Skip to main content
Log in

The role of endorectal coil MRI in preoperative staging and decision-making for the treatment of clinically localized prostate cancer

  • Review Article
  • Published:
Magnetic Resonance Materials in Physics, Biology and Medicine Aims and scope Submit manuscript

Abstract

Introduction

The optimal management of newly diagnosed prostate cancer requires individualization of the treatment plan based upon the most accurate clinical characterization of tumor location and extent of disease. The role of imaging in prostate cancer staging continues to evolve. In this review, we address the utility of endorectal coil magnetic resonance imaging (eMRI) in both local staging and its ability to facilitate the decision in choosing one treatment strategy over another after the initial diagnosis of localized prostate cancer.

Materials and methods

Using the PubMed database and reference lists of key articles, we identified studies addressing the use of eMRI in tumor characterization and risk stratification in patients undergoing treatment for clinically localized prostate cancer.

Results

The findings identified within 54 selected studies were incorporated into a summary discussing the current limitations in cancer staging and the role eMRI plays in both the preoperative assessment and clinical decision-making in an attempt to improve our ability to individualize management approaches and tailor treatment.

Conclusion

eMRI allows for more accurate local staging by complementing the existing clinical variables through improvements in spatial characterization of the prostatic zonal anatomy and molecular changes. These improvements in tumor staging enhance our ability to individualize treatment selection and tailor the approach to maximize cancer control while minimizing treatment related morbidity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ (2007) Cancer statistics. CA Cancer J Clin 57(1): 43–66

    Article  PubMed  Google Scholar 

  2. D’Amico AV, Desjardin A, Chung A, Chen MH, Schultz D, Whittington R et al (1998) Assessment of outcome prediction models for patients with localized prostate carcinoma managed with radical prostatectomy or external beam radiation therapy. Cancer 82(10): 1887–1896

    Article  PubMed  CAS  Google Scholar 

  3. Vargas SO, Jiroutek M, Welch WR, Nucci MR, D’Amico AV, Renshaw AA (1999) Perineural invasion in prostate needle biopsy specimens. Correlation with extraprostatic extension at resection. Am J Clin Pathol 111(2): 223–228

    PubMed  CAS  Google Scholar 

  4. Partin AW, Mangold LA, Lamm DM, Walsh PC, Epstein JI, Pearson JD (2001) Contemporary update of prostate cancer staging nomograms (partin tables) for the new millennium. Urology 58(6): 843–848

    Article  PubMed  CAS  Google Scholar 

  5. Stephenson AJ, Scardino PT, Eastham JA, Bianco FJ Jr, Dotan ZA, Fearn PA et al (2006) Preoperative nomogram predicting the 10-year probability of prostate cancer recurrence after radical prostatectomy. J Nat Cancer Inst 98(10): 715–717

    PubMed  Google Scholar 

  6. Freedland SJ, Csathy GS, Dorey F, Aronson WJ (2002) Percent prostate needle biopsy tissue with cancer is more predictive of biochemical failure or adverse pathology after radical prostatectomy than prostate specific antigen or Gleason score. J Urol 167(2 Pt 1): 516–520

    PubMed  Google Scholar 

  7. Stamey TA, Freiha FS, McNeal JE, Redwine EA, Whittemore AS, Schmid HP (1993) Localized prostate cancer. Relationship of tumor volume to clinical significance for treatment of prostate cancer. Cancer 71(3 Suppl): 933–938

    Article  PubMed  CAS  Google Scholar 

  8. Oesterling JE, Martin SK, Bergstralh EJ, Lowe FC (1993) The use of prostate-specific antigen in staging patients with newly diagnosed prostate cancer. JAMA 269(1): 57–60

    Article  PubMed  CAS  Google Scholar 

  9. Gleason DF, Mellinger GT (1974) Prediction of prognosis for prostatic adenocarcinoma by combined histological grading and clinical staging. J Urol 111(1): 58–64

    PubMed  CAS  Google Scholar 

  10. Pinthus JH, Witkos M, Fleshner NE, Sweet J, Evans A, Jewett MA et al (2006) Prostate cancers scored as Gleason 6 on prostate biopsy are frequently Gleason 7 tumors at radical prostatectomy: implication on outcome. J Urol 176(3): 979–984 (discussion 84)

    Article  PubMed  Google Scholar 

  11. Freedland SJ, Kane CJ, Amling CL, Aronson WJ, Terris MK, Presti JC Jr (2007) Upgrading and downgrading of prostate needle biopsy specimens: risk factors and clinical implications. Urology 69(3): 495–499

    Article  PubMed  Google Scholar 

  12. Chun FK, Briganti A, Shariat SF, Graefen M, Montorsi F, Erbersdobler A et al (2006) Significant upgrading affects a third of men diagnosed with prostate cancer: predictive nomogram and internal validation. BJU Int 98(2): 329–334

    Article  PubMed  Google Scholar 

  13. Greene F, Page D, Fleming I, Fritz A, Bach C, Haller D (2002) American Joint Committee on cancer staging manual, 6th edn. Springer, New York

    Google Scholar 

  14. Grossfeld GD, Chang JJ, Broering JM, Li YP, Lubeck DP, Flanders SC et al (2001) Under staging and under grading in a contemporary series of patients undergoing radical prostatectomy: results from the Cancer of the Prostate Strategic Urologic Research Endeavor database. J Urol 165(3): 851–856

    Article  PubMed  CAS  Google Scholar 

  15. Sciarra A, Voria G, Monti S, Mazzone L, Mariotti G, Pozza M et al (2004) Clinical understaging in patients with prostate adenocarcinoma submitted to radical prostatectomy: predictive value of serum chromogranin A. Prostate 58(4): 421–428

    Article  PubMed  CAS  Google Scholar 

  16. Kattan MW, Eastham JA, Stapleton AM, Wheeler TM, Scardino PT (1998) A preoperative nomogram for disease recurrence following radical prostatectomy for prostate cancer. J Nat Cancer Inst 90(10): 766–771

    Article  PubMed  CAS  Google Scholar 

  17. May F, Treumann T, Dettmar P, Hartung R, Breul J (2001) Limited value of endorectal magnetic resonance imaging and transrectal ultrasonography in the staging of clinically localized prostate cancer. BJU Int 87(1): 66–69

    Article  PubMed  CAS  Google Scholar 

  18. Sedelaar JP, van Leenders GJ, Goossen TE, Hulsbergen-van der Kaa CA, van Adrichem NP, Wijkstra H et al (2002) Value of contrast ultrasonography in the detection of significant prostate cancer: correlation with radical prostatectomy specimens. Prostate 53(3): 246–253

    Article  PubMed  CAS  Google Scholar 

  19. Schnall MD, Pollack HM (1990) Magnetic resonance imaging of the prostate gland. Urol Radiol 12(2): 109–114

    Article  PubMed  CAS  Google Scholar 

  20. Mullerad M, Hricak H, Kuroiwa K, Pucar D, Chen HN, Kattan MW et al (2005) Comparison of endorectal magnetic resonance imaging, guided prostate biopsy and digital rectal examination in the preoperative anatomical localization of prostate cancer. J Urol 174(6): 2158–2163

    Article  PubMed  Google Scholar 

  21. Sala E, Akin O, Moskowitz CS, Eisenberg HF, Kuroiwa K, Ishill NM et al (2006) Endorectal MR imaging in the evaluation of seminal vesicle invasion: diagnostic accuracy and multivariate feature analysis. Radiology 238(3): 929–937

    Article  PubMed  Google Scholar 

  22. Mullerad M, Hricak H, Wang L, Chen HN, Kattan MW, Scardino PT (2004) Prostate cancer: detection of extracapsular extension by genitourinary and general body radiologists at MR imaging. Radiology 232(1): 140–146

    Article  PubMed  Google Scholar 

  23. Wang L, Mullerad M, Chen HN, Eberhardt SC, Kattan MW, Scardino PT et al (2004) Prostate cancer: incremental value of endorectal MR imaging findings for prediction of extracapsular extension. Radiology 232(1): 133–139

    Article  PubMed  Google Scholar 

  24. Wang L, Hricak H, Kattan MW, Chen HN, Kuroiwa K, Eisenberg HF et al (2007) Prediction of seminal vesicle invasion in prostate cancer: incremental value of adding endorectal MR imaging to the Kattan nomogram. Radiology 242(1): 182–188

    Article  PubMed  Google Scholar 

  25. Wang L, Hricak H, Kattan MW, Chen HN, Scardino PT, Kuroiwa K (2006) Prediction of organ-confined prostate cancer: incremental value of MR imaging and MR spectroscopic imaging to staging nomograms. Radiology 238(2): 597–603

    Article  PubMed  Google Scholar 

  26. McNeal JE, Redwine EA, Freiha FS, Stamey TA (1988) Zonal distribution of prostatic adenocarcinoma. Correlation with histologic pattern and direction of spread. Am J Surg Pathol 12(12): 897–906

    Article  PubMed  CAS  Google Scholar 

  27. Akin O, Sala E, Moskowitz CS, Kuroiwa K, Ishill NM, Pucar D et al (2006) Transition zone prostate cancers: features, detection, localization, and staging at endorectal MR imaging. Radiology 239(3): 784–792

    Article  PubMed  Google Scholar 

  28. Scheidler J, Hricak H, Vigneron DB, Yu KK, Sokolov DL, Huang LR et al (1999) Prostate cancer: localization with three-dimensional proton MR spectroscopic imaging—clinicopathologic study. Radiology 213(2): 473–480

    PubMed  CAS  Google Scholar 

  29. Yu KK, Scheidler J, Hricak H, Vigneron DB, Zaloudek CJ, Males RG et al (1999) Prostate cancer: prediction of extracapsular extension with endorectal MR imaging and three-dimensional proton MR spectroscopic imaging. Radiology 213(2): 481–488

    PubMed  CAS  Google Scholar 

  30. Zakian KL, Sircar K, Hricak H, Chen HN, Shukla-Dave A, Eberhardt S et al (2005) Correlation of proton MR spectroscopic imaging with gleason score based on step-section pathologic analysis after radical prostatectomy. Radiology 234(3): 804–814

    Article  PubMed  Google Scholar 

  31. Saranchuk JW, Kattan MW, Elkin E, Touijer AK, Scardino PT, Eastham JA (2005) Achieving optimal outcomes after radical prostatectomy. J Clin Oncol 23(18): 4146–4151

    Article  PubMed  Google Scholar 

  32. Cheng L, Darson MF, Bergstralh EJ, Slezak J, Myers RP, Bostwick DG (1999) Correlation of margin status and extraprostatic extension with progression of prostate carcinoma. Cancer 86(9): 1775–1782

    Article  PubMed  CAS  Google Scholar 

  33. Blute ML, Bostwick DG, Seay TM, Martin SK, Slezak JM, Bergstralh EJ et al (1998) Pathologic classification of prostate carcinoma: the impact of margin status. Cancer 82(5): 902–908

    Article  PubMed  CAS  Google Scholar 

  34. Han M, Partin AW, Pound CR, Epstein JI, Walsh PC (2001) Long-term biochemical disease-free and cancer-specific survival following anatomic radical retropubic prostatectomy. The 15-year Johns Hopkins experience. Urol Clin North Am 28(3): 555–565

    Article  PubMed  CAS  Google Scholar 

  35. Ohori M, Scardino PT (2002) Localized prostate cancer. Curr Probl Surg 39(9): 833–957

    Article  PubMed  Google Scholar 

  36. Swindle P, Eastham JA, Ohori M, Kattan MW, Wheeler T, Maru N et al (2005) Do margins matter? The prognostic significance of positive surgical margins in radical prostatectomy specimens. J Urol 174(3): 903–907

    Article  PubMed  Google Scholar 

  37. Hricak H, Wang L, Wei DC, Coakley FV, Akin O, Reuter VE et al (2004) The role of preoperative endorectal magnetic resonance imaging in the decision regarding whether to preserve or resect neurovascular bundles during radical retropubic prostatectomy. Cancer 100(12): 2655–2663

    Article  PubMed  Google Scholar 

  38. Coakley FV, Eberhardt S, Wei DC, Wasserman ES, Heinze SB, Scardino PT et al (2002) Blood loss during radical retropubic prostatectomy: relationship to morphologic features on preoperative endorectal magnetic resonance imaging. Urology 59(6): 884–888

    Article  PubMed  Google Scholar 

  39. Hull GW, Rabbani F, Abbas F, Wheeler TM, Kattan MW, Scardino PT (2002) Cancer control with radical prostatectomy alone in 1,000 consecutive patients. J Urol 167(2 Pt 1): 528–534

    PubMed  Google Scholar 

  40. Masterson TA, Pettus JA, Middleton RG, Stephenson RA (2005) Isolated seminal vesicle invasion imparts better outcomes after radical retropubic prostatectomy for clinically localized prostate cancer: prognostic stratification of pt3b disease by nodal and margin status. Urology 66(1): 152–155

    Article  PubMed  Google Scholar 

  41. Ohori M, Scardino PT, Lapin SL, Seale-Hawkins C, Link J, Wheeler TM (1993) The mechanisms and prognostic significance of seminal vesicle involvement by prostate cancer. Am J Surg Pathol 17(12): 1252–1261

    Article  PubMed  CAS  Google Scholar 

  42. Ramsden AR, Chodak G (2004) An analysis of risk factors for biochemical progression in patients with seminal vesicle invasion: validation of Kattan’s nomogram in a pathological subgroup. BJU Int 93(7): 961–964

    Article  PubMed  CAS  Google Scholar 

  43. Nguyen PL, Whittington R, Koo S, Schultz D, Cote KB, Loffredo M et al (2004) Quantifying the impact of seminal vesicle invasion identified using endorectal magnetic resonance imaging on PSA outcome after radiation therapy for patients with clinically localized prostate cancer. Int J Radiat Oncol Biol Phys 59(2): 400–405

    PubMed  Google Scholar 

  44. Sala E, Eberhardt SC, Akin O, Moskowitz CS, Onyebuchi CN, Kuroiwa K et al (2006) Endorectal MR imaging before salvage prostatectomy: tumor localization and staging. Radiology 238(1): 176–183

    Article  PubMed  Google Scholar 

  45. Stephenson AJ, Scardino PT, Bianco FJ Jr, DiBlasio CJ, Fearn PA, Eastham JA (2004) Morbidity and functional outcomes of salvage radical prostatectomy for locally recurrent prostate cancer after radiation therapy. J Urol 172(6 Pt 1): 2239–2243

    Article  PubMed  Google Scholar 

  46. Cooperberg MR, Lubeck DP, Meng MV, Mehta SS, Carroll PR (2004) The changing face of low-risk prostate cancer: trends in clinical presentation and primary management. J Clin Oncol 22(11): 2141–2149

    Article  PubMed  Google Scholar 

  47. Stephenson RA, Stanford JL (1997) Population-based prostate cancer trends in the United States: patterns of change in the era of prostate-specific antigen. World J Urol 15(6): 331–335

    Article  PubMed  CAS  Google Scholar 

  48. Epstein JI, Walsh PC, Carmichael M, Brendler CB (1994) Pathologic and clinical findings to predict tumor extent of nonpalpable (stage T1c) prostate cancer. JAMA 271(5): 368–374

    Article  PubMed  CAS  Google Scholar 

  49. Epstein JI, Chan DW, Sokoll LJ, Walsh PC, Cox JL, Rittenhouse H et al (1998) Nonpalpable stage T1c prostate cancer: prediction of insignificant disease using free/total prostate specific antigen levels and needle biopsy findings. J Urol 160(6 Pt 2): 2407–2411

    PubMed  CAS  Google Scholar 

  50. Epstein JI, Sanderson H, Carter HB, Scharfstein DO (2005) Utility of saturation biopsy to predict insignificant cancer at radical prostatectomy. Urology 66(2): 356–360

    Article  PubMed  Google Scholar 

  51. Goto Y, Ohori M, Arakawa A, Kattan MW, Wheeler TM, Scardino PT (1996) Distinguishing clinically important from unimportant prostate cancers before treatment: value of systematic biopsies. J Urol 156(3): 1059–63

    Article  PubMed  CAS  Google Scholar 

  52. Kattan MW, Eastham JA, Wheeler TM, Maru N, Scardino PT, Erbersdobler A et al (2003) Counseling men with prostate cancer: a nomogram for predicting the presence of small, moderately differentiated, confined tumors. J Urol 170(5): 1792–1797

    Article  PubMed  Google Scholar 

  53. Partin AW, Kattan MW, Subong EN, Walsh PC, Wojno KJ, Oesterling JE et al (1997) Combination of prostate-specific antigen, clinical stage, and Gleason score to predict pathological stage of localized prostate cancer. A multi-institutional update. JAMA 277(18): 1445–1451

    Article  PubMed  CAS  Google Scholar 

  54. Shukla-Dave A, Hricak H, Kattan MW, Pucar D, Kuroiwa K, Chen HN et al (2007) The utility of magnetic resonance imaging and spectroscopy for predicting insignificant prostate cancer: an initial analysis. BJU Int 99(4): 786–793

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Karim Touijer.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Masterson, T.A., Touijer, K. The role of endorectal coil MRI in preoperative staging and decision-making for the treatment of clinically localized prostate cancer. Magn Reson Mater Phy 21, 371–377 (2008). https://doi.org/10.1007/s10334-008-0116-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10334-008-0116-4

Keywords

Navigation