[Clinical value of native and contrast enhanced MRI in staging prostatic carcinoma before planned radical prostatectomy].
OBJECTIVE
To assess the clinical value of MRI with and without contrast agent in the staging of prostatic carcinoma. Relevance for surgical management.


METHODS
60 patients with carcinoma proven by biopsy or suspected prostatic carcinoma were evaluated with MRI. The examinations were performed in a 1.5 T (Philips ACS-NT Gyroscan) imager with multiplanar orientations before and after intravenous application of 0.1 mmol/kg/bw Gadodiamide (Omniscan-Nycomed/Amersham). The gold standard was histology after radical prostatectomy and in case of non-operability the consensual final staging.


RESULTS
Compared to histology MRI revealed a sensitivity of 75% and a specificity of 82% in the differentiation of locally advanced carcinoma (T 3/4). Including the non-surgical cases MRI showed a sensitivity of 82.5% and a specificity of 86%. Interindividual analysis showed no difference in diagnostic accuracy between the non-enhanced and the contrast-enhanced techniques. In 23% of cases (n = 14) MRI induced changes in patient management.


CONCLUSIONS
MRI is an accurate procedure in the local staging of prostatic carcinoma. In combination with clinical findings, PSA, and grading scores MRI has a significant influence on treatment selection. Contrast agent administration does not seem to increase the diagnostic accuracy significantly.
Kuhn
M
M
Abt. für Diagnostische Radiologie, Allgemeines Krankenhaus, Hamburg.
Huttmann
P
P
Spielhaupter
E
E
Gross-Fengels
W
W
Schreiter
F
F
D000368:Aged; D003287:Contrast Media; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D008297:Male; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery
D003287:Contrast Media; C064925:gadodiamide; D017430:Prostate-Specific Antigen; D019786:Gadolinium DTPA
Klinischer Stellenwert der nativen und KM-unterstützten MRT im Staging des Prostatakarzinoms vor geplanter radikaler Prostatektomie.