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Magn Reson Med. 2014 Jan;71(1):26-34. doi: 10.1002/mrm.24635. Epub 2013 Mar 8.

In vivo (1) H MR spectroscopic imaging of aggressive prostate cancer: can we detect lactate?

Author information

1
Radiology Department, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.

Abstract

PURPOSE:

A semi-LASER sequence was optimized for in vivo lactate detection in the prostate.

METHODS:

The ethical committee waived the need for informed consent to measure 17 patients with high grade prostate cancer on a 3T system. A semi-LASER sequence was used with an echo time of 144 ms and optimized interpulse timing for a spectral citrate shape with high signal intensity. An LCModel basis set was developed for fitting choline, creatine, spermine, citrate, and lactate and was used to fit all spectra in tumor-containing voxels. For patients without detectable lactate, the minimal detectable lactate concentration was determined by adding in all spectra of tumor tissue a simulated lactate signal. The amplitude of the simulated lactate signal was iteratively decreased until its fit reached a Cramér Rao lower bound >20%, which was then set as the patient-specific detection limit.

RESULTS:

In none of the patients a convincing lactate signal was found. We estimated that on average the lactate levels in high grade prostate cancer are below 1.5 mM (range 0.9-3.5 mM), Interestingly, in one patient with extensive necrosis in the tumor biopsy samples (Gleason score 5+5), large lipid resonances were observed, which originated from the tumor.

CONCLUSION:

The minimal detectable lactate concentration of 1.5 mM in high grade prostate cancer indicates that if lactate is increased it remains at low concentrations.

KEYWORDS:

1H MRSI; lactate; prostate cancer; semi-LASER

PMID:
23475759
DOI:
10.1002/mrm.24635
[Indexed for MEDLINE]
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