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Use of MRI and MRS With New Surgical Technique Proves Helpful

MRI and MRS can provide a roadmap of the prostate and assist in surgical planning of robotically assisted laparoscopic radical prostatectomy (RALRP), according to a recent study conducted by researchers at the University of California, Los Angeles.

'RALRP is an increasingly prevalent surgical approach which unlike a traditional, open radical prostatectomy offers no tactile feedback to the surgeon,' said Mittul Gulati, MD, lead author of the study. 'The surgery is intended to be a curative procedure, ideally done on patients with a life expectancy of greater than 10 years and a diagnosis of organ-confined (stage T2), or in the opinion of some, limited T3 disease,' said Dr. Gulati.

The study included 16 patients with prostate cancer who went on to have RALRP. Of the 16 patients, MRI/MRS correctly staged 12 of 16 patients. In three cases, MRI/MRS demonstrated extension of cancer outside the capsule and involvement of the neurovascular bundle (NVB) which allowed the surgeon to plan wide resection of the NVB on the involved side to achieve negative surgical margins.

'The MR imaging, if done accurately, can provide a road map of the prostate, telling the surgeon if one of the NVBs are involved before the patient is taken to surgery, and if so, what needs to be done to provide an effective operation,' said Dr. Gulati.


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