基于扩散模型生成的高b值DWI评估前列腺癌根治性治疗后局部复发的应用价值  

Application of high b-value DWI generated based on diffusion model to assess local recurrence after radical treatment of prostate cancer

作　　者：邓文友 郭小芳[1] 胡奎 胡磊 DENG Wenyou;GUO Xiaofang;HU Kui;HU Lei(Department of Radiology,Hubei Cancer Hospital,Wuhan 430079,China;Department of Radiology,Guangdong Provincial People's Hospital,Guangzhou 510080,China)

机构地区：[1]湖北省肿瘤医院放射科,武汉430079 [2]广东省人民医院放射科,广州510080

出　　处：《磁共振成像》2024年第9期86-93,共8页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金项目(编号:82302130)。

摘　　要：目的探讨基于扩散模型生成高b值扩散加权成像(diffusion weighted imaging,DWI)对前列腺癌根治性治疗后局部复发的评估价值。材料与方法回顾性分析63例前列腺癌行根治性放射治疗(radiation therapy,RT)或根治性前列腺切除术(radical prostatectomy,RP)后出现生化复发(biochemical recurrence,BCR)患者的临床及影像相关资料,其中RT组21例,RP组42例。将患者初始表观扩散系数(apparent diffusion coefficient,ADC)图经过计算得到的DWI图像输入前列腺DWI生成模型,获得生成的高b值(b=2000 s/mm^(2))DWI图。通过3位阅片者对计算DWI及生成DWI进行图像质量评价,并根据前列腺复发影像报告(Prostate Imaging for Recurrence Reporting,PI-RR)系统对所有病例进行复发风险评分采用多读者多病例受试者工作特征(multi-reader multi-case receiver operating characteristic,MRMC-ROC)曲线比较不同阅片者的诊断效能差异。等级评分一致性采用组内相关系数进行检验。结果3位阅片者对生成DWI组图像质量评价均优于计算DWI组(P=0.002、0.003、0.002)。3位阅片者对RT组的生成DWI与计算DWI组的PI-RR总评分差异有统计学意义(P=0.031、0.049、0.041);3位阅片者对RP组生成DWI与计算DWI组的PI-RR总评分差异有统计学意义(P=0.034、0.049、0.036)。3位阅片者使用生成DWI进行RT与RP两组PI-RR总评分预测发生局部复发的曲线下面积(area under the curve,AUC)值范围分别为0.884~0.924、0.926~0.947;利用计算DWI进行RT与RP两组PI-RR总评分预测发生局部复发的AUC值范围分别为0.783~0.792、0.843~0.893。合并RT及RP两组病例后,使用PI-RR总评分预测所有患者局部复发的状态,生成DWI组与计算DWI组的AUC值范围分别为0.912~0.930、0.797~0.858。结论基于扩散模型生成的高b值DWI能显著提高前列腺癌根治性治疗后局部复发诊断效能。Objective:To investigate the value of generating high b-value diffusion weighted imaging(DWI)based on diffusion model for the assessment of local recurrence after radical treatment of prostate cancer.Materials and Methods:Retrospective analysis of the clinical and imaging data of 63 patients with biochemical recurrence(BCR)after radical radiotherapy(RT)or radical prostatectomy(RP)for prostate cancer,including 21 patients in the RT group and 42 patients in the RP group.DWI images calculated using the patient's initial apparent diffusion coefficient(ADC)maps were input into the prostate DWI generated model to obtain the generated high b-value(b=2000 s/mm^(2))DWI maps.The image quality of the calculated DWI and the generated DWI was evaluated by 3 readers,and the risk of recurrence was scored in all cases according to the Prostate Imaging for Recurrence Reporting(PI-RR)system score.Multi-reader multi-case receiver operating characteristic(MRMC-ROC)curve were used to compare the differences in diagnostic efficacy between different readers.Grade score agreement was tested using intragroup correlation coefficients.Results:All three readers rated the image quality of the generated DWI group better than that of the calculated DWI group(P=0.002,0.003,0.002).The difference in the total PI-RR scores between the generated DWI and calculated DWI groups of the RT group by the three readers was statistically significant(P=0.031,0.049,0.041).The difference in PI-RR total score between the generated DWI and calculated DWI groups was statistically significant(P=0.034,0.049,0.036).The range of area under the curve(AUC)values for PI-RR total score prediction of the occurrence of localized recurrence in the RT and RP groups by the three readers using the generated DWI was categorized as 0.884-0.924 and 0.926-0.947;the range of AUC value for PI-RR total score prediction of the occurrence of local recurrence in the RT and RP groups by the three readers using the calculated DWI was categorized as 0.783-0.792 and 0.843-0.893.After combin

关 键 词：前列腺癌 磁共振成像 扩散模型 扩散加权成像 根治性治疗 局部复发 

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