Application of Functional MR Imaging in Diagnose for Prostate Cancer
|Course||Medical Imaging and Nuclear Medicine|
|Keywords||prostate Cancer(PCa) magnetic resonance imaging(MRI) functional magnetic resonance imaging(fMRI) diffusion-weighted imaging (DWI) dynamic contrast-enhanced imaging (DCEI) magnetic resonance spectroscopy imaging (MRSI)|
Purpose: To evaluate the diagnostic ability of traditional MR imaging (T2WI) in combination with functional MR imaging:diffusion-weighted imaging (DWI) ,dynamic contrast-enhanced imaging (DCEI) and magnetic resonance spectroscopy imaging (MRSI) for the detection and localization of prostate cancer using 1.5 T magnetic resonance imaging (MRI) with a SENSE cardiac array phased coil.Materials and Methods: Collect the MRI data of ninety-three patients which were confirmed pathologically,from 2009.1 to 2011.3,all patients were evaluated by traditional MRI(T2WI)and functional MRI( DWI, MRSI,and DCEI) prior to needle biopsy or operation.The obtained data from T2WI alone (protocol one), a combination of T2WI and DWI (protocol two), a combination T2WI and DCEI (protocol three), a combination T2WI and MRSI (protocol four), a combination of T2WI plus DWI and DCEI (protocol five),and a combination of T2WI plus DWI,DCEI and MRSI (protocol six).To analyze All MRI data mentioned above according different protocols.The analysis result were subjected to receiver operating characteristic (ROC) curve analysis.Results: For ninety-three patients,forty-three were confirmed pathologically as cancerous and fifty patients which were confirmed pathologically as noncancerous.The sensitivity, speci?city, accuracy, and area under the ROC curve (Az) for region-based analysis were:83.72%, 46.00%, 63.44%和0.777, respectively, in protocol one; 93.02%, 78.00%, 84.95%和0.929, respectively, in protocol two; 90.70%, 64.00%, 76.43%和0.863, respectively, in protocol three; 90.70%, 82.00%, 86.02%和0.922, respectively, in protocol four; 95.35%, 84.00%, 89.25%和0.945, respectively, in protocol five; and 93.02%, 88.00%, 90.32%和0.945, respectively, in protocol six. ROC analysis revealed that protocols five and six have the best Az value,the second is protocols two,and the worst is protocols one.Significant differences have not been seen between protocols two and five(P=0.4925), protocols two and six(P=0.5549).Significant differences between protocols one and two (P=0.0003), between protocols one and four (P=0.0002), between protocols one and five (P=0.0002), and between protocols one and six (P=0.0002).Conclusion: The combination of fMRI:DWI, DCEI and MRSI can improved the diagnostic efficiency significantly of traditional MRI for the detection of prostate cancer.The protocols two which have better diagnostic appearance is a available screening diagnosis protocol.