Abdominal Imaging

, Volume 37, Issue 4, pp 664–674 | Cite as

Radical prostatectomy: value of prostate MRI in surgical planning

  • Nelly TanEmail author
  • Daniel J. A. Margolis
  • Timothy D. McClure
  • Albert Thomas
  • David S. Finley
  • Robert E. Reiter
  • Jiaoti Huang
  • Steven S. Raman


The introduction of serum prostate-specific antigen to the prostate cancer screening algorithm has led to an increase in prostate cancer diagnosis as well as a migration toward lower-stage cancer at the time of diagnosis. This stage migration has coincided with changes in treatment options; these include active surveillance, new therapies, and advances in surgical techniques. Use of robot-assisted radical prostatectomy (RARP) as a surgical technique has seen a significant increase over the past several years: the number of patients undergoing RARP has risen from 1% to 40% of all prostatectomies from 2001–2006 to as many as 80% in 2010. The robotic interface provides a 3D magnified view of the surgical field, intuitive instrument manipulation, motion scaling, tremor filtration, and excellent dexterity and range of motion. However, in some cases, the lack of tactile (haptic) feedback may limit the surgeon’s decision making ability in assessing malignant involvement of the neurovascular bundles. Pre-operative planning relies on nomograms based on limited clinical and prostate biopsy information. The surgical decision to spare or resect the neurovascular bundles is based on clinical information which is not spatially or anatomically based. Advances in magnetic resonance imaging (MRI) may provide spatially localized information to fill this void and aid surgical planning, particularly for robotic surgeons. In this review, we discuss the potential role of pre-operative MRI in surgical planning for radical prostatectomy.


Prostate MRI Surgical planning Multiparametric prostate imaging 



Prostate-specific antigen


Digital rectal exam


Radical prostatectomy


Radical retropubic prostatectomy


Robotic-assisted radical prostatectomy


Endorectal coil MRI


Dynamic contrast-enhanced MRI


MR spectroscopic imaging


Apparent diffusion coefficient


Diffusion weighted imaging


Receiver operating characteristic


Area under the curve


Extracapsular extension


Seminal vesicle invasion


Neurovascular bundle


Mid-urethral length


Positive surgical margin






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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Nelly Tan
    • 1
    Email author
  • Daniel J. A. Margolis
    • 1
  • Timothy D. McClure
    • 1
  • Albert Thomas
    • 1
  • David S. Finley
    • 2
  • Robert E. Reiter
    • 2
  • Jiaoti Huang
    • 3
  • Steven S. Raman
    • 1
  1. 1.Department of RadiologyUniversity of California, Los AngelesLos AngelesUSA
  2. 2.Department of UrologyUniversity of California, Los AngelesLos AngelesUSA
  3. 3.Department of PathologyUniversity of California, Los AngelesLos AngelesUSA

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