Rezonans magnetyczny z wykorzystaniem badania dynamicznego w ocenie stopnia zaawansowania raka stercza

Abstract

Author(s): Piotr Błaszczyk, Anna Mucha-Malecka, Ewelina Błaszczyk, Krzysztof Roszkowski

Objectives: This study aimed to prospectively analyze the role of dynamic-contrast enhancement magnetic resonance (DCEMR) in the detection of prostate tumor foci in patients.

Material and method: From 2003 to 2010, magnetic resonance imaging was performed in 106 patients with the Siemens Symphony scanner with field induction 1,5 T. The examinations were analyzed for tumor identification and location in prostate detection of extracapsular extension, and seminal vesicle invasion. The analysis of MR images comprises the following: assessment of all the sequences, doing subtractions, which create 12 sequences where only the areas accumulating the contrast media are visible. In further assessment, the areas of higher contrast concentration were chosen. The assessment of the shapes and geometrical parameters of the contrast enhancement curves (maximum time, max. enhancement and the speed of signal decrease) makes it possible to determine the areas responsible for the cancerous changes.

Results: On the basis of histopathology verification, the results of the dynamic examination carried out on 116 patients were assessed and the following sensory results of the examination for changes in capsule and seminal vesicles were obtained 78% and 72.7% respectively. The specificity was 85.1% i 98.8% respectively. The precision of this method for the infiltration of the capsule and the seminal vesicles was 81,1% and 93,4% respectively. Positive predictive values were obtained for the prostate gland lobes and prostatic capsule and seminal vesicles 86,8% and 94,1% respectively. The predictive value of the negative result for T1 images was 75,5% for the capsule of a prostate gland 93,3% for seminal vesicles.

Conclusion: Magnetic resonance with automatic application of MC enables precise differentiation in the progress of prostate gland cancer within the area of infiltration of the prostatic capsule and seminal vesicles. The assessment of the sequence of T1 weighted images obtained during dynamic examination improves significantly the sensitivity, specificity and precision of the magnetic resonance results of the prostate in comparison with conventional examination.

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