Locally advanced prostate cancer: Three-dimensional magnetic resonance spectroscopy to monitor prostate response to therapy

Anna Lia Valentini, Benedetta Gui, Giuseppe Roberto D'Agostino, Giancarlo Mattiucci, Valeria Clementi, Ippolita Valentina Di Molfetta, Pierluigi Bonomo, Giovanna Mantini

Research output: Contribution to journalArticlepeer-review


Purpose: To correlate results of three-dimensional magnetic resonance spectroscopic imaging (MRSI) with prostate-specific antigen (PSA) levels and time since external beam irradiation (EBRT) in patients treated with long-term hormone therapy (HT) and EBRT for locally advanced disease to verify successful treatment by documenting the achievement of metabolic atrophy (MA). Methods and Materials: Between 2006 and 2008, 109 patients were consecutively enrolled. MA was assessed by choline and citrate peak area-to-noise-ratio 1.5:1 or choline signal-to-noise-ratio >5:1. To test the strength of association between MRSI results and the time elapsed since EBRT (TEFRT), PSA levels, Gleason score (GS), and stage, logistic regression (LR) was performed. p value 2 years. MA was detected in 54.1% of patients of group 1, 88.9% of group 2, and in 94.5% of group 3 (100% when PSA nadir was reached). CM was detected in 50% of patients with reached PSA nadir in group 1. Local relapse was found in 3 patients previously showing CM at long TEFRT. Conclusion: MA detection, indicative of successful treatment because growth of normal or abnormal cells cannot occur without metabolism, increases with decreasing PSA levels and increasing time on HT after EBRT. This supports long-term HT in advanced prostate cancer. Larger study series are needed to assess whether MRSI could predict local relapse by detecting CM at long TEFRT.

Original languageEnglish
Pages (from-to)719-724
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Issue number3
Publication statusPublished - Nov 1 2012


  • 3D magnetic resonance spectroscopy
  • External beam irradiation
  • Hormone therapy
  • Metabolic atrophy
  • Prostate cancer

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research


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