Morphologic, functional, and metabolic magnetic resonance imaging-guided prostate biopsy in a patient with prior negative transrectal ultrasound-guided biopsies and persistently elevated prostate-specific antigen levels.
A 65-year-old patient was examined with [11C]-choline positron emission tomography-computed tomography and magnetic resonance imaging (MRI) for possible tumor detection after two negative sessions of transrectal ultrasound-guided prostate biopsy and persistently elevated prostate-specific antigen levels for 27 months. Choline positron emission tomography revealed a small and circumscribed pathologic tracer uptake in the right dorsal peripheral gland. Whereas T2-weighted MRI and high b-value diffusion-weighted imaging were able to reproduce this suspicious area, proton MR spectroscopy showed no significant increase of the amplitude of choline-containing compounds. Magnetic resonance imaging-guided prostate biopsy was successfully performed. All specimens taken from the lesion showed a Gleason 5 tubular adenocarcinoma with low proliferative activity.
Lichy
Matthias P
MP
Department of Urology, Comprehensive Cancer Center Tübingen, Eberhard-Karls-Universität Tübingen, Tübingen, Germany.
Anastasiadis
Aristotelis G
AG
Aschoff
Philip
P
Sotlar
Karl
K
Eschmann
Susanne M
SM
Pfannenberg
Christina
C
Stenzl
Arnulf
A
Claussen
Claus D
CD
Schlemmer
Heinz-Peter
HP
D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis*; D000368:Aged; D001707:Biopsy, Needle; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis*; D012680:Sensitivity and Specificity
D017430:Prostate-Specific Antigen