title: Correlation of MR imaging and MR spectroscopic imaging findings with Ki-67, phospho-Akt, and androgen receptor expression in prostate cancer.
abstract: OBJECTIVE
  To retrospectively assess whether magnetic resonance (MR) imaging and MR spectroscopic imaging and selected molecular markers correlate with each other and with clinically insignificant and significant prostate cancer (PCa), as defined at surgical pathologic analysis.
  
  
  METHODS
  The institutional review board approved this HIPAA-compliant study and waived informed consent. Eighty-nine men (mean age, 63 years; range, 46-79 years) with biopsy-proved PCa underwent combined endorectal MR imaging and MR spectroscopic imaging before radical prostatectomy. Suspicion of clinically insignificant PCa was retrospectively and separately recorded for MR imaging and combined MR imaging and MR spectroscopic imaging by using a scale of 0-3. Clinically insignificant PCa was pathologically defined as organ-confined cancer of 0.5 cm(3) or less without poorly differentiated elements. Prostatectomy specimens underwent immunohistochemical analysis for three molecular markers: Ki-67, phospho-Akt (pAkt), and androgen receptor (AR). To examine differences in marker levels for clinically insignificant and significant cancer, a Wilcoxon rank sum test was used. To examine correlations between marker levels and MR imaging or combined MR imaging and MR spectroscopic imaging scores, the Spearman correlation was used.
  
  
  RESULTS
  Twenty-one (24%) patients had clinically insignificant and 68 (76%) had clinically significant PCa at surgical pathologic review. All markers were significantly correlated with MR imaging and combined MR imaging and MR spectroscopic imaging findings (all correlation coefficients >0.5). In differentiating clinically insignificant from clinically significant PCa, areas under the receiver operating characteristic curves for Ki-67, AR, pAkt, MR imaging, and combined MR imaging and MR spectroscopic imaging were 0.75, 0.78, 0.80, 0.85, and 0.91, respectively.
  
  
  CONCLUSIONS
  The use of pretreatment MR imaging or combined MR imaging and MR spectroscopic imaging and molecular marker analyses of biopsy samples could facilitate better treatment selection.
  
  
  BACKGROUND
  http://radiology.rsnajnls.org/cgi/content/full/250/3/803/DC1.
authors.affiliation: Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021, USA. davea@mskcc.org
authors.forename: Amita
authors.initials: A
authors.lastname: Shukla-Dave
authors.forename: Hedvig
authors.initials: H
authors.lastname: Hricak
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Ishill
authors.forename: Chaya S
authors.initials: CS
authors.lastname: Moskowitz
authors.forename: Marija
authors.initials: M
authors.lastname: Drobnjak
authors.forename: Victor E
authors.initials: VE
authors.lastname: Reuter
authors.forename: Kristen L
authors.initials: KL
authors.lastname: Zakian
authors.forename: Peter T
authors.initials: PT
authors.lastname: Scardino
authors.forename: Carlos
authors.initials: C
authors.lastname: Cordon-Cardo
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000032:analysis; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology*; D051057:Proto-Oncogene Proteins c-akt / Q000032:analysis*; D011944:Receptors, Androgen / Q000032:analysis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D014018:Tissue Distribution
chemical_list: D015415:Biomarkers; D019394:Ki-67 Antigen; D011944:Receptors, Androgen; D051057:Proto-Oncogene Proteins c-akt