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Advisor(s)
Abstract(s)
Objetivos: Avaliar a performance diagnóstica na obtenção um correto estadiamento do carcinoma da próstata, utilizando uma sequência de imagem por RM 3D-T2w, inserida num protocolo de aquisição Biparamétrico. Métodos: Após aprovação institucional e consentimento informado, 22 doentes com diagnóstico confirmado de carcinoma da próstata e indicados para prostatectomia radical robótica, foram examinados num equipamento de RM 3 T, tendo sido utilizadas sequências de imagem 2D-T2w TSE, DWI e 3D-T2w SPACE (validada previamente em fantoma). Seguida a anonimização, randomização e replicação em 4 subgrupos distintos, 2 Uro-Radiologistas avaliaram individualmente cada um dos subgrupos de imagem. Foram obtidas medidas de qualidade por intermédio de uma escala de Likert, bem com estatísticas descritivas, correlações inter-técnica e inter-observador, sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo, com valores considerados significativos para p < 0,05. Resultados: Os observadores classificaram a qualidade das imagens 3D-T2w como sendo significativamente inferior face às imagens standard 2D-T2w. Verificou-se ainda a ausência de correlação entre os resultados apurados com as imagens 3D-T2w e os resultados da Anatomia Patológica, com uma sensibilidade de apenas 64%. Na avaliação integrada com a DWI, passou a verificar-se correlação com a Anatomia Patológica, e a sensibilidade subiu para 86%, juntamente com uma especificidade de 88%, valor preditivo positivo de 83% e valor preditivo negativo de 100%. Conclusões: A performance diagnóstica das imagens 3D-T2w é inferior à conseguida pelas imagens 2D-T2w, mesmo com a integração no protocolo biparamétrico.
ABSTRACT - Objectives: To evaluate the diagnostic performance in obtaining a correct staging of prostate cancer, using a 3D-T2w MRI sequence, inserted in a Biparametric acquisition protocol. Methods: After institutional approval and informed consent, 22 patients with a confirmed diagnosis of prostate cancer, before robotic radical prostatectomy, were examined in a 3 T MRI equipment and applied 2D-T2w TSE, DWI and 3D-T2w SPACE sequences (previously validated in a phantom). Following anonymization, randomization, and replication in 4 distinct subgroups, 2 Uro-Radiologists individually evaluated each of the image subgroups. Quality measurements were obtained using a Likert scale, as well as descriptive statistics, inter-technical and inter-observer correlations, sensitivity, specificity, positive predictive value, and negative predictive value, with values considered significant for p < 0,05. Results: Both observers classified 3D-T2w images quality significantly lower compared to standard 2D-T2w images. No correlation was obtained between the results of 3D-T2w images analysis and histopathological results, with a sensitivity of only 64%. In the integrated evaluation with DWI, there was a correlation with histopathological results, and sensitivity increased to 86%, along with a specificity of 88%, a positive predictive value of 83%, and a negative predictive value of 100%. Conclusions: The diagnostic performance of 3D-T2w images is lower than that achieved by 2D-T2w images, even with the integration in the biparametric protocol.
ABSTRACT - Objectives: To evaluate the diagnostic performance in obtaining a correct staging of prostate cancer, using a 3D-T2w MRI sequence, inserted in a Biparametric acquisition protocol. Methods: After institutional approval and informed consent, 22 patients with a confirmed diagnosis of prostate cancer, before robotic radical prostatectomy, were examined in a 3 T MRI equipment and applied 2D-T2w TSE, DWI and 3D-T2w SPACE sequences (previously validated in a phantom). Following anonymization, randomization, and replication in 4 distinct subgroups, 2 Uro-Radiologists individually evaluated each of the image subgroups. Quality measurements were obtained using a Likert scale, as well as descriptive statistics, inter-technical and inter-observer correlations, sensitivity, specificity, positive predictive value, and negative predictive value, with values considered significant for p < 0,05. Results: Both observers classified 3D-T2w images quality significantly lower compared to standard 2D-T2w images. No correlation was obtained between the results of 3D-T2w images analysis and histopathological results, with a sensitivity of only 64%. In the integrated evaluation with DWI, there was a correlation with histopathological results, and sensitivity increased to 86%, along with a specificity of 88%, a positive predictive value of 83%, and a negative predictive value of 100%. Conclusions: The diagnostic performance of 3D-T2w images is lower than that achieved by 2D-T2w images, even with the integration in the biparametric protocol.
Description
Mestrado em Radiações Aplicadas às Tecnologias da Saúde - Área de especialização: Imagem por Ressonância Magnética.
Keywords
Cancro da próstata Ressonância magnética Biparamétrica Imagem ponderada em T2 Tridimensional Prostate cancer Magnetic resonance imaging Biparametric T2-Weighted image Three dimensional
Citation
Castela TA. Avaliação da utilização da sequência 3D-T2w em ressonância magnética biparamétrica no estadiamento do carcinoma da próstata [dissertation]. Lisboa: Escola Superior de Tecnologia da Saúde de Lisboa/Instituto Politécnico de Lisboa; 2020.
Publisher
Instituto Politécnico de Lisboa, Escola Superior de Tecnologia da Saúde de Lisboa