Quantitative 1H MR spectroscopic imaging of the prostate gland using LCModel and a dedicated basis‐set: Correlation with histologic findings

Proton magnetic resonance spectroscopic imaging (1H‐MRSI) has been advocated as a valuable tool for prostate cancer diagnosis. However, a barrier to widespread clinical use of this technique is the lack of robust quantification methods that yield reproducible results in an institution‐independent manner. The main goal of this study was to develop a standardized and fully automated approach (LCModel‐based) for quantitative prostate 1H‐MRSI. To this end, a dedicated basis set was constructed by the combination of simulated (citrate, Cit; choline, Cho, and creatine, CR) and experimentally acquired (spermine, Spm) spectra. The overlapping Spm, Cho, and Cr could be resolved and quantified individually, thus allowing for the independent assessment of glandular (Cit and Spm) and proliferative (Cho) components. Several metabolite ratios were calculated and compared to the histologic findings of prostatectomy specimens from 10 prostate cancer patients with Gleason scores (3 + 3) and (3 + 4). The Cho mole fraction and the Cho/(Cit + Spm) ratio were found to best discriminate between prostate cancer and healthy tissue. The comparison between the quantitative MRSI results and the histologic findings suggests that no correlation exists between the detected metabolic alterations and the Gleason score of low‐grade tumors. Magn Reson Med, 2011. © 2010 Wiley‐Liss, Inc.

[1]  Dennis W J Klomp,et al.  Optimal timing for in vivo 1H‐MR spectroscopic imaging of the human prostate at 3T , 2005, Magnetic resonance in medicine.

[2]  Arend Heerschap,et al.  Fast acquisition‐weighted three‐dimensional proton MR spectroscopic imaging of the human prostate , 2004, Magnetic resonance in medicine.

[3]  J. Kavanagh,et al.  Sodium, potassium, calcium, magnesium, zinc, citrate and chloride content of human prostatic and seminal fluid. , 1985, Journal of reproduction and fertility.

[4]  J. Pauly,et al.  Dualband spectral‐spatial RF pulses for prostate MR spectroscopic imaging , 2001, Magnetic resonance in medicine.

[5]  R. Schipper,et al.  Polyamines and prostatic cancer. , 2003, Biochemical Society transactions.

[6]  H. Hricak,et al.  Correlation of MR imaging and MR spectroscopic imaging findings with Ki-67, phospho-Akt, and androgen receptor expression in prostate cancer. , 2009, Radiology.

[7]  H. Huisman,et al.  Prostate cancer localization with dynamic contrast-enhanced MR imaging and proton MR spectroscopic imaging. , 2006, Radiology.

[8]  S Mierisová,et al.  MR spectroscopy quantitation: a review of frequency domain methods , 2001, NMR in biomedicine.

[9]  M. van der Graaf,et al.  In vivo proton MR spectroscopy reveals altered metabolite content in malignant prostate tissue. , 1997, Anticancer research.

[10]  B. G. Blijenberg,et al.  Screening and prostate-cancer mortality in a randomized European study. , 2009, The New England journal of medicine.

[11]  M. Spraul,et al.  Ultra high field NMR spectroscopic studies on human seminal fluid, seminal vesicle and prostatic secretions. , 1994, Journal of pharmaceutical and biomedical analysis.

[12]  Aaron Bernstein,et al.  GAVA: spectral simulation for in vivo MRS applications. , 2007, Journal of magnetic resonance.

[13]  T. Scheenen,et al.  Three-dimensional proton MR spectroscopy of human prostate at 3 T without endorectal coil: feasibility. , 2007, Radiology.

[14]  A. Heerschap,et al.  Removal of the outer lines of the citrate multiplet in proton magnetic resonance spectra of the prostatic gland by accurate timing of a point-resolved spectroscopy pulse sequence , 1997, Magnetic Resonance Materials in Physics, Biology and Medicine.

[15]  H. Hricak,et al.  1H magnetic resonance spectroscopy of prostate cancer: biomarkers for tumor characterization. , 2008, Cancer biomarkers : section A of Disease markers.

[16]  Keshav K. Singh,et al.  Mitochondrial aconitase and citrate metabolism in malignant and nonmalignant human prostate tissues , 2006, Molecular Cancer.

[17]  F. Schick,et al.  Localized proton MR spectroscopy of citrate in vitro and of the human prostate in vivo at 1.5 T , 1993, Magnetic resonance in medicine.

[18]  John Kurhanewicz,et al.  Quantification of prostate MRSI data by model‐based time domain fitting and frequency domain analysis , 2006, NMR in biomedicine.

[19]  F. Podo Tumour phospholipid metabolism , 1999, NMR in biomedicine.

[20]  P. Carroll,et al.  Quantification of choline‐ and ethanolamine‐containing metabolites in human prostate tissues using 1H HR‐MAS total correlation spectroscopy , 2008, Magnetic resonance in medicine.

[21]  S. Provencher Estimation of metabolite concentrations from localized in vivo proton NMR spectra , 1993, Magnetic resonance in medicine.

[22]  L. Sillerud,et al.  The pH dependence of chemical shift and spin-spin coupling for citrate. , 1994, Journal of magnetic resonance. Series B.

[23]  M. Kattan,et al.  Correlation of proton MR spectroscopic imaging with gleason score based on step-section pathologic analysis after radical prostatectomy. , 2005, Radiology.

[24]  P. Carroll,et al.  Quantitative analysis of prostate metabolites using 1H HR‐MAS spectroscopy , 2006, Magnetic resonance in medicine.

[25]  A. Fowler,et al.  Differentiation of human prostate cancer from benign hypertrophy by in vitro 1H NMR , 1992, Magnetic resonance in medicine.

[26]  J. Nelson,et al.  Detection of increased choline compounds with proton nuclear magnetic resonance spectroscopy subsequent to malignant transformation of human prostatic epithelial cells. , 2001, Cancer research.

[27]  B. Meier,et al.  Computer Simulations in Magnetic Resonance. An Object-Oriented Programming Approach , 1994 .

[28]  P. Carroll,et al.  Three-dimensional H-1 MR spectroscopic imaging of the in situ human prostate with high (0.24-0.7-cm3) spatial resolution. , 1996, Radiology.

[29]  S. Van Huffel,et al.  MRS signal quantitation: a review of time- and frequency-domain methods. , 2008, Journal of magnetic resonance.

[30]  Jason A Koutcher,et al.  Prostate cancer: identification with combined diffusion-weighted MR imaging and 3D 1H MR spectroscopic imaging--correlation with pathologic findings. , 2008, Radiology.

[31]  H. Hricak,et al.  Detection of prostate cancer with MR spectroscopic imaging: an expanded paradigm incorporating polyamines. , 2007, Radiology.

[32]  C. Mountford,et al.  Proton magnetic resonance spectroscopy of the central, transition and peripheral zones of the prostate: assignments and correlation with histopathology , 2008, Magnetic Resonance Materials in Physics, Biology and Medicine.

[33]  H. Ahlström,et al.  Two-dimensional spectroscopic imaging for pretreatment evaluation of prostate cancer: comparison with the step-section histology after radical prostatectomy. , 2009, Magnetic resonance imaging.

[34]  A. Heerschap,et al.  Characterization of human prostate cancer, benign prostatic hyperplasia and normal prostate by in vitro 1H and 31P magnetic resonance spectroscopy. , 1993, The Journal of urology.

[35]  H. Huisman,et al.  Standardized Threshold Approach Using Three-Dimensional Proton Magnetic Resonance Spectroscopic Imaging in Prostate Cancer Localization of the Entire Prostate , 2007, Investigative radiology.

[36]  J Kurhanewicz,et al.  Citrate as an in vivo marker to discriminate prostate cancer from benign prostatic hyperplasia and normal prostate peripheral zone: detection via localized proton spectroscopy. , 1995, Urology.

[37]  J Kurhanewicz,et al.  Sextant localization of prostate cancer: comparison of sextant biopsy, magnetic resonance imaging and magnetic resonance spectroscopic imaging with step section histology. , 2000, The Journal of urology.

[38]  E. Klein What is ‘insignificant’ prostate carcinoma? , 2004, Cancer.

[39]  Jingfei Ma,et al.  Use of perfluorocarbon compound in the endorectal coil to improve MR spectroscopy of the prostate. , 2008, AJR. American journal of roentgenology.

[40]  Arend Heerschap,et al.  Proton MR spectroscopy of prostatic tissue focused on the etection of spermine, a possible biomarker of malignant behavior in prostate cancer , 2000, Magnetic Resonance Materials in Physics, Biology and Medicine.

[41]  B Michael Kelm,et al.  Automated estimation of tumor probability in prostate magnetic resonance spectroscopic imaging: Pattern recognition vs quantification , 2007, Magnetic resonance in medicine.

[42]  van der Graaf M,et al.  Effect of Cation Binding on the Proton Chemical Shifts and the Spin-Spin Coupling Constant of Citrate , 1996, Journal of magnetic resonance. Series B.

[43]  P. Carroll,et al.  Prostate depiction at endorectal MR spectroscopic imaging: investigation of a standardized evaluation system. , 2004, Radiology.

[44]  A. Verbaeys,et al.  Combined magnetic resonance imaging and spectroscopy in the assessment of high grade prostate carcinoma in patients with elevated PSA: a single-institution experience of 356 patients. , 2011, European journal of radiology.

[45]  J. García-Segura,et al.  In vivo proton magnetic resonance spectroscopy of diseased prostate: spectroscopic features of malignant versus benign pathology. , 1999, Magnetic resonance imaging.

[46]  S. Provencher Automatic quantitation of localized in vivo 1H spectra with LCModel , 2001, NMR in biomedicine.