Transition zone prostate cancer: Metabolic characteristics at 1H MR spectroscopic imaging-initial results

Kristen L. Zakian, Steven Eberhardt, Hedvig Hricak, Amita Shukla-Dave, Shanon Kleinman, Manickam Muruganandham, Kanishka Sircar, Michael W. Kattan, Victor E. Reuter, Peter T. Scardino, Jason A. Koutcher

Research output: Contribution to journalArticle

159 Scopus citations


PURPOSE: 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. MATERIALS AND METHODS: 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. RESULTS: 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). CONCLUSION: 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.

Original languageEnglish (US)
Pages (from-to)241-247
Number of pages7
Issue number1
StatePublished - Oct 1 2003



  • Magnetic resonance (MR) spectroscopy
  • Magnetic resonance (MR), tissue characterization
  • Prostate, MR
  • Prostate, hyperplasia
  • Prostate, neoplasms

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Zakian, K. L., Eberhardt, S., Hricak, H., Shukla-Dave, A., Kleinman, S., Muruganandham, M., Sircar, K., Kattan, M. W., Reuter, V. E., Scardino, P. T., & Koutcher, J. A. (2003). Transition zone prostate cancer: Metabolic characteristics at 1H MR spectroscopic imaging-initial results. Radiology, 229(1), 241-247.