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12 - MRS in prostate cancer

Published online by Cambridge University Press:  04 August 2010

Peter B. Barker ,
Alberto Bizzi ,
Nicola De Stefano ,
Rao Gullapalli  and
Doris D. M. Lin
Peter B. Barker
Affiliation:
The Johns Hopkins University School of Medicine
Alberto Bizzi
Affiliation:
Istituto Neurologico Carlo Besta, Milan
Nicola De Stefano
Affiliation:
Università degli Studi, Siena
Rao Gullapalli
Affiliation:
University of Maryland, Baltimore
Doris D. M. Lin
Affiliation:
The Johns Hopkins University School of Medicine
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Summary

Key points

  • Prostate cancer has a high incidence, and is one of the leading causes of death in men.

  • The sensitivity and specificity of diagnosing prostate cancer with conventional imaging methods (ultra sound, MRI) is relatively low.

  • The normal prostate contains high levels of citrate (Cit) which can be detected in the proton spectrum at 2.6 ppm. Other compounds detectable in vivo include creatine, choline, spermine, and lipids.

  • Citrate is a strongly coupled mutiple at 1.5 and 3.0 T. For optimum detection, careful attention to pulse sequence parameters (TR, TE) is required. TE 120 ms is commonly used at 1.5 T, and TE 75–100 ms at 3 T.

  • Multiple studies have reported that prostate cancer is associated with decreased levels of citrate and increased levels of Cho, compared to both normal prostate and also benign prostatic hyperplasia (BPH).

  • MRS and MRSI of the prostate is technically challenging: water- and lipid-suppressed 3D-MRSI is the method of choice for most prostate spectroscopy studies.

  • Some studies report that adding MRSI to conventional MRI increases sensitivity and specificity of prostate cancer diagnosis.

  • MRSI is traditionally performed with an endorectal surface coil, but acceptable quality data may be obtained at 3 T with external phased-array coils which are more comfortable for patients.

Type
Chapter
Information
Clinical MR Spectroscopy
Techniques and Applications
 , pp. 212 - 228
Publisher: Cambridge University Press
Print publication year: 2009

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