Prediction of prostate cancer extracapsular extension with high spatial resolution dynamic contrast-enhanced 3-T MRI.
OBJECTIVE
To assess the value of dynamic contrast-enhanced (DCE) combined with T2-weighted (T2W) endorectal coil (ERC) magnetic resonance imaging (MRI) at 3 T for determining extracapsular extension (ECE) of prostate cancer.


METHODS
In this IRB-approved study, ERC 3-T MRI of the prostate was performed in 108 patients before radical prostatectomy. T2W fast spin-echo and DCE 3D gradient echo images were acquired. The interpretations of readers with varied experience were analysed. MRI-based staging results were compared with radical prostatectomy histology. Descriptive statistics were generated for prediction of ECE and staging accuracies were determined by the area under the receiver-operating characteristic curve.


RESULTS
The overall sensitivity, specificity, positive predictive value and negative predictive value for ECE were 75 %, 92 %, 79 % and 91 %, respectively. Diagnostic accuracy for staging was 86 %, 80 % and 91 % for all readers, experienced and less experienced readers, respectively.


CONCLUSIONS
ERC 3-T MRI of the prostate combining DCE and T2W imaging is an accurate pretherapeutic staging tool for assessment of ECE in clinical practice across varying levels of reader experience.


CONCLUSIONS
• Endorectal coil (ERC) magnetic resonance imaging is widely used for imaging prostatic disease.                         • ERC 3-T MRI is reasonably accurate for local prostate cancer staging.                         • High diagnostic accuracy is achievable across different levels of reader experience.                         • MRI facilitates therapeutic decisions in patients with prostate cancer.
Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
B Nicolas
BN
Bloch
Elizabeth M
EM
Genega
Daniel N
DN
Costa
Ivan
I
Pedrosa
Martin P
MP
Smith
Herbert Y
HY
Kressel
Long
L
Ngo
Martin G
MG
Sanda
William C
WC
Dewolf
Neil M
NM
Rofsky
D000368:Aged; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000473:pathology*