title: Can high-spatial resolution T2-weighted endorectal MRI rule out clinically significant prostate cancer?
abstract: OBJECTIVE
  To evaluate whether clinically significant prostate cancer (PCa) can be ruled out by high-spatial resolution T2-weighted endorectal MRI (eMRI) in a cohort of patients with biopsy-proven PCa.
  
  
  METHODS
  A retrospective analysis was carried out for consecutive patients who underwent 1.5 Tesla eMRI for local staging before open radical prostatectomy. The cohort was dichotomized into patients with apparent or inapparent tumour on eMRI. The results were compared with final histopathology, and an analysis for presence of clinically significance PCa was performed.
  
  
  RESULTS
  A total of 385 patients were included in the study; in 85 patients (22 %), no apparent lesion suspicious for PCa was detected on eMRI, still final pathology revealed clinically significant PCa in 61 of these patients (72 %). In contrast, 256 (85 %) of the 300 patients with apparent tumour in eMRI harboured clinically significant PCa. eMRI could not differentiate clinically significant from insignificant PCa in neither of the groups (p > 0.6).
  
  
  CONCLUSIONS
  Presence of clinically significant cancer cannot be excluded by high-resolution 1.5 Tesla T2-weighted eMRI. The results of the study suggest that the role of T2-weighted eMRI for selecting patients suitable for AS is limited.
authors.affiliation: Department of Radiology, Comprehensive Cancer Center (CCC) Tuebingen, Eberhard-Karls-University, Tuebingen, Germany.
authors.forename: Matthias C
authors.initials: MC
authors.lastname: Roethke
authors.forename: Michaela
authors.initials: M
authors.lastname: Kniess
authors.forename: Sascha
authors.initials: S
authors.lastname: Kaufmann
authors.forename: Matthias P
authors.initials: MP
authors.lastname: Lichy
authors.forename: Heinz-Peter
authors.initials: HP
authors.lastname: Schlemmer
authors.forename: Arnulf
authors.initials: A
authors.lastname: Stenzl
authors.forename: David
authors.initials: D
authors.lastname: Schilling
mesh_terms: D000368:Aged; D015331:Cohort Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011467:Prostate / Q000473:pathology* / Q000601:surgery; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies