Peripheral zone prostate cancer. Pre-treatment evaluation with MR and 3D ¹H MR spectroscopic imaging: correlation with pathologic findings.
The purpose of this study was to retrospectively characterize benign and malignant prostate peripheral zone tissue by using endorectal MRI and 3D ¹H MRS. Fifty-two men with untreated biopsy-proven prostate cancer underwent combined endorectal MRI and MRSI. Whole-mount step-section histopathologic analysis constituted the reference standard. Biopsy correctly detected 74 locations; MRI correctly detected 72 locations; MRS correctly detected 72 locations; MRI + MRS correctly detected 78 locations. Cohen's test showed that biopsy had a lower degree of agreement with histology than MRI + MRS combined. The ratio of [(Cho + Cr)]/Cit correlates with the pathologic Gleason score. The addition of 3D¹H MRSI to MRI can improve diagnosis of prostate cancer contributing indirectly to improve local staging. In addition, the correlation between metabolic 3D¹H MRSI data with pathological Gleason grade may offer a non-invasive means to better predict prostate cancer aggressiveness.
Giusti
Sabina
S
University of Pisa, Italy. s.giusti@med.unipi.it
Caramella
Davide
D
Fruzzetti
Elena
E
Lazzereschi
Michele
M
Tognetti
Adele
A
Bartolozzi
Carlo
C
D000368:Aged; D001706:Biopsy; D002794:Choline / Q000032:analysis; D003401:Creatine / Q000032:analysis; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D003401:Creatine; D002794:Choline