Zusammenfassung.
Ziel: Methodische Erweiterung einer 1H-MR-spektroskopischen Bildgebungssequenz (1H-2D-CSI) für die Erkennung von Prostatakarzinomen und Validierung anhand postoperativ
angefertigter histologischer Schnitte. Methoden: Eine 1H-2D-CSI-Sequenz wurde zusätzlich mit einer frequenzselektiven Fettunterdrückung ausgestattet
und bei 18 Patienten (Voxelgröße: 1 cm3) bei 1,5 Tesla eingesetzt. Ergebnisse: Mit Hilfe des Verhältnisses von Zitrat/(Cholin + Kreatin) konnten benigne Hyperplasien
der Prostata von Karzinomen spektroskopisch unterschieden werden. Die Abgrenzung prostatisch
intraepithelialer Neoplasien (PIN, Grad III) von Prostatakarzinomen gelang nicht.
Mit der verfügbaren räumlichen Auflösung von 1 cm3 konnte der Tumordifferenzierungsgrad mittels Zitrat/(Cholin + Kreatin) nicht vorhergesagt
werden. Schlussfolgerung: Die modifizierte 1H-2D-CSI-Sequenz eignet sich aufgrund der dadurch verbesserten Spektrenqualität zur
Erkennung von Prostatakarzinomen. Eine Tumordifferenzierung war mit der verwendeten
Auflösung nicht möglich.
Spectroscopic Imaging (1H-2D-CSI) of the prostate: sequence optimization and correlation with histophatological
results.
Purpose: Methodological optimization of a 1H MR spectroscopic imaging sequence (1H-2D-CSI) and evaluation of its potential to diagnose prostate cancer as validated
by histopathological maps. Methods: The prostates of 18 patients were evaluated by 1H-MR-CSI (voxel dimension: 1 cm3) at 1,5 Tesla. This sequence was additionally combined with a frequency selective
fat suppression. Results: It was possible to distinguish prostate carcinoma from prostate hyperplasia spectroscopically
by the ratio of citrate/(choline + creatine). Differentiation of high-grade prostatic
intraepithelial neoplasia (PIN, high-grade) from prostate carcinoma was not unambiguously
possible. Prediction of tumor differentiation was not possible by the ratio of citrate/(choline
+ creatine) by our maximum spatial resolution of 1 cm3. Conclusion:
1H-2D-CSI is suitable for tumor detection. Tumor differentiation was not possible with
the spatial resolution used.
Schlüsselwörter:
Prostata - MR, Prostata - Neoplasie - Kernmagnetische Resonanz - Spektroskopie -
1H-MR-spektroskopische Bildgebung - Prostatakarzinom - Tumordetektion - Tumorgrading
- Prostatische intraepitheliale Neoplasie
Key words:
Prostate - MR, prostate - Neoplasia - Magnetic resonance (MR) spectroscopy -
1H MR spectroscopic imaging - Prostate cancer - Tumor detection - Tumor grading - Prostatic
intraepithelial neoplasia
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Dipl.-Phys. Michael Stanka
Institut für Klinische Radiologie Westfälische Wilhelms-Universität
Albert-Schweitzer-Straße 33
48129 Münster
Phone: 0251-8356140
Fax: 0251-8356145
Email: stanka@uni-muenster.de
