A qualitative approach to combined magnetic resonance imaging and spectroscopy in the diagnosis of prostate cancer.
OBJECTIVE
To investigate the feasibility and diagnostic value of a whole prostate qualitative approach to combined magnetic resonance imaging and spectroscopy (MRI+MRS) in the detection of prostate cancer in patients with elevated PSA.


METHODS
Three hundred and fifty six subjects (mean serum PSA 11.47ng/ml, range 0.40-133ng/ml) were examined with fast-T2-weighted images (MRI) and 3D-magnetic resonance spectroscopy (MRS). Both modalities were qualitatively analyzed on a whole prostate basis by a single radiologist using a 4-point diagnostic scale. Prostate cancer was histopathologically proven in 220 patients and non-evidence of cancer was determined after at least 12 months clinical follow-up in 136 subjects.


RESULTS
Receiver operating curve analysis revealed a significantly better diagnostic performance of MRI+MRS (A(z)=0.857) than MRI alone (A(z)=0.801) and MRS alone (A(z)=0.810). The sensitivity, specificity and accuracy of MRI+MRS for detection of prostate cancer were 72.3%, 92.6%, and 80.1%, respectively.


CONCLUSIONS
Spectral evaluation with a whole prostate qualitative approach is feasible in routine clinical practice. The combination of MRI and MRS yields superior diagnostic results than either modality alone.
Villeirs
Geert M
GM
Department of Radiology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. Geert.Villeirs@UGent.be
Oosterlinck
Willem
W
Vanherreweghe
Els
E
De Meerleer
Gert O
GO
D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000378:metabolism*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D014408:Biomarkers, Tumor