Topographical Sensitivity and Specificity of Endorectal Coil Magnetic Resonance Imaging for Prostate Cancer Detection

Objectives: Endorectal coil magnetic resonance imaging (EC-MRI) is useful to evaluate prostate cancer localization. Herein, we evaluate sensitivity and specificity of EC-MRI in different regions of the prostate by comparing the acquired images to whole-mount sections of the prostate after radical prostatectomy. Methods: 69 patients with localized prostate cancer were included. After virtually dividing the prostate into 12 sectors, results of EC-MRI were compared to corresponding whole-mount sections by contingency analysis. Sensitivity and specificity were calculated for each of the 12 areas as well as for the dorsal and ventral region. Results: Sensitivity right/left was dorsal apex/mid/base 41/41, 60/67 and 73/79%; ventral 33/52, 43/42 and 47/52%. Specificity right/left was dorsal apex/mid/base 92/89, 82/75 and 88/69%; ventral 100/100, 100/92 and 88/83%. Local sensitivity and specificity regarding dorsal versus ventral was 88/100 and 65/87%. Conclusions: Local sensitivity decreased from basodorsal to apicoventral direction, whereas local specific-ity increased in the same direction. Therefore, prostate cancers demonstrated by MRI are more prone to be detected in the basodorsal region, whereas less false-positive results are found in the apicoventral region. These variations in topographical specificity and sensitivity need to be considered before radical prostatectomy or MRI-guided biopsy. Copyright (C) 2010 S. Karger AG, Basel