The objective of the present essay was to describe the clinical value of bimodal 18F-choline-PET/mMRI and trimodal 18F-Choline-PET/MRI/TRUS fusion imaging in the assessment of PCa recurrence after both radical prostatectomy (RP) and radiation therapy (RT).
Radical prostatectomy (RP) and radiation therapy (RT) are well-established primary therapeutic options in the management of prostate cancer (PCa).
Despite technical improvements,
there is still a considerable risk of cancer recurrence after therapy.
27-53% of all patients undergoing radical prostatectomy (RP) or radiation therapy (RT) develop prostate-specific antigen (PSA) recurrence (biochemical recurrence) .
In PCa patients with a clinical suspicion of recurrence,
imaging plays a pivotal role in distinguishing between local recurrence and metastatic disease (i.e.
lymph-node and skeletal metastases),
with important implications in...
Findings and procedure details
Bimodal 18F-Choline-PET/mMRI fusion imaging to detect local recurrence after radical prostatectomy and radiation therapy.
Image fusion is the process of combining relevant information from two or more images into a single image,
which is more informative than either of the images separately .
To combine anatomical,
functional and metabolic information obtained from different modalities at different times,
the process of spatial co-registration is necessary,
in order to ensure that the pixels from the various imaging datasets represent the same volume with acceptable precision [13,
The performance of pelvic mpMRI is superior to that of choline-PET in depicting local relapse after RP and RT,
whereas choline PET/CT is more accurate than mpMRI in detecting metastatic disease in pelvic lymph nodes.
Both modalities are excellent in the assessment of skeletal metastases.
The combination of mpMRI and choline-PET/CT provides a comprehensive assessment for the restaging of patients with biochemical recurrence after RP and RT,
thus allowing local recurrence to be distinguished from metastatic disease.
Bimodal 18F-choline-PET/mpMRI fusion imaging provides simultaneous reading and...
Luca Cevasco MD,
School of Radiology
University of Genoa,
Van der Kwast T,
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