***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES To compare the sensitivity of 2 different non-endorectal coil strategies vs. endorectal coil ( ERC ) magnetic resonance imaging ( MRI ) for detection of prostate cancer ( PCa ) . METHODS In this prospect i ve , single-center , paired-patient , paired-reader study , 49 men with a clinical indication for MRI underwent non-ERC ( phased-array coil only ) T2-weighted imaging and diffusion-weighted imaging followed by the same sequences using both ERC and phased-array coils ( ERC Protocol ) . Patients were r and omized into 1 of 2 arms : st and ard non-ERC protocol and augmented non-ERC protocol . Lesions with Likert score≥3 were defined as suspicious for cancer . Radical prostatectomy specimen or combined systematic plus targeted biopsies served as the st and ard of reference . Cancers were stratified into risk groups according to the National Comprehensive Cancer Network guidelines . Generalized estimating equations with Bonferroni correction were used for comparisons . The level of reader confidence was inferred by the Likert scores assigned to index lesions . RESULTS The ERC protocol provided sensitivity ( 78 % ) superior to MRI without ERC for PCa detection , both with a st and ard ( 43 % ) ( P<0.0001 ) or augmented ( 60 % ) ( P<0.01 ) protocol . The ERC MRI  missed less-intermediate or high-risk index lesions ( 4 % ) than st and ard non-ERC ( 42 % ) ( P = 0.02 ) and augmented non-ERC MRI ( 25 % ) , although the latter did not reach significance ( P = 0.09 ) . The ERC improved radiologist confidence for the detection of PCa ( average Likert score = 4.2±1.4 ) compared to st and ard ( 2.3±2.3 ) and augmented ( 2.9±2.1 ) non-ERC ( P = 0.001 ) . CONCLUSIONS The use of combined ERC and pelvic phased-array coil for T2-weighted imaging and diffusion-weighted imaging provides superior sensitivity for the detection of PCa compared to an examination performed without the ERC PURPOSE We determined the ability of combined endorectal magnetic resonance imaging ( MRI ) and magnetic resonance spectroscopic imaging ( MRSI ) to detect prostate cancer foci prospect ively in men with prior negative transrectal ultrasound ( TRUS ) prostate biopsy . MATERIAL S AND METHODS Endorectal MRI with spectroscopy was performed in 24 consecutive patients with 1 or more prior negative TRUS prostatic biopsies for persistently increased prostate specific antigen and /or abnormal digital rectal examination . All studies were interpreted by a dedicated radiologist who reported areas of interest in the peripheral zone as normal , equivocal or suspicious on MRI and MRSI separately . Equivocal and suspicious areas were then correlated with a 3-dimensional prostate model . All patients underwent a st and ard TRUS 10-core peripheral zone biopsy with up to 4 additional biopsies targeted at the equivocal or suspected sites . RESULTS Prostate cancer was detected in 7 of 24 subjects ( 29.2 % ) . Considering the equivocal category as test negative the sensitivity , specificity , positive and negative predictive values , and the accuracy of MRI , MRSI and combined MRI/MRSI  for the detection of prostate cancer were 57.1 % , 57.1 % and 100.0 % , 88.2 % , 82.4 % and 70.6 % , 66.7 % , 57.1 % and 58.3 % , 83.3 % , 82.1 % and 100 % , and 79.2 % , 75.0 % and 79.2 % , respectively . The site of positive biopsy correlated correctly in 50 % and 28.6 % of MRI and MRSI labeled suspicious cores , respectively . CONCLUSIONS MRI and MRSI have the potential to identify cancer foci and direct TRUS in patients with a previous negative TRUS biopsy . Further , larger studies are required to quantify the amount of benefit A multichannel statistical classifier  for detecting prostate cancer  was developed and vali date d by combining information from three different magnetic resonance ( MR ) method ologies : T2-weighted , T2-mapping , and line scan diffusion imaging ( LSDI ) . From these MR sequences , four different sets of image intensities were obtained : T2-weighted ( T2W ) from T2-weighted imaging , Apparent Diffusion Coefficient ( ADC ) from LSDI , and proton density ( PD ) and T2 ( T2 Map ) from T2-mapping imaging . Manually segmented tumor labels from a radiologist , which were vali date d by biopsy results , served as tumor " ground truth . " Textural features were extracted from the images using co-occurrence matrix ( CM ) and discrete cosine transform ( DCT ) . Anatomical location of voxels was described by a cylindrical coordinate system . A statistical jack-knife approach was used to evaluate our classifiers . Single-channel maximum likelihood ( ML ) classifiers were based on 1 of the 4 basic image intensities . Our multichannel classifiers : support vector machine ( SVM ) and Fisher linear discriminant ( FLD ) , utilized five different sets of derived features . Each classifier generated a summary statistical map that indicated tumor likelihood in the peripheral zone ( PZ ) of the prostate gl and . To assess classifier accuracy , the average areas under the receiver operator characteristic ( ROC ) curves over all subjects were compared . Our best FLD classifier achieved an average ROC area of 0.839(+/-0.064 ) , and our best SVM classifier achieved an average ROC area of 0.761(+/-0.043 ) . The T2W ML classifier , our best single-channel classifier , only achieved an average ROC area of 0.599(+/-0.146 ) . Compared to the best single-channel ML classifier , our best multichannel FLD and SVM classifiers have statistically superior ROC performance ( P=0.0003 and 0.0017 , respectively ) from pairwise two-sided t-test . By integrating the information from multiple images and capturing the textural and anatomical features in tumor areas , summary statistical maps can potentially aid in image-guided prostate biopsy and assist in guiding and controlling delivery of localized therapy under image guidance PURPOSE To prospect ively evaluate the accuracy of transrectal ultrasonography (US)-guided biopsy directed with magnetic resonance ( MR ) spectroscopic imaging in patients with an elevated prostate specific antigen ( PSA ) level and negative findings at prior biopsy by using subsequent biopsy results as the reference st and ard . MATERIAL S AND METHODS The committee on human research approved this study , and written informed consent was obtained . MR imaging and MR spectroscopic imaging were performed in 42 men ( age range , 45 - 75 years ; average age , 63.3 years ; median age , 65 years ) with negative findings at two or more prostatic biopsies and at digital rectal examination . MR spectroscopic data were rated on a scale of 1 ( benign ) to 5 ( malignant ) on the basis of st and ardized metabolic criteria . Abnormal voxels were overlaid on the corresponding transverse transrectal US images and used to perform voxel-guided biopsy of the prostate . All patients subsequently received an extended-pattern biopsy scheme . RESULTS Thirty-one of 42 patients demonstrated metabolic abnormalities that were suspicious for cancer ( voxels with scores > or = 4 ) . Eleven patients with negative MR spectroscopic imaging results also had negative biopsy findings . Cancer was detected in 17 ( 55 % ) of 31 men with positive MR spectroscopic imaging findings ( voxels with scores > or = 4 ) with a sensitivity of 100 % , specificity of 44 % , positive predictive value of 55 % , negative predictive value of 100 % , and accuracy of 67 % . In men with at least one spectroscopic voxel with a score of 5 ( 12 of 17 men ) , the sensitivity , specificity , positive and negative predictive values , and accuracy were 71 % , 84 % , 75 % , 81 % , and 79 % , respectively . CONCLUSION Metabolic data from MR spectroscopic imaging can be transferred to transrectal US images and used to sample regions of cancer in men with rising PSA levels and negative findings at prior biopsy with good accuracy Purpose The purpose of this study was to evaluate the role of magnetic resonance spectroscopic imaging ( MRSI ) and dynamic contrast-enhanced magnetic resonance imaging ( DCE-MRI ) in detecting tumour foci in patients with elevated prostate-specific antigen ( PSA ) and negative transrectal ultrasonography (TRUS)-guided biopsy . Material s and methods This prospect i ve r and omised trial was conducted on 150 patients who underwent [1H]MRSI and DCE-MRI and targeted biopsies of suspicious areas on MRI associated with r and om biopsies . Results After the second biopsy , the diagnosis of prostate adenocarcinoma was made in 64/150 cases . On a perpatient basis , MRSI had 82.8 % sensitivity , 91.8 % specificity , 88.3 % positive predictive value ( PPV ) , 87.8 % negative predictive value ( NPV ) and 85.7 % diagnostic accuracy . The sensitivity , specificity , PPV , NPV and accuracy for DCE-MRI was 76.5 % , 89.5 % , 84.5 % , 83.7 % and 82 % , respectively . The combination of MRSI and DCE-MRI yielded 93.7 % sensitivity , 90.7 % specificity , 88.2 % PPV , 95.1 % NPV and 90.9 % accuracy in detecting prostate carcinoma . Conclusions The combined study with [1H]MRSI and DCE-MRI showed promising results in guiding the biopsy of cancer foci in patients with an initial negative TRUS-guided biopsy . RiassuntoObiettivoScopo del nostro lavoro è stato valutare il ruolo della risonanza magnetica ( RM ) con spettroscopia ( MRSI ) e studio dinamico ( DCEMR ) nell’individuazione di foci tumorali in pazienti con elevati valori di antigene prostatico specifico ( PSA ) e biopsia prostatica gui data tramite TRUS (trans-rectal-ultrasound)-gui data negativa . Material i e metodiLo studio è stato di tipo prospettico r and omizzato . Abbiamo esaminato 150 pazienti . Tutti sono stati sottoposti ad esame di 1H-MRSI e DCEMR ed a prelievi mirati nelle zone sospette alla RM , associate a biopsie r and om . RisultatiDopo la seconda biopsia , la diagnosi di adenocarcinoma prostatico è stata effettuata in 64/150 casi . Nella nostra popolazione , su una base patient by patient , l’MRSI ha mostrato i seguenti valori : sensibilità 82,8 % ; specificità 91,8 % ; valore predittivo positivo ( PPV ) 88,3 % ; valore predittivo negativo ( NPV ) 87,8 % ; accuratezza 85,7 % . La DCEMR ha mostrato i seguenti valori : sensibilità 76,5 % ; specificità 89,5 % ; PPV 84,5 % ; NPV 83,7 % ; accuratezza 82 % . L’associazione delle due metodiche , MRSI e DCEMR , aumenta la sensibilità ( 93,7 % ) , la specificità ( 90,7 % ) , il PPV ( 88,2 % ) , il PNV ( 95,1 % ) e l’accuratezza ( 90,9 % ) nel predire l’individuazione del carcinoma prostatico se paragonata alla sola metodica MRSI o DCEMR . Conclusion iLo studio combinato ha mostrato risultati promettenti nella guida alla biopsia dei foci tumorali in pazienti con prima biopsia TRUS-gui data negativa Purpose : This study aim ed to prospect ively analyze the role of magnetic resonance spectroscopy imaging ( MRSI ) and dynamic-contrast enhancement magnetic resonance ( DCEMR ) in the detection of prostate tumor foci in patients with persistently elevated prostate-specific antigen levels ( in the range of ≥4 ng/mL to < 10 ng/mL ) and prior negative r and om trans-rectal ultrasound (TRUS)-guided biopsy . Experimental Design : This was a prospect i ve r and omized single-center study . One hundred and eighty eligible cases were included in the study . Patients in group A were su bmi tted to a second r and om prostate biopsy , whereas patients in group B were su bmi tted to a 1H-MRSI-DCEMR examination and sample s targeted on suspicious areas were associated to the r and om biopsy . Results : At the second biopsy , a prostate adenocarcinoma histologic diagnosis was found in 22 of 90 cases ( 24.4 % ) in group A and in 41 of 90 cases ( 45.5 % ) in group B ( P = 0.01 ) . On a patient-by-patient basis , MRSI had 92.3 % sensitivity , 88.2 % specificity , 85.7 % positive predictive value ( PPV ) , 93.7 % negative predictive value ( NPV ) , 
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Conclusions ERC use yielded no additional benefit in terms of prostate cancer detection accuracy compared to multi-channel PAC use ( 71 % versus 68 % ) while the use of additional functional imaging techniques ( DCE-MRI , DWI and MRSI ) in a multiparametric MRI protocol improves the accuracy of prostate cancer detection allowing both the early cure and the guidance of biopsy