Evaluation of the Prostate and Prostatic Carcinoma with Gadolinium-enhanced Endorectal Coil MR Imaging

Thirteen patients who underwent subsequent radical prostatectomy for prostate cancer were studied with spin-density-T2-weighted and gadolinium-enhanced and unenhanced T1-weighted magnetic resonance (MR) imaging performed with an endorectal surface coil. With gadopentetate dimeglumine, the central gland showed inhomogeneous enhancement due to benign hyperplasia, whereas the peripheral zone demonstrated more uniform and less intense enhancement. With the T1-weighted sequence, depiction of the zonal anatomy, prostate capsule, surgical capsule, fibromuscular stroma, and periprostatic venous plexus was better with contrast enhancement, but these were best demonstrated on T2-weighted images. The trend was similar for prostatic tumor extent and capsular integrity. The seminal vesicles had a septal enhancement pattern and in several patients were best evaluated with enhanced T1-weighted images. These findings suggest that gadopentetate dimeglumine is not warranted for routine use in endorectal MR imaging of the prostate but may be useful for evaluation of the seminal vesicles in selected patients.