1. Parivar, F; Hricak, H; Shinohara, K; Kurhanewicz, J; Vigneron, D B; Nelson,
S J; Carroll, P R.
Detection of locally recurrent prostate cancer after cryosurgery:
Evaluation by transrectal ultrasound, magnetic resonance imaging, and
three-dimensional proton magnetic resonance spectroscopy.
Urology, v.48, n.4, (1996): 594-599.
Abstract:
Objectives: To assess and compare the clinical usefulness of transrectal
ultrasound (TRUS), magnetic resonance imaging (MRI), and three-dimensional
proton magnetic resonance spectroscopic imaging (3-D MRSI) in detecting
local recurrence of carcinoma of the prostate (CaP) in patients with
detectable prostate-specific antigen (PSA) levels after cryosurgery.
Methods: In a prospective study, 25 patients who had undergone cryosurgery
as primary treatment for CaP underwent endorectal MRI and 3-D MRSI,
followed by TRUS-guided prostate biopsy. At the time of study, 20 patients
had detectable PSA; the remaining 5 patients served as controls. All
patients had random sextant and guided prostate biopsy for correlation
with imaging and MR spectroscopic findings. Results: In patients with
detectable PSA, MRSI identified, location-for-location, all foci of CaP
and benign prostatic tissue that were detected by prostate biopsy. MRSI
identified more sites with CaP than did prostate biopsy, indicating a
larger volume of cancer. In 2 patients with detectable PSA and negative
prostate biopsy, MRSI identified 11 voxels with viable prostatic tissue.
In patients with undetectable PSA, both MRSI and prostate biopsy showed
necrosis. Ultrasound and MRI were very poor tools for identifying
recurrent cancer and differentiating between viable and necrotic prostate
tissue. Conclusions: 3-D MRSI is superior to TRUS and MRI in
differentiating among CaP, BPH, and necrosis when local recurrence after
cryosurgery is suspected. By providing chemical mapping of the prostate in
contiguous voxels, the addition of spectroscopy to endorectal MRI
increases the sensitivity for detection of local recurrence.
1. Guiraudon, G M; Klein, G J; Guiraudon, C M; Van Hemel, N; Yee, R.
Cryosurgical ablation of common atrial flutter-lessons from cryosurgical
ablation of common atrial flutter. (XVIIIth Congress of the European Society
of Cardiology, Birmingham, England, UK, August 25-29, 1996. )
European Heart Journal, v.17, n.ABSTR. SUPPL., (1996): 593.