title: Magnetic resonance spectroscopy in patients with locally confined prostate cancer: association of prostatic citrate and metabolic atrophy with time on hormone deprivation therapy, PSA level, and biopsy Gleason score.
abstract: This study was undertaken to determine respective associations between prostatic citrate or metabolic atrophy (no detectable citrate, choline, and creatine) at magnetic resonance spectroscopy (MRS) and time on hormone-deprivation therapy, serum PSA, and biopsy Gleason score. Clinical data, histopathology reports and PSA levels of 36 patients on hormone-deprivation therapy (age, 64+/-9 years, pre-therapeutic biopsy Gleason sum, median 6, range 3-8, antiandrogens only, n=3, LHRH-analogues only, n=4, combined hormone-deprivation therapy, n=29, duration, 27+/-19 weeks) for locally confined prostate cancer (PCA) were retrospectively correlated with findings in the peripheral zone of the prostate at 3D-MRS (endorectal coil, PRESS, TR 1,000 ms, TE 130 ms). The results show that citrate was usually detected after 13 weeks or less of hormone-deprivation therapy (10/12 vs. 6/24 patients, chi-square-test, p=0.002). All patients with PSA levels exceeding 0.20 ng/ml had detectable metabolites (citrate, n=12, choline without citrate, n=6), while 9/18 patients with PSA 0.20 ng/ml or less showed metabolic atrophy (Fisher-exact-test, p=0.001). There were no significant associations between citrate, metabolic atrophy, pre-therapeutic PSA, and biopsy Gleason sum, respectively. It has been concluded that hormone-deprivation therapy for locally confined PCA has not reached its full deprivation potential after 13 weeks. MRS detects prostate metabolism in patients with PSA exceeding 0.20 ng/ml after hormone-deprivation therapy.
authors.affiliation: Institut fur Klinische Radiologie, Klinikum der Ludwig-Maximilians-Universitaet, Muenchen-Innenstadt, Ziemssenstrasse 1, 80336 Muenchen, Germany. ullrich.mueller-lisse@med.uni-muenchen.de
authors.forename: Ullrich G
authors.initials: UG
authors.lastname: Mueller-Lisse
authors.forename: Mark G
authors.initials: MG
authors.lastname: Swanson
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Vigneron
authors.forename: John
authors.initials: J
authors.lastname: Kurhanewicz
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D001284:Atrophy / Q000175:diagnosis / Q000378:metabolism / Q000628:therapy; D014408:Biomarkers, Tumor / Q000097:blood; D001706:Biopsy; D002794:Choline / Q000097:blood; D019343:Citric Acid / Q000097:blood*; D003430:Cross-Sectional Studies; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives / Q000627:therapeutic use; D020249:Hormone Replacement Therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D017430:Prostate-Specific Antigen / Q000097:blood* / Q000187:drug effects; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D020266:Radiotherapy, Conformal; D012107:Research Design; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D014408:Biomarkers, Tumor; D019343:Citric Acid; D007987:Gonadotropin-Releasing Hormone; D017430:Prostate-Specific Antigen; D002794:Choline