title: Prostate cancer localization with dynamic contrast-enhanced MR imaging and proton MR spectroscopic imaging.
abstract: OBJECTIVE
  To prospectively determine the accuracies of T2-weighted magnetic resonance (MR) imaging, dynamic contrast material-enhanced MR imaging, and quantitative three-dimensional (3D) proton MR spectroscopic imaging of the entire prostate for prostate cancer localization, with whole-mount histopathologic section findings as the reference standard.
  
  
  METHODS
  This study was approved by the institutional review board, and informed consent was obtained from all patients. Thirty-four consecutive men with a mean age of 60 years and a mean prostate-specific antigen level of 8 ng/mL were examined. The median biopsy Gleason score was 6. T2-weighted MR imaging, dynamic contrast-enhanced MR imaging, and 3D MR spectroscopic imaging were performed, and on the basis of the image data, two readers with different levels of experience recorded the location of the suspicious peripheral zone and central gland tumor nodules on each of 14 standardized regions of interest (ROIs) in the prostate. The degree of diagnostic confidence for each ROI was recorded on a five-point scale. Localization accuracy and ROI-based receiver operating characteristic (ROC) curves were calculated.
  
  
  RESULTS
  For both readers, areas under the ROC curve for T2-weighted MR, dynamic contrast-enhanced MR, and 3D MR spectroscopic imaging were 0.68, 0.91, and 0.80, respectively. Reader accuracy in tumor localization with dynamic contrast-enhanced imaging was significantly better than that with quantitative spectroscopic imaging (P < .01). Reader accuracy in tumor localization with both dynamic contrast-enhanced imaging and spectroscopic imaging was significantly better than that with T2-weighted imaging (P < .01).
  
  
  CONCLUSIONS
  Compared with use of T2-weighted MR imaging, use of dynamic contrast-enhanced MR imaging and 3D MR spectroscopic imaging facilitated significantly improved accuracy in prostate cancer localization.
authors.affiliation: Department of Radiology, Radboud University Nijmegen Medical Center, Geert Grooteplein zuid 10, NL 6500 HB, Nijmegen, the Netherlands. J.Futterer@rad.umcn.nl
authors.forename: Jurgen J
authors.initials: JJ
authors.lastname: Fütterer
authors.forename: Stijn W T P J
authors.initials: SW
authors.lastname: Heijmink
authors.forename: Tom W J
authors.initials: TW
authors.lastname: Scheenen
authors.forename: Jeroen
authors.initials: J
authors.lastname: Veltman
authors.forename: Henkjan J
authors.initials: HJ
authors.lastname: Huisman
authors.forename: Pieter
authors.initials: P
authors.lastname: Vos
authors.forename: Christina A
authors.initials: CA
authors.lastname: Hulsbergen-Van de Kaa
authors.forename: J Alfred
authors.initials: JA
authors.lastname: Witjes
authors.forename: Paul F M
authors.initials: PF
authors.lastname: Krabbe
authors.forename: Arend
authors.initials: A
authors.lastname: Heerschap
authors.forename: Jelle O
authors.initials: JO
authors.lastname: Barentsz
mesh_terms: D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage; D019786:Gadolinium DTPA / Q000008:administration & dosage; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000473:pathology*; D012372:ROC Curve; D015203:Reproducibility of Results
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA