European Radiology

, Volume 19, Issue 3, pp 761–769

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

  • Stefano Cirillo
  • Massimo Petracchini
  • Lorenza Scotti
  • Teresa Gallo
  • Annalisa Macera
  • Maria Cristina Bona
  • Cinzia Ortega
  • Pietro Gabriele
  • Daniele Regge
Urogenital

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.

Keywords

Magnetic resonance imaging Prostatic neoplasm Prostatectomy Local neoplasm recurrence Contrast media 

References

  1. 1.
    Crawford ED (2003) Epidemiology of prostate cancer. Urology 62:3–12CrossRefPubMedGoogle Scholar
  2. 2.
    Jemal A, Siegel R, Ward E et al (2008) Cancer statistics, 2008. CA Cancer J Clin 58:71–96CrossRefPubMedGoogle Scholar
  3. 3.
    Shibata A, Whittemore AS (1998) Prostate cancer incidence and mortality in the United States and the United Kingdom. J Natl Cancer I 93:1109–1110CrossRefGoogle Scholar
  4. 4.
    Lu-Yao GL, Greenberg ER (1994) Change in prostate cancer incidence and treatment in USA. Lancet 343:251–254CrossRefPubMedGoogle Scholar
  5. 5.
    Lu-Yao GL, Yao S (1997) Population-based study of long-term survival in patients with clinically localized prostate cancer. Lancet 349:906–910CrossRefPubMedGoogle Scholar
  6. 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 169:517–23CrossRefPubMedGoogle Scholar
  7. 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 164:101–105CrossRefPubMedGoogle Scholar
  8. 8.
    Catalona WJ, Smith DS (1994) 5-year tumor recurrence rates after anatomical radical retropubic prostatectomy for prostate cancer. J Urol 152:1837–1842PubMedGoogle Scholar
  9. 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 174:1276–1281CrossRefPubMedGoogle Scholar
  10. 10.
    Kattan MW, Wheeler TM, Scardino PT (1999) Postoperative nomogram for disease recurrence after radical prostatectomy for prostate cancer. J Clin Oncol 17:1499–1507PubMedGoogle Scholar
  11. 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 152:1821–1825PubMedGoogle Scholar
  12. 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):1850–1857Google Scholar
  13. 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 162:293–300CrossRefPubMedGoogle Scholar
  14. 14.
    Freedland SJ, Sutter ME, Dorey F, Aronson WJ (2003) Defining the ideal cutpoint for determining PSA recurrence after radical prostatectomy. Urology 61:365–369CrossRefPubMedGoogle Scholar
  15. 15.
    Laufer M, Pound CR, Carducci MA, Eisenberger MA (2000) Management of patients with rising prostate-specific antigen after radical prostatectomy. Urology 55:309–315CrossRefPubMedGoogle Scholar
  16. 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 165:1146–1151CrossRefPubMedGoogle Scholar
  17. 17.
    Scattoni V, Montorsi F, Picchio M et al (2004) Diagnosis of local recurrence after radical prostatectomy. BJU Int 93:680–688CrossRefPubMedGoogle Scholar
  18. 18.
    Sella T, Schwartz LH, Swindle PW et al (2004) Suspected local recurrence after radical prostatectomy: endorectal coil MR imaging. Radiology 231:379–385CrossRefPubMedGoogle Scholar
  19. 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 61:607–611CrossRefPubMedGoogle Scholar
  20. 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 160:1387–1391CrossRefPubMedGoogle Scholar
  21. 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 162:1322–1328CrossRefPubMedGoogle Scholar
  22. 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 190:315–322PubMedGoogle Scholar
  23. 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 25:3281–3287CrossRefPubMedGoogle Scholar
  24. 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 137:157–166PubMedGoogle Scholar
  25. 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 33:1387–1398CrossRefPubMedGoogle Scholar
  26. 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 35:9–17CrossRefPubMedGoogle Scholar
  27. 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 44:32–38CrossRefPubMedGoogle Scholar
  28. 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 74:214–220CrossRefPubMedGoogle Scholar
  29. 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 168:379–385Google Scholar
  30. 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 17:1155PubMedGoogle Scholar
  31. 31.
    Leventis AK, Shariat SF, Slawin KM (2001) Local recurrence after radical prostatectomy. Correlation of US features with prostatic fossa biopsy findings. Radiology 219:432–439PubMedGoogle Scholar
  32. 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 147:1307–1309PubMedGoogle Scholar
  33. 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 144:707–709PubMedGoogle Scholar
  34. 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 147:952–955PubMedGoogle Scholar
  35. 35.
    Kapoor DA, Wasserman NF, Zhang G, Reddy PK (1993) Value of transrectal ultrasound in identifying local disease after radical prostatectomy. Urology 41:594–597CrossRefPubMedGoogle Scholar
  36. 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 149:1024–1028PubMedGoogle Scholar
  37. 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 70:995–999PubMedGoogle Scholar
  38. 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 42:25–30PubMedGoogle Scholar
  39. 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 8:43–48CrossRefPubMedGoogle Scholar
  40. 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 29:1380–1384CrossRefPubMedGoogle Scholar
  41. 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 99:1415–1420CrossRefPubMedGoogle Scholar
  42. 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 100:786–793CrossRefPubMedGoogle Scholar

Copyright information

© European Society of Radiology 2008

Authors and Affiliations

  • Stefano Cirillo
    • 1
  • Massimo Petracchini
    • 1
  • Lorenza Scotti
    • 2
  • Teresa Gallo
    • 1
  • Annalisa Macera
    • 1
  • Maria Cristina Bona
    • 3
  • Cinzia Ortega
    • 4
  • Pietro Gabriele
    • 3
  • Daniele Regge
    • 1
  1. 1.Unit of RadiologyInstitute for Cancer Research and TreatmentCandioloItaly
  2. 2.Department of StatisticUniversity of Milano—BicoccaMilanoItaly
  3. 3.Unit of RadiotheraphyInstitute for Cancer Research and TreatmentCandioloItaly
  4. 4.Unit of OncologyInstitute for Cancer Research and TreatmentCandioloItaly

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