MRI影像组学对前列腺影像报告与数据系统3~4的移行带临床显著前列腺癌的诊断价值  

Diagnostic value of MRI radiomics in clinically significant prostate cancer located in the transition zone with prostate imaging reporting and data system categories 3-4

作　　者：孙家元 严循成 王新龙[1] 高文霞 王天乐[2] SUN Jiayuan;YAN Xuncheng;WANG Xinlong;GAO Wenxia;WANG Tianle(Department of Radiology,the People’s Hospital of Rugao,Nantong,Jiangsu Province 226500,China;Department of Radiology,the Second Affiliated Hospital of Nantong University,Nantong,Jiangsu Province 226000,China)

机构地区：[1]如皋市人民医院影像科,江苏南通226500 [2]南通大学第二附属医院影像科,江苏南通226000

出　　处：《实用放射学杂志》2024年第7期1129-1132,共4页Journal of Practical Radiology

基　　金：如皋市科技计划项目[SRG(22)1081]。

摘　　要：目的探讨MRI影像组学模型对前列腺影像报告与数据系统(PI-RADS)评估为3~4的移行带临床显著前列腺癌(csPCa)的诊断价值。方法按照前列腺癌(PCa)︰前列腺增生(BPH)样本数量=1︰1的比例回顾性收集经病理证实的移行带病变患者相关资料,根据病理结果分为csPCa组和非csPCa组,在T2WI、扩散加权成像(DWI)及表观扩散系数(ADC)序列沿病灶边缘勾画感兴趣区(ROI),提取影像组学特征,经特征清洗及筛选后,构建单一序列逻辑回归模型并验证,评估并比较各模型对移行带csPCa的诊断效能。结果共纳入204例患者,csPCa组94例,非csPCa组110例,csPCa组及非csPCa组在PI-RADS、前列腺体积(PV)、前列腺特异性抗原(PSA)及其衍生指标方面差异有统计学意义,在验证集中ADC模型的曲线下面积(AUC)为0.766,DeLong检验显示ADC模型的诊断效能显著高于DWI与T2WI模型。结论当移行带病灶PI-RADS评估3~4时,ADC序列影像组学模型对csPCa的诊断效能良好,可以避免部分患者不必要的穿刺活检,有望成为一种更为客观、准确的医学诊断工具。Objective To explore the diagnostic value of MRI radiomics model for clinically significant prostate cancer(csPCa)in the transition zone with prostate imaging reporting and data system(PI-RADS)3-4.Methods According to the ratio of prostate cancer(PCa)︰benign prostatic hyperplasia(BPH)=1︰1,the relevant data of patients with transition zone lesions confirmed by pathology were retrospectively collected.Patients were divided into csPCa group and non-csPCa group according to pathological results.Region of interest(ROI)were drawn along the edge of the lesion in T2WI,diffusion weighted imaging(DWI),and apparent diffusion coefficient(ADC)sequences,the radiomics features were extracted,and a single sequence logistic regression model was constructed and validated after feature cleaning and screening.The diagnostic performances of the radiomics model for transition zone csPCa were evaluated and compared.Results A total of 204 patients were included,and there were 94 cases in the csPCa group and 110 cases in the non-csPCa group.There were statistically significant differences in PI-RADS,prostate volume(PV),prostate specific antigen(PSA)and its derivative indicators between csPCa and non-csPCa groups.In the validation set,the area under the cunve(AUC)of the ADC model was 0.766,and the DeLong test showed that the diagnostic performance of the ADC model was significantly higher than that of the DWI and T2WI models.Conclusion When the PI-RADS classification of transition zone lesion is 3-4,the ADC radiomics model has good diagnostic performance for csPCa,which can reduce unnecessary biopsy in some patients.Radiomics is expected to become a more objective and accurate medical diagnostic tool.

关 键 词：影像组学 表观扩散系数 前列腺癌 前列腺影像报告与数据系统 

分 类 号：R445[医药卫生—影像医学与核医学] R445.2[医药卫生—诊断学] R737.25[医药卫生—临床医学]