Endorectal MR Imaging and Proton Spectroscopy for Preoperative Evaluation of Clinical T1c Prostate Cancer

Introduction/Background With serum prostate specific antigen (PSA) screening, clinical stage T1c prostate cancer (defined as nonpalpable prostate cancer diagnosed by needle biopsy only, frequently due to an elevated PSA) has become the most commonly diagnosed prostate cancer. However, clinical stage T1c cancers are a heterogenous group, consisting of both clinically insignificant cancers, and cancers significant in size, grade and extent. The efficacy of the various treatment options for prostate cancer depends on the extent of disease. Therefore, to select the appropriate treatment option, an accurate and reliable assessment of disease stage is required. Currently preoperative evaluation of prostate cancer is routinely performed with a number of clinical parameters, including PSA, digital rectal examination, and transrectal ultrasound guided biopsy results. However, with the downward migration in prostate cancer volume and stage, these parameters have become less useful in stratifying patients.