COMPARING MR SPECTROSCOPY WITH COGNITIVE FUSION PROSTATIC BIOPSY IN THE DIAGNOSIS OF CARCINOMA PROSTATE- A PROSPECTIVE DESCRIPTIVE ANALYTIC STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 18
Abstract
BACKGROUND The current diagnostic approach for prostate cancer- PSA and digital rectal examination followed by transrectal ultrasound biopsies lack both sensitivity and specificity and offer only limited information about the aggressiveness and stage. Recent scientific work supports the rapidly growing use of multiparametric magnetic resonance imaging (MP-MRI) as the most sensitive and specific imaging tool for detection, lesion characterisation and staging of prostate cancer. Its use may improve many aspects of prostate cancer management from initial detection of significant tumours using MP-MRI-guided biopsies for evaluation of biological aggressiveness and accurate staging which can facilitate appropriate treatment selection. Aims and Objectives- To study the relationship between MR spectroscopy and prostate fusion biopsy in carcinoma prostate. MATERIALS AND METHODS The study was conducted on 30 patients, who attended Kilpauk Medical College Outpatient Department from August 2016 to January 2018, with an abnormal DRE and/ or PSA > 4 ng/mL. All these patients were subjected to MP-MRI 1.5 Tesla with endorectal coil imaging, sextant core and lesion targeted prostatic biopsy. MRSI findings (choline - citrate ratio > 2.5 is considered positive) and biopsy results were analysed and correlated. RESULTS Out of these 30 patients, biopsy revealed malignancy in 22, of which 16 had elevated choline - citrate ratio > 2.5. Gleason grade was > 7 in 10 cases, 7 in 6 cases and < 7 in 6 cases. Choline - citrate ratio was elevated in all cases (100%) of high-grade tumour (Gleason grade > 7), 4 out of 6 cases (66%) with Gleason score of 7 and in 2 (33%) of 6 cases with Gleason score of < 7. Cholinecitrate elevated in 2 patient’s biopsy shows chronic prostatitis. CONCLUSION MR spectroscopy of prostate is useful in diagnosing clinically significant and high-grade cancers. Sensitivity was low for low-grade tumours. It is ideally used as an adjunct with other functional studies rather than for primary diagnosis.
Authors and Affiliations
Periasamy Ponnusamy, Senthilvel Arumugam, Udayakumar Madesh
Keywords
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- EP ID EP417266
- DOI 10.14260/jemds/2018/488
- Views 69
- Downloads 0
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