Preliminary assessment of magnetic resonance spectroscopic imaging in predicting treatment outcome in patients with prostate cancer at high risk for relapse Journal Article


Authors: Pucar, D.; Koutcher, J. A.; Shah, A.; Dyke, J. P.; Schwartz, L.; Thaler, H.; Kurhanewicz, J.; Scardino, P. T.; Kelly, W. K.; Hricak, H.; Zakian, K. L.
Article Title: Preliminary assessment of magnetic resonance spectroscopic imaging in predicting treatment outcome in patients with prostate cancer at high risk for relapse
Abstract: The purpose of the study was to determine whether 3D proton magnetic resonance spectroscopic imaging (MRSI) can predict treatment outcome in high risk patients with prostate cancer, Endorectal magnetic resonance imaging (MRI) and 1H-MRSI were performed in 16 patients with prostate cancer who were considered high risk because of clinical stage T3-4, Gleason score ≥ 8, and/or prostate-specific antigen (PSA) level > 20 ng/mL. Patients were treated with chemotherapy/hormone therapy, underwent radical prostatectomy (RP) or radiation therapy, and were followed for PSA relapse (follow-up, 19-43 months). The ratio of choline plus creatine to citrate was used to localize peripheral zone cancer. An MRSI risk score on a scale of 0-3 was derived from the volume and degree of metabolic abnormality. Magnetic resonance spectroscopic imaging risk score, MRI tumor/node (TN) stage, clinical stage, Gleason score, and PSA were used as predictors of pathologic stage in patients treated with RP (n = 10) and PSA relapse in all patients. Magnetic resonance imaging TN stage (P < 0.01) and MRSI risk score (P < 0.05) correlated with pathologic stage, but clinical stage did not (P = 0.35). Magnetic resonance imaging TN stage was the only significant predictor of PSA relapse in the univariate analysis (P < 0.05). Although the MRSI risk score did not reach significance (P = 0.13), 6 patients with a score < 0.9 were relapse-free, whereas 7 of 10 patients with a score > 0.9 relapsed. Magnetic resonance imaging and MRSI risk assessments agreed in 15 of 16 patients. These preliminary results suggest that tumor metabolic assessment may indicate treatment outcome in high-risk patients with prostate cancer. Although MRSI did not provide added prognostic value to MRI in this small number of patients, MRSI might increase the confidence of the clinician in assessing risk on MRI by contributing supporting metabolic data.
Keywords: adult; cancer chemotherapy; clinical article; controlled study; treatment outcome; disease-free survival; cancer surgery; clinical trial; cancer risk; paclitaxel; cancer radiotherapy; chemotherapy; cancer staging; follow up; neoplasm staging; sensitivity and specificity; prostate specific antigen; carboplatin; controlled clinical trial; neoplasm recurrence, local; prediction; risk assessment; cancer hormone therapy; prostate-specific antigen; prostatic neoplasms; goserelin; prostatectomy; predictive value of tests; magnetic resonance spectroscopy; nuclear magnetic resonance spectroscopy; radical prostatectomy; radiation therapy; prostate carcinoma; estramustine; humans; prognosis; human; male; article
Journal Title: Clinical Prostate Cancer
Volume: 3
Issue: 3
ISSN: 1540-0352
Publisher: Elsevier Inc.  
Date Published: 2004-12-01
Start Page: 174
End Page: 181
Language: English
PROVIDER: scopus
PUBMED: 15636684
DOI: 10.3816/CGC.2004.n.028
DOI/URL:
Notes: Clin. Prostate Cancer -- Cited By (since 1996):18 -- Export Date: 16 June 2014 -- CODEN: CPCLC C2 - 15636684 -- Source: Scopus
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MSK Authors
  1. William K Kelly
    115 Kelly
  2. Peter T Scardino
    671 Scardino
  3. Lawrence H Schwartz
    307 Schwartz
  4. Darko Pucar
    12 Pucar
  5. Hedvig Hricak
    421 Hricak
  6. Kristen L Zakian
    82 Zakian
  7. Jason A Koutcher
    278 Koutcher
  8. Howard T Thaler
    245 Thaler
  9. Ankoor   Shah
    1 Shah