Document Detail


Preliminary results for characterization of pelvic lymph nodes in patients with prostate cancer by diffusion-weighted MR-imaging.
MedLine Citation:
PMID:  19996762     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: In this retrospective feasibility study diffusion-weighted magnetic resonance imaging (DWI) was evaluated as a potential tool for characterization of pelvic lymph nodes in patients with prostate cancer. METHODS AND MATERIALS: Twenty-nine patients with prostate cancer underwent DWI of the pelvis at 1.5T by a non breath-hold SSEPI sequence using a body phased array coil with b values of 50, 300, and 600 s/mm(2) and an additional T2-weighted sequence. A total of 118 lymph nodes (>6 mm short axis) were analyzed by measuring the ADC-value with a polygon region of interest. Feasibility for ADC-measurement was assessed by comparing the ADC-value from the automatically created ADC-map (ADC(MR_unit)) with a manually calculated ACD-value (ADC(calculated)) and by using a linear-regression model for comparison with size and standard deviation of the ADC-value. Diagnostic performance was estimated by receiver operator characteristic analysis using histologic and/or clinical follow-up as standard of reference. RESULTS: ADC(MR_unit) and ADC(calculated) showed a high correlation (r = 0.8999) with a mean percentual deviation of 6.33%. There was a highly significant difference between the mean ADC-value (x10(-3) mm(2)/s) of malignant (1.07 +/- 0.23) versus benign (1.54 +/- 0.25) lymph nodes, even in subgroup analysis for lymph nodes smaller versus larger than 10 mm. Receiver operator characteristic-analysis showed a good accuracy of the ADC-value (85.6% [101/118]; sensitivity: 86.0% [43/50]; specificity: 85.3% [53/68]) for differentiation of malignant and benign lymph nodes at a cutoff 1.30 x 10(-3) mm(2)/s. This was superior to a size-based analysis at a cutoff of 8 mm (accuracy: 66.1% [78/118]; sensitivity: 82.0% [41/50]; specificity: 54.4% [37/68]; P < 0.01). CONCLUSIONS: DWI has the potential of being an accurate technique for analysis of pelvic lymph nodes. Moreover, our preliminary results suggest that the ADC-value might perform significantly superior to size criteria to discriminate between benign and malignant lymph nodes.
Authors:
Matthias Eiber; Ambros J Beer; Konstantin Holzapfel; Robert Tauber; Carl Ganter; Gregor Weirich; Bernd J Krause; Ernst J Rummeny; Jochen Gaa
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Investigative radiology     Volume:  45     ISSN:  1536-0210     ISO Abbreviation:  Invest Radiol     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-22     Completed Date:  2010-03-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0045377     Medline TA:  Invest Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  15-23     Citation Subset:  IM    
Affiliation:
Department of Radiology, Technische Universit?t M?nchen, Munich, Germany. matthias.eiber@roe.med.tum.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Diffusion Magnetic Resonance Imaging / methods*
Feasibility Studies
Follow-Up Studies
Humans
Lymph Nodes / pathology*
Lymphatic Metastasis / diagnosis*
Male
Middle Aged
Prostatic Neoplasms / radiography*
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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