[Localization of prostate cancer within the central gland by endorectal MR spectroscopic imaging].
OBJECTIVE
The endorectal MR spectroscopic imaging is a new imaging test which allows more accurate and reliable localization and staging of prostate cancer than simple endorectal MRI. The combination of spectroscopic MR and MRI has recently achieved technical improvements that increased reliability in the detection of prostate cancer. Our group is now working in the detection of prostate cancer with the spectroscopic MR, in co-operation with the Agency for the Evaluation of Technology for Medical Research (Agencia de Evaluación de Tecnología para la Investigación Médica-AATRM); although we are waiting for definitive results, we can advance that this technique may be used as a good alternative for localization of prostate cancer in patients with previous negative biopsies in whom the suspicion of prostate cancer persists.


METHODS
We present a series of 5 patients under control for permanent elevation of PSA with previous negative biopsies. We were performing ultrasound guided sextant biopsies every 6 months, after blood test for PSA. Endorectal MRI and spectroscopic MRI were performed to try to localize the prostate cancer so diminishing the number of biopsies.


RESULTS
All patients in the series had a low intensity lesion within the normal low intensity of the central gland, with an obvious spectroscopic metabolic abnormality suggesting the existence of prostate cancer, as it was then demonstrated by biopsy.


CONCLUSIONS
The endorectal MR spectroscopic imaging is a non invasive method which offers the ability to detect prostate cancer within the central gland with a higher reliability in selected patients. The central gland is an area in which prostate cancer is less commonly localized, but it often shows the same signal intensity than hyperplastic tissue, so that it is difficult to be detected by purely morphological methods. Endorectal MR spectroscopic imaging allows evaluating the metabolic disturbances in the whole gland, increasing the reliability of detection of prostate cancer both in the central and peripherical glands.
Comet Batlle
Josep
J
Agencia de Evaluación de Tecnología para la Investigación Médica (AATRM), Servicio de Urología, Hospital Universitari Dr. Josep Trueta, Girona, España. 28547jcb@comb.es
Vilanova Busquets
Joan Carles
JC
Maroto Genover
Albert
A
Areal Calama
Joan
J
Osorio Fernández
Margarita
M
López Bonet
Eugeni
E
Torrent Quer
Narcis
N
Ordis Dalmau
Miquel
M
Saladié Roig
Josep María
JM
Barceló Vidal
Carles
C
D000368:Aged; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D012007:Rectum