title: Multiparametric MRI of the prostate at 3 T: limited value of 3D (1)H-MR spectroscopy as a fourth parameter.
abstract: OBJECTIVE
  The aim of our study was to assess whether multiparametric magnetic resonance imaging (MP-MRI) of the prostate with three parameters (PS3: T2-weighted, DWI, and DCE) benefits from an additional fourth parameter (PS4: including (1)H-MRSI) in the detection and grading of prostate cancer (PCa) at 3 T.
  
  
  METHODS
  MP-MRI was performed in 64 patients (mean 66.7 years, mean PSA 13 ng/ml). Reference standard was obtained by histopathology. Two readers independently evaluated the images. A summation score of each individual parameter for three parameters (PS3) and for four parameters (PS4) was calculated.
  
  
  RESULTS
  In 52 (81.3 %) of 64 patients, histopathology confirmed a PCa. The diagnostic performance for PCa detection of PS4 (O1: 91.7 %, O2: 91.3 %) equaled that of PS3 (O1: 92.8 %, O2: 92.2 %, P > 0.05). Prediction of high-grade PCa by PS4 (O1: 75.1 %, O2: 74.7 %) was as good as with PS3 (O1: 75.1 %, O2: 72.8 %, P > 0.05). Kappa agreement between the two readers was substantial (0.734 PS4) to moderate (0.558 PS3).
  
  
  CONCLUSIONS
  MP-MRI with four parameters including (1)H-MRSI does not increase the detection and grading of prostate cancer at 3 T compared to MP-MRI with three parameters. A sum score accurately detects PCa at 3 T without an endorectal coil and shows potential for the prediction of tumor grade.
authors.affiliation: Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, 1090, Vienna, Austria.
authors.forename: Stephan H
authors.initials: SH
authors.lastname: Polanec
authors.affiliation: Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, 1090, Vienna, Austria.
authors.forename: Katja
authors.initials: K
authors.lastname: Pinker-Domenig
authors.affiliation: Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, 1090, Vienna, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Brader
authors.affiliation: Division of Medical Radiation Physics, Department of Radiation Oncology, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, 1090, Vienna, Austria.|Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University Vienna (AKH), Waehringer-Guertel 18-20, 1090, Vienna, Austria.
authors.forename: Dietmar
authors.initials: D
authors.lastname: Georg
authors.affiliation: Department of Urology, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, 1090, Vienna, Austria.
authors.forename: Shahrokh
authors.initials: S
authors.lastname: Shariat
authors.affiliation: Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, 1090, Vienna, Austria.
authors.forename: Claudio
authors.initials: C
authors.lastname: Spick
authors.affiliation: Clinical Institute of Pathology, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, 1090, Vienna, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Susani
authors.affiliation: Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, 1090, Vienna, Austria. thomas.helbich@meduniwien.ac.at.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Helbich
authors.affiliation: Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, 1090, Vienna, Austria. pascal.baltzer@meduniwien.ac.at.
authors.forename: Pascal A
authors.initials: PA
authors.lastname: Baltzer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging*
keywords: 1H-MRSI; Grading; Multiparametric MRI; PI-RADS; Prostate cancer; Sum score