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Prostatic carcinoma: staging with MR imaging at 1.5 T
M Bezzi1, H Y Kressel, K S Allen
1David W. Devon Medical Imaging Center, Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.
Radiology
|November 1, 1988
Summary
Magnetic resonance (MR) imaging accurately stages prostate cancer by evaluating local disease extent and lymph node metastases. This imaging technique offers reliable comprehensive evaluation for prostate cancer staging.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Prostate cancer staging is crucial for treatment planning.
- Accurate local staging and nodal assessment are vital for prognosis.
Purpose of the Study:
- To evaluate the reliability of Magnetic Resonance (MR) imaging in staging prostate carcinoma.
- To correlate MR imaging findings with histologic data for local disease extent and nodal metastases.
Main Methods:
- MR imaging was performed on 81 patients with diagnosed prostate cancer.
- Findings were correlated with histopathology for local tumor spread (37 patients) and lymph node involvement (51 patients).
- Sensitivity, specificity, and accuracy were calculated for staging and metastasis detection.
Main Results:
- MR imaging detected tumor nodules in the peripheral zone in 34/37 patients, often showing low signal intensity.
- Hemorrhage posed a challenge for tumor detection and volume measurement.
- For differentiating Stage A/B from C/D disease, MR imaging showed 72% sensitivity, 84% specificity, and 78% accuracy.
- Assessment of seminal vesicle invasion was more accurate than extracapsular spread.
- MR imaging detected lymph node metastases with 69% sensitivity, 95% specificity, and 88% accuracy.
Conclusions:
- MR imaging is a reliable tool for comprehensive prostate cancer evaluation and staging.
- The technique demonstrates high accuracy in detecting lymph node metastases.
- While minor discrepancies in capsule invasion staging were noted, they did not impact clinical management.