Purpose
Prostate carcinoma (PCa) is one of the most common cancers in males.
Clinical screening of PCa,
based on combined digital rectal examination (DRE) and prostatic serum antigen (PSA),
has increased the detection of early-stage PCa that is curable with surgical resection [1].
After a successful radical prostatectomy (RP),
PSA becomes undetectable (<1.0 ng/mL) within one month [2].
Recurrent disease should be considered in presence of any increase of PSA after RP and should be suspected particularly when a trend of rising PSA in three consecutive...
Methods and Materials
1. Study population
From February 2009 to November 2012,
48 consecutive patients suspected of having a local recurrence of PCa,
were prospectively evaluated with MRI.
22/48 patients (age 67,86 ± 5,87 years),
in whom the presence/absence of local recurrence was established by biopsy or clinical follow-up (C-Choline PET/CT and PSA),
were identified.
The following information were collected: PSA values,
digital rectal examination (DRE) and TRUS findings closest to the time of MRI.
All patients who had undergone a biopsy within 90 days of MRI were...
Results
On the basis of biopsy and/or clinical follow-up,
11/22 patients had a local recurrence; in this group mean (± SD) PSA level was 1,64 ± 1,25 ng/ml,
at the time of MRI.
11/11 patients (100%) had positive MRI findings (Figure 2),
in detail: T2-weighted images showed an hyperintense nodule in 8/11 (72.7%); DWI showed an hyperintense nodule in 9/11 (82%) patients,; DCE-MRI showed type 1T/I curve in 3 (27%),
type 2 in 7 (64%) and type 3 in 1 (9%).
In patients without local recurrence,...
Conclusion
Endorectal-MRI is an important tool in the evaluation of post-prostatectomy bed,due to its high contrast resolution which is able to provide an excellent evaluation of the vesico-urethral anastomosis.
T2-weighted imaging alone showed an inferior diagnostic performance in detecting areas/nodules of local recurrence compared to DWI and DCE-MRI.
We demonstrated that DCE-MRI,
combined with DWI,
showed a better diagnostic performance in detecting areas of local recurrence compared to the two techniques evaluated separately.
In addition,
we suppose that a characterization of soft tissue in RP bed...
References
Nudell DM,
Wefer AE,
Hricak H,
Carroll PR.
Imaging for recurrent prostate cancer.
Radiol Clin North Am2000,38(1):213-229.
Katz S,
Rosen M.
MR imaging and MR spetroscopy in prostate cancer management .
Radiol Clin North Am 2006;44(5):723-734.
Drudi FM,
Giovagnorio F,
Carbone A,
Ricci P,
Petta S,
Cantisani V,
Ferrari FS,
Marchetti F,
Passariello R.
Transrectal color doppler contrast sonography in the diagnosis of local recurrence after radical prostatectomy – comparison with MRI.
Ultraschall in Med 2006; 27: 146–151.
Sciarra A,
Panebianco V,
Salciccia S,
Osimani...
