Evaluation of endorectal magnetic resonance imaging and magnetic resonance spectroscopic imaging in diagnosing and staging prostate cancer - a prospective pilot study.

Aims: The main objective of our study was to evaluate the efficacy of End. MRI and MRSI in (1) detecting and (2) staging prostate cancer by correlating it with histopathological results. Methods: In a double blind prospective study of 20 patients were divided into two groups. In group A with 10 patients, the inclusion criteria were elevated PSA and/or a palpable nodule. All 10 patients with undiagnosed prostate cancer underwent End. MRI and MRSI followed by TRUS guided ten quadrant biopsy. In group B, 10 patients with already proven carcinoma prostate were included. All these patients underwent End. MRI and MRSI followed by radical prostatectomy. Results: The mean S.PSA was 19.8 ng/ml (1.9-52) and the mean Gleason score was 6.8 (5-8). In group A End. MRI/MRSI revealed a diagnosis of prostate cancer in 10 patients, but only six were positive on biopsy. In group B, End. MRI/MRSI showed eight patients to have periprostatic extension but only three were confirmed on final histology. Out of the eight patients that showed periprostatic spread on End. MRI/MRSI, seven patients showed seminal vesicle invasion, and one patient showed capsular infiltration. But on histopathology study seminal vesicle involvement was confirmed in only one patient and only two patients had capsular infiltration. Conclusions: This pilot study reveals that End.MRI/MRSI, although a relatively well-established investigation in the west, has not shown the same degree of accuracy in our setup.