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Genitourinary Imaging |
1 From the Departments of Medical Physics (K.L.Z., A.S.D., S.K., M.M., J.A.K.), Radiology (K.L.Z., S.E., H.H., J.A.K.), Pathology (K.S., V.E.R.), Urology (M.W.K., P.T.S.), Epidemiology and Biostatistics (M.W.K.), and Medicine (J.A.K.), Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021. Received October 28, 2002; revision requested December 12; revision received January 15, 2003; accepted February 28. Supported by National Institutes of Health grants R21 CA 84258-01 and 7-R01 CA76423. Address correspondence to K.L.Z. (e-mail: zakiank@mskcc.org).
PURPOSE: To determine whether cancers of the prostate transition zone (TZ) possess a unique metabolic pattern by which they may be identified at proton magnetic resonance (MR) spectroscopic imaging.
MATERIALS AND METHODS: Findings in 40 patients who underwent combined endorectal MR imaging and hydrogen 1 MR spectroscopic imaging before radical prostatectomy and who had TZ tumor identified subsequently at step-section pathologic analysis were retrospectively reviewed. Within this population, a subset of 16 patients whose TZ tumor had a largest diameter of 1 cm or greater and was included in the MR spectroscopic imaging excitation volume was identified. In these 16 patients, the ratios of choline-containing compounds (Cho) and creatine/phosphocreatine (Cr) to citrate (Cit) (ie, [Cho + Cr]/Cit), Cho/Cr, and Cho/Cit were compared in tumor and control tissues. The presence of only Cho and the absence of all metabolites were also assessed.
RESULTS: The mean values of (Cho + Cr)/Cit, Cho/Cr, and Cho/Cit were different between TZ cancer and control tissues (P = .001, P = .003, and P = .001, respectively; Wilcoxon signed rank test). Nine (56%) of 16 patients had at least one tumor voxel in which Cho comprised the only detectable peak, while no control voxels showed only Cho (P = .008, McNemar test). The percentage of voxels in which no metabolites were detected did not differ between tumor and control tissues (P = .134, McNemar test).
CONCLUSION: TZ cancer has a metabolic profile that is different from that of benign TZ tissue; however, the broad range of metabolite ratios observed in TZ cancer precludes the use of a single ratio to differentiate TZ cancer from benign TZ tissue.
© RSNA, 2003
Index terms: Magnetic resonance (MR), spectroscopy, 844.12145 • Magnetic resonance (MR), tissue characterization, 844.12145 • Prostate, hyperplasia, 844.316 • Prostate, MR, 844.12145 • Prostate, neoplasms, 844.32
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