title: Accuracy of preoperative endo-rectal coil magnetic resonance imaging in detecting clinical under-staging of localized prostate cancer.
abstract: OBJECTIVE
  To assess the accuracy of intra-rectal coil magnetic resonance imaging (ER-MRI) for staging early prostate cancer (EPC).
  
  
  METHODS
  ER-MRI was performed with the Magnetom Symphony 1.5 Tesla system. ER-MRI and pathology findings were statistically correlated.
  
  
  RESULTS
  One hundred and fifty-four consecutive patients underwent radical prostatectomy (RRP) for EPC (cT1c-2 Nx M0). An average age was 66, mean PSA 11.04 µg/L (median 7.33 µg/L) and mean pathologic Gleason score 6. Pathology detected 97 out of 154 patients (63 %) as EPC and 57 cases (37 %) as extra-prostate extension (EPED) (pT3) with extra-capsular extension (ECE) (pT3a) in 41 (27 %) and seminal vesicle invasion (SVI) (pT3b) in 16 (10 %). ER-MRI staged 100 patients (65 %) as cT2 and 54 (35 %) as EPED with ECE in 37 cases (24 %) and SVI in 17 (11 %). ER-MRI sensitivity, specificity, positive predictive value, negative predictive value, overall accuracy resulted respectively 0.78, 0.96, 0.86, 0.92, 0.91 for ECE as well as 0.88, 0.98, 0.82, 0.99 and 0.97 for SVI.
  
  
  CONCLUSIONS
  ER-MRI was effective in detecting preoperative EPC under-staging. In the next future, multi-parametric 3-Tesla ER-MRI will be the procedure for diagnosing, staging and following-up prostate cancer patients.
authors: Department of Urology, Azienda Ospedaliera Universitaria Integrata-Ospedale Civile Maggiore, Piazzale Stefani N 1, 37126, Verona, Italy, drporcaro@yahoo.com.
authors: Antonio B
authors: AB
authors: Porcaro
authors: Alessandro
authors: A
authors: Borsato
authors: Mario
authors: M
authors: Romano
authors: Teodoro
authors: T
authors: Sava
authors: Claudio
authors: C
authors: Ghimenton
authors: Filippo
authors: F
authors: Migliorini
authors: Carmelo
authors: C
authors: Monaco
authors: Emanuele
authors: E
authors: Rubilotta
authors: Stefano Zecchini
authors: SZ
authors: Antoniolli
authors: Vincenzo
authors: V
authors: Lacola
authors: Stefania
authors: S
authors: Montemezzi
mesh_terms: D000368:Aged; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery; D012007:Rectum; D012189:Retrospective Studies; D012680:Sensitivity and Specificity