INTRODUCTION: To evaluate the ability of endorectal coil (e-coil) magnetic resonance imaging (MRI) to identify early prostatic fossa recurrence after radical prostatectomy. MATERIALS AND METHODS: We identified 187 patients from 2005-2011 who underwent e-coil MRI with dynamic gadolinium-contrast enhancement followed by transrectal ultrasound (TRUS) guided prostatic fossa biopsy for possible local prostate cancer recurrence. For analysis, local recurrence was defined as a negative evaluation for distant metastatic disease with a positive prostatic fossa biopsy, decreased prostate-specific antigen (PSA) following salvage radiation therapy, or increased lesion size on serial imaging. RESULTS: Local recurrence was identified in 132 patients, with 124 (94%) detected on e-coil MRI. The median PSA was 0.59 ng/mL (range < 0.1-13.1), and median lesion size on MRI was 1 cm. The sensitivity of MRI was 91%, with a specificity of 45%. The positive predictive value was 85%, with a negative predictive value of 60%. For patients with a PSA < 0.4 ng/mL the sensitivity of e-coil MRI was 86%. When a lesion was identified on MRI, the positive biopsy rate was 65% and lesion size was a significant predictor of positive biopsies. The positive biopsy rates were 51%, 74%, and 88% when the lesion was < 1 cm, 1 cm-2 cm, or > 2 cm, respectively (p = 0.0006). CONCLUSIONS: E-coil MRI has a high level of sensitivity in identifying local recurrence of prostate cancer following radical prostatectomy, even at low PSA levels. E-coil MRI should be considered as the first imaging evaluation for biochemical recurrence for identifying patients suitable for localized salvage therapy.
INTRODUCTION: To evaluate the ability of endorectal coil (e-coil) magnetic resonance imaging (MRI) to identify early prostatic fossa recurrence after radical prostatectomy. MATERIALS AND METHODS: We identified 187 patients from 2005-2011 who underwent e-coil MRI with dynamic gadolinium-contrast enhancement followed by transrectal ultrasound (TRUS) guided prostatic fossa biopsy for possible local prostate cancer recurrence. For analysis, local recurrence was defined as a negative evaluation for distant metastatic disease with a positive prostatic fossa biopsy, decreased prostate-specific antigen (PSA) following salvage radiation therapy, or increased lesion size on serial imaging. RESULTS: Local recurrence was identified in 132 patients, with 124 (94%) detected on e-coil MRI. The median PSA was 0.59 ng/mL (range < 0.1-13.1), and median lesion size on MRI was 1 cm. The sensitivity of MRI was 91%, with a specificity of 45%. The positive predictive value was 85%, with a negative predictive value of 60%. For patients with a PSA < 0.4 ng/mL the sensitivity of e-coil MRI was 86%. When a lesion was identified on MRI, the positive biopsy rate was 65% and lesion size was a significant predictor of positive biopsies. The positive biopsy rates were 51%, 74%, and 88% when the lesion was < 1 cm, 1 cm-2 cm, or > 2 cm, respectively (p = 0.0006). CONCLUSIONS: E-coil MRI has a high level of sensitivity in identifying local recurrence of prostate cancer following radical prostatectomy, even at low PSA levels. E-coil MRI should be considered as the first imaging evaluation for biochemical recurrence for identifying patients suitable for localized salvage therapy.
Authors: Martin T Freitag; Jan P Radtke; Ali Afshar-Oromieh; Matthias C Roethke; Boris A Hadaschik; Martin Gleave; David Bonekamp; Klaus Kopka; Matthias Eder; Thorsten Heusser; Marc Kachelriess; Kathrin Wieczorek; Christos Sachpekidis; Paul Flechsig; Frederik Giesel; Markus Hohenfellner; Uwe Haberkorn; Heinz-Peter Schlemmer; A Dimitrakopoulou-Strauss Journal: Eur J Nucl Med Mol Imaging Date: 2016-12-17 Impact factor: 9.236
Authors: Jennifer S McDonald; Rickey E Carter; R Jeffrey Karnes; John D Port; Akira Kawashima; Stephanie K Carlson; Claire E Bender Journal: AJR Am J Roentgenol Date: 2015-11 Impact factor: 3.959
Authors: Hebert Alberto Vargas; Alexandre G Martin-Malburet; Toshikazu Takeda; Renato B Corradi; James Eastham; Andreas Wibmer; Evis Sala; Michael J Zelefsky; Wolfgang A Weber; Hedvig Hricak Journal: Urol Oncol Date: 2016-06-23 Impact factor: 3.498