PTU - Polskie Towarzystwo Urologiczne
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Estimation of sensitivity of magnetic resonans (mr) imaging in the diagnostics of prostate cancer (pc) based on the histopathological data after radical prostatectomy
Article published in Urologia Polska 2008/61/Supl. 1.

authors

Andrzej Wronczewski, Jerzy Siekiera, Krzysztof Kamecki, Witold Mikołajczak, Andrzej Petrus
Oddział Urologii Onkologicznej, Centrum Onkologii im. prof. F. Łukaszczyka w Bydgoszczy

summary

Introduction.

MR using endorectal coil is a method of diagnostic imaging used in the evaluation of prostate cancer. Different current forms of MR enable to visualize not only morphology of the prostate but also to assess the metabolic disturbances and microvascular abnormalities appearing in the prostate tissue in the presence of neoplasm. These diagnostic tools are useful in localization of the tumor and enable to establish clinical stage of the disease.

Objectives.

The aim of the study is to estimate the sensitivity of MR in PC and its use in clinical practice.

Materials and methods.

The MR data of 43 patients (at age 44-76, med. 66) with prostate cancer (pT2-T3, Gleason 4-9) were analyzed. 4 out of 43 patients underwent morphological imaging, 39 dynamic contrast enhanced MR. In 8 out of 43 cases MR spectroscopy was done. In each case the extracapsular extension, seminal vesicles infiltration and the presence of metastatic pelvic lymph nodes were estimated. In MR spectroscopy the sensitivity of tumor localization in the gland was taken under consideration. All the MR data were compared with histological diagnosis after radical prostatectomy.

Results.

The estimation of prostate capsule invasion in MR data in 37 (86%) patients was compatible to histological data. In 4 (9.3%) cases the result was underestimated, and in 2 (4.65%) cases was overestimated. The conformability between MR and histological data in seminal vesicles infiltration took place in 32 (74.4%) of cases. There were 10 (23.25) falsely negative results (underestimation) and 1 (2.32%) falsely positive result (overestimation). The estimation of pelvic lymph nodes was compatible in both data in 41 (95.3%) patients. In 2 (4.65%) MR data the result was falsely negative (underestimation). The localization of the tumor in MR spectroscopy data was confirmed in histology in 7 (87.5%) patients. In 1 (2.32%) case there was no evidence of the tumor presence in MR spectroscopy (falsely negative result).

Conclusions.

The variety of MR imaging methods being used currently enables to achieve precise images in the diagnosis of the prostate cancer. Their high sensitivity in staging establishment makes them a very useful tool in clinical practice to qualify patients with prostate cancer to radical treatment and to choose a suitable method of treatment as well. They may play an important role in marking a range of surgical and non surgical treatment (radiotherapy) too.