Purpose
Despite radical treatment for clinically localized Prostate Cancer (PCa) with curative intent, early recurrence occurs between 27% and 53% of all men undergoing prostatectomy (RP)or radiotherapy (RT) [1]. In this background, the aim of the study wasto propose a standardized multiparametric magnetic resonance imaging (mpMRI) method for the acquisition, interpretation and reporting of prostate cancer (PCa) local recurrence diagnosis after radical prostatectomy (RP) and develop assessment categories that summarize levels of local recurrence suspicion.
Methods and materials
Arecurrence score was created and achieved through an evidence-based literature search in conjunction with professional experience.
Two radiologists (both with 5 years of experience in prostate mpMRI) prospectively and independently analyzed 65 mpMRI consecutive studies of men after radical prostatectomy with suspicion of prostate cancer (PCa) recurrence and PSA levels of 0.2- 1.5 ng/ml at the time of the exam. The protocol consisted of dynamic contrast enhanced (DCE), T2-weighted (T2W) and diffusion weighted (DWI) imaging, acquired at 3T scan.
Each mpMRI sequence was considered “positive”...
Results
A4-point score was elaborated to define the likelihood of local recurrence, based on the findings on DCE, T2W and DWI. In addition, we described the imaging characteristics of other tissues that might lead to a misdiagnosis, consisting with fibrosis, residual gland or inflammation.
Following the evaluation of the finding in each sequence, evaluated as "positive" or "negative" considering the presence or absence of several suspect characteristics in each sequence, an algorithm was developed with assessment categories (from 1 to 4) that reflect the increasing probability...
Conclusion
Our recurrence score is based on the different mpMRI features and has the aim to standardize the mpMRI evaluation and reporting and to estimate the probability of relapse after RP using a 4-point scale.Detection of PCa local recurrence is crucial in order to guide treatment decisions. For this reason, astandardized method of image assessment is needed to help in image analysis and reporting and to reduce variation in the acquisition, interpretation and reporting of prostate mpMRI in case of PCa local recurrence after RP.
Personal information and conflict of interest
M. Pecoraro; Rome/IT - nothing to disclose S. Cipollari; Rome/IT - nothing to disclose G. Anello; Rome/IT - nothing to disclose F. Giganti; London/UK - nothing to disclose R. Campa; Rome/IT - nothing to disclose M. Del Monte; Rome/IT - nothing to disclose C. Catalano; Rome/IT - nothing to disclose D. Fierro; Rome/IT - nothing to disclose V. Panebianco; Rome/IT - nothing to disclose
References
1.Mottet et al. EAU Guidelines: Prostate Cancer. EAU Guidelines (2019).