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Clinical Research

Assessing prostate cancer growth with citrate measured by intact tissue proton magnetic resonance spectroscopy

Prostate Cancer and Prostatic Diseases volume 15, pages 278–282 (2012)Cite this article

Subjects

Abstract

Background:

Annual PSA tests have led to a significant increase in the number of prostate cancer (PCa) cases diagnosed. This increased incidence has led to overtreatment of many patients, as current pathology often cannot distinguish latent from aggressive PCa. Studies have shown that the depletion of zinc in prostate cells correlated with cell-line growth rates, and may therefore relate to the progression of PCa. Furthermore, as zinc is normally an inhibitor of citrate oxidation, the reduction of zinc in PCa may cause a decrease in citrate secretion levels in the glandular epithelia of PCa patients.

Methods:

Using high-resolution magic angle spinning proton magnetic resonance spectroscopy followed by quantitative histopathology, we investigate unit histo-benign prostate epithelial citrate concentrations in intact tissue samples obtained from 18 patients with pre-surgical PSA values less than 20 ng/ml. Using these data, we evaluate correlations between citrate concentrations and PSA velocities, densities and blood percent-free PSA.

Results:

We observe different linear patterns between citrate concentrations and histo-benign glandular epithelia from patients of different PSA velocities. More importantly, we obtain a significant correlation between PSA velocity, density and percent-free PSA, and citrate concentrations in unit volume of histo-benign epithelial glands of the peripheral zone.

Conclusions:

Low levels of citrate in unit volume represent rapidly increasing PSA values, and, therefore, may be used as an indicator of fast-growing PCa. Thus, tissue samples obtained at the time of biopsy may be evaluated for their citrate concentrations for the prediction of PCa growth rates, allowing for the implementation of alternative treatment options and reducing overtreatment.

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Acknowledgements

This work was supported by PHS/NIH grants CA115746, CA115746S2, CA162959, and CA141139 (LLC), and MGH A.A. Martinos Center for Biomedical Imaging.

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Authors and Affiliations

  1. Departments of Radiology, Pathology and Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    R Dittrich, J Kurth, E A Decelle, E M DeFeo, S Wu, C-l Wu, W S McDougal & L L Cheng

  2. Charité Universitätsmedizin, Berlin, Germany

    R Dittrich, J Kurth & M Taupitz

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  1. R Dittrich
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Correspondence to L L Cheng.

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Dittrich, R., Kurth, J., Decelle, E. et al. Assessing prostate cancer growth with citrate measured by intact tissue proton magnetic resonance spectroscopy. Prostate Cancer Prostatic Dis 15, 278–282 (2012). https://doi.org/10.1038/pcan.2011.70

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