Ces Urol 2010, 14(3):186-196 | DOI: 10.48095/cccu2010032

Position of magnetic resonance and magnetic resonance with spectroscopy in detection of prostate cancer

Jiří Bárta¹, Zuzana Ryznarová^3,4, Petr Klézl¹, František Záťura², Magdaléna Adamová³, Miroslav Kašpar³, Jaroslav Novák¹

¹ Urologické oddělení FN Na Bulovce, Praha

² Urologická klinika LF JEP, Olomouc

³ Radiodiagnostická klinika 1. LF UK a FN Na Bulovce, Praha

⁴ MR Budějovická, MEDICON a.s., Praha

Aim:
Magnetic resonance (MRI) presently represents an eligible diagnostic method for more precise determination of local extension of prostate cancer status using magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS).
In our work we present our own experience with MRI and MRS in the detection of prostate cancer.

Methods and results:
We present our experience in MRI and MRS in the group of patiens with previously diagnosed prostate cancer (CaP) referred for radical prostatectomy. Histopathologic findings in radical prostatectomy (RP) specimens were compared to MRI results. The average age in the group was 64.4 years (from 52 to 70 years) and the average prostatic specific antigen (PSA) value was 8.37 ?g/l (from 1.5 to 28.5 ?g/l). Correspondence in tumor stage definition was found in 27 (73%) cases, which means 76% sensitivity and 80% specificity.
In the second group we investigated on MR 23 patients with previously negative histopathologic findings on prostate biopsy and persisting PSA elevation. Correspondence in MR findings and prostate biopsy was found in 14 patients (61%). Discrepancy in MR and biopsy findings was in 9 patients (39%). Prostate cancer was diagnosed only in 5 patients.
In 5 patients with PSA elevation after RP we expected MR examination to confirm the local recurrence after RP. However MRI and MRS have not brought suspicion of local recurrence of the disease and later histopathologic investigation of specimens obtained by focused biopsy has not confirmed disease recurrence.

Conclusion:
MRI and MRS are according to our opinion suitable methods for the assessment of local extension of prostate neoplasm. On the other hand our results so far do not confirm the possibility of detecting local recurrence after RP and the possibility of verificating prostate cancer with repeateadly negative prostate biopsies and continuing elevation of PSA level.

Keywords: prostate cancer, magnetic resonance (MRI), magnetic resonance spectroscopy (MRS)

Received: May 11, 2009; Accepted: May 12, 2010; Published: June 1, 2010