MR spectroscopy in prostate cancer
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MR spectroscopy is a promising development in the radiological evaluation of possible prostate malignancy.
The MR spectroscopic evaluation is mainly based on the choline peak elevation and choline-creatinine ratios.
Choline/creatine to citrate ratios:
- > 0.5: suspicious
- > 0.8: very suspicious
- > 2: abnormal
Additionally, the peak heights of citrate and choline can be compared visually2.
The addition of MR spectroscopic data to the conventional MRI has improved detection of prostate cancer and has also improved tumor volume detection, and staging capabilities of MRI.
Endorectal coils are considered superior to the body coils in the evaluation of prostate and periprostatic tissue imaging. With improving hardware and field strengths of MRI the surface array coils can also be used effectively in evaluating prostate.
The spectroscopic data can be superimposed on anatomical images and color tumor maps can be obtained to depict the true tumor volume, this can be done in all three planes. Volumetric depiction is also possible.
- 1. Westphalen AC, Coakley FV, Qayyum A et-al. Peripheral zone prostate cancer: accuracy of different interpretative approaches with MR and MR spectroscopic imaging. Radiology. 2008;246 (1): 177-84. doi:10.1148/radiol.2453062042 - Pubmed citation
- 2. Barentsz JO, Richenberg J, Clements R et-al. ESUR prostate MR guidelines 2012. Eur Radiol. 2012;22 (4): 746-57. doi:10.1007/s00330-011-2377-y - Free text at pubmed - Pubmed citation