La radiologia medica

, 113:517 | Cite as

Local staging of penile cancer using magnetic resonance imaging with pharmacologically induced penile erection

  • G. Petralia
  • G. Villa
  • E. Scardino
  • E. Zoffoli
  • G. Renne
  • O. de Cobelli
  • M. Bellomi
Uro-Genital Radiology/Radiologia Uro-Genitale

Abstract

Purpose

This study was undertaken to compare the local staging of penile cancer by magnetic resonance imaging (MRI) combined with pharmacologically induced penile erection (PIPE), with clinical examination and pathology, and to verify whether MRI-PIPE led to changes in treatment planning in our cohort.

Materials and methods

Thirteen patients with untreated penile cancer underwent local staging by clinical examination and MRI-PIPE obtained by intracavernosal injection of 10 μg prostaglandin E1. Transverse, sagittal and coronal T2-weighted and T1-weighted (before and after intravenous gadolinium injection) images were obtained with a four-channel phased-array coil. Tumours were treated according to stage, as defined by MRI-PIPE and clinical examination. Stage T1 tumours underwent laser ablation and stage T2 or T3 tumours partial or total penectomy.

Results

Twelve penile cancers were squamous cell carcinomas and one was a sarcoma. MRI-PIPE correctly staged 12 out of 13 patients, failing to detect one in situ carcinoma. Clinical examination correctly staged eight out of 13 patients, overstaging two patients (one Tis was overstaged as T1 and one T1 as T2) and understaging three patients (two T2 as T1 and one T3 as T2).

Conclusion

MRI-PIPE performed better than the clinical examination and changed treatment planning in three patients.

Keywords

Penile cancer Magnetic resonance imaging Intracavernosal injection of prostaglandin E1 (PGE1) Tunica albuginea Preoperative local staging 

Stadiazione locale del tumore del pene con risonanza magnetica abbinata a test di farmacoinfusione intracavernosa (RM-TFI)

Riassunto

Obiettivi

Confrontare la stadiazione locale del tumore del pene definita con la risonanza magnetica abbinata all’erezione farmacologicamente indotta con iniezione intracavernosa di prostaglandine (RM con test di farmacoinfusione intracavernosa, RM-TFI) con l’esame clinico e con l’anatomia patologica. Verificare se la RM-TFI abbia determinato cambiamenti nella strategia terapeutica.

Materiali e metodi

Tredici pazienti con tumore del pene mai trattato sono stati esaminati con RM-TFI (ottenuta con iniezione intracavernosa di 10 μg di prostaglandine E1). Sono state acquisite immagini assiali, coronali e sagittali pesate in T2 e T1 (prima e dopo iniezione endovenosa di gadolinio), utilizzando una bobina phased-array a quattro canali. In accordo con la stadiazione della RM-TFI e dell’esame clinico, i tumori in stadio T1 sono stati sottoposti ad ablazione laser, mentre i tumori T2 e T3 a penectomia parziale o totale.

Risultati

Dodici tumori del pene sono risultati squamocellulari e uno sarcoma. La RM-TFI ha stadiato correttamente dodici pazienti su tredici, non riconoscendo la presenza di un carcinoma in situ, e l’esame clinico otto pazienti su tredici, sovrastadiando due pazienti (un carcinoma in situ come T1 ed uno stadio T1 come T2) e sottostadiando tre pazienti (due stadi T2 come T1 ed uno stadio T3 come T2).

Conclusioni

La RM-TFI si è dimostrata superiore all’esame clinico e ha modificato la strategia terapeutica in tre pazienti.

Parole chiave

Tumore del pene Risonanza magnetica Iniezione intracavernosa di prostaglandine E1 (PGE1) Tonaca albuginea Stadiazione locale pre-operatoria 

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Copyright information

© Springer-Verlag Italia 2008

Authors and Affiliations

  • G. Petralia
    • 1
  • G. Villa
    • 1
  • E. Scardino
    • 2
  • E. Zoffoli
    • 3
  • G. Renne
    • 4
  • O. de Cobelli
    • 2
    • 3
  • M. Bellomi
    • 1
    • 3
  1. 1.Divisione di RadiologiaIstituto Europeo di Oncologia IRCCSMilanoItaly
  2. 2.Divisione di UrologiaIstituto Europeo di Oncologia IRCCSMilanoItaly
  3. 3.Facoltà di Medicina e ChirurgiaUniversità degli Studi di MilanoMilanoItaly
  4. 4.Divisione di Anatomia Patologica e Medicina di LaboratorioIstituto Europeo di Oncologia IRCCSMilanoItaly

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