INTRODUCTION: Preoperative prostate cancer stage predicts prognosis and affects treatment decisions. The purpose of this study was to estimate the sensitivity and specificity of surface coil magnetic resonance imaging (MRI) for prostate cancer stage using surgical pathologic data as the reference standard. METHODS: High-risk patients (>/=cT3 or PSA >/=20 ng/mL or Gleason >/=8) and selected intermediate-risk patients (clinically bulky disease on exam or biopsy, cT2b/c, or Gleason 7 with >/=3 of 5 biopsy cores positive in a lobe) routinely received a pelvic MRI at our institution. The images of identified patients were reviewed by one radiologist who was blinded to clinical information. The radiologist reported presence or absence of tumour within each lobe of the prostate. Extraprostatic extension (EPE), seminal vesicle (SV) invasion and pelvic lymph node (PLN) metastasis were also reported. Radiological findings were compared with prostatectomy pathology reports. RESULTS: During the study period, about 320 radical prostatectomies were performed. Of these, 32 had a preoperative surface coil pelvic MRI adequate for analysis. Pathologically, 53 of 64 (82.8%) prostate lobes contained tumour, 17 (26.6%) lobes had associated EPE, 12 (18.8%) had SV involvement and 7 (10.9%) sets of PLNs contained cancer. Magnetic resonance imaging sensitivity and specificity were, respectively, 94.3% and 81.8% for tumour location, 82.4% and 87.2% for EPE, 83.3% and 92.3% for SV invasion and 71.4% and 94.7% for PLN involvement. INTERPRETATION: Surface coil MRI accurately stages many prostate cancer patients with elevated risk of extraprostatic disease. This mode of imaging may be reasonable at centres that do not have endorectal coil MRI.
INTRODUCTION:Preoperative prostate cancer stage predicts prognosis and affects treatment decisions. The purpose of this study was to estimate the sensitivity and specificity of surface coil magnetic resonance imaging (MRI) for prostate cancer stage using surgical pathologic data as the reference standard. METHODS: High-risk patients (>/=cT3 or PSA >/=20 ng/mL or Gleason >/=8) and selected intermediate-risk patients (clinically bulky disease on exam or biopsy, cT2b/c, or Gleason 7 with >/=3 of 5 biopsy cores positive in a lobe) routinely received a pelvic MRI at our institution. The images of identified patients were reviewed by one radiologist who was blinded to clinical information. The radiologist reported presence or absence of tumour within each lobe of the prostate. Extraprostatic extension (EPE), seminal vesicle (SV) invasion and pelvic lymph node (PLN) metastasis were also reported. Radiological findings were compared with prostatectomy pathology reports. RESULTS: During the study period, about 320 radical prostatectomies were performed. Of these, 32 had a preoperative surface coil pelvic MRI adequate for analysis. Pathologically, 53 of 64 (82.8%) prostate lobes contained tumour, 17 (26.6%) lobes had associated EPE, 12 (18.8%) had SV involvement and 7 (10.9%) sets of PLNs contained cancer. Magnetic resonance imaging sensitivity and specificity were, respectively, 94.3% and 81.8% for tumour location, 82.4% and 87.2% for EPE, 83.3% and 92.3% for SV invasion and 71.4% and 94.7% for PLN involvement. INTERPRETATION: Surface coil MRI accurately stages many prostate cancerpatients with elevated risk of extraprostatic disease. This mode of imaging may be reasonable at centres that do not have endorectal coil MRI.
Authors: A W Partin; M W Kattan; E N Subong; P C Walsh; K J Wojno; J E Oesterling; P T Scardino; J D Pearson Journal: JAMA Date: 1997-05-14 Impact factor: 56.272
Authors: M D Rifkin; E A Zerhouni; C A Gatsonis; L E Quint; D M Paushter; J I Epstein; U Hamper; P C Walsh; B J McNeil Journal: N Engl J Med Date: 1990-09-06 Impact factor: 91.245
Authors: A M Hövels; R A M Heesakkers; E M Adang; G J Jager; S Strum; Y L Hoogeveen; J L Severens; J O Barentsz Journal: Clin Radiol Date: 2008-02-04 Impact factor: 2.350
Authors: Erik Rud; Dagmar Klotz; Kristin Rennesund; Eduard Baco; Truls Erik Bjerklund Johansen; Lien My Diep; Aud Svindland; Lars Magne Eri; Heidi B Eggesbø Journal: World J Urol Date: 2014-07-25 Impact factor: 4.226