Three-dimensional proton MR spectroscopy of human prostate at 3 T without endorectal coil: feasibility.

PURPOSE To evaluate sensitivity and specificity of proton magnetic resonance (MR) spectroscopy of the prostate with external surface coil elements at 3 T for differentiation of cancer from healthy tissue within an acceptable measurement time, by using histopathologic findings as the reference standard. MATERIALS AND METHODS The study was approved by the institutional review board; informed consent was obtained. Forty-five men (age range, 51-70 years) underwent 3-T MR imaging with external radiofrequency surface coils for signal reception. MR spectroscopy was performed with acquisition-weighted three-dimensional water- and lipid-suppressed point-resolved spectroscopy pulse sequence. Voxels were classified into healthy peripheral zone, central gland, and periurethral zone and cancer tissue. Cancer voxels were classified according to cancer size and certainty in matching histopathologic findings with MR images. After visual inspection of automated fitting of classified voxels, the choline plus creatine-to-citrate (Cho + Cr/Cit) ratio was calculated for all tissues. Area under the receiver operating characteristic curves (A(z)) values were used to assess accuracy of discrimination of cancer from healthy tissues. P < .05 indicated a significant difference. RESULTS After exclusion of four patients with no voxels that passed visual inspection of the automated fit, a median of 82% of the classified voxels per patient was used in the analysis. Mean Cho + Cr/Cit ratios for healthy tissues were 0.22 +/- 0.12 (standard deviation) for peripheral zone, 0.34 +/- 0.14 for central gland, and 0.36 +/- 0.20 for periurethral area; all were significantly different from that of cancer (P < .001). A(z) for discrimination of probable and definite cancer tissue from healthy tissue for the peripheral zone (0.84) was significantly higher than that for the central gland (0.69) (P < .05). CONCLUSION Three-dimensional proton MR spectroscopy of the prostate, with a combination of only external radiofrequency surface coils at 3 T, can be used to discriminate cancer from healthy tissue.

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

[2]  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.

[3]  F. Schick,et al.  3D proton MR spectroscopic imaging of prostate cancer using a standard spine coil at 1.5 T in clinical routine: a feasibility study , 2005, European Radiology.

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

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

[6]  Dennis W J Klomp,et al.  Initial Experience of 3 Tesla Endorectal Coil Magnetic Resonance Imaging and 1H-Spectroscopic Imaging of the Prostate , 2004, Investigative radiology.

[7]  Mark A Brown,et al.  Time‐domain combination of MR spectroscopy data acquired using phased‐array coils , 2004, Magnetic resonance in medicine.

[8]  Mark Rijpkema,et al.  Combined quantitative dynamic contrast‐enhanced MR imaging and 1H MR spectroscopic imaging of human prostate cancer , 2004, Journal of magnetic resonance imaging : JMRI.

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

[10]  M. Graefen,et al.  Insignificant prostate cancer in radical prostatectomy specimen: time trends and preoperative prediction. , 2003, European urology.

[11]  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.

[12]  H. Hricak,et al.  Clinical application of BASING and spectral/spatial water and lipid suppression pulses for prostate cancer staging and localization by in vivo 3D 1H magnetic resonance spectroscopic imaging , 2000, Magnetic resonance in medicine.

[13]  J. Kurhanewicz,et al.  Improved water and lipid suppression for 3D PRESS CSI using rf band selective inversion with gradient dephasing (basing) , 1997, Magnetic resonance in medicine.

[14]  A. Heerschap,et al.  In vivo proton MR spectroscopy reveals altered metabolite content in malignant prostate tissue. , 1997, Anticancer research.

[15]  Michael Garwood,et al.  Solvent Suppression Using Selective Echo Dephasing , 1996 .

[16]  J R Thornbury,et al.  Local staging of prostate cancer with endorectal MR imaging: correlation with histopathology. , 1996, AJR. American journal of roentgenology.

[17]  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.

[18]  A. Wilman,et al.  The response of the strongly coupled AB system of citrate to typical 1H MRS localization sequences. , 1995, Journal of magnetic resonance. Series B.

[19]  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.

[20]  A S Whittemore,et al.  Localized prostate cancer. Relationship of tumor volume to clinical significance for treatment of prostate cancer , 1993, Cancer.

[21]  P. Bottomley.  Spatial Localization in NMR Spectroscopy in Vivo , 1987, Annals of the New York Academy of Sciences.

[22]  C. Balch,et al.  AJCC Cancer Staging Manual. 6th ed , 2002 .