title: Does endorectal coil MRI increase the accuracy of preoperative prostate cancer staging?
abstract: BACKGROUND
  We sought to investigate the association of preprostatectomy magnetic resonance imaging (MRI) and surgical pathologic findings in patients with prostate cancer.
  
  
  METHODS
  All patients with prostate cancer and preprostatectomy MRI available between 2002 and 2015 were included. Age, prostate-specific antigen at diagnosis, Gleason score at biopsy, MRI technique, radiology report suggestive of prostate cancer, extraprostatic invasion and seminal vesicle involvement, lymphadenopathy and final pathology report were retrospectively reviewed. Data was analyzed for sensitivity, specificity, positive and negative predictive values of MRI findings for predicting T3 disease. Consistency of MRI findings with pathology report was compared between MRIs with or without endorectal coil (ERC).
  
  
  RESULTS
  A cohort of 83 patients was identified. Eighty-seven percent of the patients had MRI findings suggestive of prostate cancer. MRI was performed with and without ERC in 21 (25.3%) and 62 (74.3%) patients respectively. Eighty-five percent of patients with ERC and 88.7% of those without ERC had MRI findings suggestive of prostate cancer (p = 0.659). MRI correlated with final surgical pathology stage T3 in 53 patients (64%). MRI findings were consistent with final pathology report in 70% of ERC group and 61.3% of non ERC group (p = 0.482). In terms of extra prostatic invasion or seminal vesicle involvement, MRI had specificity, sensitivity, positive and negative predictive values of 84.44%, 37.84%, 66.67% and 62.3% respectively.
  
  
  CONCLUSIONS
  MRI was specific but not sensitive in determining extraprostatic or seminal vesicle invasion. MRI was not accurate for lymph node involvement. In addition, using an ERC did not increase the accuracy of prostate MRI in this small cohort.
authors.affiliation: Division of Urology, University of Nebraska Medical Center, Omaha, Nebraska, USA.
authors.forename: Aydin
authors.initials: A
authors.lastname: Pooli
authors.forename: Sudhir
authors.initials: S
authors.lastname: Isharwal
authors.forename: Gates
authors.initials: G
authors.lastname: Cook
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Oliveto
authors.forename: Chad A
authors.initials: CA
authors.lastname: LaGrange
mesh_terms: D000368:Aged; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000032:analysis; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000473:pathology; D012669:Seminal Vesicles / Q000000981:diagnostic imaging / Q000473:pathology; D012680:Sensitivity and Specificity
chemical_list: D017430:Prostate-Specific Antigen