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학술저널
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연세대학교 의과대학 Yonsei Medical Journal Yonsei Medical Journal 제49권 제5호
발행연도
2008.1
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765 - 774 (10page)

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Purpose: To determine the added value of dynamic subtraction magnetic resonance (MR) imaging for the localization of prostate cancer. Materials and Methods: We examined 21 consecutive patients who underwent MR imaging in 3T unit with a phased-array body coil and then had radical prostatectomy. After T2-weighted fast spin-echo imaging, we performed a contrast-enhanced dynamic 3D gradient-echo imaging consisting of pre-contrast, 2 successive early-phased (first imaging was started just after the appearance of contrast material in the aortic bifurcation followed by second imaging 35 seconds after the initiation of first imaging) and one 5-minute delayed post-contrast series. Subtraction of pre-contrast images from corresponding post-contrast images of each phase was performed on the console. Results: On ROC analysis, the overall accuracy (Az value) of dynamic imaging combined with subtraction imaging was higher than T2-weighted imaging (p=0.001) or conventional dynamic imaging alone (p =0.074) for localization of cancer foci regardless of their zonal locations. Among pathologically verified 81 lesions, the mean volume of detected lesions with the subtraction images (n=49, 0.69cm³) was smaller than with T2-weighted images (n=14, 1.05cm³) or conventional dynamic images (n=43, 0.71cm³). Conclusion: For localization of small prostate cancer, additional subtraction for the dynamic imaging could be superior to both T2-weighted imaging and un-subtracted dynamic imaging.

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