title: Contribution of the MR spectroscopic imaging in the diagnosis of prostate cancer in the peripheral zone.
abstract: OBJECTIVE
  To establish the additional value of 3D magnetic resonance spectroscopy (3D-MRS) imaging to endorectal MR imaging in the diagnosis of prostrate cancer in the peripheral zone.
  
  
  METHODS
  MR imaging and MRS imaging were performed in 79 patients with suspicion of prostate cancer on the basis of digital rectal exploration, transrectal ultrasound and PSA level. All the examinations were performed with 1.5 T MR scan using an endorectal coil (transverse and coronal FSE T2-weighted sequences, axial SE T1-weighted and PRESS 3D CSI). MR examinations have been evaluated by two Radiologists blind of the clinical data in a "per patients" analysis. MR imaging and MRS imaging findings were compared with the result of histological data from radical prostatectomy in 53 patients and biopsy in 17 patients.
  
  
  RESULTS
  Nine patients (11.4%) were excluded because of serious artefacts in the MR spectrum. The reported values of sensitivity, specificity, PPV and NPV for MR imaging alone were respectively 84%, 50%, 76% and 63% (LR+ 1.7; LR- 0.3). Instead the reported values of sensitivity, specificity, PPV and NPV for the combination of MR imaging to MRS imaging were respectively 89%, 79%, 89% and 79% (LR+ 4.28; LR- 0.14). We found an incremental benefit of MRS imaging to MR imaging for tumour diagnosis although these results did not show statistically significant differences.
  
  
  CONCLUSIONS
  The MRS imaging improves the accuracy of the endorectal MR imaging in the diagnosis of prostate cancer.
authors.affiliation: Department of Radiology, University of Rome “La Sapienza”, Via del Policlinico, 155, 00166, Rome, Italy. emanuelecasciani@hotmail.com
authors.forename: Emanuele
authors.initials: E
authors.lastname: Casciani
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Polettini
authors.forename: Luca
authors.initials: L
authors.lastname: Bertini
authors.forename: Gabriele
authors.initials: G
authors.lastname: Masselli
authors.forename: Paolo
authors.initials: P
authors.lastname: Emiliozzi
authors.forename: Mostafà
authors.initials: M
authors.lastname: Amini
authors.forename: Vito
authors.initials: V
authors.lastname: Pansadoro
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Gualdi
mesh_terms: D000368:Aged; D001706:Biopsy; D016009:Chi-Square Distribution; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography
chemical_list: D017430:Prostate-Specific Antigen