Tehran University Medical Journal

Background: Prostate cancer is the most common cancer and the second cause of cancer mortality in men. Although histopathological examination is the gold-standard for its diagnosis, tendency toward less invasive methods is growing. The purpose of this study was to evaluate the relationship between choline plus creatine- to-citrate ratio in magnetic resonance spectroscopy (MRS) with the invasion of prostate cancer in a series of patients with prostate cancer.
Methods: Totally, 200 patients with pathologically proven prostate cancer were enrolled in this cross-sectional study by a non-probability sampling method in Hazrat Rasul Akram Hospital in Tehran, Iran during 2009-2010. Pathological staging was the gold standard for the diagnosis of prostate cancer while the patients underwent MRS for choline plus creatine- to-citrate ratio determination. MRS and pathological results were compared and analyzed.
Results: The mean (±SD) values of choline plus creatine- to-citrate ratio in patients with Gleason scores less than 3, 3 to 4 and greater than 4 were 245.8±146.8, 427.1±173.6 and 427.1±173.6, respectively (P<0.001). The mean (±SD) values of choline plus creatine- to-citrate ratio in patients with PSA levels less than 4, 4 to 10 and greater than 10 were 180.7±58.3, 247±93.5 and 385.1±106.6, respectively (P<0.001).
Conclusion: Choline plus creatine- to-citrate ratio determined by magnetic resonance spectroscopy has a significant relationship with the degree of invasion of prostate cancer and can be used for the staging of the disease.