Does incidental seminal vesicle invasion on RT planning MRI for an otherwise cT1-T2 patient influence your recommendation on ADT or pelvic fields?
How would you interpret this finding when MRI was not used in defining risk category for prostate cancer?
Answer from: Radiation Oncologist at Academic Institution
The finding of seminal vesicle invasion on either a diagnostic MR or planning MR would definitely raise concerns for more advanced and aggressive cancer than a DRE staged cT1-T2 prostate cancer. In most cases, there may be other indications of tumor aggressiveness that would precede an incidental fi...
Answer from: Radiation Oncologist at Community Practice
If the MRI is discordant with the rest of an otherwise "low-risk" or "low-intermediate-risk" lesion, I would typically refer the patient to urology for "involved" SV biopsy. More often than not, in my experience, a "(+)" MRI in this setting has been a FALSE "(+)" . . With a (-)...
Answer from: Radiation Oncologist at Academic Institution
I agree that seeing unexpected SVI could potentially alter management assuming that you believe the radiographic interpretation and that the finding is reasonably congruent with the clinical case otherwise.
Each practice will have its own test characteristics of MRI. ...
Answer from: Radiation Oncologist at Academic Institution
I would believe findings of mpMRI completed in 3T MR scanner, but I am not sure how much information a regular planning MR provides (planning MR protocol varies significantly among institutions). SV invasion in mpMRI definitely raises my concern that this is locally aggressive disease, and I w...