Magnetic resonance spectroscopy in prostate disease: diagnostic possibilities and future developments.

Magnetic resonance spectroscopy (MRS) is a relatively new technique for studying membrane and intracellular metabolic events occurring in cancer. A series of transrectal probes were used for performing MRS and subsequently for integrated MRS/magnetic resonance imaging (MRI) of the prostate. Studies using transrectal 31P/1H MRS showed that it can characterize metabolic differences between normal and malignant prostates. Specifically, malignant prostates are characterized by low levels of phosphocreatine and citrate and high levels of phosphomonoesters relative to normal glands. These findings were verified in biochemical studies of prostate biopsies. The images obtained by transrectal coil techniques were superior to images obtained by the conventional body coil technique. In the future, the integration of 1H imaging and multi-volume localization techniques (spectroscopic imaging) will allow the acquisition of metabolic maps of the prostate which may eventually be useful in diagnosis and in management of patients with prostate cancer.