Pelvic adenopathy in prostatic and urinary bladder carcinoma: MR imaging with a three-dimensional TI-weighted magnetization-prepared- rapid gradient-echo sequence

• Published in: American journal of roentgenology (1976) Vol. 167; no. 6; pp. 1503 - 1507
• Main Authors: Jager, GJ, Barentsz, JO, Oosterhof, GO, Witjes, JA, Ruijs, SJ
• Format: Journal Article
• Language: English
• Published: Leesburg, VA Am Roentgen Ray Soc 01.12.1996; American Roentgen Ray Society
• Subjects: Aged; Biological and medical sciences; Cardiovascular system; Digestive system; Female; Humans; Image Processing, Computer-Assisted; Investigative techniques, diagnostic techniques (general aspects); Lymph Nodes - pathology; Lymphatic Metastasis - diagnosis; Magnetic Resonance Imaging - methods; Male; Medical sciences; Middle Aged; Neoplasm Staging; Pelvis - pathology; Predictive Value of Tests; Prostatic Neoplasms - pathology; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Sensitivity and Specificity; Urinary Bladder Neoplasms - pathology; Human; Evaluation; Urinary system disease; Prostate disease; Malignant lymphadenopathy; Urinary tract disease; Malignant tumor; Nuclear magnetic resonance imaging; Abdomen; Gradient echo; Urinary bladder; Abdominal disease; Bladder disease; Diagnosis; Male genital diseases; Prostate
• ISSN: 0361-803X; 1546-3141
• DOI: 10.2214/ajr.167.6.8956585

The purpose of this study was to evaluate a magnetization-prepared-rapid gradient-echo (MP-RAGE) sequence as a three-dimensional (3D) T1-weighted MR imaging technique to reveal lymph node metastases from carcinoma of the bladder and the prostate. Using a 3D T1-weighted MP-RAGE sequence, MR images of 134 consecutive patients with prostatic carcinoma (n = 63) or urinary bladder carcinoma (n = 71) who were scheduled for radical prostatectomy or radical cystectomy were correlated with histopathologic findings after fine-needle aspiration biopsy (FNAB) (n = 6), open or laparoscopic pelvic lymph node dissection (n = 127), or autopsy (n = 1). MR imaging was used 10 times to guide FNAB in nine patients. The sensitivity, specificity, accuracy, and positive predictive valve of the technique were 75%, 98%, 90%, and 94%, respectively. Thin-slice (1.2-mm) multiplanar reconstructed images correctly revealed diseased nodes in 33 patients. However, MR imaging failed to reveal microscopic metastatic deposits in normally sized nodes in 11 patients. Two other patients had enlarged nodes without metastasis. Furthermore, FNAB guided by MR imaging revealed metastases in six of nine patients. MR imaging with a 3D MP-RAGE sequence was accurate in revealing nodal metastases from carcinoma of the prostate and bladder. This imaging technique can be used to select patients for biopsy or laparoscopic pelvic lymph node dissection.