In vivo proton magnetic resonance spectroscopy of diseased prostate: Spectroscopic features of malignant versus benign pathology

In vivo Proton Magnetic Resonance Spectroscopy appears potentially useful f or non-invasive discrimination between benign prostatic hyperplasia (BPH) a nd prostate carcinoma (PC), Aiming to delimit the range within which spectr a from one or the other pathology should occur, and establish extreme spect roscopic features of malignant versus benign prostate disease, we performed endorectal proton MR spectroscopy on 20 patients severely affected of eith er benign prostatic hyperplasia (BPH) (n = 10) or prostate cancer (PC) (n = 10), They were selected on the basis of the large volume and homogeneity o f their lesions, which were histologically confirmed after spectroscopy. Co nsequently, high-quality short-TE proton spectra with well-resolved metabol ite signals, and practically free of volume averaging issues were obtained in all cases. Apart from the typical citrate, creatine, and choline signals of prostate spectra, both BPH and PC spectra showed a peak centered at 3.6 ppm which was assigned to myo-inositol. The intensity of this contribution was found significantly increased in PC cases compared to BPH. Possible re lationships between neoplastic transformation and the metabolic pathways in which myo-inositol participates are discussed. Average spectroscopic profi les were calculated for both advanced pathologies, and showed obvious diffe rentiated features. In quantitative terms, the ratio of citrate to choline peak areas as well as that of creatine to myo-inositol appeared as the most convenient to discriminate between advanced PC cases (both ratios below 1. 0) and advanced BPH cases (both ratios above 1.0) (C) 1999 Elsevier Science Inc.