The Characteristics Of Dynamic Contrast Enhanced MRI In Prostate Cancer At3.0T MR And The Correlation Between DWI、MRS

PartⅠ The Characteristics of dynamic contrast enhancedMRI in prostate cancer at3.0T MRObjective: By analyzing the characteristics of dynamic contrast enhanced MRimaging (DCE-MRI) in prostate cancer at3.0T MR, to evaluate the diagnostic value ofDCE-MRI and to investigate the correlation between DCE-MRI and the Gleason score.Materials and Methods: The prospective pilot study enrolled85patients withsuspected prostate cancer in our hospital from2012.8to2013.8, the age ranged47-83withaverage of70years. All patients received examination by using GE Signa HDx3.0T MRand the heart phased coil. We conducted axial plane T1WI, T2WI, coronal T2WI, sagittalT2WI and the Liver Acquisition with Volume Acceleration (LAVA) DCE-MRI. Byanalyzing the characteristics of the3.0T LAVA of prostate cancer, analyzing the styles ofthe signal intense-tine (SI-T) curve, to calculate the time to maximum (Tmax), themaximum degree of enhancement (STmax%), the rate of enhancement (Rmax). The stylesof SI-T curve and the parameters in the positive (with prostate cancer) and negative group(with no evidence of cancer) were analyzed respectively. The correlation between Tmax,SImax%, R value and Gleason score was also analyzed statistically.Results:59cases of prostate cancer were proved by biopsy, and there was noevidence of tumor in26cases,507zones have histopathological results with positive group250(Gleason score2-636, Gleason score7-10214) and negative group257. The mostcommon style of SI-T curve in positive group was rapidly ascending followed withdescending curve, the most common style of SI-T curve in negative group was persistentascending curve and plateau curve. The mean value of Tmax, SImax%, Rmax in positive group was （69.49±22.53）s、1.74±0.43、7.83±3.80, the mean value of Tmax, SImax%,Rmax in negative group was （175.61±52.64）s、1.05±0.35、1.86±1.10, there werestatistically significant differences（t=-24.24、16.34、17.75，P all＜0.01）. The mean valueof Tmax, SImax%, Rmax in the low-risk group (Gleason score2-6) was （89.19±31.72）s、1.58±0.46、5.21±3.34, the mean value of Tmax, SImax%, Rmax in the high-risk group(Gleason score7-10) was （64.25±14.68）s、1.76±0.43、8.25±3.70, there were statisticallysignificant differences （t=7.09、-8.74、-7.83，P all＜0.01）. The Tmax value of prostatecancer was negatively correlated with the Gleason score（r=-0.471，P＜0.01）, the SImax%and Rmax value were positively correlated with Gleason score（r=0.472、0.537，P all＜0.01）.Conclusions:3.0T LAVA DCE-MRI has great value in the diagnosis of prostatecancer, the parameters of DCE-MRI are correlated with Gleason score.PartⅡ Study of the Correlation between3.OT MagneticResonance Spectrospcopy and Diffusion Weighted Imaging inthe prostate cancerObjective: By analyzing the (Cho+Cre)/Cit value and the apparent diffusioncoefficients (ADC) value in prostate cancer, to study the relationship between them, and toevaluate the diagnostic value of magnetic resonance spectrospcopy (MRS) and diffusionweighted imaging (DWI) in prostate cancer.Materials and Methods: The prospective pilot study enrolled29patients withsuspected prostate cancer in our hospital from2012.8to2013.8, the age ranged52-79withaverage of68years. All patients received examination by using GE Signa HDx3.0T MRand the heart phased coil. We conducted axial plane T1WI, T2WI, coronal T2WI, sagittalT2WI and MRS, DWI scan. The (Cho/Cre)/Cit values and ADC values The (Cho/Cre)/Citvalues and ADC values in the positive (with prostate cancer) and negative group (with noevidence of cancer) were analyzed respectively. The correlation between them was also analyzed statistically.Results:16cases of prostate cancer were proved by biopsy, and there was noevidence of tumor in13cases,174zones have histopathological results with positive group73and negative group101. The mean value of (Cho/Cre)/Cit in cancerous andnoncancerous was2.59±1.89、0.71±0.15, there was statistically significant difference（t=3.56，P＜0.01）. The area under the ROC curve was0.93(P=0.000), the best thresholdof (Cho/Cre)/Cit value for the diagnosis of prostate cancer was （Cho+Cre）/Cit=1.04, thediagnostic sensitivity and specificity were of87.5%and92.3%, respectively. The meanvalue of ADC in cancerous and noncancerous was （0.86±0.20）×10-3mm2/s、（1.13±0.12）×10-3mm2/s, there there was statistically significant difference（t=-6.02，P＜0.01）. The bestthreshold of ADC value for the diagnosis of prostate cancer was1.06×10-3mm2/s, thediagnostic sensitivity and specificity were of87.5%and77.3%, respectively. The ADCvalue of prostate cancer was negatively correlated with the (Cho/Cre)/Cit value（r=-0.71，P＜0.01）.Conclusions:3.0T MRS and DWI have great value in the diagnosis of prostate cancer.The ADC value less than1.04×10-3/mm2and the (Cho/Cre)/Cit value higher than1.06is apreferable threshold to differentiate cancer from noncancerous tissue in our study.