人工智能超声CT检查在前列腺癌早期诊断中的价值  

Artificial neural network analysis on computerized transrectal ultrasound in early detection of prostate cancer

作　　者：谢立平[1] 郑祥义[1] 王潇[1] 朱意[1] 纪阿林 刘犇[1] 

机构地区：[1]浙江大学医学院附属第一医院泌尿外科,杭州310003

出　　处：《中华泌尿外科杂志》2015年第11期822-825,共4页Chinese Journal of Urology

基　　金：浙江省重大科技专项重大国际科技合作再创新产业化项目（2014C04008-2）

摘　　要：目的 探讨人工智能超声CT（artificial neural network analysis/computerized transrectal ultrasound,ANNAcTRUS）在前列腺癌早期诊断中的价值.方法 选取2014年1月至2015年7月收治的60例PSA＞4μg/L或直肠指检异常、有前列腺穿刺指征的患者,年龄51～89岁,平均（65.6±8.9）岁;PSA平均（9.8 ±4.9）μg/L.患者取左侧卧位,行经直肠超声检查,自前列腺尖部至精囊水平,每隔5 mm留取超声影像.将超声图像传送至德国超声CT中心,进行实时在线分析,对原始超声图像中的肿瘤可疑区域进行标记（亮红色）,根据结果评估穿刺的必要性并指导靶向穿刺.结果 根据ANNAcTRUS结果,60例中52例需接受经直肠前列腺穿刺活检,共穿刺253针,每例平均穿刺针数为（4.9±1.0）针.24例穿刺活检病理确诊为前列腺癌,穿刺阳性率46.2％.Gleason评分：3＋3分9例,3＋4分8例,4＋3分4例,4＋4分2例,5＋4分l例.33例首次穿刺者中确诊前列腺癌17例,穿刺阳性率51.5％;19例重复穿刺者中确诊前列腺癌7例,穿刺阳性率36.8％.结论 ANNAcTRUS指导的靶向穿刺不仅能以较少的穿刺针数取得较高的前列腺癌穿刺阳性率,而且更易于发现低级别的前列腺癌.Objective To investigate the application of artificial neural network analysis on computerized transrectal ultrasound （ANNAcTRUS） in early detection of prostate cancer.Methods Sixty men with or without prior biopsies, either due to elevated PSA or abnormal digital rectal findings, were included in this study from January 2014 to July 2015.Patient＆#39;s mean age was （65.6 ± 8.9） years （51-89 years）.Their PSA level was （9.8 ± 4.9）μg/L.The patients received the ANNAcTRUS targeted 6-core biopsy.Each patient received six targeted biopsies of suspicious regions, which was identified by ANNAcTRUS online system.Histopathologic examination was further carried out to confirm the result of the targeted biopsies.Results According to the results of ANNAcTRUS,52 of 60 patients received biopsy in ANNAcTRUS group.ANNAcTRUS targeted 6-core biopsy was able to detect prostate cancer in 24 （46.2%） of 52 patients.The distribution of Gleason Score was as follows ： 3 ＋ 3 （n =9）, 3 ＋ 4 （n =8）, 4 ＋ 3 （n =4）, 4 ＋4 （n =2） and 5 ＋4 （n =1）.For patients without prior negative biopsy,ANNAcTRUS targeted 6-core biopsy was able to detect prostate cancer in 17 （51.5%） of 33 patients.Conclusions ANNAcTRUS targeted 6-core biopsy illustrates a higher detection rate of prostate cancer.Furthermore, ANNAcTRUS targeted 6-core biopsy tends to detect low-grade prostate cancer.

关 键 词：前列腺肿瘤 经直肠超声 早期诊断 人工智能超声CT 

分 类 号：R737.25[医药卫生—肿瘤]