Abstract
Purpose. To determine to what extent an inflatable endorectal coil (ERC) affects whole prostate (WP) volume and shape during prostate MRI. Materials and Methods. 79 consecutive patients underwent T2W MRI at 3T first with a 6-channel surface coil and then with the combination of a 16-channel surface coil and ERC in the same imaging session. WP volume was assessed by manually contouring the prostate in each T2W axial slice. PSA density was also calculated. The maximum anterior-posterior (AP), left-right (LR), and craniocaudal (CC) prostate dimensions were measured. Changes in WP prostate volume, PSA density, and prostate dimensions were then evaluated. Results. In 79 patients, use of an ERC yielded no significant change in whole prostate volume (0.6 ± 5.7%, P = 0.270) and PSA density (−0.2 ± 5.6%, P = 0.768). However, use of an ERC significantly decreased the AP dimension of the prostate by −8.6 ± 7.8% (P < 0.001), increased LR dimension by 4.5 ± 5.8% (P < 0.001), and increased the CC dimension by 8.8 ± 6.9% (P < 0.001). Conclusion. Use of an ERC in prostate MRI results in the shape deformation of the prostate gland with no significant change in the volume of the prostate measured on T2W MRI. Therefore, WP volumes calculated on ERC MRI can be reliably used in clinical workflow.
Highlights
Prostate volume is an important parameter in prostate cancer screening and in planning radiation therapy [1,2,3,4]
All 79 patients were successfully scanned with non-endorectal coil (ERC) and ERC magnetic resonance images (MRI) in the same scanning session
This study demonstrates that the use of an ERC does not cause significant change in planimetric whole prostate (WP) volume estimation on axial T2 weighted (T2W) MRI
Summary
Prostate volume is an important parameter in prostate cancer screening and in planning radiation therapy [1,2,3,4]. Prostate volumes alone are used to predict BPH-related outcomes such as acute urinary retention (AUR) and BPH progression [5, 6]. By normalizing the prostate-specific antigen (PSA) to prostate volume, prostate density has a higher positive predictive value for prostate cancer compared with PSA alone [7, 8]. A PSA density threshold of 0.15 ng/mL/cm is used to decide whether prostate cancer patients are eligible for active surveillance [10, 11]. Prostate volume measurements are used during radiation therapy planning [12]. Varying prostate volumes have been seen to affect the accuracy of targeted prostate biopsies [13, 14]
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