title: Value of Endorectal MRI in Romanian Men for High Risk of Prostate Cancer: MRI Findings Compared with Saturation Biopsy.
abstract: OBJECTIVE
  To evaluate the potentials of T2 weighted (T2W)MRI and diffusion weighted (DW) MRI for prostate cancer(PCa) detection, local staging and treatment planning in high-risk group.
  
  
  METHODS
  Endorectal MRI was performed in 17 Romanian men (median age: 66 years; range: 58 75 years), prostate specific antigen (PSA) serum levels (median: 20 ng mL; range: 8.6 100 ng mL) with positive findings for PCa(median Gleason score: 8; range: 7 - 9). Imaging findings were compared to standarised 20-core transperineal saturation biopsy. The prostate was divided into 16 standart sectors(10 posterior and 6 anterior).
  
  
  RESULTS
  Overall, prostate cancer was detected in 16 patients(94%) on DW-MRI alone and in all 17 patients (100%) on T2W-MRI alone, and on combined imaging. On T2W-MRI165 sectors out of 272 were suspicious for PCa and 124 (75%)were cancer positive. On DW-MRI 126 sectors out of 272 were suspicious for PCa and 118 (95%) were cancer positive. On the combined imaging approach 134 sectors out of 272 were suspicious for PCa and 126 (94%) were cancer positive. This resulted in diagnostic accuracies per sector of 76% for T2WMRI, 86% for DW-MRI and 89% for combined imaging. Multifocal PCa was confirmed both on MR imaging and by biopsy in 8 of the 17 men (47%) Extra capsular extension(ECE) or seminal vesicles invasion (SVI) was highly suspected in 8 (47%) respectively 7 (41%) of the 17 patients. 6 patients(35%) presented both ECE and SVI. MRI findings were taken into account for treatment planning and none of these patients underwent radical prostatectomy and instead was treated with palliative cryotherapy, radiotherapy and hormone therapy.
  
  
  CONCLUSIONS
  Endorectal MRI is highly accurate in PCa detection in the high-risk group and seems to have an important role in local staging and treatment planning for Romanian population.
authors.forename: A
authors.initials: A
authors.lastname: Lebovici
authors.forename: S A
authors.initials: SA
authors.lastname: Sfrangeu
authors.forename: C
authors.initials: C
authors.lastname: Caraiani
authors.forename: C
authors.initials: C
authors.lastname: Lucan
authors.forename: M
authors.initials: M
authors.lastname: Suciu
authors.forename: F
authors.initials: F
authors.lastname: Elec
authors.forename: Gh
authors.initials: G
authors.lastname: Iacob
authors.forename: M
authors.initials: M
authors.lastname: Buruian
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D001706:Biopsy / Q000379:methods; D017679:Cryotherapy / Q000379:methods; D019160:Endosonography; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care / Q000379:methods; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D018714:Radiotherapy, Adjuvant / Q000379:methods; D012007:Rectum; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012383:Romania; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen