Multiparametric Magnetic Resonance Imaging Without Artificial Erection for Preoperative Staging of Primary Penile Carcinoma

European Urology Open Science · Published 2026-07-09 · DOI 10.1016/j.euros.2026.06.002

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Authors (10)

Marta D. Switlyk, Andreas Hopland, Andreas Tulipan, Shivanthe Sivanesan, Viktor Berge, Bjørn Brennhovd, Sigrun Dahl, Kjetil Berner, Ulrika Axcrona, Knut H. Hole

Abstract

Background and objective: Surgery is the most common treatment option for penile carcinoma. The aim of this prospective study was to strengthen the evidence for the use of multiparametric magnetic resonance imaging (mpMRI) without artificial erection in the preoperative assessment of penile cancer. Methods: Seventy-one patients with penile cancer referred between August 2022 and September 2025 were included. Preoperative mpMRI and fluorodeoxyglucose positron emission tomography with computed tomography (FDG-PET/CT) were performed. Correlation between mpMRI and histopathology for tumor diameter and infiltration depth, along with the sensitivity and specificity of mpMRI, physical examination and FDG-PET/CT for T and N staging, were recorded. Imaging differences between human papillomavirus (HPV)-positive and HPV-negative tumors were also recorded. Key findings and limitations: mpMRI was highly sensitive and specific for the assessment of T stage, involvement of anatomical structures, and detection of skip lesions. mpMRI performed better than physical examination for T staging and had lower sensitivity but higher specificity than FDG-PET/CT for regional N staging. Moreover, significant differences between HPV-positive and HPV-negative tumors were demonstrated on functional MRI. The impact of observer variability and the need for expertise and specialized training in interpreting penile MRI are not known and may be recognized as a limitation. Conclusions and clinical implications: In this prospective single-center cohort, mpMRI without artificial erection was associated with improved preoperative locoregional assessment compared with physical examination.

Abstract from DOAJ. Public domain (CC0 1.0).

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Publication details

Year
2026

Citation

Switlyk, M., Hopland, A., Tulipan, A., et al. (2026). Multiparametric Magnetic Resonance Imaging Without Artificial Erection for Preoperative Staging of Primary Penile Carcinoma. European Urology Open Science. https://doi.org/10.1016/j.euros.2026.06.002

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