Comparison of Magnetic Resonance Imaging and Ultrasonography in Staging Early Prostate Cancer

Rifkin, Matthew D.; Zerhouni, Elias A.; Gatsonis, Constantine; Quint, Leslie E.; Paushter, David M.; Epstein, Jonathan I.; Hamper, Ulrike M.; Walsh, Patrick C.; McNeil, Barbara J.

doi:10.1056/nejm199009063231001

Cited by 483 publications

(183 citation statements)

References 26 publications

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“…Conventional imaging modalities (14), serum prostatespecific antigen levels, Gleason grading, and tumor volume in needle biopsies (15) have been consistently correlated with pathologic findings in prostatectomy specimens in the individual patient (16,17). However, their predictive value has been inadequate on a patient-by-patient basis, particularly in cases in which moderately differentiated carcinomas (Gleason Grade 3) were diagnosed by needle biopsy (18).…”

Section: Discussionmentioning

confidence: 99%

Increased Cellularity of Tumor-Encased Native Vessels in Prostate Carcinoma Is a Marker for Tumor Progression

et al. 2000

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Changes in the native vasculature of the prostate gland associated with prostate adenocarcinoma have not been well characterized. Eighty-nine whole mounts of entirely submitted radical prostatectomies were reviewed. Thirty prostates with a minimum of five native arteries surrounded by carcinoma with corresponding control arteries were found and included in this study. The number of nuclei in the media of native arteries was recorded per 0.138 mm 2 using a 40؋ objective.The number of nuclei in vessels embedded in carcinoma (n ‫؍‬ 204) was increased when compared with controls (26.37 versus 20.58 mean nuclei per 0.138 mm 2 ; P < .001). Pathologic Stage T3 carcinomas contained vessels that were more cellular than stage T2 (P < .001). Vessels embedded in Gleason Grade 4 showed more cellularity than arteries embedded in Gleason Grade 3 (P < .002).Increased media cellularity of native prostate vessels encased in carcinoma is a histologic feature of higher grade/stage prostate carcinoma and provides positive indicator of advanced prostate cancer.

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Section: Discussionmentioning

confidence: 99%

Increased Cellularity of Tumor-Encased Native Vessels in Prostate Carcinoma Is a Marker for Tumor Progression

et al. 2000

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“…MRI is a non-invasive method of demonstrating anatomy and pathology based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radio waves that can be received then reconstructed into 3-D images. Prostate MRI using T1-and T2-weighted imaging was trialled in the 1980s, but at the time it lacked the adequate sensitivity and specificity to justify routine use [13]. Since then, technical improvements and the addition of functional parameters (diffusion-weighted, dynamic contrast-enhanced and spectroscopic imaging) to purely anatomic (T1/2-weighted) imaging have improved its accuracy.…”

Section: Overview Of Multi-parametric Mrimentioning

confidence: 99%

The role of magnetic resonance imaging in the diagnosis and management of prostate cancer

et al. 2013

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Background• The diagnosis of prostate cancer has long been plagued by the absence of an imaging tool that reliably detects and localises significant tumours. Recent evidence suggests that multi-parametric MRI could improve the accuracy of diagnostic assessment in prostate cancer. This review serves as a background to a recent USANZ position statement. It aims to provide an overview of MRI techniques and to critically review the published literature on the clinical application of MRI in prostate cancer. Technical Aspects• The combination of anatomical (T2-weighted) MRI with at least two of the three functional MRI parameterswhich include diffusion-weighted imaging, dynamic contrast-enhanced imaging and spectroscopy -will detect greater than 90% of significant (moderate to high risk) tumours; however MRI is less reliable at detecting tumours that are small (<0.5 cc), low grade (Gleason score 6) or in the transitional zone. The higher anatomical resolution provided by 3-Tesla magnets and endorectal coils may improve the accuracy, particularly in primary tumour staging.

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“…34,39,40 The detection of seminal vesicle involvement has been demonstrated in several studies that examined retrospectively the results of radical prostatectomy in patients with clinically con®ned disease. In a study by Terris et al the seminal vesicle positive rate was 13.8%.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided seminal vesicle biopsies in prostate cancer

Wymenga

Duisterwinkel

Groenier

et al. 2000

Prostate Cancer Prostatic Dis

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Invasion of prostatic adenocarcinoma into the seminal vesicles (SV) is generally accepted as an index of poor prognosis. The pre-operative identi®cation of SV invasion is an important element in staging since it may alter subsequent treatment decisions. We studied the possibility of diagnosing SV invasion with two biopsies from the junction between the prostate and seminal vesicles. Also we studied the correlation of several prognostic factors with the risk of clinical stage T 1,2,3 prostate cancer patients of having cancer growth into the seminal vesicles.Consecutive patients referred for transrectal ultrasound (TRUS) and biopsy because of clinical suspicion of prostate cancer were examined. This staging procedure was evaluated in patients who underwent a pelvic lymphadenectomy and radical retropubic prostatectomy (RRP).In 83 out of 138 patients prostate cancer was detected whereas 55 patients had benign disease. In 44% of prostate cancer patients a positive SV biopsy was found. The accuracy of the biopsies adjacent to the junction of the SV and the prostate was 91%. The best predictors for SV invasion were tumor grade of the biopsy sample (P`0.001), serum prostate-speci®c antigen (PSA) (P`0.0005), PSA density (P`0.0005) and clinical stage (P`0.0005). No signi®cance was found in the relation to seminal vesicle involvement with free/total (f/t) PSA ratio (P 0.588) for the prostate cancer group (SV and SV 7 ).In a receiver operating characteristic curves analysis, PSA density was signi®cantly more accurate for prediction of SV invasion than PSA or f/t PSA ratio. In ®ve prostatectomized patients (and negative SV biopsy) no SV invasion was found in the ®nal pathologic examination either.SV biopsy at the junction of the SV and prostate is accurate for staging with high ef®cacy and low morbidity. To predict SV invasion in prostate cancer patients, PSA density was more accurate than PSA or f/t PSA ratio. The determination of the f/t PSA ratio in patients with low and intermediate PSA levels (eg`15 mg/L) is not useful to estimation of the risk of seminal vesicle involvement. The combination of serum PSA concentration, PSA density, tumor grade from the biopsy specimens ad clinical stage provides the best prediction of SV invasion. These parameters are identical to the conventional predictors of pathology after RRP. SV biopsies may provide additional information; if one or both basal biopsies are positive, a clinical T 1,2 disease is altered to T 3 . Hence SV biopsy is useful for selection of patients who might obtain good results from RRP for prostate cancer. Prostate Cancer and Prostatic Diseases (2000) 3, 100±106.

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Comparison of Magnetic Resonance Imaging and Ultrasonography in Staging Early Prostate Cancer

Cited by 483 publications

References 26 publications

Increased Cellularity of Tumor-Encased Native Vessels in Prostate Carcinoma Is a Marker for Tumor Progression

Increased Cellularity of Tumor-Encased Native Vessels in Prostate Carcinoma Is a Marker for Tumor Progression

The role of magnetic resonance imaging in the diagnosis and management of prostate cancer

Ultrasound-guided seminal vesicle biopsies in prostate cancer

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