Zastosowanie rezonansu magnetycznego w ocenie stopnia zaawansowania pacjentow z nowo zdiagnozowanym rakiem gruczolu krokowego

Abstract

Author(s): Maciej Harat, Andrzej Lebioda, Tomasz Wisniewski, Roman Makarewicz

Purpose: According to 2012 NCCN Guidelines pelvic magnetic resonance imaging (MRI) scanning is recommended in stage T3 or T4 of prostate cancer, or T1 or T2 disease and a nomogram indicates there is greater than 20% chance of lymph node involvement. This study was formed to determine the relative benefits of using MRI in final staging of patients with newly diagnosed prostate cancer.

Methods: 174 patients were reviewed between year 2007 - 2011. All patients included in the study underwent biopsy, TRUS and MRI during process of diagnosis of prostate cancer in Oncology Centre in Bydgoszcz. Patients were analyzed due to international risk group, age, pathological type of tumor, tumor localization, Gleason score, PSA level, previous hormonotherapy. Information received were compared with MRI results obtained at the time of diagnosis.

Results: Analysis showed that MRI changed staging of 90 patients with prostate cancer (52%). There were no significant changes in 84 cases using MRI comparing to previous staging based on clinical examination, TRUS and biopsy. Variance analysis showed a significant correlation between restaging , T2 stage and PSA max value (p<0,028). In each NCCN risk group (T stage, PSA level, Gleason score) there existed MRI findings that changed final stage. The results were not connected with previous hormonotherapy or tumor localization in the gland.

Conclusions: The study showed that MRI is a useful method in final staging of prostate cancer patient before radical radiotherapy. We failed to identify a significant factor or group of factors which strictly indicate that diagnostic MRI can be omitted.

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