Endorectal 3D T2-weighted 1mm-slice thickness MRI for prostate cancer staging at 1.5Tesla: Should we reconsider the indirects signs of extracapsular extension according to the D’Amico tumor risk criteria?

• Published in: European journal of radiology 2012-04, Vol.81 (4), p.e591-e597
• Main Authors: Cornud, F., Rouanne, M., Beuvon, F., Eiss, D., Flam, T., Liberatore, M., Zerbib, M., Delongchamps, N.B.
• Format: Article
• Language: English
• Subjects: 3D MRI; Aged; France - epidemiology; Humans; Imaging, Three-Dimensional - statistics & numerical data; Magnetic Resonance Imaging - methods; Male; Middle Aged; Neoplasm Staging - methods; Prevalence; Prognosis; Proportional Hazards Models; Prostate cancer; Prostatic Neoplasms - epidemiology; Prostatic Neoplasms - pathology; Rectum - pathology; Reproducibility of Results; Risk Assessment; Risk Factors; Sensitivity and Specificity; Staging
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2011.06.056

To evaluate the accuracy of a 3D-endorectal 1mm-thick slices MRI acquisition for local staging of low, intermediate and high D’Amico risk prostate cancer (PCa). 178 consecutive patients underwent a multiparametric MRI protocol prior to radical prostatectomy (RP). T2W images were acquired with the 3D sampling perfection with application optimized contrasts using different flip angle evolutions (SPACE) sequence (5mn acquisition time). Direct and indirect MRI signs of extracapsular extension (ECE) were evaluated to predict the pT stage. The likelihood of SVI (seminal vesicle invasion) was also assessed. Histology showed ECE and SVI in 38 (21%) and 12 (7%) cases, respectively. MRI sensitivity and specificity to detect ECE were 55 and 96% if direct signs of ECE were used and 84 and 89% (p