Department of Urology, Azienda Ospedaliera Universitaria Integrata-Ospedale Civile Maggiore, Piazzale Stefani N 1, 37126, Verona, Italy,
World J Urol. 2013 Oct;31(5):1245-51. doi: 10.1007/s00345-012-0900-7. Epub 2012 Jul 7.
To assess the accuracy of intra-rectal coil magnetic resonance imaging (ER-MRI) for staging early prostate cancer (EPC).
ER-MRI was performed with the Magnetom Symphony 1.5 Tesla system. ER-MRI and pathology findings were statistically correlated.
One hundred and fifty-four consecutive patients underwent radical prostatectomy (RRP) for EPC (cT1c-2 Nx M0). An average age was 66, mean PSA 11.04 µg/L (median 7.33 µg/L) and mean pathologic Gleason score 6. Pathology detected 97 out of 154 patients (63 %) as EPC and 57 cases (37 %) as extra-prostate extension (EPED) (pT3) with extra-capsular extension (ECE) (pT3a) in 41 (27 %) and seminal vesicle invasion (SVI) (pT3b) in 16 (10 %). ER-MRI staged 100 patients (65 %) as cT2 and 54 (35 %) as EPED with ECE in 37 cases (24 %) and SVI in 17 (11 %). ER-MRI sensitivity, specificity, positive predictive value, negative predictive value, overall accuracy resulted respectively 0.78, 0.96, 0.86, 0.92, 0.91 for ECE as well as 0.88, 0.98, 0.82, 0.99 and 0.97 for SVI.
ER-MRI was effective in detecting preoperative EPC under-staging. In the next future, multi-parametric 3-Tesla ER-MRI will be the procedure for diagnosing, staging and following-up prostate cancer patients.
评估直肠内线圈磁共振成像（ER-MRI）在早期前列腺癌（EPC）分期中的准确性。
使用 Magnetom Symphony 1.5 特斯拉系统进行 ER-MRI。将 ER-MRI 和病理结果进行统计学相关分析。
154 例连续接受根治性前列腺切除术（RRP）治疗 EPC（cT1c-2 Nx M0）的患者入组本研究。平均年龄 66 岁，平均 PSA 为 11.04μg/L（中位数 7.33μg/L），平均病理 Gleason 评分为 6。病理检查发现 154 例患者中有 97 例（63%）为 EPC，57 例（37%）为前列腺外扩展（EPED）（pT3），其中 41 例（27%）有包膜外扩展（ECE）（pT3a），16 例（10%）有精囊侵犯（SVI）（pT3b）。ER-MRI 将 100 例患者（65%）分期为 cT2，54 例（35%）分期为 EPED 伴 ECE，37 例（24%）和 17 例（11%）为 SVI。ECE 的 ER-MRI 敏感性、特异性、阳性预测值、阴性预测值和总准确性分别为 0.78、0.96、0.86、0.92 和 0.91，SVI 分别为 0.88、0.98、0.82、0.99 和 0.97。
ER-MRI 可有效检测术前 EPC 分期不足。在未来，多参数 3-Tesla ER-MRI 将成为诊断、分期和随访前列腺癌患者的方法。
