Skip to main content
SpringerLink
Log in

Endorectal magnetic resonance imaging at 1.5 Tesla to assess local recurrence following radical prostatectomy using T2-weighted and contrast-enhanced imaging

  • Urogenital
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

To evaluate diagnostic performance of endorectal magnetic resonance (eMR) for diagnosing local recurrence of prostate cancer (PC) in patients with previous radical prostatectomy (RP) and to assess whether contrast-enhanced (CE)-eMR improved diagnostic accuracy in comparison to unenhanced study. Unenhanced eMR data of 72 male patients (mean of total PSA: 1.23 ± 1.3 ng/ml) with previous RP were interpreted retrospectively and classified either as normal or suspicious for local recurrence. All eMR examinations were re-evaluated also on CE-eMR 4 months after the first reading. Images were acquired on a 1.5-T system. These data were compared to the standard of reference for local recurrence: prostatectomy bed biopsy results; choline positron emission tomography results; PSA reduction or increase after pelvic radiotherapy; PSA modification during active surveillance. Sensitivity, specificity, predictive positive value, negative predictive value and accuracy were 61.4%, 82.1%, 84.4%, 57.5% and 69.4% for unenhanced eMR and 84.1%, 89.3%, 92.5%, 78.1% and 86.1% for CE-eMR. A statistically significant difference was found between accuracy and sensitivity of the two evaluations (χ2 = 5.33; p = 0.02 and χ2 = 9.00; p = 0.0027). EMR had great accuracy for visualizing local recurrence of PC after RP. CE-eMR improved diagnostic performance in comparison with T2-weighted imaging alone.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Crawford ED (2003) Epidemiology of prostate cancer. Urology 62:3–12

    Article  PubMed  Google Scholar 

  2. Jemal A, Siegel R, Ward E et al (2008) Cancer statistics, 2008. CA Cancer J Clin 58:71–96

    Article  PubMed  Google Scholar 

  3. Shibata A, Whittemore AS (1998) Prostate cancer incidence and mortality in the United States and the United Kingdom. J Natl Cancer I 93:1109–1110

    Article  Google Scholar 

  4. Lu-Yao GL, Greenberg ER (1994) Change in prostate cancer incidence and treatment in USA. Lancet 343:251–254

    Article  CAS  PubMed  Google Scholar 

  5. Lu-Yao GL, Yao S (1997) Population-based study of long-term survival in patients with clinically localized prostate cancer. Lancet 349:906–910

    Article  CAS  PubMed  Google Scholar 

  6. Han M, Partin AW, Zahurak M, Piantadosi S, Epstein JI, Walsh PC (2003) Biochemical (prostate specific antigen) recurrence probability following radical prostatectomy for clinically localized prostate cancer. J Urol 169:517–23

    Article  PubMed  Google Scholar 

  7. Amling CL, Blute ML, Bergstralh EJ, Seay TM, Slezak J, Zincke H (2000) Long-term hazard of progression after radical prostatectomy for clinically localized prostate cancer: continued risk of biochemical failure after 5 years. J Urol 164:101–105

    Article  CAS  PubMed  Google Scholar 

  8. Catalona WJ, Smith DS (1994) 5-year tumor recurrence rates after anatomical radical retropubic prostatectomy for prostate cancer. J Urol 152:1837–1842

    CAS  PubMed  Google Scholar 

  9. Freedland SJ, Mangold LA, Walsh PC, Partin AW (2005) The prostatic specific antigen era is alive and well: prostatic specific antigen and biochemical progression following radical prostatectomy. J Urol 174:1276–1281

    Article  CAS  PubMed  Google Scholar 

  10. Kattan MW, Wheeler TM, Scardino PT (1999) Postoperative nomogram for disease recurrence after radical prostatectomy for prostate cancer. J Clin Oncol 17:1499–1507

    CAS  PubMed  Google Scholar 

  11. Trapasso JG, deKernion JB, Smith RB, Dorey F (1994) The incidence and significance of detectable levels of serum prostate specific antigen after radical prostatectomy. J Urol 152:1821–1825

    CAS  PubMed  Google Scholar 

  12. Zincke H, Oesterling JE, Blute ML, Bergstralh EJ, Myers RP, Barrett DM (1994) Long-term (15 years) results after radical prostatectomy for clinically localized (stage T2c or lower) prostate cancer. J Urol 1994; 152 5 Pt 2):1850–1857

    Google Scholar 

  13. Polascik TJ, Oesterling JE, Partin AW (1999) Prostate specific antigen. a decade of discovery – what we have learned and where we are going. J Urol 162:293–300

    Article  CAS  PubMed  Google Scholar 

  14. Freedland SJ, Sutter ME, Dorey F, Aronson WJ (2003) Defining the ideal cutpoint for determining PSA recurrence after radical prostatectomy. Urology 61:365–369

    Article  PubMed  Google Scholar 

  15. Laufer M, Pound CR, Carducci MA, Eisenberger MA (2000) Management of patients with rising prostate-specific antigen after radical prostatectomy. Urology 55:309–315

    Article  CAS  PubMed  Google Scholar 

  16. Amling CL, Bergstralh EJ, Blute ML, Slezak A, Zincke H (2001) Defining prostate specific antigen progression after radical prostatectomy: what is the most appropriate cutpoint? J Urol 165:1146–1151

    Article  CAS  PubMed  Google Scholar 

  17. Scattoni V, Montorsi F, Picchio M et al (2004) Diagnosis of local recurrence after radical prostatectomy. BJU Int 93:680–688

    Article  CAS  PubMed  Google Scholar 

  18. Sella T, Schwartz LH, Swindle PW et al (2004) Suspected local recurrence after radical prostatectomy: endorectal coil MR imaging. Radiology 231:379–385

    Article  PubMed  Google Scholar 

  19. Kane CJ, Amling CL, Johnstone PA et al (2003) Limited value of bone scintigraphy and computed tomography in assessing biochemical failure after radical prostatectomy. Urology 61:607–611

    Article  PubMed  Google Scholar 

  20. Cher ML, Bianco FJ Jr, Lam JS et al (1998) Limited role of radionuclide bone scintigraphy in patients with prostate specific antigen elevations after radical prostatectomy. J Urol 160:1387–1391

    Article  CAS  PubMed  Google Scholar 

  21. Seltzer MA, Barbaric Z, Belldegrun A et al (1999) Comparison of helical computerized tomography, positron emission tomography and monoclonal antibody scans for evaluation of lymph node metastases in patients with prostate specific antigen relapse after treatment for localized prostate cancer. J Urol 162:1322–1328

    Article  CAS  PubMed  Google Scholar 

  22. Oyen RH, van Poppel HP, Ameye FE et al (1994) Lymph node staging of localized prostatic carcinoma with CT and CT-guided fine-needle aspiration biopsy: prospective study of 285 patients. Radiology 190:315–322

    CAS  PubMed  Google Scholar 

  23. Lecouvet FE, Geukens D, Stainier A et al (2007) Magnetic resonance imaging of the axial skeleton for detecting bone metastases in patients with high-risk prostate cancer: diagnostic and cost-effectiveness and comparison with current detection strategies. J Clin Oncol 25:3281–3287

    Article  PubMed  Google Scholar 

  24. Walsh JW, Amendola MA, Konerding KF, Tisnado J, Hazra TA (1980) Computed tomographic detection of pelvic and inguinal lymph-node metastases from primary and recurrent pelvic malignant disease. Radiology 137:157–166

    CAS  PubMed  Google Scholar 

  25. Cimitan M, Bortolus R, Morassut S et al (2006) 18F-Fluorocholine PET/CT imaging for the detection of recurrent prostate cancer at PSA relapse: experience in 100 consecutive patients. Eur J Nucl Med Mol Imaging 33:1387–1398

    Article  PubMed  Google Scholar 

  26. Reske SN, Blumstein NM, Glatting G (2008) 11C-Choline PET/CT imaging in occult local relapse of prostate cancer after radical prostatectomy. Eur J Nucl Med Mol Imaging 35:9–17

    Article  PubMed  Google Scholar 

  27. De Jong IJ, Pruim J, Elsinga PH, Vaalburg W, Mensink HJ (2003) 11C-Choline positron emission tomography for the evaluation after treatment of localized prostate cancer. Eur Urol 44:32–38

    Article  PubMed  Google Scholar 

  28. Yoshida S, Nakagomi K, Goto S, Futatsubashi M, Torizuka T (2005) 11C-Choline positron emission tomography in prostate cancer: primary staging and recurrent site staging. Urol Int 74:214–220

    Article  CAS  PubMed  Google Scholar 

  29. Silverman JM, Krebs TL (1997) MR imaging evaluation with a transrectal surface coil of local recurrence of prostatic cancer in men who have undergone radical prostatectomy. Am J Roentgenol 168:379–385

    CAS  Google Scholar 

  30. Cox JD, Gallagher MJ, Hammond EH, Kaplan RS, Schellhammer PF (1999) Consensus statements on radiation therapy of prostate cancer: guidelines for prostate re-biopsy after radiation and for radiation therapy with rising prostate specific antigen levels after radical prostatectomy. American Society for Therapeutic Radiology and Oncology Consensus Panel. J Clin Oncol 17:1155

    CAS  PubMed  Google Scholar 

  31. Leventis AK, Shariat SF, Slawin KM (2001) Local recurrence after radical prostatectomy. Correlation of US features with prostatic fossa biopsy findings. Radiology 219:432–439

    CAS  PubMed  Google Scholar 

  32. Goldenberg SL, Carter M, Dashefsky S, Cooperberg PL (1992) Sonographic characteristics of the urethrovesical anastomosis in the early post-radical prostatectomy patient. J Urol 147:1307–1309

    CAS  PubMed  Google Scholar 

  33. Parra RO, Wolf RM, Huben RP (1990) The use of transrectal ultrasound in the detection and evaluation of local pelvic recurrences after a radical urological pelvic operation. J Urol 144:707–709

    CAS  PubMed  Google Scholar 

  34. Abi-Aad AS, Macfarlane MT, Stein A, deKernion JB (1992) Detection of local recurrence after radical prostatectomy by prostate specific antigen and transrectal ultrasound. J Urol 147:952–955

    CAS  PubMed  Google Scholar 

  35. Kapoor DA, Wasserman NF, Zhang G, Reddy PK (1993) Value of transrectal ultrasound in identifying local disease after radical prostatectomy. Urology 41:594–597

    Article  CAS  PubMed  Google Scholar 

  36. Foster LS, Jajodia P, Fournier G Jr, Shinohara K, Carroll P, Narayan P (1993) The value of prostate specific antigen and transrectal ultrasound guided biopsy in detecting prostatic fossa recurrences following radical prostatectomy. J Urol 149:1024–1028

    CAS  PubMed  Google Scholar 

  37. Kramer S, Gorich J, Gottfried HW et al (1997) Sensitivity of computed tomography in detecting local recurrence of prostatic carcinoma following radical prostatectomy. Br J Radiol 70:995–999

    CAS  PubMed  Google Scholar 

  38. Kotzerke J, Volkmer BG, Glatting G et al (2003) Intraindividual comparison of 11C-acetate and 11C-choline PET for detection of metastases of prostate cancer. Nuklearmedizin 42:25–30

    CAS  PubMed  Google Scholar 

  39. Heinisch M, Dirisamer A, Loidl W et al (2006) Positron emission tomography/computed tomography with F18-fluorocholine for restaging of prostate cancer patients: meaningful at PSA <5 ng/ml? Mol Imaging Biol 8:43–48

    Article  PubMed  Google Scholar 

  40. Kotzerke J, Volkmer BG, Neumaier B, Gschwend JE, Hautmann RE, Reske SN (2002) C11-Acetate positron emission tomography can detect local recurrence of prostate cancer. Eur J Nucl Med Mol Imaging 29:1380–1384

    Article  CAS  PubMed  Google Scholar 

  41. Vees H, Buchegger F, Albrecht S (2007) 18F-Choline and/or 11C-acetate positron emission tomography: detection of residual or progressive subclinical disease at very low prostate-specific antigen values (<1 ng/ml) after radical prostatectomy. BJU Int 99:1415–1420

    Article  CAS  PubMed  Google Scholar 

  42. Rinnab L, Mottaghy FM, Blumstein NM, Reske SN, Hautmann RE, Hohl K, Möller P, Wiegel T, Kuefer R, Gschwend JE (2007) Evaluation of 11C-choline positron-emission/computed tomography in patients with increasing prostate-specific antigen levels after primary treatment for prostate cancer. BJU Int 100:786–793

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Unit of Radiology, Institute for Cancer Research and Treatment, Strada Provinciale 142, Km 3.95, 10060, Candiolo, Torino, Italy

    Stefano Cirillo, Massimo Petracchini, Teresa Gallo, Annalisa Macera & Daniele Regge

  2. Department of Statistic, University of Milano—Bicocca, Milano, Italy

    Lorenza Scotti

  3. Unit of Radiotheraphy, Institute for Cancer Research and Treatment, Candiolo, Torino, Italy

    Maria Cristina Bona & Pietro Gabriele

  4. Unit of Oncology, Institute for Cancer Research and Treatment, Candiolo, Torino, Italy

    Cinzia Ortega

Authors
  1. Stefano Cirillo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Massimo Petracchini
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lorenza Scotti
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Teresa Gallo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Annalisa Macera
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Maria Cristina Bona
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Cinzia Ortega
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Pietro Gabriele
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Daniele Regge
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stefano Cirillo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cirillo, S., Petracchini, M., Scotti, L. et al. Endorectal magnetic resonance imaging at 1.5 Tesla to assess local recurrence following radical prostatectomy using T2-weighted and contrast-enhanced imaging. Eur Radiol 19, 761–769 (2009). https://doi.org/10.1007/s00330-008-1174-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-008-1174-8

Keywords

Search

Navigation