PURPOSE: To determine the morphologic changes in the prostate gland after cryosurgery and to assess the value of magnetic resonance (MR) imaging in detecting residual tumor. MATERIALS AND METHODS: Twenty-seven patients with prostate carcinoma underwent endorectal MR imaging after cryosurgery. Eighteen patients also underwent MR imaging before cryosurgery. MR findings were correlated with posttreatment clinical data, prostate-specific antigen level, and biopsy results. RESULTS: Mean prostate volume had decreased by 52% in patients examined 8 weeks or more after cryosurgery. Zonal differentiation was lost in 22 of 27 patients (81%). Areas of intraprostatic necrosis were identified in 14 of 27 patients (52%). A thick capsule enveloped the gland and neurovascular bundles in 24 of 27 patients (89%). Osteonecrosis of the symphysis pubis was seen in six of 27 patients (22%). Positive and negative predictive values for MR assessment of recurrent tumor were 44% and 73%, respectively. CONCLUSION: Cryosurgery-induced changes in the prostate gland preclude reliable detection of residual prostate carcinoma at MR imaging.
PURPOSE: To determine the morphologic changes in the prostate gland after cryosurgery and to assess the value of magnetic resonance (MR) imaging in detecting residual tumor. MATERIALS AND METHODS: Twenty-seven patients with prostate carcinoma underwent endorectal MR imaging after cryosurgery. Eighteen patients also underwent MR imaging before cryosurgery. MR findings were correlated with posttreatment clinical data, prostate-specific antigen level, and biopsy results. RESULTS: Mean prostate volume had decreased by 52% in patients examined 8 weeks or more after cryosurgery. Zonal differentiation was lost in 22 of 27 patients (81%). Areas of intraprostatic necrosis were identified in 14 of 27 patients (52%). A thick capsule enveloped the gland and neurovascular bundles in 24 of 27 patients (89%). Osteonecrosis of the symphysis pubis was seen in six of 27 patients (22%). Positive and negative predictive values for MR assessment of recurrent tumor were 44% and 73%, respectively. CONCLUSION: Cryosurgery-induced changes in the prostate gland preclude reliable detection of residual prostate carcinoma at MR imaging.
Authors: Berrend G Muller; Jurgen J Fütterer; Rajan T Gupta; Aaron Katz; Alexander Kirkham; John Kurhanewicz; Judd W Moul; Peter A Pinto; Ardeshir R Rastinehad; Cary Robertson; Jean de la Rosette; Rafael Sanchez-Salas; J Stephen Jones; Osamu Ukimura; Sadhna Verma; Hessel Wijkstra; Michael Marberger Journal: BJU Int Date: 2013-11-13 Impact factor: 5.588
Authors: Farid G Mitri; Brian J Davis; Azra Alizad; James F Greenleaf; Torrence M Wilson; Lance A Mynderse; Mostafa Fatemi Journal: IEEE Trans Biomed Eng Date: 2008-11 Impact factor: 4.538