CURRENT ROLE OF MR-IMAGING IN THE STAGING OF ADENOCARCINOMA OF THE PROSTATE

Surgical cure of adenocarcinoma of the prostate (ACP) is possible in o ver 80% of cases when the disease is confined to the gland capsule. Th e endorectal probe for magnetic resonance (MR) imaging has increased r esolution of the prostate gland and capsule, which has improved the se nsitivity and specificity for staging ACP (.65 sensitivity, .69 specif icity for body coil; .87 sensitivity, .85 specificity for the endorect al coil). Normal glandular regions in the peripheral zone and central zone have significantly higher citrate levels than ACP and fibromuscul ar and fibrous benign prostatic hyperplasia at proton spectroscopy. AC P has a higher phosphomonoester-phosphocreatine ratio than normal glan dular tissue at phosphorus spectroscopy. The combination of endorectal coil MR imaging for local spread, and body coil MR imaging for advanc ed disease, makes MR imaging the premier imaging modality for the preo perative staging of ACP.