PURPOSE: To evaluate the staging accuracy of preoperative multiparametric MRI (mp-MRI), its influence on the technique of radical retropubic prostatectomy (RRP), and its value for daily clinical practice. METHODS: A total of 106 patients underwent RRP (January 2011-June 2012) and had preoperative MRI staging data available for review. Staging results acquired by mp-MRI were correlated to both biopsy and histopathology results. Surgical reports were reviewed for intraoperative aspect of tumor extension, technique of RRP (nerve sparing or extended), and extent of lymphadenectomy. RESULTS: The accuracy of diagnosing extracapsular extension (ECE) was 72.2 %, with an overall sensitivity and specificity of 30.0 and 93.3 %, respectively. The negative predictive value was 72.7 %. The sensitivity and specificity to diagnose positive seminal vesical invasion (SVI) were 63.6 and 92.9 %, respectively. Neither higher field force nor the use of an endorectal coil could enhance the accuracy of mp-MRI. In case of awareness of an existing MRI, there was a significantly higher percentage of nerve protection (left: 93 %; right: 89 % vs. left 75 %; right: 75 %). The higher percentage of nerve sparing surgery did not result in a higher level of positive resection margins. CONCLUSIONS: In routine clinical practice, mp-MRI at non-academic centers has very limited clinical value in predicting ECE and SVI. Our data support the current recommendations against the widespread preoperative use of mp-MRI because it is not adding reliable predictive information on the extent of prostate cancer.
PURPOSE: To evaluate the staging accuracy of preoperative multiparametric MRI (mp-MRI), its influence on the technique of radical retropubic prostatectomy (RRP), and its value for daily clinical practice. METHODS: A total of 106 patients underwent RRP (January 2011-June 2012) and had preoperative MRI staging data available for review. Staging results acquired by mp-MRI were correlated to both biopsy and histopathology results. Surgical reports were reviewed for intraoperative aspect of tumor extension, technique of RRP (nerve sparing or extended), and extent of lymphadenectomy. RESULTS: The accuracy of diagnosing extracapsular extension (ECE) was 72.2 %, with an overall sensitivity and specificity of 30.0 and 93.3 %, respectively. The negative predictive value was 72.7 %. The sensitivity and specificity to diagnose positive seminal vesical invasion (SVI) were 63.6 and 92.9 %, respectively. Neither higher field force nor the use of an endorectal coil could enhance the accuracy of mp-MRI. In case of awareness of an existing MRI, there was a significantly higher percentage of nerve protection (left: 93 %; right: 89 % vs. left 75 %; right: 75 %). The higher percentage of nerve sparing surgery did not result in a higher level of positive resection margins. CONCLUSIONS: In routine clinical practice, mp-MRI at non-academic centers has very limited clinical value in predicting ECE and SVI. Our data support the current recommendations against the widespread preoperative use of mp-MRI because it is not adding reliable predictive information on the extent of prostate cancer.
Authors: G J Jager; E T Ruijter; C A van de Kaa; J J de la Rosette; G O Oosterhof; J R Thornbury; S H Ruijs; J O Barentsz Journal: Radiology Date: 1997-06 Impact factor: 11.105
Authors: Nick G Costouros; Fergus V Coakley; Antonio C Westphalen; Aliya Qayyum; Benjamin M Yeh; Bonnie N Joe; John Kurhanewicz Journal: AJR Am J Roentgenol Date: 2007-03 Impact factor: 3.959
Authors: Liang Wang; Michael Mullerad; Hui-Ni Chen; Steven C Eberhardt; Michael W Kattan; Peter T Scardino; Hedvig Hricak Journal: Radiology Date: 2004-05-27 Impact factor: 11.105
Authors: Georgios Hatzichristodoulou; Stefan Wagenpfeil; Gregor Weirich; Michael Autenrieth; Tobias Maurer; Mark Thalgott; Thomas Horn; Matthias Heck; Kathleen Herkommer; Jürgen E Gschwend; Hubert Kübler Journal: World J Urol Date: 2015-06-23 Impact factor: 4.226
Authors: Nicola Frego; Marco Paciotti; Nicolò Maria Buffi; Davide Maffei; Roberto Contieri; Pier Paolo Avolio; Vittorio Fasulo; Alessandro Uleri; Massimo Lazzeri; Rodolfo Hurle; Alberto Saita; Giorgio Ferruccio Guazzoni; Paolo Casale; Giovanni Lughezzani Journal: Front Surg Date: 2022-02-25