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World J Clin Urol. Mar 24, 2015; 4(1): 56-63
Published online Mar 24, 2015. doi: 10.5410/wjcu.v4.i1.56
Value of preoperative MRI for prostate cancer staging and continence outcomes prior to prostatectomy: A review of the literature
Eric D Andresen, James A Brown, Kenneth G Nepple
Eric D Andresen, James A Brown, Kenneth G Nepple, Department of Urology, University of Iowa, Iowa, IA 52242-1089, United States
Author contributions: Andresen ED, Brown JA and Nepple KG designed research; Andresen ED performed research; Andresen ED and Nepple KG analyzed data; Andresen ED, Brown JA and Nepple KG wrote the paper.
Conflict-of-interest: Each author reports no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kenneth G Nepple, MD, Department of Urology, University of Iowa, 200 Hawkins Dr., 3 RCP, Iowa, IA 52242-1089, United States. kenneth-nepple@uiowa.edu
Telephone: +1-319-3562114 Fax: +1-319-3563900
Received: August 28, 2014
Peer-review started: August 28, 2014
First decision: November 1, 2014
Revised: November 17, 2014
Accepted: December 29, 2014
Article in press: December 31, 2014
Published online: March 24, 2015
Abstract

Pelvic imaging in newly diagnosed prostate cancer is primarily used for staging prior to definitive treatment. Over the past decade use of magnetic resonance imaging (MRI) for pre-surgical planning has increased, as well has he technology and methods for performing prostate MRI. To investigate and define the different MRI technologies available and further assess MRI technology ability to predict pathologic stage. Searching PubMed, we identified current published literature, where the cohort population underwent pre-operative MRI followed by prostatectomy. Keywords used in the PubMed literature search included: MRI, prostate cancer, prostate cancer staging, multiparamentric MRI and incontinence. Papers were included for review if they discussed use of MRI prior to prostatectomy and had corresponding pathologic data, staging, incontinence, and surgical outcomes. Primary information noted was MRI sensitivity, specificity and overall accuracy for detecting extracapsular extension (ECE) and seminal vesicle involvement (SVI). Secondary information derived included assessing the surgical influence of staging information, and identifying predictors of urinary incontinence recovery. Review of the literature showed that in regards to extracapsular extension the reported MRI accuracy ranged from 76%-98%, sensitivity from 20%-90% and specificity from 82%-99%. As for seminal vesicle involvement the reported MRI accuracy ranged from 76%-98%, sensitivity from 20%-90% and specificity from 82%-99%. There is a widely varying sensitivity and specificity for both ECE and SVI and the wide variability in the MRI technology used in the literature supports that use of MRI technology for prostate cancer remains investigational.

Keywords: Magnetic resonance imaging, Metastasis, Urinary incontinence, Prostate cancer, Seminal vesicle invasion, Extracapsular extension

Core tip: Over the past decade use of magnetic resonance imaging (MRI) for pre-surgical planning has increased, as well has he technology and methods for performing prostate MRI. To investigate and define the different MRI technologies available and further assess MRI technology ability to predict pathologic stage. We evaluated the current literature to identify MRI sensitivity, specificity and overall accuracy for detecting extracapsular extension and seminal vesicle involvement. Primary information noted was MRI sensitivity, specificity and overall accuracy for detecting extracapsular extension and seminal vesicle involvement. Secondary information derived included assessing the surgical influence of staging information, and identifying predictors of urinary incontinence recovery.