Locally Recurrent Prostate Cancer After High-Dose-Rate Brachytherapy: The Value of Diffusion-Weighted Imaging, Dynamic Contrast-Enhanced MRI, and T2-Weighted Imaging in Localizing Tumors

Tamada, Tsutomu; Sone, Toshio; Jo, Yoshimasa; Hoshino, Junichi; Higaki, Atsushi; Higashi, Hideyuki; Ito, Katsuyoshi

doi:10.2214/ajr.10.5772

Cited by 58 publications

(45 citation statements)

References 35 publications

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“…In a series of 16 patients who underwent HDR brachytherapy, the consensus sensitivity of 2 readers for detecting recurrence was 77%, and the PPV was 68% (15 Our consensus sensitivity was comparable at 88.2%. Average PPV was also comparable at 62%.…”

Section: Discussionmentioning

confidence: 64%

Multiparametric MRI for the detection of local recurrence of prostate cancer in the setting of biochemical recurrence after low dose rate brachytherapy

Valle¹,

Greer²,

Shih³

et al. 2018

Diagn Interv Radiol

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PURPOSEProstate multiparametric magnetic resonance imaging (mpMRI) has utility in detecting post-radiotherapy local recurrence. We conducted a multireader study to evaluate the diagnostic performance of mpMRI for local recurrence after low dose rate (LDR) brachytherapy. METHODSA total of 19 patients with biochemical recurrence after LDR brachytherapy underwent 3T endorectal coil mpMRI with T2-weighted imaging, dynamic contrast-enhanced imaging (DCE) and diffusion-weighted imaging (DWI) with pathologic confirmation. Prospective reads by an experienced prostate radiologist were compared with reads from 4 radiologists of varying experience. Readers identified suspicious lesions and rated each MRI detection parameter. MRI-detected lesions were considered true-positive with ipsilateral pathologic confirmation. Inferences for sensitivity, specificity, positive predictive value (PPV), kappa, and index of specific agreement were made with the use of bootstrap resampling. RESULTSPathologically confirmed recurrence was found in 15 of 19 patients. True positive recurrences identified by mpMRI were frequently located in the transition zone (46.7%) and seminal vesicles (30%). On patient-based analysis, average sensitivity of mpMRI was 88% (standard error [SE], 3.5%). For highly suspicious lesions, specificity of mpMRI was 75% (SE, 16.5%). On lesion-based analysis, the average PPV was 62% (SE, 6.7%) for all lesions and 78.7% (SE, 10.3%) for highly suspicious lesions. The average PPV for lesions invading the seminal vesicles was 88.8% (n=13). The average PPV was 66.6% (SE, 5.8%) for lesions identified with T2-weighted imaging, 64.9% (SE, 7.3%) for DCE, and 70% (SE, 7.3%) for DWI. CONCLUSIONThis series provides evidence that mpMRI after LDR brachytherapy is feasible with a high patient-based cancer detection rate. Radiologists of varying experience demonstrated moderate agreement in detecting recurrence.You may cite this article as: Valle LF, Greer MD, Shih JH, et al. Multiparametric MRI for the detection of local recurrence of prostate cancer in the setting of biochemical recurrence after low dose rate brachytherapy. Diagn Interv Radiol 2018; 24: 46-53.

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Section: Discussionmentioning

confidence: 64%

Multiparametric MRI for the detection of local recurrence of prostate cancer in the setting of biochemical recurrence after low dose rate brachytherapy

Valle¹,

Greer²,

Shih³

et al. 2018

Diagn Interv Radiol

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“…The addition of dynamic contrast enhancement allows assessment of neoangiogenesis, while diffusion weighting provides better spatial resolution and more accurate lesion identification compared to conventional T2-weighted MRI [32]. Furthermore, the addition of spectroscopy has also improved the specificity and diagnostic accuracy of MRI by adding a functional assessment through measuring metabolite levels such as choline, which is increased in PCa, and citrate, which is decreased [33].…”

Section: Imagingmentioning

confidence: 99%

Management of Biochemical Recurrence After Primary Treatment of Prostate Cancer: A Systematic Review of the Literature

et al. 2013

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Context: Despite excellent cancer control with the treatment of localized prostate cancer (PCa), some men will experience a recurrence of disease. The optimal management of recurrent disease remains uncertain. Objective: To systematically review recent literature regarding management of biochemical recurrence after primary treatment for localized PCa. Evidence acquisition: A comprehensive systematic review of the literature was performed from 2000 to 2012 to identify articles pertaining to management after recurrent PCa. Search terms included prostate cancer recurrence, salvage therapy, radiorecurrent prostate cancer, post HIFU, post cryoablation, postradiation, and postprostatectomy salvage. Studies were selected according to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines and required to provide a comprehensive description of primary and secondary treatments along with outcomes. Evidence synthesis: The data from 32 original publications were reviewed. The most common option for local salvage therapy after radical prostatectomy (RP) was radiation. Options for local salvage therapy after primary radiation included RP, brachytherapy, and cryotherapy. Different definitions of recurrence and risk profiles among patients make comparative assessment among salvage treatment modalities difficult. Triggers for intervention and factors predicting response to salvage therapy vary. Conclusions: Radiation therapy (RT) after RP can provide durable prostate-specific antigen (PSA) responses in a sizeable percentage of men, especially when given early (ie, PSA <1 ng/ml). Though a few studies suggest improvements in mortality, prospective randomized trials are needed and underway. The role of salvage treatment after RT is less clear.

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“…DW-MRI has recently been introduced as an innovative diagnostic tool in the study of microstructural and functional changes in several pathologies of various organs without contrast medium [6]. In the field of urologic oncology, DW-MRI has various applications, mainly related to the characterization of focal renal masses and the detection of prostate and bladder cancer [7].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, some authors have described the high sensitivity of DWI in detecting recurrent PCa after brachytherapy [6] and RRP [7].…”

mentioning

confidence: 99%

A Case of Prostate Cancer Recurrence in the Bladder Wall after Radical Prostatectomy: The Role of Diffusion-Weighted and Dynamic Contrast-Enhanced Magnetic Resonance Imaging

Gaudiano¹,

Busato²,

Cecchelli³

et al. 2016

UROL

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Locally Recurrent Prostate Cancer After High-Dose-Rate Brachytherapy: The Value of Diffusion-Weighted Imaging, Dynamic Contrast-Enhanced MRI, and T2-Weighted Imaging in Localizing Tumors

Abstract: These results indicate that a multiparametric MRI protocol that includes DWI provides a sensitive method to detect local recurrence after HDR brachytherapy.

Cited by 58 publications

References 35 publications

Multiparametric MRI for the detection of local recurrence of prostate cancer in the setting of biochemical recurrence after low dose rate brachytherapy

Multiparametric MRI for the detection of local recurrence of prostate cancer in the setting of biochemical recurrence after low dose rate brachytherapy

Management of Biochemical Recurrence After Primary Treatment of Prostate Cancer: A Systematic Review of the Literature

A Case of Prostate Cancer Recurrence in the Bladder Wall after Radical Prostatectomy: The Role of Diffusion-Weighted and Dynamic Contrast-Enhanced Magnetic Resonance Imaging

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