Correlation of endorectal coil magnetic resonance imaging of the prostate with pathologic stage.

Abstract

The aim was to evaluate the pretreatment efficacy of endorectal coil (ERC) MRI in accurately predicting extracapsular extension in a group of intermediate risk patients. A total of 40 intermediate risk patients were identified who underwent pretreatment ERC MRI and subsequent radical prostatectomy (RP). Imaging studies and pathologic analysis were compared with respect to presence of extracapsular extension (ECE), involvement of seminal vesicles, and appearance of regional nodes. Mean age was 62 years, PSA 14.8, and most common stage was cT2a/pT2c and Gleason 6. ERC MRI has a positive predictive value of 81%, specificity 89%, and odds ratio 6.47 in determining extracapsular extension. Conversely, its sensitivity is only 43%, with a negative predictive value of 59%. ERC MRI may be useful as an adjunctive study for intermediate risk patients due to its high specificity and positive predictive value, thereby adding information to the clinical decision-making process.