In this multicenter, retrospective study, we evaluated the added value of magnetic resonance dispersion imaging (MRDI) to standard multiparametric MRI (mpMRI) for PCa detection. The study included 76 patients, including 51 with clinically significant prostate cancer (csPCa), who underwent radical prostatectomy and had an mpMRI including dynamic contrast-enhanced MRI. Two radiologists performed three separate randomized scorings based on mpMRI, MRDI and mpMRI+MRDI. Radical prostatectomy histopathology was used as the reference standard. Imaging and histopathology were both scored according to the Prostate Imaging-Reporting and Data System V2.0 sector map. Sensitivity and specificity for PCa detection were evaluated for mpMRI, MRDI and mpMRI+MRDI. Inter- and intra-observer variability for both radiologists was evaluated using Cohen’s Kappa. On a per-patient level, sensitivity for csPCa for radiologist 1 (R1) for mpMRI, MRDI and mpMRI+MRDI was 0.94, 0.82 and 0.94, respectively. For the second radiologist (R2), these were 0.78, 0.94 and 0.96. R1 detected 4% additional csPCa cases using MRDI compared to mpMRI, and R2 detected 20% extra csPCa cases using MRDI. Inter-observer agreement was significant only for MRDI (Cohen’s Kappa = 0.4250,p= 0.004). The results of this study show the potential of MRDI to improve inter-observer variability and the detection of csPCa.
在这项多中心回顾性研究中，我们评估了磁共振弥散成像（MRDI）对标准多参数磁共振成像（mpMRI）在前列腺癌（PCa）检测中的附加价值。研究纳入了76例患者，其中51例患有临床显著性前列腺癌（csPCa），这些患者均接受了根治性前列腺切除术，并进行了包含动态对比增强MRI的mpMRI检查。两位放射科医师分别基于mpMRI、MRDI以及mpMRI+MRDI进行了三次独立的随机评分。以根治性前列腺切除术的组织病理学结果为参考标准。影像学和组织病理学均按照前列腺影像报告和数据系统V2.0分区图进行评分。评估了mpMRI、MRDI和mpMRI+MRDI对PCa检测的敏感性和特异性。使用Cohen's Kappa评估了两位观察者之间及观察者自身的一致性。在患者层面，放射科医师1（R1）使用mpMRI、MRDI和mpMRI+MRDI检测csPCa的敏感性分别为0.94、0.82和0.94。对于第二位放射科医师（R2），这些值分别为0.78、0.94和0.96。与单独使用mpMRI相比，R1使用MRDI额外检测出4%的csPCa病例，而R2使用MRDI额外检测出20%的csPCa病例。观察者间一致性仅在MRDI上具有显著性（Cohen's Kappa = 0.4250, p = 0.004）。本研究结果表明，MRDI具有改善观察者间变异性和提高csPCa检测能力的潜力。
肿瘤(癌症)患者之家