Local staging of penile cancer using magnetic resonance imaging with pharmacologically induced penile erection.
OBJECTIVE
This study was undertaken to compare the local staging of penile cancer by magnetic resonance imaging (MRI) combined with pharmacologically induced penile erection (PIPE), with clinical examination and pathology, and to verify whether MRI-PIPE led to changes in treatment planning in our cohort.


METHODS
Thirteen patients with untreated penile cancer underwent local staging by clinical examination and MRI-PIPE obtained by intracavernosal injection of 10 mug prostaglandin E1. Transverse, sagittal and coronal T2-weighted and T1-weighted (before and after intravenous gadolinium injection) images were obtained with a four-channel phased-array coil. Tumours were treated according to stage, as defined by MRI-PIPE and clinical examination. Stage T1 tumours underwent laser ablation and stage T2 or T3 tumours partial or total penectomy.


RESULTS
Twelve penile cancers were squamous cell carcinomas and one was a sarcoma. MRI-PIPE correctly staged 12 out of 13 patients, failing to detect one in situ carcinoma. Clinical examination correctly staged eight out of 13 patients, over-staging two patients (one Tis was over-staged as T1 and one T1 as T2) and under-staging three patients (two T2 as T1 and one T3 as T2).


CONCLUSIONS
MRI-PIPE performed better than the clinical examination and changed treatment planning in three patients.
Petralia
G
G
Divisione di Radiologia, Istituto Europeo di Oncologia IRCCS, Via Ripamonti 435, 20141 Milano, Italy. giuseppe.petralia@ieo.it
Villa
G
G
Scardino
E
E
Zoffoli
E
E
Renne
G
G
de Cobelli
O
O
Bellomi
M
M
D000368:Aged; D000527:Alprostadil / Q000494:pharmacology; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery; D015331:Cohort Studies; D006801:Humans; D053685:Laser Therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010410:Penile Erection / Q000187:drug effects; D010412:Penile Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D012509:Sarcoma / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000494:pharmacology
D014665:Vasodilator Agents; D000527:Alprostadil