Endorectal coil MRI and MR-spectroscopic imaging in patients with elevated serum prostate specific antigen with negative trus transrectal ultrasound guided biopsy

ABSTRACT

The aim of this study was to see the efficacy of endorectal coil MRI and MR spectroscopic imaging in patients with elevated serum PSA and negative transrectal ultrasonography [TRUS]-guided biopsy. This study was conducted on 87 patients presented with Elevated prostatic specific antigen levels >5 ng/ml. Symptoms and signs of prostatic carcinoma. Patients with negative TRUS-guided biopsy. Suspicious lesion on TRU. All the patients were subjected to TRUS and followed by TRUS-guided biopsy of the lesion identified on endorectal coil MRI and MR-Spectroscopy. TRUS-guided biopsy of prostate was done with a Siemens Sonoline Adana Scanner. The scanning was performed by mechanical probe 5-7.5 MHz. Out of 87 patients, 43 [49.4%] had hypointense lesion, 11 [12.6%] had hyperintense lesion. Out of 87 patients, MR-spectroscopy showed peak choline-creatine in 74 patients. Normal citrate peak was seen in 13 patients. Patients who had choline-creatine peak, among them 28 [37.8%] had peak in left peripheral zone, 23 [31.1%] had peak in the right peripheral zone, 2 [2.7%] had peak in the central zone, 17 had [23%] peak bilaterally. Four patients [5.4%] had peaks in right and central zones. The difference was statistically significant [P < 0.001]. Prostatic biopsy directed with endorectal coil MRI and MR-spectroscopic imaging findings in patients with elevated serum PSA and prior negative biopsy, improves the early diagnosis of prostatic carcinoma and accurate localization of prostate cancer within the gland.