Proton spectroscopic and dynamic contrast-enhanced magnetic resonance: a modern approach in prostate cancer imaging.

摘要

At present, the evaluation of prostate cancer is more determined by the use of clinical nomograms including prostate-specific antigen (PSA) determination and by pathologic findings of the tumour at biopsy or after surgery. For a long time, a valid diagnostic imaging procedure has not been available for prostate cancer detection, staging, and follow-up during therapies. All three cross-sectional imaging modalities [computer tomography (CT), ultrasonography,and magnetic resonance (MR)] have been employed in patients with prostate cancer, and each have important limitations. In particular, reports on the value of magnetic resonance imaging (MRI) have been contradictory .Recently a large number of studies [2-5] have shown that the addition of proton 1H-magnetic resonance spectroscopic imaging (1H-MRSI) and dynamic contrast-enhanced imaging to MR (DCEMR) could represent a powerful tool for the management of prostate cancer in most of its aspects: initial diagnosis, cancer localization and local staging, assessment of tumour aggressiveness, road-map for surgery and radiotherapy, and early detection of local recurrence.