Preoperative T-staging of prostate carcinoma: Endorectal MRI compared with other imaging and clinical methods.

Purpose: The diagnostic value of endorectal magnetic resonance imaging (MRI) in comparison to clinical information and other imaging modalities was analysed in order to define the most accurate preoperative staging method. Methods: 54 patients with biopsy proven prostate carcinoma, who underwent subsequent prostatectomy, were examined with an endorectal surface coil. The results were compared to body coil MRI, digital rectal examination and prostate specific antigen levels. In 37 patients, results of endorectal ultrasound were available. Results: Staging accuracy, sensitivity and specificity of endorectal coil MRI were 83.3%. For body coil MRI, staging accuracy was 59.2%, sensitivity 43.3% and specificity 82.6%, for transrectal ultrasound 59.5%, 36.4% and 91.7% and for the digital rectal examination 55.6%, 26.7% and 91.7%, respectively. Staging accuracy of endorectal MRI was significantly (p < 0,05) superior to that of the other imaging modalities. Conclusion: Endorectal coil MRI allows reliable distinction between localised and advanced tumour stages and is superior to other imaging techniques in this regard. It can thus be recommended for staging in patients with prostate carcinoma.