| Part I: Between before and after treatment for prostate cancer endocrine cancer area, non-cancer area, lymph nodes and bone metastases compare ADC value of lesions,Correlation and ADC value and clinical efficacy evaluation of PSAObjective: Retrospective analysis before and after PCa patients with endocrine therapy for prostate cancer area, non-cancer area, lymph nodes and bone metastases apparent diffusion coefficient(ADC value) changes its meaning, Evaluate the efficacy of PCa DWI ADC value as indicators of the value of monitoring and analysis.Materials and Methods: Collected by histopathology confirmed 43 cases of PCa clinical and imaging data,The group of patients had no previous history of PCa treatment,Both before and after hormonal therapy routine MRI and DWI checks Where 31 cases of the control group, 12 cases of recurrence,Measurement and control group before and after treatment for prostate cancer recurrence group area, non-cancer area, lymph nodes and bone metastases ADC values and serum PSA level,Differences observed before and a fter treatment indicators(ADC values and serum PSA level) between the statistical analysis,To investigate the correlation ADC value change with PSA value change between before and after treatment.Results: Control Group:ADC value before cancer treatment area(0.6571 ± 0.12) × 10-3mm2/s, non-cancerous area(1.4928 ± 0.33) × 10-3mm2 / s, lymph nodes(0.8042 ± 0.14) × 10-3mm2/ s, bone metastases( 0.58 ± 0.12) × 10-3mm2 / s, pre-treatment PSA value:(60.4068 ± 38.15) μg / L; ADC value after treatment: cancer area(1.0366 ± 0.17) × 10-3mm2 / s, non-cancerous area(1.2750 ± 0.22) × 10-3mm2 / s, lymph nodes(1.0683 ± 0.20) × 10-3mm2/ s, bone metastases(0.925 ± 0.25) × 10-3mm2 / s, post-treatment PSA value(2.5737 ± 3.91)μg / L wherein the difference between before and after the cancer area, lymph nodes, bone metastases treatment PSA values and ADC values were statistically significant change(p <0.05), the difference before and after the ADC values between the treatment of non-cancerous regions was not statistically significant(p> 0.05). Recurrence group:ADC value before cancer treatment area(0.6779 ± 0.15) × 10-3mm2/ s, non-cancerous area(1.6746 ± 0.27) × 10-3mm2 / s, lymph nodes(0.7150 ± 0.17) × 10-3mm2 / s, bone metastases( 0.7025 ± 0.11) × 10-3mm2 / s, pre-treatment PSA value:(79.5817 ± 35.76) μg / L; ADC value after treatment: cancer area(0.9167 ± 0.31) × 10-3mm2 / s, non-cancerous area(1.4446 ± 0.17) × 10-3mm2 / s, lymph nodes(1.1867 ± 0.37) × 10-3mm2 / s, bone metastases(1.0592 ± 0.30) × 10-3mm2 / s, post-treatment PSA value(30.9563 ± 38.63) μg / L wherein the difference between the ADC values cancer area, non-cancer area, bone metastases and PSA levels before and after treatment was statistically significant(p <0.05), the difference before and after the ADC values between the treatment of the lymph nodes was not statistically significant(p> 0.05). The control group and the group of cancer recur rence in the treatment area before the ADC values were(0.6571 ± 0.12) × 10-3mm2 / s and(0.6779 ± 0.15) × 10-3mm2 / s, the difference between them was not statistically significant(p > 0.05); ADC value after treatment were(1.0366 ± 0.17) × 10-3mm2 / s and(0.9167 ± 0.31) × 10-3mm2 / s, the difference between them was not statistically significant(p> 0.05).Recurrence of cancer and control groups zone before treatment after treatment compared with ADC value increased, but the rate of increase relapse group [(0.2387 ± 0.21) × 10-3mm2 / s] compared with the control group [(0.3765 ± 0.18) × 10-3mm2 / s] is small. Spearman correlation analysis control group and relapse group before and after treatment between ADC value change PSA levels and cancer area was no significant correlation(p> 0.05).Conclusion: The study showed that in the control group and relapse group, the average change in ADC values cancer area, non-cancerous area, lymph nodes and bone metastases and water before and after PSA PCa endocrine therapy, ADC values of the two groups in the cancer and bone metastases and PSA value, the control group of lymph nodes and the non-recurrence of cancer zone differences between groups before and after treatment were statistically significant, while the rec urrence group measured ADC values and the difference in PSA values between before and after treatment compared with the control group is small. Thus, ADC value PCa endocrine therapy occurred after the change can be used to monitor the efficacy of endocrine therapy clinical PCa, as the clinical efficacy of detection index PCa useful supplement PSA, have potential clinical application in the monitoring and assessment of the efficacy of endocrine therapy PCa value. PCa endocrine ADC value changes before and after treatment with PSA values between change no significant correlation.Part II: Compare prostate cancer before and after cancer endocrine therapy area, non-cancerous region DCE-MRI parameters, quantitative comparative analysis; and to explore the correlation DCE-MRI parameters and clinical outcome measures of PSAObjective: To analyze changes in endocrine PCa DCE-MRI before and after treatment of the parameters discussed DCE-MRI parameters employed as an analytical indicator of value PCa after endocrine therapy efficacy monitoring.Materials and Methods: Collected by histopathology confirmed 33 cases of PCa patients with clinical and radiological data, the group of patients had no previous history of PCa treatment, both before and after treatment in endocrine routine MRI, DWI and DCE-MRI examination, where the control group of 22 cases, 11 cases of recurrence groups. Measurement parameters: Semi-quantitative parameters: O nset time, time to peak(TTP), peak enhancement(SImax), maximum enhancement ratio(SImax%), the inflow rate(Washin rate), clearance rate(Washout rate); quantitative parameters: transfer constant(K t rans), extravascular extracellular space volume percent(Ve) and rate constants(Kep). Measurement control group and relapse group of endocrine cancer area, DC E-MRI non-cancerous areas, each parameter value and serum PSA levels before and after treatment, measured before and after treatment between endocrine parameters differences were statistically analyzed and discussed and DC E-MRI parameters PSA values of the correlation between changes.Results:Control groups: treatment before cancer district: O nset time(18.3677 ± 10.37) s, TTP(88.3632±36.81) s, SImax 2209.1477 ± 766.33, SImax%(190.2745 ± 49.25)%, Washin rate(107.3277 ± 44.02) s-1, Washout rate(9.7686 ± 6.01) s-1, K trans(3.4471 ± 1.52) × 10-3min-1, Kep was(2.1395 ± 1.52) × 10-3min-1, Ve1.9067 ± 0.88; After treatment, cancer district: Onset time(28.3145 ± 9.51) s, TTP(197.9464 ± 31.05) s, SImax 2275.9918 ± 806.67, SImax%(204.0577 ± 65.23)%, Washin rate(69.7582 ± 32.21) s-1, Washout rate(7.7755 ± 13.71) s-1, K trans(2.4224 ± 1.26) × 10-3min-1, Kep was(0.9418 ± 0.37) × 10-3min-1, Ve2.1962 ± 0.71, where Onset time, TTP, Washin rate, K t rans value, Kep values are statistically significant difference between before and after treatment in(p <0.05), while SImax, SImax%, Washout rate and Ve difference between before and after treatment in the absence of statistically significant(p> 0.05). Recurrence group:Before treatment, cancer district: O nset time(23.2945 ± 11.14) s, TTP(120.0027 ± 71.87) s, SImax 1880.4491 ± 445.73928, SImax%(173.7145 ± 27.04)%, Washin rate(88.2445 ± 39.56) s-1, Washout rate(6.6873 ± 5.71) s-1, K t rans(2.8563 ± 1.31) × 10-3min-1, Kep was(2.7233 ± 1.73) × 10-3min-1, Ve1.4291 ± 0.24; after cancer treatment District: Onset time(33.47 ± 4.41) s, TTP(175.9955 ± 53.49) s, SImax 1644.2073 ± 498.38, SImax%(172.2427 ± 38.94)%, Washin rate(50.2018 ± 19.19) s-1, Washout rate(4.2209 ± 5.22) s-1, K t rans(1.7172 ± 0.90) × 10-3min-1, Kep was(1.2138 ± 1.06) × 10-3min-1, Ve1.7610 ± 0.78, wherein the cancer area O nset time, Washin rate, K t rans, Kep value difference between before and after treatment was statistically significant(p <0.05); and TTP, SImax, SImax%, Washout rate and Ve difference between before and after treatment was not statistically significance(p> 0.05). Before treatment, the control group and the group of cancer recurrence district DCE-MRI parameters(same parameters) in the difference between the two groups no significant difference(p> 0.05), no statistically significant difference between the two groups after treatment(p> 0.05). DCE-MRI parameters before and after the control group and the treatment of recurrent changes in the cancer group, in whic h the two groups of Onset time, Washin rate, K trans, Kep and control groups of TTP before and after differences between endocrine therapy was statistically significant(p <0.05). The control group of cancer district DCE-MRI parameters before and after treatment in between the magnitude of change [Onset time(9.9468 ± 11.41) s, Washin rate(37.4795 ± 47.98) s-1, K t rans(1.0247 ± 1.76) ×10-3min- 1, Kep(1.1977 ± 1.46) × 10-3min-1] representing the variation width of the recurrent group d [O nset time(10.1755 ± 10.75) s, Washin rate(38.0427 ± 39.84) s-1, K t rans(1.1391 ± 1.79) × 10-3min-1, Kep(1.5095 ± 2.14) × 10-3min-1] Little. The difference between non-cancerous region DCE-MRI semi-quantitative parameters and quantitative parameters before and after endocrine therapy was not statistically significant(p> 0.05). Spearman correlation analysis showed that the control group and the group before and after treatment relapse among parameters DC E-MRI and PSA value change no significant correlation(p> 0.05).Conclusion: The study showed that in the control group and the treatment of recurrent cancerous area between the front and rear DCE-MRI parameters are changed, where the initial two Onset time, Washin rate, K t rans, Kep and control groups TTP before and after treatment in endocrine there was significant difference between(p <0.05). The group measured initial onset time, Washin rate, K t rans, Kep difference between before and after treatment compared with the control group of large, but not statistically significant(p> 0.05). Thus, DCE-MRI parameters(Onset time, Washin rate, K t rans, Kep) occurred after the change PCa endocrine therapy can be used to monitor the efficacy of clinical PCa endocrine therapy, as clinical efficacy PCa detection index PSA supplement, in monitor and evaluate the efficacy of PCa endocrine therapy have potential clinical value. PCa endocrine parameters DCE-MRI before and after treatment with PSA value between change no significant correlation. |
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