OBJECTIVE: We aimed to do a meta-analysis of the existing literature to assess the accuracy of prostate cancer studies which use magnetic resonance spectroscopy (MRS) as a diagnostic tool. MATERIALS AND METHODS: Prospectively, independent, blind studies were selected from the Cochrane library, Pubmed, and other network databases. The criteria for inclusion and exclusion in this study referenced the criteria of diagnostic research published by the Cochrane center. The statistical analysis was adopted by using Meta-Test version 6.0. Using the homogeneity test, a statistical effect model was chosen to calculate different pooled weighted values of sensitivity, specificity, and the corresponding 95% confidence intervals (95% CI). The summary receiver operating characteristic (SROC) curves method was used to assess the results. RESULTS: We chose two cut-off values (0.75 and 0.86) as the diagnostic criteria for discriminating between benign and malignant. In the first diagnostic criterion, the pooled weighted sensitivity, specificity, and corresponding 95% CI (expressed as area under curve [AUC]) were 0.82 (0.73, 0.89), 0.68 (0.58, 0.76), and 83.4% (74.97, 91.83). In the second criterion, the pooled weighted sensitivity, specificity, and corresponding 95% CI were 0.64 (0.55, 0.72), 0.86 (0.79, 0.91) and 82.7% (68.73, 96.68). CONCLUSION: As a new method in the diagnostic of prostate cancer, MRS has a better applied value compared to other common modalities. Ultimately, large scale RCT (randomized controlled trial) randomized controlled trial studies are necessary to assess its clinical value.
Humans ; Magnetic Resonance Spectroscopy/*diagnostic use ; Male ; Prospective Studies ; Prostatic Neoplasms/*diagnosis/metabolism ; ROC Curve ; Sensitivity and Specificity

We report a case of intracranial foreign body granuloma that showed features of a high grade tumor on magnetic resonance (MR) imaging. However, the relative cerebral blood volume was not increased in the enhancing mass on perfusion MRI and the choline/creatine ratio only slightly increased on MR spectroscopy. The results suggest that the lesion is benign in nature. Perfusion MRI and MR spectroscopy may be helpful to differentiate a foreign body granuloma from a neoplastic condition.
Adult ; Blood Volume ; Brain/*pathology/surgery ; Contrast Media/diagnostic use ; Diagnosis, Differential ; Echo-Planar Imaging/*methods ; Female ; Follow-Up Studies ; Gadolinium/diagnostic use ; Granuloma, Foreign-Body/*pathology/surgery ; Humans ; Image Enhancement/methods ; Magnetic Resonance Angiography/*methods ; Magnetic Resonance Spectroscopy/*methods

Optical imaging techniques use visual and near infrared rays. Despite their considerably poor penetration depth, they are widely used due to their safe and intuitive properties and potential for intraoperative usage. Optical imaging techniques have been actively investigated for clinical imaging of lymph nodes and lymphatic system. This article summarizes a variety of optical tracers and techniques used for lymph node and lymphatic imaging, and reviews their clinical applications. Emerging new optical imaging techniques and their potential are also described.
Contrast Media/diagnostic use ; Fluorescent Dyes/diagnostic use ; Humans ; Lymph Nodes/pathology/*radiography ; Lymphatic System/*pathology ; Lymphography ; Magnetic Resonance Imaging ; *Optical Imaging ; Positron-Emission Tomography ; Quantum Dots/diagnostic use ; Spectroscopy, Near-Infrared

OBJECTIVE: We wanted to estimate the practical improvements of 3T proton MR spectroscopy (1H MRS) as compared with 1.5T 1H MRS for the evaluation of human brain tumors. MATERIALS AND METHODS: Single voxel 1H MRS was performed at both 1.5T and 3T in 13 patients suffering with brain tumors. Using the same data acquisition parameters at both field strengths, the 1H MRS spectra were obtained with a short echo time (TE) (35 msec) and an intermediate TE (144 msec) with the voxel size ranging from 2.0 cm3 to 8.7 cm3. The signal to noise ratios (SNRs) of the metabolites (myoinositol (MI), choline compounds (Cho), creatine /phosphocreatine (Cr), N-acetyl-aspartate (NAA), lipid and lactate (LL)) and the metabolite ratios of MI/Cr, Cho/Cr, Cho/NAA and LL/Cr were compared at both TEs between the two field strengths in each brain tumor. The degrees of spectral resolution between the Cho and Cr peaks were qualitatively compared between the two field strengths in each brain tumor. RESULTS: The SNRs of the metabolites at 3T demonstrated 49-73% increase at a short TE (p < 0.01) and only 2-12% increase at an intermediate TE (p > 0.05) compared with those of 1.5T. The SNR of inverted lactate at an intermediate TE decreased down to 49% with poorer inversion at 3T (p < 0.05). There was no significant difference in the metabolite ratios between the two field strengths. The degrees of the spectral resolution at 3T were slightly superior to those of 1.5T at a short TE. CONCLUSION: As compared with 1.5T, 3T 1H MRS demonstrated 49-73% SNR increase in the cerebral metabolites and slightly superior spectral resolution only at a short TE, but little at an intermediate TE, in the brain tumors. There was no significant difference in the metabolite ratios between the two field strengths.
Sensitivity and Specificity ; Reproducibility of Results ; Protons/*diagnostic use ; Middle Aged ; Male ; Magnetic Resonance Spectroscopy/*methods ; Humans ; Female ; Brain Neoplasms/*diagnosis/*metabolism ; Biological Markers/*analysis ; Aged ; Adult ; Adolescent

OBJECTIVE: The purpose of our study was to determine the ability of H-1 MR spectroscopy (MRS) to lateralize the lesion in patients with hippocampal sclerosis. MATERIALS AND METHODS: Twenty healthy volunteers and 25 patients with intractable temporal lobe epilepsy whose MR imaging diagnosis was unilateral hippocampal sclerosis were included. This diagnosis was based on the presence of unilateral atrophy and/or high T2 signal intensity of the hippocampus. Single-voxel H-1 MRS was carried out on a 1.5-T unit using PRESS sequence (TE, 136 msec). Spectra were obtained from hippocampal areas bilaterally with volumes of interest (VOIs) of 6.0 cm 3and 2.25 cm 3 in healthy volunteers, and of either 6.0 c m 3 (n = 14) or 2.25 cm 3 (n = 11) in patients. Metabolite ratios of NAA/Cho and NAA/Cr were calculated from relative peak height measurements. The capability of MRS to lateralize the lesion and to detect bilateral abnormalities was compared with MR imaging diagnosis as a standard of reference. RESULTS: In healthy volunteers, NAA/Cho and NAA/Cr ratios were greater than 0.8 and 1.0, respectively. In patients, the mean values of these ratios were significantly lower on the lesion side than on the contralateral side, and lower than those of healthy volunteers (p <.05). The overall correct lateralization rate of MRS was 72% (18/25); this rate was lower with a VOI of 6.0 cm 3 than of 2.25 cm 3 (64% versus 82%, p <.05). Bilateral abnormalities on MRS were found in 24% (6/25) of cases. CONCLUSION: Although its rate of correct lateralization is low, single-voxel H-1 MRS is a useful and promising diagnostic tool in the evaluation of hippocampal sclerosis, particularly for the detection of bilateral abnormalities. To improve the diagnostic accuracy of H-1 MRS, further investigation, including the use of a smaller VOI and measurement of the absolute amount of metabolites, are needed.
Adult ; Case-Control Studies ; Epilepsy, Temporal Lobe/*diagnosis/pathology ; Female ; Hippocampus/metabolism/*pathology ; Human ; Magnetic Resonance Spectroscopy/*diagnostic use/methods ; Male ; Sclerosis

OBJECTIVE: To evaluate the multiphase contrast-enhanced magnetic resonance (MR) imaging features of Bacillus Calmette-Guerin (BCG)-induced granulomatous prostatitis (GP). MATERIALS AND METHODS: Magnetic resonance images obtained from five patients with histopathologically proven BCG-induced GP were retrospectively analyzed for tumor location, size, signal intensity on T2-weighted images (T2WI) and diffusion-weighted images (DWI), apparent diffusion coefficient (ADC) value, and appearance on gadolinium-enhanced multiphase images. MR imaging findings were compared with histopathological findings. RESULTS: Bacillus Calmette-Guerin-induced GP (size range, 9-40 mm; mean, 21.2 mm) were identified in the peripheral zone in all patients. The T2WI showed lower signal intensity compared with the normal peripheral zone. The DWIs demonstrated high signal intensity and low ADC values (range, 0.44-0.68 x 10(-3) mm2/sec; mean, 0.56 x 10(-3) mm2/sec), which corresponded to GP. Gadolinium-enhanced multiphase MR imaging performed in five patients showed early and prolonged ring enhancement in all cases of GP. Granulomatous tissues with central caseation necrosis were identified histologically, which corresponded to ring enhancement and a central low intensity area on gadolinium-enhanced MR imaging. The findings on T2WI, DWI, and gadolinium-enhanced images became gradually obscured with time. CONCLUSION: Bacillus Calmette-Guerin-induced GP demonstrates early and prolonged ring enhancement on gadolinium-enhanced MR imaging which might be a key finding to differentiate it from prostate cancer.
Aged ; Gadolinium/*diagnostic use ; Humans ; Image Enhancement ; Immunotherapy/*adverse effects ; Magnetic Resonance Imaging/*methods ; Magnetic Resonance Spectroscopy ; Male ; Middle Aged ; Mycobacterium bovis/*pathogenicity ; Prostate-Specific Antigen/blood ; Prostatic Neoplasms/diagnosis ; Prostatitis/*diagnosis ; Retrospective Studies ; Urinary Bladder Neoplasms/drug therapy

Coenzyme Q therapy has been used to support metabolic derangements in patients with mitochondrial encephalomyopathies. Biochemical analysis of the living human brain can be performed by magnetic resonance spectroscopy (MRS). We report upon a KSS patient who was serially imaged with localized proton MRS to monitor the efficacy of CoQ treatment. A 17-year-old girl with KSS was serially imaged with localized proton MRS performed on a GE 1.5 T SIGNA MRI/MRS system. The elevated lactate contents of lesions decreased after one month of CoQ therapy but were re-elevated 10 months after treatment. We conclude that MRS presents us with a powerful tool for monitoring the effects of therapeutic trials in mitochondrial encephalomyopathies.
Adolescence ; Brain/metabolism ; Brain/drug effects ; Case Report ; Female ; Human ; Kearns Syndrome/metabolism* ; Kearns Syndrome/drug therapy* ; Kearns Syndrome/diagnosis ; Lactic Acid/metabolism ; Magnetic Resonance Spectroscopy/diagnostic use* ; Pyruvic Acid/metabolism* ; Treatment Outcome ; Ubiquinone/therapeutic use*

OBJECTIVE: To explore the in-vivo 1H- MR spectral features of adnexal lesions and to characterize the spectral patterns of various pathologic entities. MATERIALS AND METHODS: Thirty-one patients with surgically and histopathologically confirmed adnexal lesions underwent short echo-time STEAM (stimulated echo acquisition method) 1H- MR spectroscopy, and the results obtained were analysed. RESULTS: The methylene present in fatty acid chains gave rise to a lipid peak of 1.3 ppm in the 1H- MR spectra of most malignant tumors and benign teratomas. This same peak was not observed, however, in the spectra of benign ovarian epithelial tumors: in a number of these, a peak of 5.2 ppm, due to the presence of the olefine group (-CH=CH-) was noted. The ratios of lipid peak at 1.3 ppm to water peak (lipid/water ratios) varied between disease groups, and in some benign teratomas was characteristically high. CONCLUSION: An intense lipid peak at 1.3 ppm is observed in malignant ovarian tumors but not in benign epithelial tumors. 1H- MRS may therefore be helpful in the differential diagnosis of adnexal lesions.
Adnexal Diseases/*diagnosis ; Adult ; Aged ; Cystadenoma, Mucinous/diagnosis ; Diagnosis, Differential ; Female ; Human ; Magnetic Resonance Spectroscopy/*diagnostic use ; Middle Age ; Ovarian Neoplasms/diagnosis ; Protons ; Support, Non-U.S. Gov't ; Teratoma/diagnosis ; Uterine Neoplasms/diagnosis

OBJECTIVE: To evaluate the clinical feasibility and obtain useful parameters of 31P magnetic resonance spectroscopy (MRS) study for making the differential diagnosis of brain tumors. MATERIALS AND METHODS: Twenty-eight patients with brain tumorous lesions (22 cases of brain tumor and 6 cases of abscess) and 11 normal volunteers were included. The patients were classified into the astrocytoma group, lymphoma group, metastasis group and the abscess group. We obtained the intracellular pH and the metabolite ratios of phosphomonoesters/phosophodiesters (PME/PDE), PME/inorganic phosphate (Pi), PDE/Pi, PME/adenosine triphosphate (ATP), PDE/ATP, PME/phosphocreatine (PCr), PDE/PCr, PCr/ATP, PCr/Pi, and ATP/Pi, and evaluated the statistical significances. RESULTS: The brain tumors had a tendency of alkalization (pH = 7.28 +/- 0.27, p = 0.090), especially the pH of the lymphoma was significantly increased (pH = 7.45 +/- 0.32, p = 0.013). The brain tumor group showed increased PME/PDE ratio compared with that in the normal control group (p = 0.012). The ratios of PME/PDE, PDE/Pi, PME/PCr and PDE/PCr showed statistically significant differences between each brain lesion groups (p < 0.05). The astrocytoma showed an increased PME/PDE and PME/PCr ratio. The ratios of PDE/Pi, PME/PCr, and PDE/PCr in lymphoma group were lower than those in the control group and astrocytoma group. The metastasis group showed an increased PME/PDE ratio, compared with that in the normal control group. CONCLUSION: We have obtained the clinically applicable 31P MRS, and the pH, PME/PDE, PDE/Pi, PME/PCr, and PDE/PCr ratios are helpful for differentiating among the different types of brain tumors.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Astrocytoma/diagnosis/*metabolism ; Brain Abscess/diagnosis/*metabolism ; *Brain Chemistry ; Brain Neoplasms/diagnosis/*metabolism/secondary ; Case-Control Studies ; Diagnosis, Differential ; Feasibility Studies ; Female ; Humans ; Hydrogen-Ion Concentration ; Lymphoma/diagnosis/*metabolism ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy/*methods ; Male ; Middle Aged ; Phosphorus/diagnostic use ; Prospective Studies ; Young Adult

In a patient receiving 5-fluorouracil and levamisole, neurologic deficits suggest the cerebral demyelinating syndrome as a differential diagnosis. The authors report a patient diagnosed as multifocal inflammatory leukoencephalopathy for which thallium-201 ((201)Tl) single photon emission computed tomography (SPECT) and proton magnetic resonance spectroscopy (MRS) were employed as noninvasive diagnostic tools. (201)Tl SPECT study was negative and proton MRS showed an increase of choline and lactate and well preserved N-acetylaspartate. These findings support histopathologic findings of multifocal inflammatory leukoencephalopathy revealing demyelination with relative axonal sparing in the patient.
Adjuvants, Immunologic/adverse effects/therapeutic use ; Antimetabolites, Antineoplastic/adverse effects/therapeutic use ; Aspartic Acid/*analogs & derivatives/metabolism ; Axons/pathology ; Biopsy ; Brain/pathology ; Brain Neoplasms/secondary ; Choline/metabolism ; Colorectal Neoplasms/drug therapy/pathology ; Diagnosis, Differential ; Fluorouracil/adverse effects/therapeutic use ; Human ; Lactic Acid/metabolism ; Leukoencephalopathy, Progressive Multifocal/*diagnosis/etiology ; Levamisole/adverse effects/therapeutic use ; Magnetic Resonance Spectroscopy/*methods ; Male ; Middle Aged ; Neoplasm Metastasis ; Thallium Radioisotopes/*diagnostic use ; Tomography, Emission-Computed, Single-Photon/*methods