Mr Spectroscopic Imaging of Peripheral Zone in Prostate Cancer Using a 3t Mri Scanner: Endorectal versus External Phased Array Coils

Magnetic resonance spectroscopic imaging (MRSI) detects alterations in major prostate metabolites, such as citrate (Cit), creatine (Cr), and choline (Ch). We evaluated the sensitivity and accuracy of three-dimensional MRSI of prostate using an endorectal compared to an external phased array “receive” coil on a 3T MRI scanner. Eighteen patients with prostate cancer (PCa) who underwent endorectal MR imaging and proton (1H) MRSI were included in this study. Immediately after the endorectal MRSI scan, the PCa patients were scanned with the external phased array coil. The endorectal coil-detected metabolite ratio [(Ch+Cr)/Cit] was significantly higher in cancer locations (1.667 ± 0.663) compared to non-cancer locations (0.978 ± 0.420) ( P < 0.001). Similarly, for the external phased array, the ratio was significantly higher in cancer locations (1.070 ± 0.525) compared to non-cancer locations (0.521 ± 0.310) ( P < 0.001). The sensitivity and accuracy of cancer detection were 81% and 78% using the endorectal ‘receive’ coil, and 69% and 75%, respectively using the external phased array ‘receive’ coil.

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3T MRI of the prostate correlation to 3D reconstruction of transperineal mapping biopsies.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e15176 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e15176-e15176

Author(s):

Kyle O. Rove ◽

Thomas J. Pshak ◽

Nayana Patel ◽

Colin O'Donnell ◽

E. David Crawford

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Positive Predictive Value ◽

3D Reconstruction ◽

Predictive Value ◽

Three Dimensional ◽

3T Mri ◽

3 Dimensional ◽

Endorectal Coil ◽

Clinically Significant

e15176 Background: MRI is new tool in the diagnosis and surveillance of localized prostate cancer. Studies have examined the sensitivity and specificity of MRI for detecting and localizing prostate cancer as compared to radical prostatectomy specimens. We have previously demonstrated excellent correlation between 3-dimensional transperineal mapping biopsies (3DMB) to radical prostatectomy specimens. We hypothesize that MRI does not perform as well detecting smaller lesions of the prostate as larger ones. In this study, we retrospectively compare the correlation of 3DMB to 3T MRI-positive lesions. Methods: Between 2010 and 2011, 34 men with histologically-proven prostate cancer underwent 3T endorectal coil MRI and subsequent template-guided (5-mm grid) 3DMB. Three-dimensional computer models of the mapping biopsies were created using Proview software to identify clusters of positive biopsies likely belonging to a single lesion. MRIs were read by two trained radiologists blinded to 3DMB results. Disagreement between radiologists was settled by consensus. MRI and 3DMB were then compared in a retrospective fashion. Results: Median age and PSA were 65 years (49-76) and 4.3 ng/mL (0.7-15.0). Median prostate volume was 40 cm3 (21-105 cm3). Median total biopsy cores on 3DMB was 60 (26-151), and mean positive cores was 3 (0-13). 3D reconstruction of patient biopsy sets resulted in 58 distinct foci of cancer. MRI identified 64 individual lesions suspicious for cancer. Of these, 66% (n=42) could be correlated to a positive area on 3DMB consisting of one or more positive biopsies, and 34% (n=22) corresponded to negative regions on 3DMB. When two or more biopsies represented a positive lesion on 3DMB, the positive-predictive value of MRI was 100% (n=24). Conversely, only 72% (n=42) of positive 3DMB areas could be correlated to a lesion on MRI, and 28% (n=16) were not seen on MRI.. Conclusions: MRI has vast potential as a less-invasive method in the detection and surveillance of prostate cancer. While MRI does appear to have excellent positive predictive value, the number of false negatives and relevance to clinically-significant lesions require further illumination.

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Prostate cancer: comparison of local staging accuracy of pelvic phased-array coil alone versus integrated endorectal–pelvic phased-array coils

European Radiology ◽

10.1007/s00330-006-0418-8 ◽

2006 ◽

Vol 17 (4) ◽

pp. 1055-1065 ◽

Cited By ~ 132

Author(s):

Jurgen J. Fütterer ◽

Marc R. Engelbrecht ◽

Gerrit J. Jager ◽

Robert P. Hartman ◽

Bernard F. King ◽

...

Keyword(s):

Prostate Cancer ◽

Phased Array ◽

Staging Accuracy ◽

Local Staging ◽

Phased Array Coil ◽

Phased Array Coils ◽

Array Coil ◽

Array Coils

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Location of local recurrence after MRI-guided partial prostate brachytherapy targeting only the peripheral zone: Implications for focal therapy.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.6_suppl.149 ◽

2013 ◽

Vol 31 (6_suppl) ◽

pp. 149-149 ◽

Cited By ~ 1

Author(s):

Konstantin Kovtun ◽

Tobias Penzkofer ◽

Neha Agrawal ◽

Tina Kapur ◽

Andriy Fedorov ◽

...

Keyword(s):

Prostate Cancer ◽

Local Recurrence ◽

Central Zone ◽

Peripheral Zone ◽

Focal Therapy ◽

Prostate Brachytherapy ◽

Local Recurrences ◽

Endorectal Coil ◽

Mri Scans ◽

Mri Guided

149 Background: Prostate cancer local recurrences usually occur at the same site as the dominant primary tumor in patients treated with radiation therapy to the whole gland. We characterized location of local recurrences in patients who were treated with MRI Guided Partial Brachytherapy in which only the peripheral zone was targeted. Methods: We retrospectively reviewed ten patients with initial cT1c, Gleason score 3+4 or less prostate cancer who developed biopsy proven local recurrences and had available imaging after MRI Guided Partial Brachytherapy targeting the peripheral zone from 1998 to 2006. All 10 patients had 1.5T endorectal coil MRI at diagnosis, performed primarily for staging and not for tumor localization, while at recurrence 8 had 3T endorectal coil MRI and 2 had 1.5T endorectal coil MRI. Scans consisted of at least T1 and T2 sequences. Two radiologists (C.T. and T.P.) blinded to clinical data reviewed diagnosis MRI scans together and quantified likelihood of tumor on a 1 to 5 scale in each section of an eight part prostate in both pre-treatment and recurrence scans. Local recurrence was judged to be in the same location as the baseline tumor if at least 50% of the tumor location overlapped. Results: Only 3 of 10 patients had local recurrences at the same location as the baseline tumor with a mean overlap of 64%. 7 of 10 patients had local recurrences at a different location with a mean overlap of 5%. 5 of 10 patients had recurrences in the central zone of the prostate which did not definitively show tumor on review of the initial 1.5T staging scan. Conclusions: After MRI-guided brachytherapy targeting only the peripheral zone in men initially staged with 1.5T MRI, 50% of the local recurrences occurred at the non-targeted central zone, raising the possibility that focal therapy directed only at the dominant tumor will result in increased out-of-field recurrences. Whether the superior ability of modern 3T multiparametric MRI to detect and precisely localize occult prostate cancer foci will reduce this risk is the subject of current study.

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Value of Diffusion-Weighted Imaging for the Prediction of Prostate Cancer Location at 3T Using a Phased-Array Coil

Investigative Radiology ◽

10.1097/rli.0b013e3181461d21 ◽

2007 ◽

Vol 42 (12) ◽

pp. 842-847 ◽

Cited By ~ 150

Author(s):

Chan Kyo Kim ◽

Byung Kwan Park ◽

Hyun Moo Lee ◽

Ghee Young Kwon

Keyword(s):

Prostate Cancer ◽

Diffusion Weighted Imaging ◽

Phased Array ◽

Diffusion Weighted ◽

Phased Array Coil ◽

Array Coil

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Three-dimensional proton magnetic resonance spectroscopic imaging with and without an endorectal coil: a prostate phantom study

Acta Radiologica ◽

10.1177/0284185114556704 ◽

2014 ◽

Vol 56 (11) ◽

pp. 1342-1349 ◽

Cited By ~ 3

Author(s):

Chao Ma ◽

Luguang Chen ◽

Tom WJ Scheenen ◽

Jianping Lu ◽

Jian Wang

Keyword(s):

Magnetic Resonance ◽

Proton Magnetic Resonance ◽

Three Dimensional ◽

Spectroscopic Imaging ◽

Phantom Study ◽

Magnetic Resonance Spectroscopic Imaging ◽

Endorectal Coil

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Peripheral zone prostate cancer. Pre-treatment evaluation with MR and 3D 1H MR spectroscopic imaging: correlation with pathologic findings

Abdominal Imaging ◽

10.1007/s00261-009-9577-9 ◽

2009 ◽

Vol 35 (6) ◽

pp. 757-763 ◽

Cited By ~ 15

Author(s):

Sabina Giusti ◽

Davide Caramella ◽

Elena Fruzzetti ◽

Michele Lazzereschi ◽

Adele Tognetti ◽

...

Keyword(s):

Prostate Cancer ◽

Spectroscopic Imaging ◽

Peripheral Zone ◽

Treatment Evaluation ◽

Pathologic Findings ◽

Pre Treatment ◽

Mr Spectroscopic Imaging

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Adding a New Spectral Dimension to Localized1H MR Spectroscopy of Human Prostates using an Endorectal Coil

Spectroscopy An International Journal ◽

10.1155/2003/649546 ◽

2003 ◽

Vol 17 (2-3) ◽

pp. 521-527 ◽

Cited By ~ 7

Author(s):

M. Albert Thomas ◽

Nader Binesh ◽

Kenneth Yue ◽

Shida Banakar ◽

Nathaniel Wyckoff ◽

...

Keyword(s):

Mr Spectroscopy ◽

Phased Array ◽

Acquisition Time ◽

Spectroscopic Techniques ◽

Endorectal Coil ◽

Spectral Dispersion ◽

Body Coil ◽

Clinical Scanner ◽

Cosy Spectra ◽

Array Coil

Localized 2D shift-correlated MR spectra (L-COSY) of human prostates were recorded using an endorectal “receive” coil. Typically, 4 ml voxels were placed in the peripheral zones of the prostate. Seven healthy volunteers and one BPH patient have participated in this study so far. The total acquisition time for a 2D L-COSY was approximately 20 minutes. A 1.5 Tesla GE scanner with a body coil for RF transmission and a pelvic phased-array coil combined with a disposable rectal coil for reception was used. The 2D L-COSY spectra showed cross peaks due to citrate, spermine and occasionally choline, creatine and lipids. The 2D cross peaks due to both the multiplets of spermine were clearly resolved from choline and creatine which has been a major problem with the conventional MR spectroscopic techniques. In contrast to 2D JPRESS, improved spectral dispersion, less crowded 2D cross peaks and unequivocal detection of both multiplets of spermine were monitored in 2D L-COSY. Pilot results suggest that localized 2D L-COSY can be successfully implemented in human prostates on a clinical scanner.

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