title: Changes in prostate shape and volume and their implications for radiotherapy after introduction of endorectal balloon as determined by MRI at 3T.
abstract: OBJECTIVE
  To determine the changes in prostate shape and volume after the introduction of an endorectal coil (ERC) by means of magnetic resonance imaging (MRI) at 3T.
  
  
  METHODS
  A total of 44 consecutive patients with biopsy-proven prostate cancer underwent separate MRI examinations at 3T with a body array coil and subsequently with an ERC inflated with 50 mL of fluid. Prospectively, two experienced readers independently evaluated all data sets in random order. The maximal anteroposterior, right-to-left, and craniocaudal prostate diameters, as well as the total prostate and peripheral zone and central gland volumes were measured before and after ERC introduction. The changes in prostate shape and volume were analyzed using Wilcoxon's test for paired samples.
  
  
  RESULTS
  The introduction of the ERC significantly changed the prostate shape in all three directions, with mean changes in the anteroposterior, right-to-left, and craniocaudal diameters of 15.7% (5.5 mm), 7.7% (3.5 mm), and 6.3% (2.2 mm), respectively. The mean total prostate, peripheral zone, and central gland volume decreased significantly after ERC introduction by 17.9% (8.3 cm(3)), 21.6% (4.8 cm(3)), and 14.2% (3.4 cm(3)), respectively.
  
  
  CONCLUSIONS
  ERC introduction as observed by 3T MRI changed the prostate shape and volume significantly. The mean anteroposterior diameter was reduced by nearly one-sixth of its original diameter, and the mean total prostate volume was decreased by approximately 18%. This could cause difficulties and should be considered when using ERC-based MRI for MRI-computed tomography fusion and radiotherapy planning.
authors.affiliation: Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. S.Heijmink@rad.umcn.nl
authors.forename: Stijn W T P J
authors.initials: SW
authors.lastname: Heijmink
authors.forename: Tom W J
authors.initials: TW
authors.lastname: Scheenen
authors.forename: Emile N J T
authors.initials: EN
authors.lastname: van Lin
authors.forename: Andries G
authors.initials: AG
authors.lastname: Visser
authors.forename: Lambertus A L M
authors.initials: LA
authors.lastname: Kiemeney
authors.forename: J Alfred
authors.initials: JA
authors.lastname: Witjes
authors.forename: Jelle O
authors.initials: JO
authors.lastname: Barentsz
mesh_terms: D000368:Aged; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011446:Prospective Studies; D011467:Prostate / Q000033:anatomy & histology* / Q000473:pathology; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000532:radiotherapy; D047368:Tumor Burden