الفهرس 
ANATOMY OF THE PROSTATE 6LANDOnly 14 pages are availabe for public view
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Abstract
Prostate cancer being one of the relatively controllable, slowly progressive, and one of the least morbid cancers in its early stages, has provoked many studies to try, predict, diagnose, and stage it.
Diagnostic assessment of the prostate on MRI was improved with the introduction of the endorectal surface coil which improves the image quality and accuracy in the preoperative staging of prostate cancer compared with the whole body-coil. However, the accuracies obtained with the endorectal coil in staging prostate cancer vary widely, from 51% to 89%. An improvement of the staging accuracy was also achieved using the combination of endorectal coil and body phased-array coil.
Magnetic resonance spectroscopic imaging has shown very promising results, being a method of obtaining biochemical information from a series of voxels placed over the prostate gland, and can be performed as part of endorectal prostate MRI with a commercial MRI scanner.
Combined endorectal MR imaging and MR spectroscopic imaging has an accuracy rate similar to that of biopsy for prostate cancer sextant localization, and is more accurate than biopsy of the prostate apex.
It is unclear how specific the ADC is for prostate cancer. The ADC then reflects various physical and physiologic characteristics of tissue but is not specific for cancer itself. This non specificity of ADC for cancer tissue may result in an overlap of ADC between cancer and noncancerous tissue. Therefore, we suggest that the ADC map is helpful as a supplement to T2-weighted images rather than as a substitute for T2-weighted images.
The addition of diffusion-weighted imaging to conventional T2-weighted MR imaging has been found to improve the detection of prostate cancer.
In a study that involved both diffusion-weighted imaging and 3D IH MR spectroscopic imaging, reported a positive correlation between ADC values and the ratio of citrate to choline and creatine in men with elevated prostate specific antigen (PSA) levels; this correlation may reflect a direct relationship between the reduction of citrate levels and structural changes of prostate tissue associated with malignancy.
More recently, reported increased specificity, without a reduction in sensitivity, for combined diffusion- weighted imaging and two-dimensional IH MR spectroscopic imaging-as compared with MR spectroscopy alone or diffusion-weighted imaging alone-in voxels containing 70% or more tumorous tissue.
Dynamic contrast-enhanced MRI (DCE MRI) is known to be a powerful tool for visualizing the vascularity of solid tumors such as breast and musculoskeletal tumors. In recent studies, DCEMRI of the prostate gland has also been shown to provide additional information that is useful for the detection, staging, also, the use of dynamic sequences increases the capacity of MR in recognizing tumoral foci.
Previous studies on the use of DCE MRI for cancer localization were technically limited in that only a single slice or at best a few slices, were used based on the findings of T2-weighted images. Thus, this technique only allowed part of the entire volume to be visualized, leading to a degree of operator- dependant bias in slice selection.
The advances in MR imaging of cancer prostate are helpful for better treatment selection and to decrease morbidity and mortality of prostate cancer.