Radiology, Vol 125, 637-644, Copyright © 1977 by Radiological Society of North America
An evaluation of lymphography in localized carcinoma of the prostate
MC Spellman, RA Castellino, GR Ray, DA Pistenma and MA Bagshaw
Lymph node biopsies were positive in 20% (7/35) of stage T1 and T2 (stage
B) tumors and 64% (21/33) of stage T3 (stage C) tumors in 69 previously
untreated and unselected patients with apparently localized carcinoma of
the prostate. One patient with a To (stage A) tumor had no evidence of
lymph node metastasis. Prospective analysis demonstrated an overall
lymphographic accuracy of 78%, sensitivity of 57% and specificity of 92%.
The detection of lymph node metastases in the lymphogram is limited by the
frequency of microscopic metastasis and the frequency of benign changes
within pelvic lymph nodes in this older patient population. Diagnostic
criteria for metastatic disease which gives a low incidence of
false-positive interpretations should be maintained, since relaxing the
criteria will not necessarily improve the detection rate of metastases and
would decrease specificity.
