Accuracy of preoperative endo-rectal coil magnetic resonance imaging in detecting clinical under-staging of localized prostate cancer

Objectives To assess the accuracy of intra-rectal coil magnetic resonance imaging (ER-MRI) for staging early prostate cancer (EPC). Materials and methods ER-MRI was performed with the Magnetom Symphony 1.5 Tesla system. ER-MRI and pathology findings were statistically correlated. Results One hundred...

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Bibliographic Details
Published in:World journal of urology 2013-10, Vol.31 (5), p.1245-1251
Main Authors: Porcaro, Antonio B., Borsato, Alessandro, Romano, Mario, Sava, Teodoro, Ghimenton, Claudio, Migliorini, Filippo, Monaco, Carmelo, Rubilotta, Emanuele, Antoniolli, Stefano Zecchini, Lacola, Vincenzo, Montemezzi, Stefania
Format: Article
Language:English
Subjects:
Aged
Humans
Magnetic Resonance Imaging - methods
Male
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Staging
Nephrology
Oncology
Original Article
Predictive Value of Tests
Preoperative Care - methods
Prostatectomy
Prostatic Neoplasms - pathology
Prostatic Neoplasms - surgery
Rectum
Retrospective Studies
Sensitivity and Specificity
Urology
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Summary:Objectives To assess the accuracy of intra-rectal coil magnetic resonance imaging (ER-MRI) for staging early prostate cancer (EPC). Materials and methods ER-MRI was performed with the Magnetom Symphony 1.5 Tesla system. ER-MRI and pathology findings were statistically correlated. Results One hundred and fifty-four consecutive patients underwent radical prostatectomy (RRP) for EPC (cT1c-2 Nx M0). An average age was 66, mean PSA 11.04 µg/L (median 7.33 µg/L) and mean pathologic Gleason score 6. Pathology detected 97 out of 154 patients (63 %) as EPC and 57 cases (37 %) as extra-prostate extension (EPED) (pT3) with extra-capsular extension (ECE) (pT3a) in 41 (27 %) and seminal vesicle invasion (SVI) (pT3b) in 16 (10 %). ER-MRI staged 100 patients (65 %) as cT2 and 54 (35 %) as EPED with ECE in 37 cases (24 %) and SVI in 17 (11 %). ER-MRI sensitivity, specificity, positive predictive value, negative predictive value, overall accuracy resulted respectively 0.78, 0.96, 0.86, 0.92, 0.91 for ECE as well as 0.88, 0.98, 0.82, 0.99 and 0.97 for SVI. Conclusion ER-MRI was effective in detecting preoperative EPC under-staging. In the next future, multi-parametric 3-Tesla ER-MRI will be the procedure for diagnosing, staging and following-up prostate cancer patients.
ISSN:0724-4983
1433-8726
DOI:10.1007/s00345-012-0900-7