Prediction of aggressiveness of prostate cancer using MR spectroscopy at ultra-high magnetic field

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In 2003, 5 patients with biopsy proved prostate cancer were included in this study. MR images and MR spectra were obtained using 3 tesla MR unit. In 4 of 5 patients, spectra could not be evaluated because of poor quality due to post-biopsy prostate hemorrhage.Elimination of rectal gas and prostate hemorrhage was needed to keep magnetic field homogeneity. MR examination was performed before prostate biopsy, and using a purgative the day before the MR examination in 2004 study.High quality spectra were obtained in 25 of 51 patients (50%). It was presumed that one of the reasons of low successful rate was inhomogeneous radiofrequency (RF) excitation of whole prostate. In 25 patients, the (choline + creatine) / citrate peak area ratio (CC/C) was calculated after spectroscopic acquisition. The mean CC/C was 1.94 in peripheral zone (PZ) cancer, and 0.46 in healthy PZ (p<0.0001). In transition zone (TZ), the mean CC/C was 1.84 in cancer, and 1.03 in healthy TZ.The limitation of this study was low successful examination rate, but the spectral quality in patient with successful RF excitation was superior to usual spectrum at 1.5 tesla. When the RF excitation method is improved completely, significantly important metabolite information is produced using ultra-high MR unit.