Multiparametric Magnetic Resonance Imaging of Recurrent Prostate Cancer

Abstract

There is growing consensus that multi-parametric MRI (mpMRI) is an effective modality in the detection of locally recurrent prostate cancer after prostatectomy and radiation therapy. The emergence of MR guided focal therapies, such as cryoablation, high-intensity focused ultrasound, and laser ablation, have made the use of mpMRI even more important, as the normal anatomy is inevitably altered and the detection of recurrence is made more difficult. The aim of this article is to review the utility of mpMRI in detecting recurrent prostate cancer in patients following radical prostatectomy (RP), radiation therapy (RT), and focal therapy (FT) and to discuss expected post-treatment mpMRI findings, the varied appearance of recurrent tumors, and their mimics.

The Role of Multiparametric Prostate Magnetic Resonance Imaging in Biochemical Recurrence

“…Işınlanan prostat dokusu mpMRG'de karakteristik değişiklikler gösterir. T2A görüntülemede radyasyon sonrası gland atrofisi ve fibrozis tüm glandda diffüz sinyal azalması olarak kendini gösterir (6). Tedavi edilmiş prostatın heterojen ve diffüz hipo-izointens sinyal özelliklerine rağmen zonal anatomi yine de ayırt edilebilir (26).…”

“…The aim of this article is to discuss mpMRI findings for detection of recurrent prostate cancer after various treatments. Keywords: Prostate cancer, biochemical recurrence, multiparametric prostate MRI Genellikle PSA değerindeki eşik değer üzeri (>0,2 ng/dL) seri artışlar RP sonrası BKN'nin tanımı için kullanılmaktadır (6). RT (7,8,9).…”

“…RT (7,8,9). Ama distorsiyona uğramış anatomi, fibrozis, cerrahi klipslerin neden olduğu artefaktlar ve MRG sinyal karakterinde farklılıklar gibi tedavi sonrası değişiklikler yorumlamayı belirgin şekilde zorlaştırmaktadır (6). Bu yüzden tedavi sonrası değişikler ile lokal nüksleri birbirinden ayırmak önemli bir konum kazanmaktadır.…”

PET Imaging of Recurrent and Metastatic Prostate Cancer with Novel Tracers

“…Primary definitive therapy options for PCa remain radiation therapy (RT) and radical prostatectomy (RP), which are used with curative intent, although both methods have improved over time. Despite the high success rates in primary treatment, 15-25% of patients still experience biochemical recurrence (BCR), following primary definitive therapy with RP or RT [2][3][4][5][6][7]. The definition of BCR varies between therapy methods.…”

“…The definition of BCR varies between therapy methods. For instance, following RP a rising PSA above 0.2 ng/ml defines BCR whereas following RT BCR is defined as a PSA change of 2.0 ng/ml above the nadir following RT and is known as the Phoenix criteria [7]. As rising PSA in post primary therapy patients is an indicator of PCa BCR, close monitoring of serum PSA levels following treatment is critical [7,8].…”