Zakian Kristen L, Eberhardt Steven, Hricak Hedvig, Shukla-Dave Amita, Kleinman Shanon, Muruganandham Manickam, Sircar Kanishka, Kattan Michael W, Reuter Victor E, Scardino Peter T, Koutcher Jason A
Departments of Medical Physics, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA.
Radiology. 2003 Oct;229(1):241-7. doi: 10.1148/radiol.2291021383. Epub 2003 Aug 14.
To determine whether cancers of the prostate transition zone (TZ) possess a unique metabolic pattern by which they may be identified at proton magnetic resonance (MR) spectroscopic imaging.
Findings in 40 patients who underwent combined endorectal MR imaging and hydrogen 1 MR spectroscopic imaging before radical prostatectomy and who had TZ tumor identified subsequently at step-section pathologic analysis were retrospectively reviewed. Within this population, a subset of 16 patients whose TZ tumor had a largest diameter of 1 cm or greater and was included in the MR spectroscopic imaging excitation volume was identified. In these 16 patients, the ratios of choline-containing compounds (Cho) and creatine/phosphocreatine (Cr) to citrate (Cit) (ie, [Cho + Cr]/Cit), Cho/Cr, and Cho/Cit were compared in tumor and control tissues. The presence of only Cho and the absence of all metabolites were also assessed.
The mean values of (Cho + Cr)/Cit, Cho/Cr, and Cho/Cit were different between TZ cancer and control tissues (P =.001, P =.003, and P =.001, respectively; Wilcoxon signed rank test). Nine (56%) of 16 patients had at least one tumor voxel in which Cho comprised the only detectable peak, while no control voxels showed only Cho (P =.008, McNemar test). The percentage of voxels in which no metabolites were detected did not differ between tumor and control tissues (P =.134, McNemar test).
TZ cancer has a metabolic profile that is different from that of benign TZ tissue; however, the broad range of metabolite ratios observed in TZ cancer precludes the use of a single ratio to differentiate TZ cancer from benign TZ tissue.
确定前列腺移行区（TZ）癌是否具有独特的代谢模式，以便在质子磁共振（MR）波谱成像中识别它们。
回顾性分析40例在前列腺癌根治术前接受直肠内MR成像和氢1 MR波谱成像检查，且随后在病理切片分析中发现TZ肿瘤的患者的检查结果。在这组患者中，确定了一个子集，其中16例患者的TZ肿瘤最大直径为1 cm或更大，并且包含在MR波谱成像激发体积内。在这16例患者中，比较了肿瘤组织和对照组织中含胆碱化合物（Cho）、肌酸/磷酸肌酸（Cr）与柠檬酸盐（Cit）的比率（即[Cho + Cr]/Cit）、Cho/Cr和Cho/Cit。还评估了仅存在Cho以及所有代谢物均不存在的情况。
TZ癌组织与对照组织之间的（Cho + Cr）/Cit、Cho/Cr和Cho/Cit平均值存在差异（分别为P =.001、P =.003和P =.001；Wilcoxon符号秩检验）。16例患者中有9例（56%）至少有一个肿瘤体素，其中Cho是唯一可检测到的峰，而对照体素中未发现仅含Cho的情况（P =.00 Eight，McNemar检验）。肿瘤组织和对照组织中未检测到代谢物的体素百分比没有差异（P =.134，McNemar检验）。
TZ癌具有与良性TZ组织不同的代谢特征；然而，TZ癌中观察到的代谢物比率范围较广，无法使用单一比率将TZ癌与良性TZ组织区分开来。
