Contribution of the MR spectroscopic imaging in the diagnosis of prostate cancer in the peripheral zone.
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.
Casciani
Emanuele
E
Department of Radiology, University of Rome “La Sapienza”, Via del Policlinico, 155, 00166, Rome, Italy. emanuelecasciani@hotmail.com
Polettini
Elisabetta
E
Bertini
Luca
L
Masselli
Gabriele
G
Emiliozzi
Paolo
P
Amini
Mostafà
M
Pansadoro
Vito
V
Gualdi
Gian Franco
GF
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
D017430:Prostate-Specific Antigen