Prognosis and treatment of prostate cancer requires staging. Prostate carcinoma confined to the gland has a 5-year survival rate of 94 percent. With extracapsular extension, the 5-year survival rate is less than 70 percent. Transrectal ultrasound is not able to acceptably stage local prostate cancer. Ultrasound is unable to consistently identify the prostate capsule and subtle infiltration of tumor beyond the prostate. With the use of endorectal surface coil, MRI is able to routinely identify the tumor, the prostate capsule, the neurovascular bundles and surrounding periprostatic structures.

Suggested systematic approach to evaluate tumor extension:

Identify the tumor.
Identify the capsule and possible invasion.
Evaluate for periprostatic fat infiltration.
Evaluate the neurovascular bundles and other periprostatic vascular structures.
Evaluate abnormalities within the seminal vesicles.
Determine whether the base of the prostate is involved and whether extraprostatic extension at the base is present.
Identify the apex of the prostate and evaluate for possible tumor involvement and apical extension.
Identify any regional or extraregional lymph nodes.
Identify any bone involvement.