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EDUCATION EXHIBIT |
1 From the Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388–1 Poong-nap-dong, Songpa-gu, Seoul 138–736, South Korea (Y.J.C., J.K.K., N.K., K.W.K., K.S.C.); and Department of Radiology, Weill Medical College of Cornell University, New York, NY (E.K.C.). Recipient of a Certificate of Merit award for an education exhibit at the 2005 RSNA Annual Meeting. Received April 24, 2006; revision requested May 30 and received July 25; accepted July 26. Supported by Korean Research Foundation Grant KRF-2005–041-E00300. All authors have no financial relationships to disclose. Address correspondence to J.K.K. (e-mail: rialto{at}amc.seoul.kr).
T2-weighted magnetic resonance (MR) imaging has been widely used for pretreatment work-up for prostate cancer, but its accuracy for the detection and localization of prostate cancer is unsatisfactory. To improve the utility of MR imaging for diagnostic evaluation, various other techniques may be used. Dynamic contrast material–enhanced MR imaging allows an assessment of parameters that are useful for differentiating cancer from normal tissue. The advantages of this technique include the direct depiction of tumor vascularity and, possibly, obviation of an endorectal coil; however, there also are disadvantages, such as limited visibility of cancer in the transitional zone. Diffusion-weighted imaging demonstrates the restriction of diffusion and the reduction of apparent diffusion coefficient values in cancerous tissue. This technique allows short acquisition time and provides high contrast resolution between cancer and normal tissue, but individual variability in apparent diffusion coefficient values may erode diagnostic performance. The accuracy of MR spectroscopy, which depicts a higher ratio of choline and creatine to citrate in cancerous tissue than in normal tissue, is generally accepted. The technique also allows detection of prostate cancer in the transitional zone. However, it requires a long acquisition time, does not directly depict the periprostatic area, and frequently is affected by artifacts. Thus, a comprehensive evaluation in which both functional and anatomic MR imaging techniques are used with an understanding of their particular advantages and disadvantages may help improve the accuracy of MR for detection and localization of prostate cancer.
© RSNA, 2007
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