Clinical application of BASING and spectral/spatial water and lipid suppression pulses for prostate cancer staging and localization by in vivo 3D 1H magnetic resonance spectroscopic imaging.

In previous in situ point-resolved spectroscopy (PRESS) three-dimensional (3D) 1H magnetic resonance (MR) spectroscopic imaging studies, it has been demonstrated that the ratio of prostatic metabolites can noninvasively discriminate prostate cancer from surrounding normal tissue. However, in these studies, conventional chemical shift selective suppression (CHESS) and short-time inversion recovery (STIR) techniques often resulted in inadequate water and lipid suppression. To improve suppression and spatial coverage, the newly developed T1 insensitive dual band selective inversion with gradient dephasing (BASING) Bandstop Filter and dual phase-compensating spectral/spatial spin-echo pulses have been implemented in a clinical setting. In phantom studies, no change in metabolic profiles was observed with application of either BASING or spectral/spatial pulses. In a study of 17 prostate cancer patients, the use of either BASING or spectral/spatial pulses allowed for suppression of water (BASING 99.80 +/- 0.14% and spectral/spatial 99.73 +/- 0.47%) and lipid (BASING 98.56 +/- 1.03% and spectral/spatial 98.44 +/- 1.90%) without a significant difference in the prostatic metabolite ratios. Spectral/spatial suppression has the added advantage of reducing the chemical shift dependence of the PRESS volume, but optimal performance requires high-speed gradients with negligible eddy current effects. BASING suppression is less reliant on accurate pulse and gradient timings and can be implemented easily with no loss in performance on clinical MR scanners with conventional gradients.