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Transition Zone Prostate Cancer: Metabolic Characteristics at ¹H MR Spectroscopic Imaging—Initial Results¹

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).

View larger version (17K): [in a new window]   Figure 1. Scatterplot depicts average metabolite ratios for 16 patients in cancerous TZ regions (Ca) and benign control regions.

View larger version (134K): [in a new window]   Figure 2a. MR imaging/MR spectroscopic imaging data and pathology section in a 51-year-old patient (patient 5) with a large left-sided TZ tumor. The patient also had a small tumor in the right side of the PZ. (a) MR spectroscopic imaging grid superimposed on transverse T2-weighted MR image obtained with 1,000/130, PRESS volume excitation with BASING water and lipid suppression, 16 x 8 x 8 chemical shift imaging, a 100 x 50 x 50-mm field of view, 6.25-mm resolution, one signal acquired, and a 17-minute imaging time shows tumor (T) in dashed region. (b) Spectral grid corresponding to a shows metabolite levels. T and dashed lines indicate tumor regions. (c) Whole-mount pathology step section shows tumor regions (outlined).

View larger version (42K): [in a new window]   Figure 2b. MR imaging/MR spectroscopic imaging data and pathology section in a 51-year-old patient (patient 5) with a large left-sided TZ tumor. The patient also had a small tumor in the right side of the PZ. (a) MR spectroscopic imaging grid superimposed on transverse T2-weighted MR image obtained with 1,000/130, PRESS volume excitation with BASING water and lipid suppression, 16 x 8 x 8 chemical shift imaging, a 100 x 50 x 50-mm field of view, 6.25-mm resolution, one signal acquired, and a 17-minute imaging time shows tumor (T) in dashed region. (b) Spectral grid corresponding to a shows metabolite levels. T and dashed lines indicate tumor regions. (c) Whole-mount pathology step section shows tumor regions (outlined).

View larger version (160K): [in a new window]   Figure 2c. MR imaging/MR spectroscopic imaging data and pathology section in a 51-year-old patient (patient 5) with a large left-sided TZ tumor. The patient also had a small tumor in the right side of the PZ. (a) MR spectroscopic imaging grid superimposed on transverse T2-weighted MR image obtained with 1,000/130, PRESS volume excitation with BASING water and lipid suppression, 16 x 8 x 8 chemical shift imaging, a 100 x 50 x 50-mm field of view, 6.25-mm resolution, one signal acquired, and a 17-minute imaging time shows tumor (T) in dashed region. (b) Spectral grid corresponding to a shows metabolite levels. T and dashed lines indicate tumor regions. (c) Whole-mount pathology step section shows tumor regions (outlined).

View larger version (135K): [in a new window]   Figure 3a. MR imaging/MR spectroscopic imaging data and pathology section in a 56-year-old patient (patient 8) with glandular BPH, stromal BPH, and TZ tumor. (a) MR spectroscopic imaging grid superimposed on transverse T2-weighted MR image obtained with 1,000/130, PRESS volume excitation with BASING water and lipid suppression, 16 x 8 x 8 chemical shift imaging, a 100 x 50 x 50-mm field of view, 6.25-mm resolution, one signal acquired, and a 17-minute imaging time shows tumor, which is indicated by dashed line. G = glandular BPH, S = stromal BPH. (b) Subgrid of spectra corresponding to the black rectangular region in a. G = glandular BPH, S = stromal BPH. (c) Pathology step section corresponding most closely to a shows tumor regions (outlined).

View larger version (30K): [in a new window]   Figure 3b. MR imaging/MR spectroscopic imaging data and pathology section in a 56-year-old patient (patient 8) with glandular BPH, stromal BPH, and TZ tumor. (a) MR spectroscopic imaging grid superimposed on transverse T2-weighted MR image obtained with 1,000/130, PRESS volume excitation with BASING water and lipid suppression, 16 x 8 x 8 chemical shift imaging, a 100 x 50 x 50-mm field of view, 6.25-mm resolution, one signal acquired, and a 17-minute imaging time shows tumor, which is indicated by dashed line. G = glandular BPH, S = stromal BPH. (b) Subgrid of spectra corresponding to the black rectangular region in a. G = glandular BPH, S = stromal BPH. (c) Pathology step section corresponding most closely to a shows tumor regions (outlined).

View larger version (104K): [in a new window]   Figure 3c. MR imaging/MR spectroscopic imaging data and pathology section in a 56-year-old patient (patient 8) with glandular BPH, stromal BPH, and TZ tumor. (a) MR spectroscopic imaging grid superimposed on transverse T2-weighted MR image obtained with 1,000/130, PRESS volume excitation with BASING water and lipid suppression, 16 x 8 x 8 chemical shift imaging, a 100 x 50 x 50-mm field of view, 6.25-mm resolution, one signal acquired, and a 17-minute imaging time shows tumor, which is indicated by dashed line. G = glandular BPH, S = stromal BPH. (b) Subgrid of spectra corresponding to the black rectangular region in a. G = glandular BPH, S = stromal BPH. (c) Pathology step section corresponding most closely to a shows tumor regions (outlined).

View larger version (131K): [in a new window]   Figure 4a. MR imaging/MR spectroscopic imaging data obtained in the same patient as in Figure 3 but at a more inferior location. (a) MR spectroscopic imaging grid superimposed on transverse T2-weighted MR image obtained with 1,000/130, PRESS volume excitation with BASING water and lipid suppression, 16 x 8 x 8 chemical shift imaging, a 100 x 50 x 50-mm field of view, 6.25-mm resolution, one signal acquired, and a 17-minute imaging time shows tumor (T) surrounded by dashed line. (b) Subgrid of spectra corresponding to the black rectangular region in a. T = tumor. (c) Pathology step section corresponding most closely to a shows tumor regions (outlined).

View larger version (32K): [in a new window]   Figure 4b. MR imaging/MR spectroscopic imaging data obtained in the same patient as in Figure 3 but at a more inferior location. (a) MR spectroscopic imaging grid superimposed on transverse T2-weighted MR image obtained with 1,000/130, PRESS volume excitation with BASING water and lipid suppression, 16 x 8 x 8 chemical shift imaging, a 100 x 50 x 50-mm field of view, 6.25-mm resolution, one signal acquired, and a 17-minute imaging time shows tumor (T) surrounded by dashed line. (b) Subgrid of spectra corresponding to the black rectangular region in a. T = tumor. (c) Pathology step section corresponding most closely to a shows tumor regions (outlined).

View larger version (117K): [in a new window]   Figure 4c. MR imaging/MR spectroscopic imaging data obtained in the same patient as in Figure 3 but at a more inferior location. (a) MR spectroscopic imaging grid superimposed on transverse T2-weighted MR image obtained with 1,000/130, PRESS volume excitation with BASING water and lipid suppression, 16 x 8 x 8 chemical shift imaging, a 100 x 50 x 50-mm field of view, 6.25-mm resolution, one signal acquired, and a 17-minute imaging time shows tumor (T) surrounded by dashed line. (b) Subgrid of spectra corresponding to the black rectangular region in a. T = tumor. (c) Pathology step section corresponding most closely to a shows tumor regions (outlined).