Srinivasan, P V (2011) Role of magnetic resenonce spectroscopy as a noninvasive diagnostic investigation in carcinoma prosatate. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION : Prostate cancer is common and remains the second leading cause of cancer death among elderly men. Current methods for its detection, like Digital rectal examination, Transrectal ultrasound, Prostate Specific Antigen assay and even sextant biopsy have limited accuracy for most early prostate cancers. Moreover diagnosing carcinoma prostate in patients in grey zone of PSA [4 to 10 ng/ml] and patients with normal Digital rectal examination is still difficult. There is much overlap between Benign prostatic hyperplasia [BPH] and carcinoma prostate in this diagnostic grey zone of Prostate specific antigen. The histologic diagnosis of prostate cancer is made, in the majority of cases, by prostate needle biopsy. Prostate cancer rarely causes symptoms until it is advanced. Thus, suspicion of prostate cancer resulting in a recommendation for prostatic biopsy is most often raised by abnormalities found on digital rectal examination [DRE] or by serum prostate-specific antigen (PSA) elevations. Although there is controversy regarding the benefits of early diagnosis, it has been demonstrated that an early diagnosis of prostate cancer is best achieved using a combination of DRE and PSA. Transrectal ultrasound (TRUS)-guided, systematic needle biopsy is the most reliable method, at present, to ensure accurate sampling of prostatic tissue in men considered at high risk for harboring prostatic cancer on the basis of DRE and PSA findings. So this study is intented to assess the role of MR spectroscopy in diagnosing carcinoma prostate in patients with grey zone PSA with normal DRE. AIM & OBJECTIVES : To find out the "Role of Magnetic resenonce spectroscopy as a noninvasive diagnostic investigation in carcinoma prostate” in patients with PSA between 4 and 10ng/ml [Diagnostic grey zone] and normal DRE. MATERIALS AND METHODS : Inclusion Criteria - 20 males with age between 50 - 78 yrs, PSA between 4 and 10 ng/ml Normal DRE, Proper consent obtained, No other co morbidities. Exclusion criteria: Patients with UTI, Bleeding disorder, Claustrophobia, Nodular DRE, Patients with AUR, Patients with prostatitis, Patients with implants. Pre procedural antibiotics tab.ciprofloxacin-500mg half an hour prior to procedure and rectal enema were given. Viral serology done. All the patients are explained about the procedure. Supine position for MRSI and left lateral position for TRUS and Biopsy. CONCLUSION : MR spectroscopy of prostate for patients with grey zone PSA and normal DRE is a non invasive and feasible option to detect carcinoma prostate with a Positive predictive value of 75% and Negative predictive value of 100%.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | magnetic resenonce spectroscopy ; noninvasive diagnostic investigation ; carcinoma prosatate. |
| Subjects: | MEDICAL > Urology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 10 Aug 2017 02:22 |
| Last Modified: | 10 Aug 2017 03:31 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/2545 |
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