title: Comparison of prostate cancer detection at 3-T MRI with and without an endorectal coil: A prospective, paired-patient study.
abstract: To compare the sensitivity of 2 different non-endorectal coil strategies vs. endorectal coil (ERC) magnetic resonance imaging (MRI) for detection of prostate cancer (PCa).
  
  
  
  In this prospective, single-center, paired-patient, paired-reader study, 49 men with a clinical indication for MRI underwent non-ERC (phased-array coil only) T2-weighted imaging and diffusion-weighted imaging followed by the same sequences using both ERC and phased-array coils (ERC Protocol). Patients were randomized into 1 of 2 arms: standard non-ERC protocol and augmented non-ERC protocol. Lesions with Likert score≥3 were defined as suspicious for cancer. Radical prostatectomy specimen or combined systematic plus targeted biopsies served as the standard of reference. Cancers were stratified into risk groups according to the National Comprehensive Cancer Network guidelines. Generalized estimating equations with Bonferroni correction were used for comparisons. The level of reader confidence was inferred by the Likert scores assigned to index lesions.
  
  
  
  The ERC protocol provided sensitivity (78%) superior to MRI without ERC for PCa detection, both with a standard (43%) (P<0.0001) or augmented (60%) (P<0.01) protocol. The ERC MRI missed less-intermediate or high-risk index lesions (4%) than standard non-ERC (42%) (P = 0.02) and augmented non-ERC MRI (25%), although the latter did not reach significance (P = 0.09). The ERC improved radiologist confidence for the detection of PCa (average Likert score = 4.2±1.4) compared to standard (2.3±2.3) and augmented (2.9±2.1) non-ERC (P = 0.001).
  
  
  
  The use of combined ERC and pelvic phased-array coil for T2-weighted imaging and diffusion-weighted imaging provides superior sensitivity for the detection of PCa compared to an examination performed without the ERC.
authors.affiliation: Department of Radiology and Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX. Electronic address: daniel.costa@utsouthwestern.edu.
authors.forename: Daniel N
authors.initials: DN
authors.lastname: Costa
authors.affiliation: Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Qing
authors.initials: Q
authors.lastname: Yuan
authors.affiliation: Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Yin
authors.initials: Y
authors.lastname: Xi
authors.affiliation: Department of Radiology and Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Neil M
authors.initials: NM
authors.lastname: Rofsky
authors.affiliation: Department of Radiology and Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Lenkinski
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Yair
authors.initials: Y
authors.lastname: Lotan
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Claus G
authors.initials: CG
authors.lastname: Roehrborn
authors.affiliation: Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Franto
authors.initials: F
authors.lastname: Francis
authors.affiliation: Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Debbie
authors.initials: D
authors.lastname: Travalini
authors.affiliation: Department of Radiology and Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Ivan
authors.initials: I
authors.lastname: Pedrosa
mesh_terms: D000368:Aged; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity
keywords: Detection; Endorectal coil; Imaging; MRI; Prostate cancer