ABSTRACT
Objective To investigate the diagnostic value of multiparametric MRI in early prostate cancer(PCa) based on PI-RADS version 2.Methods 27 surgically-proved early PCa patients were collected in this retrospective study.T2WI,DWI and DCE were evaluated by two blinded radiologists.By 12 sub-region classification method the possibility of the presence of cancer at each sub-region was scored according to the PI-RADS V2.The receiver operating characteristic (ROC) curve was used to analyze the diagnosic efficacy of the following 4 protocols:T2WI alone(protocol 1),T2WI+DWI(protocol 2),T2WI+DCE(protocol 3),T2WI+DWI+DCE(protocol 4).The sensitivity,specificity and accuracy for each protocol were calculated.The average scores of cancerous sub-regions and non-cancerous sub-regions were calculated and the independent sample t test was used to compare the four protocols.Results 324 sub-regions were analyzed in 27 early PCa patients and then divided into 119 cancerous sub-regions and 205 non-cancerous sub-regions,including 64 peripheral zone cancerous sub-regions and transition zone cancerous sub-regions.In protocol 1-4, the average scores of cancerous sub-regions in orderwere 3.13±1.19,3.27±1.15,3.28±1.23, 3.33±1.16,respectively.Non-cancerous sub-regions's scores in order were 1.98±0.90,1.91±0.91, 2.03±0.99,1.94±0.96 respectively and there were significant differences among each protocol (P0.05).In four protocols, the sensitivity in order were 45.40%, 56.30%, 59.70%, 61.34%, while the specificity in order were 95.10%, 96.10%, 89.80%, 96.60%, and the accuracy in order were 76.85%, 81.48%, 78.70%, 83.65%.Conclusion Multiparametric MRI can improve the diagnostic accuracy for the detection of early PCa, and T2WI+DWI+DCE is with the highest value.The PI-RADS V2 system is a better semi quantitative method for evaluation of early PCa.
ABSTRACT
Objective To evaluate the utility of apparent diffusion coefficient (ADC) values from DWI in identifying intermediate and high grade prostate cancer (patients harboring Gleason 4 and/or 5 components in their radical prostatectomy specimens). Methods We retrospectively analyzed the DWI of 54 patients with biopsy-proven prostate cancer and biopsy Gleason score (GS)≤3+3=6. These patients were divided into two groups, intermediate and high grade prostate cancer (patients harboring Gleason 4 and/or 5 components in their radical prostatectomy specimens) and low-grade prostate cancer (patients not harboring Gleason 4 and/or 5 components in their radical prostatectomy specimens). ROIs were drawn on areas of the most suspicious lesion on T2WI and the ADC values were calculated. The ADC values of the two groups were compared to determine whether there were differences between them with independent-sample t test. Receiver operating characteristic (ROC) curve was used to determine the ability of ADC values in differentiating intermediate/high grade prostate cancer from low-grade prostate cancer. Results Twenty-eight patients had intermediate and high grade prostate cancer while the other twenty-six ones had low-grade prostate cancer. Significant differences were found for the ADC values of these two groups [(0.905±0.162)×10-3mm2/s vs. (1.143±0.165)×10-3mm2/s, t=5.361,P<0.01]. The area under the ROC curve of ADC in differentiating intermediate and high grade prostate cancer from low-grade prostate cancer was 0.861, with sensitivity of 88.5% and specificity of 67.9% at the cut-off of 1.000 × 10-3mm2/s. Conclusion The ADC values of suspicious areas in prostate contribute to identify intermediate/high grade prostate cancer in patients with a GS≤3+3=6 on biopsy.
ABSTRACT
Hypoxia ischemic encephalopathy(HIE) is the brain hypoxia ischemic damage resulted from perinatal hypoxia.MRI can reflect not only the anatomical and pathological changes of neonatal HIE,but also the molecular and metabolical changes in early stage,and evaluate the property and degree of HIE without radioactive damage,which is considered as an ideal imaging examination method for neonatal HIE.This review will summarize progresses in application of MRI to neonatal HIE diagnosis and prognosis.