title: [Active surveillance for prostate cancer: usefulness of endorectal MR at 1.5 Tesla with pelvic phased array coil in detecting significant tumors].
abstract: OBJECTIVE
  To describe and assess MRI signs of significant tumor in a series of patients who all underwent radical prostatectomy and also fulfilled criteria to choose active surveillance according to French "SurAcaP" protocol.
  
  
  METHODS
  The clinical reports of 681 consecutive patients operated on for prostate cancer between 2002 and 2007 were reviewed retrospectively. All patients had endorectal MR (1.5 Tesla) with pelvic phased array coil. (1.5 T erMR PPA). Sixty-one patients (8.9%) fulfilled "SurAcaP" protocol criteria. Preoperative data (MR+core biopsy) were assessed by comparison to whole-mount step section pathology.
  
  
  RESULTS
  85.3% of the 61 patients entering SurAcaP protocol had significant tumor at pathology. (Non Organ Confined Disease (Non OCD)=8.2%, Gleason sum score>6=39.2%). A new exclusion criterion has been assessed: T3MRI±NPS>1 as a predictor tool of significant tumor. ("T3MRI±NPS>1"=Non OCD at MR±number of positive sextants involved in tumor at MR and/or Core Biopsy > to 1). Sensitivity, specificity, PPV, NPV of the criterion "T3MRI±NPS>1" in predicting significant tumor were, respectively: 77%, 33%, 86%, 20%. Adding this criterion to other criteria of the "SurAcaP" protocol could allow the exclusion of all Non OCD, and a decrease in Gleason sum Score>6 rates (20%).
  
  
  CONCLUSIONS
  Endorectal MR at 1.5 Tesla with pelvic-phased array coil should be considered when selecting patients for active surveillance in the management of prostate cancer. A criterion based upon MR and core biopsy findings, called "T3MR±NSP>1" may represent an exclusion citeria due to its ability to predict significant tumor.
authors.affiliation: Clinique Urologique, CHU de Nantes Hôtel-Dieu, 1, place A.-Ricordeau, 44093 Nantes, France. poetschevleesch@hotmail.com
authors.forename: F
authors.initials: F
authors.lastname: Luyckx
authors.forename: P
authors.initials: P
authors.lastname: Hallouin
authors.forename: C
authors.initials: C
authors.lastname: Barré
authors.forename: G
authors.initials: G
authors.lastname: Aillet
authors.forename: P
authors.initials: P
authors.lastname: Chauveau
authors.forename: J-F
authors.initials: JF
authors.lastname: Hétet
authors.forename: O
authors.initials: O
authors.lastname: Bouchot
authors.forename: J
authors.initials: J
authors.lastname: Rigaud
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000473:pathology*; D012189:Retrospective Studies