncancerous foci were statistically significant (P<0.05). 90th Kapp (r=0.630, P<0.05) and maximum Kapp (r=0.565, P<0.05) increased with the Gleason scores increasing.@*Conclusion@#Histogram analysis of DKI model is valuable for diagnosing and assessing aggressiveness of prostate cancer.
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Objective To explore the value of diffusion kurtosis imaging (DKI) histogram analysis for differential diagnosis of prostate cancer and noncancerous foci and the correlation between histogram parameters and Gleason score. Methods Twenty?one patients were retrospectively enrolled in Beijing Hospital from May 2017 to May 2018. All subjects underwent Philips 3.0 T MR scanning. The pathologies were confirmed by in?bore MR?guided biopsy. Finally, 31 lesions were collected (two lesions each from 10 patients), including 15 prostate cancer and 16 noncancerous foci (benign prostatic hyperplasia and prostatitis). ROI was drawn manually by two experienced radiologists. All the lesions were measured mean apparent diffusion coefficient (Dapp), mean apparent kurtosis coefficient (Kapp) and their histogram parameters, the averages of two measurements were used to be calculated. The values of these parameters in cancer and noncancerous foci were compared using independent?samples t test. The Spearman test was used to evaluate the correlation of these parameters and Gleason scores of prostate cancer. Results Mean Dapp, 10th Dapp, 25th Dapp, 50th Dapp, 75th Dapp, 90th Dapp, minimum Dapp, maximum Dapp, mean Kapp, 50th Kapp, 75th Kapp, 90th Kapp, maximum Kapp between prostate cancer and noncancerous foci were statistically significant (P<0.05). 90th Kapp (r=0.630, P<0.05) and maximum Kapp (r=0.565, P<0.05) increased with the Gleason scores increasing. Conclusion Histogram analysis of DKI model is valuable for diagnosing and assessing aggressiveness of prostate cancer.