title: 1H-MRSI of prostate cancer: the relationship between metabolite ratio and tumor proliferation.
abstract: OBJECTIVE
  To investigate whether 1H-MRSI can be used to predict the proliferative activity of prostate cancer.
  
  
  METHODS
  Thirty-eight patients with prostate cancer (PCa) and thirty-three patients with benign prostate hyperplasia (BPH) were included in this study. Patients were examined in supine position using a 1.5T superconducting magnetic scanner equipped with a pelvic phased-array multi-coil and CSI-3D-PROSTATE sequence. Commercial software was used to acquire and process MR spectroscopic imaging data. Mean (Cho+Cr)/Cit ratios of PCa, BPH, and peripheral zone (PZ) were calculated. Cellularity of PCa was recorded based on hematoxylin and eosin staining. PCNA was detected using immunohistochemical techniques.
  
  
  RESULTS
  The mean (Cho+Cr)/Cit ratio of the peripheral zone (0.38+/-0.09) was lower than that of BPH (0.51+/-0.19) (P<0.05). The average value of (Cho+Cr)/Cit ratio of prostate cancer was 3.98+/-0.12. The (Cho+Cr)/Cit ratio of prostate cancer was higher than that of the peripheral zone and BPH (P<0.05). The cellularity and PCNA LI of prostate cancer were 12.90+/-4.07% and 72.1+/-19.01%, respectively. The (Cho+Cr)/Cit ratio of prostate cancer positively correlated with tumor cellularity (r=0.582, P=0.027) and PCNA LI (r=0.495, P=0.022).
  
  
  CONCLUSIONS
  The (Cho+Cr)/Cit ratio of PCa can reveal the differences in proliferative activity between PCa and BPH. MRSIs are therefore able to predict the proliferative rate of variously differentiated prostate cancers.
authors.affiliation: Shandong Medical Imaging Research Institute, Shandong University, 324# JingWu Road, Jinan 250021, PR China. zhen94320@yahoo.com.cn
authors.forename: Xi Zhen
authors.initials: XZ
authors.lastname: Wang
authors.forename: Bin
authors.initials: B
authors.lastname: Wang
authors.forename: Zhi Qin
authors.initials: ZQ
authors.lastname: Gao
authors.forename: Jin Gang
authors.initials: JG
authors.lastname: Liu
authors.forename: Zuo Qin
authors.initials: ZQ
authors.lastname: Liu
authors.forename: Qing Liang
authors.initials: QL
authors.lastname: Niu
authors.forename: Zhen Kui
authors.initials: ZK
authors.lastname: Sun
authors.forename: Yu Xiao
authors.initials: YX
authors.lastname: Yuan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D014408:Biomarkers, Tumor / Q000032:analysis*; D002794:Choline / Q000032:analysis*; D019343:Citric Acid / Q000032:analysis*; D003401:Creatine / Q000032:analysis*; D003936:Diagnosis, Computer-Assisted / Q000379:methods; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000378:metabolism*; D011522:Protons; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic
chemical_list: D014408:Biomarkers, Tumor; D011522:Protons; D019343:Citric Acid; D003401:Creatine; D002794:Choline