3-D MR spectroscopy shows promise for improving pretreatment evaluations in prostate cancer

The ability to accurately evaluate extracapsular extension in prostate cancer could be very helpful in pretreatment decision-making, as the presence of ECE has been correlated with failed treatment after radical prostatectomy. Endorectal MR has shown some promise in diagnosing ECE, but has problems with diagnostic and reader variability.

The authors at the University of California, San Francisco, looked at whether adding three-dimensional proton MR spectroscopic imaging to endorectal MR would improve the diagnostic accuracy. To do so, they retrospectively reviewed MR images from 53 patients who had undergone the combined imaging examination, and subsequently had a radical prostatectomy within three months.

When the 3-D spectroscopic findings were compared with the pathologic findings of ECE, the results showed some of the modality's predictive potential. Specifically, patients with less than one cancer voxel per section on spectroscopy were found to have only a 6% risk of ECE, while those with greater than four per section had an 80% risk.

Compared with MR imaging, the 3-D spectroscopy also significantly improved the diagnostic accuracy for a less-experienced reader, the authors found.