Is there a role for routine pelvic magnetic resonance imaging in intermediate risk prostate cancer?

Abstract

ObjectivesTo determine the role of staging pelvic magnetic resonance imaging (MRI) in men with intermediate risk prostate cancer.Patients and methodsWe identified all patients diagnosed with intermediate risk (NICE definition: PSA 10-20 ng/ml, or Gleason score 7, or clinical stage T2b/T2c) prostate cancer between 1st January 2007 and 31st December 2008. Through retrospective case note review, we determined the number of patients who had undergone a pelvic MRI and whether such an investigation had altered the patient's management by increasing tumour stage.ResultsA total of 222 men (mean age 66 years; range: 48-88) were diagnosed with intermediate risk prostate cancer during our study period. The mean PSA was 11.8 ng/ml (range: 3-20 ng/ml). Of these, 112 (50.5%) underwent an MRI. Overall, in 25/112 (22.3%) patients, pelvic MRI findings impacted significantly upon patient treatment by demonstrating either extra-prostatic extension of cancer, lymph node involvement or bone metastases.ConclusionsOur retrospective study has demonstrated that a pelvic MRI in men diagnosed with intermediate risk prostate cancer may influence treatment decision in approximately a quarter of patients. Routine pelvic MRI is indicated in men with intermediate risk prostate cancer where radical treatment is contemplated.