Ces radiol. 2008, 62(1):44-50

MRI staging of prostate carcinoma - our experienceOriginal article

Ingrid Marková¹, Nikola Izák², Vladimír Baláž³, Jozef Babela³, Milan Švec³

¹ Rádiologické oddelenie FNsP F.D.R., Banská Bystrica

² Rádiologická klinika FN a LF UP, Olomouc

³ Urologická klinika FNsP F.D.R., Banská Bystrica

Aim: To review the efficacy of MR imaging in prostate cancer staging, to compare preoperative and postoperative histologic findings with MRI findings with regard to detection of extracapsular tumourous extension.

Method: Between 2004 and July 2007, seventy five patients with newly diagnosed prostate cancer confirmed by transrectal biopsy under TRUS (transrectal ultrasonography) guidance were enrolled. We compared preoperative and postoperative histologic findings with MRI findings. All patients were examined on 1.5T MR system, using pelvic phased-array coil, by using T2-weighted FSE images in three planes and T1-weighted FSE in axial plane for lymphonode detection. Contrast medium was used only in cases of suspected tumourous recurrence or other malignancy using DCE (dynamic contrast enhanced) MR imaging. Both MRI and histological findings were reported in terms of TNM classification.

Results: Of 75 patients with newly diagnosed prostate cancer, 19 patients (25.3%) did not undergo surgery due to advanced MRI findings (pT3a-c), originally reported as pT2a-c (PSA ranging from 10 to 188 ng/ml, Gleason score 6-8. Five patients (6.7%) underwent TURP (transurethral prostate resection) because of advanced disease, two patients refused RAPE (radical prostatectomy). Thirty four (45.3%) patients underwent RAPE (T1c-T2c, PSA from 3 to 10 ng/ml, Gleason score 3-7). Five cases (6.7%) were underdiagnosed in T classification (T2a-c before and T3a-b after surgery), four patients are waiting for RAPE (5.3%). During the follow-up of subjects after RAPE, there was no tumourous recurrence noted, in the group of advanced disease (pT3, concomitant malignancy) nobody died. Thirteen patients (17.3%) were not operated/followed-up at our institution after MRI examination, therefore we were not able to compare our results with postoperative findings.

Conclusion: Staging of prostate carcinoma using MR imaging has unambiguous value. It contributes to proper determination of the patient's prognosis and selection of the optimal therapeutical strategy.

Keywords: prostate cancer, MR, staging

Accepted: January 15, 2008; Published: March 1, 2008  Show citation