What is the role of MRI in the workup of prostate cancer?

Updated: Jan 14, 2019
  • Author: Lanna Cheuck, DO; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Answer

Conventional endorectal MRI is helpful for localizing cancer within the prostate and seminal vesicles and for local staging. Dynamic, contrast-enhanced MRI and MR spectroscopic imaging are complementary in local staging, but their use is currently limited to a research setting.

Diffusion-weighted MRI appears to improve detection of transition-zone prostate cancer. In a retrospective study of 156 prostate cancer patients before they underwent radical prostatectomy, the addition of diffusion-weighted endorectal magnetic resonance imaging (MRI) to T2-weighted imaging improved not only the detection of transition zone prostate cancer but also the evaluation of tumor aggressiveness. [24] At the (individual) patient and sextant (localization) levels, there was improvement in the areas under the receiver operating characteristic curves. There was also an inverse correlation between tumor apparent diffusion coefficients and tumor Gleason scores in the transition zone. [24]


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