Comparison of magnetic resonance imaging and ultrasonography in staging early prostate cancer; results of a multi-institutional cooperative trial

Article Abstract:

Prostate cancer is the most common form of cancer in men, and of all types of cancer, it is the second most prevalent cause of death in American men. In prostate and other cancers, it is important that the exact stage of the cancer be determined so that the most appropriate and effective treatment can be chosen. Various imaging techniques are now available for visualizing internal structures; these include magnetic resonance imaging (MRI) and ultrasonography. With the current pressure to reduce medical costs, research is needed that compares the accuracy of different imaging techniques so that only the most useful procedures are performed. In this study, MRI and transrectal (through the rectum) ultrasonography were compared. The subjects were 230 men with clinically localized prostate cancer of stage Ta or Tb. The accuracy of the imaging techniques for predicting the stage of the cancer was determined by comparing the imaging results with the findings from subsequent surgical removal and laboratory analysis of the cancer. The researchers were disappointed in the results because neither MRI nor ultrasonography could reliably distinguish between localized and advanced prostate cancer in these patients. Neither imaging technique is sophisticated enough at this time to stage the cancer adequately. While the difference between the techniques in overall accuracy was not statistically significant, MRI was consistently more accurate than ultrasonography. The overall accuracy was 69 percent for MRI and 58 percent for ultrasonography. Both methods were more successful in staging advanced disease than localized disease. It is recommended that these two techniques be refined further, rather than abandoned, because they offer the most promise for eventually staging prostate cancer reliably. (Consumer Summary produced by Reliance Medical Information, Inc.)

Ultrasound imaging

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Invasion of the neurovascular bundle by prostate cancer: evaluation of MR imaging

Article Abstract:

Prostate cancer is a major cause of death and disease for American men. Treatment choices include surgery, radiation therapy and hormonal therapy, and the choice depends primarily upon the stage of the disease at diagnosis. Prostatectomy, surgical removal of the prostate, can be a very effective treatment. Unfortunately, it also leads to impotence in over 90 percent of men who undergo it. This appears to be a result of injury to the neurovascular bundle (NVB) during surgery. The NVB can be spared if the tumor is confined to the prostate, and even if the tumor has spread through the prostatic capsule, impotency can be prevented if the NVB on one side is left intact. Imaging techniques that can accurately depict the tumor are needed to see if the NVB can be spared. This study evaluated magnetic resonance (MR) imaging for this purpose. MR images from 50 prostate cancer patients were reviewed and an evaluation of tumor extent and NVB involvement were made on the basis of the images. These evaluations were then compared with actual surgical and pathologic results. Pathologic results showed the NVB to be affected by tumor in 32 (64 percent) of the patients, substantially so in 28 of those. The MR images detected NVB invasion in 19 of the 28 (68 percent) cases of substantial NVB invasion, and detected localized disease in 13 of the remaining 22 patients. MR imaging was thus only 64 percent accurate in predicting NVB invasion. These results indicate that MR imaging has a limited use in evaluating the invasion of the NVB by tumors of the prostate. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Prevention, Complications and side effects, Impotence

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Localized prostate cancer

Article Abstract:

The article discusses the management of a prostate cancer case relevant to the results of the pathological tests. It suggests the line of treatment that may be adopted, assesses life expectancy while putting forward possible risks.

United States, Care and treatment, Case studies, Radiotherapy, Prostate-specific antigen, Prostate specific antigen

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