Magnetic resonance spectroscopic imaging 3T and prostate cancer: correlation with transperineal ultrasound guided prostate biopsy.

OBJECTIVES: The aim of our study was to correlate the results obtained by 3T Magnetic Resonance Spectroscopic Imaging (MRSI3T) with those obtained by histological examination of samples of the trans-perineal ultrasound-guided prostate biopsy (TPUS-B). METHODS: 34 patients were enrolled in the study. All patients had a clinical suspicion of cancer due to increased PSA and/or positive digital rectal examination. Patients were subjected to an MRSI 3T examination and subsequently to TPUS-B. RESULTS: Of the 22 (22/34) patients who presented abnormalities MRSI at 3T, 9 had a histological diagnosis of Prostate adenocarcinoma. Of the remaining 13 patients, 6 were found to be histologically positive for Benign Prostatic Hypertrophy and 7 Chronic Interstitial Inflammation or High Grade Prostatic Intraepithelial Neoplasia. 12 (12/34) patients found to have no peripheral alterations in their prostate on 3T MRSI, none were positive for ADK or inflammation on histology. The sensitivity, specificity, positive predictive value and negative predictive value were 100%, 48%, 40% and 100% respectively. DISCUSSION: In this study, we correlated the values obtained from 3T MRSI with the results of histologically examined prostate biopsies. Our work shows that 72.8% of the voxels in which there was a change in ratio of Cit/(Cho + Cr), corresponded to areas of prostate tissue disease. Of these, 73.2% were positive for ADK and 26.8% for CII or HG PIN. In literature, it is noted that PCa can be distinguished from areas of benign tissue, in the peripheral zone, on the basis of the values of the ratio Cit/(Cho + Cr) (17), although some benign conditions, such as prostatitis or PINHG, can alter these values (18-19). CONCLUSIONS: In conclusion, the use of MRSI 3T before performing prostate biopsies may represent a valid aid for the urologist in the diagnosis of PCa, allowing them to avoid unnecessary prostate biopsies that may be negative. Furthermore, it would also be possible to reduce the total number of biopsies, thus decreasing patient exposure to the unnecessary risks associated with biopsy.

Magnetic resonance spectroscopic imaging 3T and postate cáncer: correlation with transperineal ultrasound guided prostate biopsy

OBJETIVO: El objetivo de este estudio era correlacionar los resultados obtenidos con la resonancia magnética por espectroscopia 3T (RMNE3T) con los obtenidos por la evaluación histológica de las muestras de biopsia de próstata transperineal guiada por ecografía. MÉTODOS: 34 Pacientes fueron incluidos en el estudio. Todos los pacientes tenían la sospecha de cáncer de próstata por elevación del PSA y/o tacto rectal anormal. Los pacientes fueron sometidos a RMNE 3T y posteriormente biopsia transperineal guiada por ecografía. RESULTADOS: De los 22 pacientes (22/34) que presentaban anomalías en la RMNE 3T, 9 tuvieron el diagnóstico histológico de adenocarcinoma. De los 13 restantes, 6 fueron diagnosticados de hiperplasia benigna de próstata y 7 de inflamación intersticial crónica o PIN de alto grado. De 12 pacientes (12/34) que no presentaban alteraciones periféricas en la próstata en la RMNE 3T, ninguno tenía adenocarcinoma o inflamación en la histología. La sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo fueron del 100%, 48%, 40% y 100% respectivamente. DISCUSIÓN: En este estudio correlacionamos los valores obtenidos por RMNE 3T con los resultados del examen histológico de las biopsias de próstata. Nuestro trabajo muestra que el 72% de los voxeles en los que había un cambio en el cociente de Cit/(Cho+ Cr) correspondían con áreas de enfermedad del tejido prostático. De éstas, el 73,2% eran positivas para adenocarcinoma y el 26% para inflamación intersticial crónica o PIN de alto grado. En la literatura, se observa que el cáncer de próstata se puede distinguir de áreas de tejido benigno en la zona periférica, en base a los valores de la ratio Cit/(Cho+cr) (17), aunque algunas condiciones benignas, tales cómo la prostatitis o el PIN de alto grado, pueden alterar estos valores (18-19). CONCLUSIONES: En conclusión, el uso de la RMNE 3T antes de la realización de biopsias de próstata puede representar una ayuda válida para el urólogo en el diagnóstico de CaP, permitiéndole evitar biopsias de próstata innecesarias que pudieran ser negativas. Además, también sería posible reducir el número total de biopsias, disminuyendo así la exposición del paciente a riesgos innecesarios asociados con la biopsia

OBJECTIVES: The aim of our study was to correlate the results obtained by 3T Magnetic Resonance Spectroscopic Imaging (MRSI3T) with those obtained by histological examination of samples of the trans-perineal ultrasound-guided prostate biopsy (TPUS-B). METHODS: 34 patients were enrolled in the study. All patients had a clinical suspicion of cancer due to increased PSA and/or positive digital rectal examination. Patients were subjected to an MRSI 3T examination and subsequently to TPUS-B. RESULTS: Of the 22 (22/34) patients who presented abnormalities MRSI at 3T, 9 had a histological diagnosis of Prostate adenocarcinoma. Of the remaining 13 patients, 6 were found to be histologically positive for Benign Prostatic Hypertrophy and 7 Chronic Interstitial Inflammation or High Grade Prostatic Intraepithelial Neoplasia. 12 (12/34) patients found to have no peripheral alterations in their prostate on 3T MRSI, none were positive for ADK or inflammation on histology. The sensitivity, specificity, positive predictive value and negative predictive value were 100%, 48%, 40% and 100% respectively. DISCUSSION: In this study, we correlated the values obtained from 3T MRSI with the results of histologically examined prostate biopsies. Our work shows that 72.8% of the voxels in which there was a change in ratio of Cit/(Cho + Cr), corresponded to areas of prostate tissue disease. Of these, 73.2% were positive for ADK and 26.8% for CII or HG PIN. In literature, it is noted that PCa can be distinguished from areas of benign tissue, in the peripheral zone, on the basis of the values of the ratio Cit/(Cho + Cr) (17), although some benign conditions, such as prostatitis or PINHG, can alter these values (18-19). CONCLUSIONS In conclusion, the use of MRSI 3T before performing prostate biopsies may represent a valid aid for the urologist in the diagnosis of PCa, allowing them to avoid unnecessary prostate biopsies that may be negative. Furthermore, it would also be possible to reduce the total number of biopsies, thus decreasing patient ex posure to the unnecessary risks associated with biopsy