Citrate in the diagnosis of prostate cancer

BACKGROUND. One of the major current problems involved in prostate cancer ( PCa) is the unavailability of sensitive, accurate, and preferably noninvasi ve procedures for the diagnosis of PCa. Moreover, procedures are needed whi ch will permit the early detection, staging, location, and estimation of th e volume of malignancy, and preferably a mapping of the prostate for follow -up of progression and regression of the malignancy. METHODS. The unique citrate relationships of the prostate, coupled with rec ent developments and technological advancements in magnetic resonance spect roscopy (MRS) for the in situ determination of citrate levels, now provides an excellent diagnostic procedure which can achieve all these goals. There exist strong, compelling basic and clinical studies in support of the empl oyment of 1H MRS measurements of citrate and other associated metabolites i n the diagnosis of PCa. RESULTS. This review provides the background leading to the current status of MRS citrate analysis, summarizes the data from clinical trials, and desc ribes the applications of the procedure for the diagnosis of PCa and follow -up of patients. The use of MRS studies in defining the functional, as well as pathological relationships of the prostate, is also discussed. CONCLUSIONS. This review is intended to be informative to the prostate and oncology-interested community, and, hopefully, to engender much-needed inte rest and support in future research regarding the prostate relationships de scribed in this report. (C) 1999 Wiley-Liss, Inc.