Commentary on ' Endorectal magnetic resonance imaging for predicting pathologic T3 disease in Gleason score 7 prostate cancer: Implications for prostate brachytherapy'

摘要

MRI has long been looked to as a potential tool to better select patients for prostate brachytherapy. The rationale is to use MRI to identify patients with substantial extracapsular extension (ECE), for whom brachytherapy is presumably inadequate treatment. Like Dr Pugh et al. (1), I find this rationale logical and compelling. However, there are several problems with the use of current MRI technology for treatment selection.First, after exhaustive imaging-pathology correlative studies, MRI is still widely deemed to be too inaccurate for surgical staging. If it is too inaccurate for presurgical staging, it is hard to believe that it is prime time ready for brachytherapy selection.