Value of endorectal coil versus body coil MRI for diagnosis of recurrent pelvic malignancies.
BACKGROUND
To compare endorectal coil magnetic resonance imaging (MRI) with body coil MRI in detecting local recurrence of gynecologic tumors and prostate and rectal cancers.


METHODS
Forty-six patients with suspected recurrent pelvic malignancies (13 gynecologic, 15 prostatic, and 18 anorectal primaries) were enrolled in the study. Axial T1- and T2-weighted body coil images and T2- and contrast-enhanced T1-weighted axial endorectal coil images were obtained on a 1.5 T system. Results of the MR examinations were compared with histological findings and follow-up examinations with respect to the diagnostic accuracy and diagnostic confidence for assessment or exclusion of local recurrence.


RESULTS
Recurrent disease was histologically confirmed in eight patients with primary gynecologic malignancies, seven with suspected prostatic recurrence, and seven with suspected anorectal recurrence. Overall, accuracy of body coil MRI was 67% for gynecologic tumors, 36% for prostatic recurrences, and 59% for rectal recurrences. T2- and contrast-enhanced T1-weighted endorectal sequences yielded similar results, with an accuracy of 73% for depiction of gynecologic recurrence, 77% for prostatic recurrence, and 77% for rectal recurrence. The difference in accuracy between body coil and endorectal coil examinations was statistically significant (p < 0. 05) only for prostatic cancer. Diagnostic confidence was, however, significantly improved (p < 0.05) in all tumors (T2-weighted endorectal coil examination was superior to T2-weighted body coil images in 71% of cases).


CONCLUSIONS
Although the results of endorectal coil MRI are only slightly superior to those of body coil MRI for the detection of recurrent gynecologic and anorectal tumors, diagnosis can be made with greater diagnostic confidence in many cases. For detection of prostatic recurrence, endorectal MRI is highly recommended.
Huch Böni
R A
RA
Department of Diagnostic Radiology, University Hospital Zurich, Rämistrasse 100, CH 8091 Zurich, Switzerland.
Meyenberger
C
C
Pok Lundquist
J
J
Trinkler
F
F
Lütolf
U
U
Krestin
G P
GP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001005:Anus Neoplasms / Q000175:diagnosis; D003287:Contrast Media; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005831:Genital Diseases, Female / Q000175:diagnosis; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D010386:Pelvic Neoplasms / Q000175:diagnosis*; D011471:Prostatic Neoplasms / Q000175:diagnosis; D012004:Rectal Neoplasms / Q000175:diagnosis; D012680:Sensitivity and Specificity
D003287:Contrast Media