Local staging of prostate cancer by endorectal MRI using fast spin-echo sequences: prospective correlation with pathological findings after radical prostatectomy
| Autor: | Bertrand Dufour, X. Belin, B. Debre, Yves Chretien, Olivier Hélénon, J. M. Casanova, Moreau Jf, François Cornud, Nicolas Thiounn, Thierry Flam, F Paraf, Deslignières S |
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| Rok vydání: | 1996 |
| Předmět: |
Male
medicine.medical_specialty Pathology Urology medicine.medical_treatment Sensitivity and Specificity Prostate cancer Prostate medicine Humans Neoplasm Invasiveness Prospective Studies Aged Neoplasm Staging Prostatectomy Urethral Neoplasms medicine.diagnostic_test business.industry Prostatic Neoplasms Seminal Vesicles Magnetic resonance imaging Middle Aged medicine.disease Magnetic Resonance Imaging Extraprostatic Neck of urinary bladder medicine.anatomical_structure Urinary Bladder Neoplasms Rectal administration Genital Neoplasms Male Adenocarcinoma Radiology business |
| Zdroj: | Scopus-Elsevier |
| ISSN: | 1464-410X 1464-4096 |
| DOI: | 10.1046/j.1464-410x.1996.01313.x |
| Popis: | Objective To evaluate the accuracy of endorectal magnetic resonance imaging (MRI) with fast spin-echo sequences in the local staging of clinically localized prostate cancer. Patients and methods Seventy-one patients with a clinical T1 (18 patients) or T2 tumour (53 patients) underwent endorectal MRI 2–12 weeks before radical prostatectomy. Extraprostatic tumour was diagnosed if MRI showed signs of capsular penetration and/or invasion of the seminal vesicle and/or distal urethra or bladder neck. If the pathological examination showed a single positive margin with no periprostatic tissue, the tumour was classified as indeterminate and not as a T3 tumour. Results Of the 25 cases of capsular penetration, MRI correctly identified 10 (sensitivity 42%, specificity 100%). Of the 14 cases with seminal vesicle invasion, MRI correctly identified six (sensitivity 43%, specificity 100%), but showed other signs of extraprostatic tumour spread in seven of the eight unidentified cases. Overall, MRI identified 16 of the 30 patients (53%) with occult extraprostatic spread of tumour; there was only one false-positive result. The sensitivity, specificity and accuracy of MRI were 53, 96 and 74%, respectively. Conclusion Endorectal MRI can reduce the rate of pre-operative understaging from 42% to 22% and it can be used for a given individual because it can detect extraprostatic invasion with 96% specificity, ensuring that very few, if any, patients will be deprived of curative surgery. |
| Databáze: | OpenAIRE |
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