Abdominal Imaging

, Volume 40, Issue 7, pp 2814–2838

Post-treated prostate cancer: normal findings and signs of local relapse on multiparametric magnetic resonance imaging

  • João Lopes Dias
  • Rita Lucas
  • João Magalhães Pina
  • Raquel João
  • Nuno Vasco Costa
  • Cecília Leal
  • Tiago Bilhim
  • Luís Campos Pinheiro
  • Rui Mateus Marques
Pictorial Essay

DOI: 10.1007/s00261-015-0473-1

Cite this article as:
Lopes Dias, J., Lucas, R., Magalhães Pina, J. et al. Abdom Imaging (2015) 40: 2814. doi:10.1007/s00261-015-0473-1

Abstract

The use of multiparametric magnetic resonance imaging (mp-MRI) for prostate cancer has increased over recent years, mainly for detection, staging, and active surveillance. However, suspicion of recurrence in the set of biochemical failure is becoming a significant reason for clinicians to request mp-MRI. Radiologists should be able to recognize the normal post-treatment MRI findings. Fibrosis and atrophic remnant seminal vesicles after prostatectomy are often found and must be differentiated from local relapse. Moreover, brachytherapy, external beam radiotherapy, cryosurgery, and hormonal therapy tend to diffusely decrease the signal intensity of the peripheral zone on T2-weighted images (T2WI) due to the loss of water content, consequently mimicking tumor and hemorrhage. The combination of T2WI and functional studies like diffusion-weighted imaging and dynamic contrast-enhanced improves the identification of local relapse. Tumor recurrence tends to restrict on diffusion images and avidly enhances after contrast administration either within or outside the gland. The authors provide a pictorial review of the normal findings and the signs of local tumor relapse after radical prostatectomy, external beam radiotherapy, brachytherapy, cryosurgery, and hormonal therapy.

Keywords

Prostate cancer Multiparametric resonance imaging Recurrence 

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • João Lopes Dias
    • 1
    • 5
    • 6
  • Rita Lucas
    • 2
  • João Magalhães Pina
    • 3
    • 6
  • Raquel João
    • 3
    • 6
  • Nuno Vasco Costa
    • 1
    • 6
  • Cecília Leal
    • 4
    • 6
  • Tiago Bilhim
    • 1
    • 6
  • Luís Campos Pinheiro
    • 1
    • 6
  • Rui Mateus Marques
    • 1
    • 6
  1. 1.Department of RadiologyHospital de S. JoséLisbonPortugal
  2. 2.Department of RadiologyHospital de Santo António dos CapuchosLisbonPortugal
  3. 3.Department of UrologyHospital de S. JoséLisbonPortugal
  4. 4.Department of RadiologyHospital de Santa MartaLisbonPortugal
  5. 5.LisbonPortugal
  6. 6.Faculdade de Ciências MédicasNova Medica SchoolLisbonPortugal

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