OBJECTIVES: Penile preserving surgery is increasingly offered to men with localised penile cancer and surgical margins of less than 10 mm appear to offer excellent oncological control.
Invasion of the tunica albuginea (TA) and the urethra are important factors in determining the feasibility of such surgery. We assessed the accuracy of magnetic resonance imaging (MRI) in predicting the invasion of the tunica albuginea and the urethra during the primary staging of penile cancer.
METHODS: One hundred and four consecutive patients with clinical T1-T3 penile cancer had a penile MRI as a part of local staging protocol. An artificial erection was induced by injecting alprostadil (prostaglandin E1). Four men with poor quality MRI images were excluded from the study. The preoperative MRI was compared to final histology to assess its accuracy in predicting the invasion of the tunica albuginea and urethral invasion.
RESULTS: Data of one hunded patients who underwent penile MRI prior to definitive surgery for invasive penile carcinoma was available for analysis. The mean age was 65 years and number of patients with pathological stage T1, T2 and T3 were 32, 52 and 16 respectively. The sensitivity and specificity of MRI in predicting the invasion of tunica albuginea and urethra were 82.1%, 73.6% and 62.5%, 82.1% respectively. There were no MRI related complications.
CONCLUSIONS: This study shows that penile MRI is an accurate imaging modality in assessing the tunica albuginea invasion but is less sensitive in assessing urethral invasion. These results support the use of MRI in the local staging of penile cancer.
Written by:
Hanchanale V, Yeo L, Subedi N, Smith J, Wah T, Harnden P, Bhattarai S, Chilka S, Eardley I. Are you the author?
Reference: BJU Int. 2015 Jan 20. Epub ahead of print.
doi: 10.1111/bju.13041
PubMed Abstract
PMID: 25600638