Purpose
To report our initial experience using “whole body and dedicated prostate (WB+P)” MRI as a single exam for the assessment of local recurrence and metastatic disease in patients with suspected recurrent prostate cancer (PCa) after radical prostatectomy (RP).
Materials and Methods
IRB-approved retrospective single-center study. 76 consecutive patients with clinically suspected recurrent PCa following RP underwent combined WB+P-MRI in a single session (10/2014-01/2016). WB+P-MRI scans were evaluated for the detection of disease in the prostate bed, regional nodes and distant sites. Comparison was made to other imaging tests and prostate bed, node and bone biopsies, performed within 90-days.
Results and Conclusions
WB+P-MRI was completed successfully in all patients. Median PSA was 0.36 ng/ml (range:<0.05-56.12). WB+P-MRI identified suspected disease recurrence in 16/76 (21%) of patients (local recurrence in the RP bed in 6/76, nodal metastases in 3/76, osseous metastases in 4/76, and multifocal metastatic disease in 3/76). 43 patients had at least one standard staging scan in addition to WB+P-MRI, with concordance demonstrated between imaging modalities in 36/43(84%). All metastatic lesions detected on other imaging tests were detected on WB+P-MRI. In addition, WB+P-MRI detected osseous metastases in 4 patients with false-negative findings on other imaging tests (including 2 bone scans and 3 CT scans), and excluded osseous disease in 1 patient with a positive 18F-FDG-PET/CT, and subsequent negative bone biopsy.
Whole body and pelvic (WB+P) MRI is feasible in a clinical practice setting, and can provide incremental information when compared to standard imaging in men with suspected PCa recurrence following RP.