Imaging: MRSI can potentially differentiate between aggressive and indolent prostate cancer.

摘要

The main drawback of the well-documented increase in prostate cancer detection resulting from widespread PSA screening is the overtreatment of indolent disease. Thus, the ability to identify patients with more-aggressive disease would help prevent overtreatment of those with low-risk tumors. Transrectal biopsy can confirm the presence of prostate cancer and determine the Gleason score of the tumor, but often underestimates the true aggressiveness of the disease.Magnetic resonance spectroscopic imaging (MRSI) can detect tissue levels of specific metabolites, such as citrate, choline and creatine. The ratios of choline plus creatine to citrate (Cho + Cr:Cit) and cholinexreatine (Cho:Cr) have previously been shown to correlate with Gleason score when using 1.5 T MRI with an endorectal coil, but not when body array coils are used alone.