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MR spectroscopy may be superior for determining prostate cancer prognosis

A new way of evaluating prostate tumors may help physicians determine the best treatment strategy. Using magnetic resonance (MR) spectroscopy, which provides detailed information on the chemical composition of tissue samples, researchers from Massachusetts General Hospital (MGH) have shown that chemical profiles of prostate tissue can determine a tumor's prognosis better than standard pathological studies do. The report appears in the April 15 issue of Cancer Research.

"Our study indicates that analyzing prostate tissue's metabolic profile may give clinicians additional information about the biologic status of the disease that could allow them, in consultation with their patients, to make better-informed decisions on the next steps to take," says Leo L. Cheng, PhD, of the MGH Radiology and Pathology Departments, the report's lead author.

Since the prostate-specific antigen (PSA) test became widely used to screen for prostate cancer, tumor detection rates have increased dramatically, particularly among those at early stages of the disease. But increased detection has led to a clinical dilemma, since standard histologic evaluation, based on a biopsy sample's appearance under a microscope, often cannot distinguish which tumors are going to spread and which are not. Many men live for years with slow-growing prostate tumors before they die of unrelated causes, and treating such patients could cause more harm than benefit, Cheng notes. So finding a better way to determine which patients need aggressive treatment and which can try watchful waiting has been a major challenge.

Another problem is that a biopsy sample from one area the prostate may miss malignant cells elsewhere in the gland. Removal of the entire prostate can give a more definitive diagnosis, but if the tumor is a slow-growing one, the patient would have undergone unnecessary surgery. Surgery also is not appropriate when cancer has already spread beyond the prostate, since tha
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Contact: Sue McGreevey
smcgreevey@partners.org
617-724-2764
Massachusetts General Hospital
15-Apr-2005


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