Prostate cancer: metabolic response to cryosurgery as detected with 3D H-1 MR spectroscopic imaging.
Prostate cancer: metabolic response to cryosurgery as detected with 3D H-1 MR spectroscopic imaging.
复制标题
DOI：
10.1148/radiology.200.2.8685346
复制
发表时间：
1996-08
期刊：
影响因子：
19.7
通讯作者：
J. Kurhanewicz;Daniel B. Vigneron;Hedvig Hricak;Farhad Parivar;S. Nelson;K. Shinohara;P. Carroll
中科院分区：
文献类型：
--
作者：
J. Kurhanewicz;Daniel B. Vigneron;Hedvig Hricak;Farhad Parivar;S. Nelson;K. Shinohara;P. Carroll
目的：确定在接受冷冻手术治疗的前列腺癌患者中，磁共振（MR）波谱测量的胆碱和柠檬酸盐水平是否有助于区分残留肿瘤区域与其他前列腺组织和坏死。材料与方法对25例接受冷冻手术的前列腺癌患者（平均年龄69岁）进行MR成像和三维质子波谱成像。体积成像和光谱数据进行了分析校正的直肠内和盆腔相控阵线圈的接收配置文件。光谱数据与MR成像数据一致，并与血清前列腺特异性抗原水平和活检结果进行比较。结果：组织学证实的坏死组织（432体素）未显示任何可观察到的胆碱或柠檬酸盐。冷冻手术后，组织学证实的良性前列腺增生（0.61 +/- 0.21 [标准差]，52体素）和癌症（2.4 +/- 1.0，65体素）区域的（胆碱+肌酸）/柠檬酸盐值与治疗前无统计学显著差异，但与坏死组织中的比值以及彼此之间的比值有统计学显著差异。（胆碱+肌酸）/柠檬酸盐图像阈值和T2加权图像上的彩色叠加产生了前列腺癌和良性前列腺增生的空间范围的估计。结论：磁共振波谱成像的体积成像提供了一个非侵入性的评估残余癌的存在和位置后，治疗不成功，并帮助确定成功的冷冻手术的患者仍然有升高的前列腺特异性抗原水平。
PURPOSE To determine, in patients with prostate cancer treated with cryosurgery, whether levels of choline and citrate measured at magnetic resonance (MR) spectroscopy can help discriminate regions of residual tumor from other prostatic tissues and necrosis. MATERIALS AND METHODS Combined MR imaging and three-dimensional proton spectroscopic imaging were performed in 25 patients (mean age, 69 years) with prostate cancer who underwent cryosurgery. Volume imaging and spectroscopic data were analytically corrected for the reception profile of the endorectal and pelvic phased-array coils. Spectral data were aligned with the MR imaging data and compared with serum prostate-specific antigen levels and biopsy results. RESULTS Histologically confirmed necrotic tissue (432 voxels) did not demonstrate any observable choline or citrate. The (choline + creatine)/ citrate values in regions of histologically confirmed benign prostatic hyperplasia (0.61 +/- 0.21 [standard deviation], 52 voxels) and cancer (2.4 +/- 1.0, 65 voxels) after cryosurgery were not statistically significantly different from those before therapy but were statistically significantly different from the ratio in necrotic tissue and from each other. The (choline + creatine)/citrate images threshold and overlaid in color on T2-weighted images yielded an estimate of the spatial extent of prostate cancer and benign prostatic hyperplasia. CONCLUSION Volume MR imaging with MR spectroscopic imaging provided a noninvasive assessment of the presence and location of residual cancer after unsuccessful therapy and helped identify successful cryosurgery in patients who still had an elevated prostate-specific antigen level.