Learning objectives
To review the normal magnetic resonance imaging (MRI) findings of the prostatic region after different kinds of treatment for prostate cancer (PCa).
To illustrate the most frequent MRI patterns of residual and recurrence prostate cancer after different kinds of treatment for PCa.
Background
The primary treatments for PCa are: radical prostatectomy (RP),
radiation therapy (RT) via either external beam RT (EBRT) or brachytherapy,
cryotherapy,
high-intensity focused ultrasound (HIFU) and laser interstitial thermal therapy.
Radical prostatectomy and radiation therapy are treatments with curative intent.
The focal ablative techniques,
such as cryotherapy,
HIFU and laser interstitial thermal therapy,
are minimally invasive procedures not completely established yet.
The first sign of recurrent PCa is a rising PSA,
but biochemical failure is not synonymous with local recurrence; so,
it is crucial to...
Findings and procedure details
All multiparametric MRI (mpMRI) examinations are performed with a 1,5T scanner (Avanto,
Siemens) using a phased array body coil and a dedicated endorectal coil.
Our mp-MRI protocol includes: high spatial resolution T2-weighted sequences with small field of view in axial,
sagittal e coronal plane; wide field of view T2-weighted sequence from renal hilum to the pubic symphysis to detect nodal involvement; axial diffusion-weighted sequence with b-value 50-400-1200 and ADC map; axial dynamic T1 contrast-enhanced sequence with high temporal resolution (7 sec.
per phase,
4 min....
Conclusion
MRI can play an important role when there is clinical or biochemical suspicion of residual or recurrent disease after treatment.
In particular,
MRI allows the differentiation between residual glandular healthy tissue,
scar/fibrotic tissue,
granulation tissue and tumor recurrence.
It is mandatory for a radiologist to distinguish normal and pathological findings of the prostatic region to allow patients to be correctly worked up.
Personal information
G.
Di Costanzo: Department of Radiology,
Santa Maria delle Grazie Hospital,
Pozzuoli (Naples,
Italy)
L.
Palumbo: Department of Radiology,
Santa Maria delle Grazie Hospital,
Pozzuoli (Naples,
Italy)
A.
Ponsiglione: Department of Advanced Biomedical Sciences,
University Federico II,
Naples (Italy)
G.
Gervasio: Department of Radiology,
Santa Maria delle Grazie Hospital,
Pozzuoli (Naples,
Italy)
A.
Ragozzino: Chief Department of Radiology,
Santa Maria delle Grazie Hospital,
Pozzuoli (Naples,
Italy)
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