Rodríguez RJA, Ramírez AC, Ramos OG, Rivas GR

Language: Spanish
References: 8
Page: 85-92
PDF size: 133.10 Kb.

ABSTRACT

Magnetic Resonante Spectroscopic Imaging (MRSI) provides a noninvasive method of detecting small molecular markers (historically the metabolitos choline and citrato) within the cytosol and extracellular spaces of the prostate, and is performed in conjunction with high-resolution anatomic imaging provided by Magnetic Resonance Imaging (MRI) can significantly improve the assessment of cancer location and extent within the prostate, extracapsular spread and cancer aggressiveness. Objective. To demonstrate if the image of spectroscopy of the magnetic resonance allows to diagnose those prostatic cancer “hidden”, that have escaped to the transrectal ultrasound biopsy. Material and method. From February to September of the 2004, 22 male patients with repeated and consecutive elevations of the specific prostate antigen that had been put under, in two occasions evaluated themselves at least, transrectal biopsies of prostate guided by ultrasound, minimum 10 samples, and whose histology results were negative to malignancy. Results. With the application of spectroscopy and magnetic resonance by transrectal coil, we demonstrated prostate diminution of the choline and elevation of the citrate in at least one periphery zone of the prostate gland in 4 patients, the biopsy taken directly from this area demonstrated adenocarcinoma of the prostate in these patients. The other 18 patients found normal levels of the molecular markers and the biopsies taken form “the suspicious” areas by resonance image, solely, were negative for cancer. Discussion. The recent studies have indicated that the metabolic information provided by MRSI combined with the anatomical information provided by magnetic resonance (MRI) can perceivably improve the diagnosis, degree of location and amount of cancer within the prostate, as well as the extracapsular extension, and the aggressiveness of the tumor. Conclusion. The clinical studies of the MRSI demonstrate that it is a non invasive method, by which it is possible to be studied the cellular metabolism and the anatomy of the prostate. This technology has the potential to define the volume of the tumor with projection of functional of metabolic image, improving our understanding of the aggressiveness of the cancer. The image of MRI combined with MRSI has demonstrated a potential already for diagnose, the staging, and to planning the treatment for patients with prostatic cancer. The additional studies will reveal the positive aspects and the clinical challenges of the spectroscopic image of the magnetic resonance.

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