Objectives
To assess the value of dynamic contrast-enhanced (DCE) combined with T2-weighted (T2W) endorectal coil (ERC) magnetic resonance imaging (MRI) at 3 T (3T) for determining extracapsular extension (ECE) of prostate cancer.
Methods
In this IRB-approved study, ERC 3T MRI of the prostate was performed in 108 patients prior to radical prostatectomy. T2W fast spin-echo and DCE 3D gradient echo images were acquired. The interpretations of readers with varied experience were analyzed. MRI-based staging results were compared with radical prostatectomy histology. Descriptive statistics were generated for prediction of ECE and staging accuracies were determined by the area under the receiver-operating-characteristic curve.
Results
The overall sensitivity, specificity, positive predictive value, and negative predictive value for ECE were 75%, 92%, 79% and 91%, respectively. Diagnostic accuracy for staging was 86%, 80% and 91% for all readers, experienced and less experienced readers, respectively.
Conclusions
ERC 3T MRI of the prostate combining DCE and T2W imaging is an accurate pretheurapeutic staging tool for assessment of ECE in clinical practice across varying levels of reader experience.