Prostate cancer: pre-treatemnt evaluation with Magnetic Resonance Imaging and three-dimensional 1H-Magnetic Resonance Spectroscopy

Prostate cancer is the most frequent malignancy of the male genitourinary tract, with an incidence in Europe of approximately 30 per 100.000 [48,49]. MRI of the prostate with a combined pelvic and endorectal coil has become an accepted method for staging prostate cancer. The advantages of this technique get results especially in local staging sensitivity, with a better judgement of surrounding structures [50,51]. Three-dimensional 1H-spectroscopy (3D MRS) of the prostate with evaluation of the metabolites choline, creatine, and citrate is a promising method for detecting prostate carcinomas which in particular show a higher choline and a reduced citrate level in comparison with healthy prostatic tissue [52,53]. The first objective of our study was to assess sensitivity, specificity and accuracy of 3-D MRI and 3D MRS in patients with high prostate-specific antigen (PSA) levels and biopsy proven prostate carcinoma, candidate to radical prostatectomy. The second purpose was to find a cut-off value of (Cho+Cr)/Cit ratio to discriminate between normal peripheral zone tissue and cancer. Besides we find a correlation between (Cho+Cr)/Cit ratio and histologic Gleason score.