According to an article published in the International Journal of Radiation Oncology, Biology, Physics, endorectal coil magnetic resonance imaging (MRI) appears to improve the accuracy of seed implant placement for patients being treated for prostate cancer.

The prostate is a male sex gland that secretes a substance that forms a component of semen. It is approximately the size of a walnut and is located between the bladder and the rectum. Treatment options for prostate cancer often depend upon the extent of the disease, which is determined by where the cancer has spread and the volume of the cancer. One common treatment option for prostate cancer is the placement of radiation “seeds” directly into and surrounding the cancer. However, in order for seed implants to provide optimal results, it is important for the physician to know the exact location and extent of the cancer, as these factors determine where the seeds are placed. Physicians may utilize procedures such as a digital rectal exam (DRE), ultrasound, computed tomography (CT) or MRI prior to placing the seeds. Researchers are investigating new therapeutic approaches in order to improve upon the accuracy of placement of seed implants and thus, improve chances for an optimal treatment outcome.

Researchers from Inova Alexandria Cancer Center in Virginia recently conducted a clinical trial to determine if endorectal coil MRI may improve accuracy of seed placement in patients with prostate cancer. Endorectal coil MRI involves the placement of a probe into the patient’s rectum to allow technicians better visualization and detection of the spread of prostate cancer than conventional MRI. This trial included 327 patients with localized prostate cancer who underwent MRI, the majority of whom underwent endorectal coil MRI, following clinical staging by DRE. Patients were to undergo seed implantation with or without external beam radiation. MRI findings changed the stage, or extent, of cancer from the clinically assigned stage in 70% of patients. Furthermore, different treatment approaches were recommended to 18% of patients and the radiation seed placement was changed in 56% of patients following MRI results. Three years following therapy, 94% of patients did not experience a progression in their cancer.

These results indicate that endorectal coil MRI may be a valuable diagnostic procedure to accurately determine the extent of prostate cancer, which may ultimately lead to the most appropriate treatment decisions. In particular, patients undergoing seed implantation may derive great benefit from endorectal coil MRI in guiding proper placement of radiation seeds. Patients with prostate cancer may wish to speak with their physician about the risks and benefits of endorectal coil MRI or the participation in a clinical trial evaluating other novel diagnostic approaches. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (cancer.gov) and www.eCancerTrials.com. eCancerTrials.com also provides personalized clinical trial searches on behalf of patients.

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Reference: Clarke D, Banks S, Wiederhorn A, et al. The role of endorectal coil MRI in patient selection and treatment planning for prostate seed implants. I

nternational Journal of Radiation Oncology, Biology, Physics. 2002; 52:903-910.

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