MR spectroscopic imaging and diffusion-weighted imaging of prostate cancer with Gleason scores

Rajakumar Nagarajan, Daniel Margolis, Steven Raman, Manoj K. Sarma, Ke Sheng, Christopher R. King, Gaurav Verma, James Sayre, Robert E. Reiter, M. Albert Thomas

Research output: Contribution to journalArticlepeer-review

46 Scopus citations

Abstract

Purpose: To investigate functional changes in prostate cancer patients with three pathologically proven different Gleason scores (GS) (3+3, 3+4, and 4+3) using magnetic resonance spectroscopic imaging (MRSI) and diffusion-weighted imaging (DWI). Materials and Methods: In this study MRSI and DWI data were acquired in 41 prostate cancer patients using a 1.5T MRI scanner with a body matrix combined with an endorectal coil. The metabolite ratios of (Cho+Cr)/Cit were calculated from the peak integrals of total choline (Cho), creatine (Cr), and citrate (Cit) in MRSI. Apparent diffusion coefficient (ADC) values were derived from DWI for three groups of Gleason scores. The sensitivity and specificity of MRSI and DWI in patients were calculated using receiver operating characteristic curve (ROC) analysis. Results: The mean and standard deviation of (Cho+Cr)/Cit ratios of GS 3+3, GS 3+4, and GS 4+3 were: 0.44 ± 0.02, 0.56 ± 0.06, and 0.88 ± 0.11, respectively. For the DWI, the mean and standard deviation of ADC values in GS 3+3, GS 3+4, and GS 4+3 were: 1.13 ± 0.11, 0.97 ± 0.10, and 0.83 ± 0.08 mm2/sec, respectively. Statistical significances were observed between the GS and metabolite ratio as well as ADC values and GS. Conclusion: Combined MRSI and DWI helps identify the presence and the proportion of aggressive cancer (ie, Gleason grade 4) that might not be apparent on biopsy sampling. This information can guide subsequent rebiopsy management, especially for active surveillance programs. J. Magn. Reson. Imaging 2012;36:697-703.

Original languageEnglish (US)
Pages (from-to)697-703
Number of pages7
JournalJournal of Magnetic Resonance Imaging
Volume36
Issue number3
DOIs
StatePublished - Sep 2012
Externally publishedYes

Keywords

  • apparent diffusion coefficient
  • diffusion weighted imaging
  • Gleason scores
  • MR spectroscopy
  • prostate cancer

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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