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Prostate cancer in magnetic resonance imaging: diagnostic utilities of spectroscopic sequences
Author(s) -
Caivano Rocchina,
Cirillo Patrizia,
Balestra Antonio,
Lotumolo Antonella,
Fortunato Giovanna,
Macarini Luca,
Zandolino Alexis,
Vita Giulia,
Cammarota Aldo
Publication year - 2012
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/j.1754-9485.2012.02449.x
Subject(s) - medicine , magnetic resonance imaging , prostate cancer , prostate , nuclear medicine , rectal examination , biopsy , radiology , in vivo magnetic resonance spectroscopy , ultrasound , fast spin echo , prostate specific antigen , cancer
Objective The aim of our work is to determine the efficacy of a combined study 3 T esla M agnetic R esonance I maging (3 T 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. Subjects and 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 P hilips A chieva 3 T scanner and phased‐array coil. The images were obtained with turbo spin‐echo sequences T 2‐weighted images, T 1‐weighted before and after the administration of contrast medium, DWI sequences and 3 D 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 3 T MR study with phased‐array coil and the use of DWI and spectroscopic sequences, in addition to T 2‐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.