title: Prostate cancer in magnetic resonance imaging: diagnostic utilities of spectroscopic sequences.
abstract: OBJECTIVE
  The aim of our work is to determine the efficacy of a combined study 3 Tesla Magnetic Resonance Imaging (3T MRI), with phased-array coil, for the detection of prostate cancer using magnetic resonance spectroscopy (MRS) and diffusion-weighted images (DWI) in identifying doubt nodules.
  
  
  METHODS
  In this study, we prospectively studied 46 patients who consecutively underwent digital-rectal exploration for high doses of prostate specific antigen (PSA), as well as a MRI examination and a subsequent rectal biopsy. The study of magnetic resonance imaging was performed with a Philips Achieva 3T scanner and phased-array coil. The images were obtained with turbo spin-echo sequences T2-weighted images, T1-weighted before and after the administration of contrast medium, DWI sequences and 3D spectroscopic sequences. The ultrasound-guided prostate biopsy was performed approximately 15 days after the MRI. The data obtained from MR images and spectroscopy were correlated with histological data.
  
  
  RESULTS
  MRI revealed sensitivity and specificity of 88% and 61% respectively and positive predictive value (PPV) of 73%, negative predicted value (NPV) of 81% and accuracy of 76%. In identifying the location of prostate cancer, the sensitivity of 3T MRS was 92%, with a specificity of 89%, PPV of 87%, NPV of 88% and accuracy of 87%; DWI showed a sensitivity of 88%, specificity of 61%, PPV of 73%, NPV of 81% and accuracy of 76%.
  
  
  CONCLUSIONS
  The 3T MR study with phased-array coil and the use of DWI and spectroscopic sequences, in addition to T2-weighted sequences, revealed to be accurate in the diagnosis of prostate cancer and in the identification of nodules to be biopsied. It may be indicated as a resolute way before biopsy in patients with elevated PSA value and can be proposed in the staging and follow-up.
authors.affiliation: Department of Radiology, I.R.C.C.S. - C.R.O.B., Rionero in Vulture (Pz), Italy. rocchina.caivano@gmail.com
authors.forename: Rocchina
authors.initials: R
authors.lastname: Caivano
authors.forename: Patrizia
authors.initials: P
authors.lastname: Cirillo
authors.forename: Antonio
authors.initials: A
authors.lastname: Balestra
authors.forename: Antonella
authors.initials: A
authors.lastname: Lotumolo
authors.forename: Giovanna
authors.initials: G
authors.lastname: Fortunato
authors.forename: Luca
authors.initials: L
authors.lastname: Macarini
authors.forename: Alexis
authors.initials: A
authors.lastname: Zandolino
authors.forename: Giulia
authors.initials: G
authors.lastname: Vita
authors.forename: Aldo
authors.initials: A
authors.lastname: Cammarota
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / 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* / Q000378:metabolism*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor