Accurate early detection of recurrent prostate cancer after surgical or nonsurgical treatment is increasingly relevant in the era of evolving options for salvage therapy. The importance of differentiating between local tumor recurrence, distant metastatic disease, and a combination of both in a patient with biochemical recurrence of prostate cancer is essential for appropriate treatment selection. Magnetic resonance imaging (MRI) is the best test for localization and characterization of locally residual or recurrent prostate cancer. It is essential for the radiologist involved in prostate MRI interpretation to be familiar with key imaging findings and advantages of different sequences to reach a confident diagnosis in the post-treatment setting. In this pictorial review, we present imaging findings of post-treatment prostate MRI including expected post-treatment anatomy and imaging characteristics, and the typical appearances of local tumor recurrence after radical prostatectomy, radiation therapy, and focal therapy for prostate cancer. While a multi-parametric MRI approach remains key just as in the treatment-naïve gland, this review emphasizes the much greater importance of the dynamic contrast-enhanced MRI sequence for evaluation in the post-treatment setting.
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This project was performed at the Departments of Radiology at Duke University Medical Center and Mayo Clinic—Rochester. There is no external or internal funding for this project.
Conflicts of interest
Rajan T. Gupta, M.D. declares that he has no conflict of interest. In the interest of full disclosure, Dr. Gupta is a consultant for Invivo Corp. Drs. Potretzke and Froemming declare that neither has a conflict of interest.
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Potretzke, T.A., Froemming, A.T. & Gupta, R.T. Post-treatment prostate MRI. Abdom Radiol (2019). https://doi.org/10.1007/s00261-019-02348-x
- Prostate cancer
- Magnetic resonance imaging
- Neoplasm recurrence