Organ-Confined Prostate Cancer: Effect of Prior Transrectal Biopsy on Endorectal MRI and MR Spectroscopic Imaging
Aliya Qayyum1,
Fergus V. Coakley1,
Ying Lu1,
Jeffrey D. Olpin1,2,
Louis Wu1,
Benjamin M. Yeh1,
Peter R. Carroll3 and
John Kurhanewicz1
1 Department of Radiology, University of California, San Francisco, 505
Parnassus Ave., San Francisco, CA 94143-0628.
2 Present address: Department of Radiology, University of Utah, 30 N 1900 East,
#1A71, Salt Lake City, UT 84132-2140.
3 Department of Urology, University of California, San Francisco, San Francisco,
CA 94143-0628.
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Fig. 1A. —50-year-old man with mean prostate-specific antigen level of
17.6 ng/mL and positive transrectal biopsy indicating Gleason-score-6 tumor at
right base and mid gland. Thin-section high-spatial-resolution axial
T2-weighted image (TR/TEeff, 5,000/96; slice thickness, 3 mm;
interslice gap, 0 mm; field of view, 14 cm) shows spiculated
low-signal-intensity change extending from prostate capsule at right base
(arrow).
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Fig. 1B. —50-year-old man with mean prostate-specific antigen level of
17.6 ng/mL and positive transrectal biopsy indicating Gleason-score-6 tumor at
right base and mid gland. Axial T1-weighted image (TR/TE, 700/8; slice
thickness, 5 mm; interslice gap, 1 mm; field of view, 24 cm) shows
high-signal-intensity hemorrhage in peripheral zone of right base
(arrow) after biopsy.
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Fig. 2. —58-year-old man with mean prostate-specific antigen level of
6.3 ng/mL and positive transrectal biopsy indicating Gleason-score-6 tumor at
left lateral apex. Axial T1-weighted image (TR/TE, 700/8) shows
high-signal-intensity hemorrhage in right apex and spectral degradation in
voxels (asterisks) from this region. Voxels adjacent to regions of
hemorrhage show normal metabolic spectra, even though one voxel contains some
high-signal-intensity change on T1-weighted image. Low-signal-intensity change
is present in peripheral zone bilaterally on T2-weighted image. Cho = choline,
Cr = creatine.
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Fig. 3. —Patterns of spectral degradation from lipid contamination and
motion artifact. Top image is from 65-year-old man with negative findings on
prostate biopsy, and bottom image is from 68-year-old man with Gleason-score-6
tumor at right base. Spectra on top are obtained from left base location
(small rectangle) of adjacent T2-weighted axial image
(TR/TEeff, 5,000/96) and are examples of spectral degradation from
periprostatic lipid contamination as shown by presence of large lipid peak.
Spectra on bottom are obtained from left base location (small
rectangle) of adjacent T2-weighted axial image (5,000/96) and are
examples of spectral degradation from motion artifact as shown by broad
metabolite peaks and frequency shift of lipid peak that overlaps citrate
peak.
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Fig. 4. —Graph shows correlation of total hemorrhage score after
biopsy with time (days) from prostate biopsy.
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Fig. 5. —Graph shows correlation of spectrally degraded voxels with
time (days) from biopsy.
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Fig. 6. —Graph shows correlation of spectrally degraded voxels with
extent of visible hemorrhage.
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Copyright © 2004 by the American Roentgen Ray Society.
