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Year : 2013  |  Volume : 5  |  Issue : 3  |  Page : 172-178

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

1 Department of CVTS, SKIMS, Srinagar, Jammu and Kashmir, India
2 Department of urology, SKIMS, Srinagar, Jammu and Kashmir, India
3 Department of Radiology, SKIMS, Srinagar, Jammu and Kashmir, India
4 Department of Health Services, Jammu and Kashmir, India

Correspondence Address:
Farooq Ahmad Ganie
Senior Resident, CVTS, SKIMS
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DOI: 10.4103/0974-7796.115741

PMID: 24049380

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Background: 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. Materials and Methods: 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. Results: 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). Conclusion: 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.

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