Multiparametric Prostate MR Imaging and Spectroscopy in Patients with High-Risk Localized Prostate Cancer Before Radical Prostatectomy Assesses Risk of Extracapsular Extension And/or Positive Margins.

Ernesto Castillo^1,2, Emilio Hernandez³, Jose Maria Rodriguez-Barbero⁴, Pilar Perez Sanz¹, Javier Gonzalez³, Pedro Cabrera³, Javier C. Angulo, ²³

In 30 patients with high-risk localized (T1-2) prostate cancer the risk of extracapsular extension and affected margins before radical prostatectomy were evaluated blindly before surgery. The pathologists evaluation of the biopsy cylinders predicted the risk erroneously in 35% of the evaluations. Using multiparametric MRI and MR spectroscopic imaging, diffusion-weighted imaging and dynamic CE-MRI with an endorectal coil the radiologist did so in 18.3%. Multiparametric MRI of the prostate preoperatively alerts upon the risk of extracapsular disease in high-risk localized prostate cancer better than accurate review of transrectal biopsy.