title: 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.
abstract: 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.
authors.affiliation: Department of Urology, Comprehensive Cancer Center Tübingen, Eberhard-Karls-Universität Tübingen, Tübingen, Germany.
authors.forename: Matthias P
authors.initials: MP
authors.lastname: Lichy
authors.forename: Aristotelis G
authors.initials: AG
authors.lastname: Anastasiadis
authors.forename: Philip
authors.initials: P
authors.lastname: Aschoff
authors.forename: Karl
authors.initials: K
authors.lastname: Sotlar
authors.forename: Susanne M
authors.initials: SM
authors.lastname: Eschmann
authors.forename: Christina
authors.initials: C
authors.lastname: Pfannenberg
authors.forename: Arnulf
authors.initials: A
authors.lastname: Stenzl
authors.forename: Claus D
authors.initials: CD
authors.lastname: Claussen
authors.forename: Heinz-Peter
authors.initials: HP
authors.lastname: Schlemmer
mesh_terms: 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
chemical_list: D017430:Prostate-Specific Antigen