Oral (Free Paper) Session 2 - Uro-Oncology: Prostate & Kidney: no. OP.2-2OBJECTIVE: To evaluate MRI with endorectal coil (ER-MRI) in detecting laterality of tumor and T staging on patients with localized prostate cancer before RaLRP …postprin

Ho, BSH

Ma, WK

Ng, ATL

Tam, PC

Tsu, HL

Wong, JKW

Yiu, MK

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Title Is pre-operative MRI really a Must for Robotic-assistedLaparoscopic Radical Prostatectomy (RaLRP)?Author(s) Wong, JKW; Ma, WK; Ho, BSH; Ng, ATL; Tsu, HL; Tam, PC; Yiu,MKCitationThe 20th Annual Scientific Meeting of the Hong Kong UrologicalAssociation (HKUA), Hong Kong, China, 9 November 2014. InProgramme Book, 2014, p. 41, abstract no. OP.2-2Issued Date 2014URL http://hdl.handle.net/10722/207792Rights Creative Commons: Attribution 3.0 Hong Kong License[OP.2-2]  Is Pre-Operative MRI Really A Must for Robotic-Assisted Laparoscopic Radical Prostatectomy (RaLRP)?  KW Wong, WK Ma, SH Ho, TL Ng, HL Tsu, PC Tam, MK Yiu   Division of Urology, Department of Surgery Queen Mary Hospital, Hong Kong    Objective: To evaluate MRI with endorectal coil (ER-MRI) in detecting laterality of tumor and T staging on patients with localized prostate cancer before RaLRP  Patients & Methods: Between November 2007 and February 2014, 149 patients were recruited. All patients had biopsy-confirmed disease and ER-MRI before operation. ER-MRI and prostatectomy pathology findings were correlated.   Results: ER-MRI staged 104 patients as T2 disease, 14 patients as T3 disease and did not detect any tumor in 31 patients. Pathology showed T2 disease in 127 patients, T3 disease in 20 patients and no tumor in 2 patients. Laterality of tumor reported by ER-MRI was consistent with pathology findings in 46.4% of patients. ER-MRI sensitivity, specificity, PPV and NPV resulted respectively 0.70, 0.32, 0.86 and 0.16 for T2 disease and 0.20, 0.92, 0.29 and 0.88 for T3 disease. For low-risk tumor classified with D’Amico risk stratification system, ER-MRI appears most accurate to confirm T2 disease and rule out T3 disease with PPV of 0.97 and NPV of 0.97 respectively.  Conclusion: While ER-MRI is far from perfect as pre-op assessment tool for prostate cancer, it is very accurate to confirm organ confined disease in low-risk patients. Judicious use and interpretation of ER-MRI is important.  41 

Is pre-operative MRI really a Must for Robotic-assisted Laparoscopic Radical Prostatectomy (RaLRP)?

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Is pre-operative MRI really a Must for Robotic-assisted Laparoscopic Radical Prostatectomy (RaLRP)?

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