You have accessJournal of UrologyProstate Cancer: Staging II1 Apr 2012359 IS MRI RELIABLE IN PROSTATE CANCER STAGING? Francesco Porpiglia, Cristian Fiori, Filippo Russo, Enrico Armando, Fabrizio Mele, Matteo Manfredi, Marco Lucci Chiarissi, Massimiliano Poggio, Susanna Grande, and Daniele Regge Francesco PorpigliaFrancesco Porpiglia Orbassano, Italy More articles by this author , Cristian FioriCristian Fiori Orbassano, Italy More articles by this author , Filippo RussoFilippo Russo Candiolo, Italy More articles by this author , Enrico ArmandoEnrico Armando Candiolo, Italy More articles by this author , Fabrizio MeleFabrizio Mele Orbassano, Italy More articles by this author , Matteo ManfrediMatteo Manfredi Orbassano, Italy More articles by this author , Marco Lucci ChiarissiMarco Lucci Chiarissi Orbassano, Italy More articles by this author , Massimiliano PoggioMassimiliano Poggio Orbassano, Italy More articles by this author , Susanna GrandeSusanna Grande Orbassano, Italy More articles by this author , and Daniele ReggeDaniele Regge Candiolo, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.421AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Magnetic Resonance Imaging (MRI) has shown promise in localizing Prostate Cancer (PCa) and it is largely exploited in clinical routine to visualize and characterize tumours, thus improving the detection and staging of PCa. Aim of this study is to determine the diagnostic accuracy of MRI, evaluating the sensitivity in identifying lesions correlated with tumor volume and the ability in preoperative staging of PCa. METHODS The study included 100 consecutive patients with PCa who underwent preoperative MRI and Radical Prostatectomy (RP). MRI Imaging MRI performing a conventional study with T1-w, T2-w, DWI and DCE-MRI. All images were examined by an expert uro-radiologist. Briefly, hypointense glandular areas in T2-w, with low ADC values (< 1.1 sec/mm2) and showing an early impregnation peak followed by washout in DCE-MRI were defined positive for the presence of neoplastic tissue. Extra-Capsular Extension (ECE) was defined if lesion had a large degree of contact or if the presence of neoplastic tissue in the periprostatic tissue was observed. It was attributed Seminal Vesicles Invasion (SVI) when a lesion of the base had a margin of contact with the vesicles or if we observed the presence of hypointense tissue on T2-w and contrast-impregnation. Radical prostatectomy All patients underwent pure or robotic assisted laparoscopic prostatectomy by the same surgeon. Pathological analysis After RP, all specimens were reviewed by the same uro-pathologist. Pathological and radiological results were then compared to identify sensitive and specificity of MRI in identifying neoplastic lesions (overall and after stratification by pathological lesion volume: < 0.2 cc, from 0.2 to 0.5 cc, > 0.5 cc.), ECE and SVI. RESULTS 190 PCa tumor foci were found in histopathological examination. The overall sensivity was 65.8% (125/190); the sensitivity for lesions <0.2 cc was 37.5% (18/48); from 0.2 to 0.5 cc was 36.3% (12/33); >0.5 cc was 87.2% (95/109). The MRI assessment of ECE has shown sensitivity, specificity, PPV and NPV of 87.1%, 89.3%, 61.4% and 97.3%, respectively. The MRI evaluation of SVI has provided values of sensitivity, specificity, PPV and NPV of 83.3%, 98.9%, 83.3% and 98.9%, respectively. CONCLUSIONS Our study showed that MRI has high accuracy in staging PCa, more than most of the studies in the literature. MRI has a high sensitivity to localize the lesions with a volume greater than 0.5 cc, which are the most frequent and statistically are more likely to progress. Furthermore it has a high NPV against the ECE and SVI (97.3% and 98.9% respectively). We think that this can help the surgeon to make the best choice in treatment planning. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e147 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Francesco Porpiglia Orbassano, Italy More articles by this author Cristian Fiori Orbassano, Italy More articles by this author Filippo Russo Candiolo, Italy More articles by this author Enrico Armando Candiolo, Italy More articles by this author Fabrizio Mele Orbassano, Italy More articles by this author Matteo Manfredi Orbassano, Italy More articles by this author Marco Lucci Chiarissi Orbassano, Italy More articles by this author Massimiliano Poggio Orbassano, Italy More articles by this author Susanna Grande Orbassano, Italy More articles by this author Daniele Regge Candiolo, Italy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...