Imaging for the Detection of Locoregional Recurrences in Biochemical Progression After Radical Prostatectomy—A Systematic Review

Sandgren, Kristina; Westerlinck, Philippe; Jönsson, Johan; Blomqvist, Lennart; Karlsson, Camilla; Nyholm, Tufve; Dirix, Piet

doi:10.1016/j.euf.2017.11.001

Cited by 36 publications

(29 citation statements)

References 52 publications

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“…Secondly and separately, imaging at BCR also can rule--in and confirm loco--regional recurrence in order to plan salvage local treatment. mpMRI is the technique of choice here 78,77 . However, even where imaging is negative, pelvic bed EBRT is administered on the assumption that local recurrence is undetected at imaging, a strategy supported by several trials of salvage EBRT.…”

Section: Optimal Methods For Imaging Metastases In Patients With Biocmentioning

confidence: 99%

Use of modern imaging methods to facilitate trials of metastasis-directed therapy for oligometastatic disease in prostate cancer: a consensus recommendation from the EORTC Imaging Group

Lecouvet

Oprea-Lager

Liu

et al. 2018

The Lancet Oncology

103

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Oligometastatic disease (OMD) represents a clinical and anatomical manifestation between localized and polymetastatic disease. In prostate cancer, as with other cancers, recognition of OMD enables focal, metastases-directed therapies. These therapies potentially shorten or postpone the use of systemic treatment and may delay further metastatic progression, thus increasing overall survival. To validate their efficacy, metastases-directed therapies require imaging methods that definitively recognize OMD and reliably monitor response, particularly to avoid morbidity of inappropriately treating disease subsequently recognized as polymetastatic. This paper reviews current imaging methods used for identifying metastatic prostate cancer at first diagnosis, at biochemical recurrence (BCR), or at the castration resistant stage. Standard imaging methods recommended by current guidelines have insufficient diagnostic accuracy for reliably diagnosing OMD. Modern imaging methods using positron emission tomography /computed tomography (PET/CT) with tumour specific radiotracers (choline or PSMA ligand), and increasingly even whole-body magnetic resonance imaging (WB-MRI) with diffusion-weighted imaging (DWI), allow earlier and more precise identification of metastases. The EORTC Imaging Group suggests clinical algorithms for integrating modern imaging methods into the care pathway at the various stages of prostate cancer in order to identify OMD. Clinical trials utilizing modern imaging methods are proposed for evaluating the benefits of metastasis-directed therapies.

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Section: Optimal Methods For Imaging Metastases In Patients With Biocmentioning

confidence: 99%

Use of modern imaging methods to facilitate trials of metastasis-directed therapy for oligometastatic disease in prostate cancer: a consensus recommendation from the EORTC Imaging Group

Lecouvet

Oprea-Lager

Liu

et al. 2018

The Lancet Oncology

103

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“…The most frequent sites are the perianastomotic areas around the bladder neck or membranous urethra, the vesicorectal space, and the seminal vesicle remnants [39]. Other common recurrence sites are the anterior and lateral edges of the prostate (eg, abutting the levator ani muscles) [6,40]. The localisation of a local recurrence should be described in terms of the clock position, with the vesicourethral anastomosis at the centre of the clock.…”

Section: Recurrence Following Rtmentioning

confidence: 99%

Prostate Magnetic Resonance Imaging for Local Recurrence Reporting (PI-RR): International Consensus -based Guidelines on Multiparametric Magnetic Resonance Imaging for Prostate Cancer Recurrence after Radiation Therapy and Radical Prostatectomy

Panebianco

Villeirs

Weinreb

et al. 2021

European Urology Oncology

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Background: Imaging techniques are used to identify local recurrence of prostate cancer (PCa) for salvage therapy and to exclude metastases that should be addressed with systemic therapy. For magnetic resonance imaging (MRI), a reduction in the variability of acquisition, interpretation, and reporting is required to detect local PCa recurrence in men with biochemical relapse after local treatment with curative intent. Objective: To propose a standardised method for image acquisition and assessment of PCa local recurrence using MRI after radiation therapy (RP) and radical prostatectomy (RT). Evidence acquisition: Prostate Imaging for Recurrence Reporting (PI-RR) was formulated using the existing literature. An international panel of experts conducted a nonsystematic review of the literature. The PI-RR system was created via consensus through a combination of face-to-face and online discussions. Evidence synthesis: Similar to with PI-RADS, based on the best available evidence and expert opinion, the minimum acceptable MRI parameters for detection of

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“…The pooled sensitivities and specificities after radiation therapy were 82% and 74%, respectively (63). These findings were supported in another metaanalysis comprising 718 patients (64), with pooled sensitivities and specificities of 84% and 85%, respectively, for the use of mpMRI to detect local recurrence after radical prostatectomy. Barchetti et al (65) evaluated the performance of unenhanced WB MRI for the detection of lesions in the setting of BCR in 152 patients.…”

Section: Imaging In Bcr and Recurrent Disease After Treatmentmentioning

confidence: 63%

Multimodality Imaging of Prostate Cancer

2019

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Learning Objectives: On successful completion of this activity, participants should be able to describe (1) the various distinct clinical scenarios for prostate cancer; (2) the various imaging modalities available for use in prostate cancer; (3) the role of these imaging modalities in primary or recurrent prostate cancer and their advantages and disadvantages; and (4) the future potential of theranostic approaches and the evolving indications for contemporary hybrid imaging modalities such as PET/MRI and whole-body MRI. Financial Disclosure: Dr. Burger has received research grants and speaker honorarium from GE Healthcare. The authors of this article have indicated no other relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, SAM, and other credit types, participants can access this activity through the SNMMI website (http://www.snmmilearningcenter.org) through October 2022. Prostate cancer is a very heterogeneous disease, and contemporary management is focused on identification and treatment of the prognostically adverse high-risk tumors while minimizing overtreatment of indolent, low-risk tumors. In recent years, imaging has gained increasing importance in the detection, staging, posttreatment assessment, and detection of recurrence of prostate cancer. Several imaging modalities including conventional and functional methods are used in different clinical scenarios with their very own advantages and limitations. This continuing medical education article provides an overview of available imaging modalities currently in use for prostate cancer followed by a more specific section on the value of these different imaging modalities in distinct clinical scenarios, ranging from initial diagnosis to advanced, metastatic castration-resistant prostate cancer. In addition to established imaging indications, we will highlight some potential future applications of contemporary imaging modalities in prostate cancer.

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Imaging for the Detection of Locoregional Recurrences in Biochemical Progression After Radical Prostatectomy—A Systematic Review

Abstract: After reviewing imaging studies of recurrent prostate cancer after prostatectomy, we concluded that choline positron emission tomography and diffusion-weighted magnetic resonance imaging can be proposed as the current standard, with high sensitivity and specificity.

Cited by 36 publications

References 52 publications

Use of modern imaging methods to facilitate trials of metastasis-directed therapy for oligometastatic disease in prostate cancer: a consensus recommendation from the EORTC Imaging Group

Use of modern imaging methods to facilitate trials of metastasis-directed therapy for oligometastatic disease in prostate cancer: a consensus recommendation from the EORTC Imaging Group

Prostate Magnetic Resonance Imaging for Local Recurrence Reporting (PI-RR): International Consensus -based Guidelines on Multiparametric Magnetic Resonance Imaging for Prostate Cancer Recurrence after Radiation Therapy and Radical Prostatectomy

Multimodality Imaging of Prostate Cancer

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