The Role of Magnetic Resonance Imaging in the Local Staging of Penile Cancer

Kayes, Oliver; Minhas, Suks; Allen, Clare; Hare, Chris; Freeman, Alex; Ralph, David

doi:10.1016/j.eururo.2006.11.014

Cited by 112 publications

(42 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Invasions of the corpora cavernosa and the corpus spongiosum are appreciable and tunica albuginea infiltration is seen as an interruption of the thin echogenic line of the tunica [9]. However, experiences with US have shown that this technique is unreliable especially in the presence of microscopic invasion and in patients with advanced tumours that reach the base of the penis, evaluating the proximal tumour extent of the lesion can be difficult [9,10] and we do not routinely use US in our centre. MRI with its superior soft tissue resolution is the most sensitive imaging modality for local staging [11].…”

Section: Primary Tumour Stagingmentioning

confidence: 94%

Imaging in primary penile cancer: current status and future directions

2009

View full text Add to dashboard Cite

Penile cancer is a rare neoplasm in the developed world. Clinical assessment often results in inaccurate staging and radiological techniques have a key role in staging and postoperative assessment. Magnetic resonance imaging (MRI) depicts penile anatomy in detail and is the most accurate technique for local staging and postoperative follow-up. MRI and ultrasound (US), although helpful for assessment of lymph nodes, are not reliable enough for accurate nodal staging. US-guided fine needle aspiration cytology (FNAC), however, remains a valuable tool to confirm metastases in suspicious inguinal nodes. Lymphoscintigraphy with dynamic sentinel node biopsy (DSNB) is a promising technique used to predict occult lymph node metastases. Novel imaging techniques such as positron emission tomography/computed tomography (PET-CT) and nanoparticle enhanced MRI have high sensitivity and specificity for lymph node metastases but their availability is limited and clinical utility is not fully established. The radiologist needs to be familiar with the normal penile anatomy, imaging appearances of pre- and post-treatment penile cancer, and the advantages and limitations of the available imaging techniques. This review highlights the above points and presents a systematic approach to make the best use of imaging in the management of patients with penile cancer.

show abstract

Section: Primary Tumour Stagingmentioning

confidence: 94%

Imaging in primary penile cancer: current status and future directions

2009

View full text Add to dashboard Cite

show abstract

“…Later studies, with the use of intracavernosal agents, have shown that MRI was useful when infiltration of the corpora ''could not be determined properly by clinical examination'' and that MRI is probably better than ultrasound in this context [19]. In particular, several studies have shown that invasion of the corpora cavernosa is rarely missed [7,19,20], and proximal tumours, which are hard to scan on ultrasound and difficult to palpate, are shown well. However, even with intracorporal agents MRI can sometimes overstage tumours, and in one study of 55 patients 6 patients with T1 lesions were staged as T2 [20].…”

Section: Mri For Penile Cancermentioning

confidence: 99%

“…In particular, several studies have shown that invasion of the corpora cavernosa is rarely missed [7,19,20], and proximal tumours, which are hard to scan on ultrasound and difficult to palpate, are shown well. However, even with intracorporal agents MRI can sometimes overstage tumours, and in one study of 55 patients 6 patients with T1 lesions were staged as T2 [20]. This was ascribed to technical factors-poor response to prostaglandin, previous radiotherapy, motion artefact and infection-but it is likely that some of the error was also due to fundamental limits to the resolution of MRI and the difficulty in distinguishing abutment and bulge from true invasion.…”

Section: Mri For Penile Cancermentioning

confidence: 99%

MRI of the penis

Kirkham¹

2012

The British Journal of Radiology

View full text Add to dashboard Cite

ABSTRACT. MRI of the penis is an expensive test that is not always superior to clinical examination or ultrasound. However, it shows many of the important structures, and in particular the combination of tumescence from intracavernosal alprostadil, and highresolution T 2 sequences show the glans, corpora and the tunica albuginea well. In this paper we summarise the radiological anatomy and discuss the indications for MRI. For penile cancer, it may be useful in cases where the local stage is not apparent clinically. In priapism, it is an emerging technique for assessing corporal viability, and in fracture it can in most cases make the diagnosis and locate the injury. In some cases of penile fibrosis and Peyronie's disease, it may aid surgical planning, and in complex pelvic fracture may replace or augment conventional urethrography. It is an excellent investigation for the malfunctioning penile prosthesis.

show abstract

“…Magnetic resonance imaging (MRI) of the penis with prostaglandin E1-induced erection is considered one of the most sensitive imaging modality to date to determine the depth of corporal invasion. 19 Ultrasound may also serve as an adjunct to physical examination for determining infiltration into the corpus cavernosum. 20 Computed tomography (CT) imaging is not sufficient to determine the depth of tumour penetration locally, but it is useful to detect enlarged lymph nodes.…”

Section: Clinical Staging Of the Primarymentioning

confidence: 99%