title: Staging of prostatic carcinoma at 1.5-T MRI: correlation of a simplified MRI exam with whole-mount radical prostatectomy specimens.
abstract: OBJECTIVE
  To retrospectively analyze the accuracy of simplified multiparametric MRI at 1.5 T for local staging by using whole-mount-section histopathological analysis as the standard of reference.
  
  
  METHODS
  123 consecutive patients underwent T2 weighted, T1 weighted and diffusion-weighted MRI without endorectal coil prior to radical prostatectomy. The accuracy of predicting extracapsular extension (ECE) (T3a) was assessed using direct signs or the combination of direct and indirect signs of extraprostatic extension. The accuracy of predicting seminal vesicle invasion (T3b) was evaluated, taking into account different routes of seminal vesicle involvement. Finally, adjacent organ invasion (T4) was evaluated in this patient population.
  
  
  RESULTS
  Histopathology showed T3a, T3b and T4 in 61, 28 and 9 cases, respectively. The use of direct signs of extraprostatic extension showed a sensitivity of 57.4% and specificity of 91.9%. The combination of direct signs and indirect signs improved sensitivity (85.2%) at the expense of moderate loss of specificity (83.9%). MR sensitivity for the detection of seminal vesicle invasion was low (53.6%); however, it was dependent on the route of seminal vesicle tumour infiltration. MR sensitivity and specificity for adjacent organ invasion were 88.9% and 99.1%.
  
  
  CONCLUSIONS
  Simplified MRI study at 1.5 T provides a relatively high sensitivity for detecting ECE (T3a) when using the combination of indirect and direct signs. However, this high sensitivity reading is at the cost of a moderate loss of specificity. Invasion of the seminal vesicles (T3b) occurs most often along the ejaculatory duct complex with low MR sensitivity.
  
  
  CONCLUSIONS
  Simplified MRI study at 1.5 T without endorectal coil could be used for the local T staging of prostate cancer.
authors.affiliation: 1 Department of Radiology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Andries
authors.initials: A
authors.lastname: Van Holsbeeck
authors.affiliation: 2 Department of Histopathology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Annemarie
authors.initials: A
authors.lastname: Degroote
authors.affiliation: 1 Department of Radiology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Liesbeth
authors.initials: L
authors.lastname: De Wever
authors.affiliation: 1 Department of Radiology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Els
authors.initials: E
authors.lastname: Vanhoutte
authors.affiliation: 1 Department of Radiology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Frederik
authors.initials: F
authors.lastname: De Keyzer
authors.affiliation: 3 Department of Urology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Van Poppel
authors.affiliation: 1 Department of Radiology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Raymond
authors.initials: R
authors.lastname: Oyen
mesh_terms: D000368:Aged; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D015203:Reproducibility of Results; D012189:Retrospective Studies