MR OF THE PROSTATE: TECHNICAL AND CLINICAL APLICATIONS
BUSQUETS, JUAN CARLES VILANOVA

EDUCATIONAL OBJECTIVES:
1- To learn the applications, advantages and limitations of spectroscopic imaging in prostate cancer.
2- To become familiar with the incremental value to combine MR imaging and spectroscopic imaging information in the evaluation of prostate cancer

INTRODUCTION
Prostate cancer is an important, growing healthy problem, presenting a challenge to urologists, oncologists, and radiologists. Today, with the widespread use of screening of PSA levels and with better diagnostic methods at biospy, 90% of newly diagnostied cases of prostate cancer are considered to be of a local or regional stage. Thus, it is of great clinical interest to perform a non-invasive evaluation of tumor prognostic variables (location, volume, aggressiveness, and extension) as to choose the appropriate therapy. Patients with cancer that is localized within the prostate or has minimally extension beyond the capsule are candidates for local therapy and thus curable, whereas those with greater cancer spread require systemic therapy or a combination of systemic and local therapy. New discoveries in the molecular and cellular biology of prostate cancer present opportunities for the development of noninvasive imaging modalities that could improve the characterization of prostate cancer. Functional MR technique with 1H MR spectroscopic imaging is a novel modality that can improve the characterization of prostate cancer in patients prior and after therapy. The use of a combination of magnetic resonance imaging (MRI) and magnetic resonance spectroscopic imaging (MRSI) represents a promising approach to improve the clinical decision-making on the optimal strategy for the management of prostate cancer. This lecture will focus on the use of the optimal MRI and MRSI protocol using multivolume three-dimensional 1H MRSI and will addresses the important role in the detection, localization, staging and pre- and post-therapy decisions for prostate cancer.