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3-T multiparametric MRI characteristics of prostate cancer patients suspicious for biochemical recurrence after primary focal cryosurgery (hemiablation)

  • Urology - Original Paper
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Abstract

Introduction

We aimed to report on multiparametric MRI (mpMRI) characteristics of post-primary focal cryosurgery (PFC) patients suspected of biochemical recurrence (BCR) by the Phoenix criteria.

Methods

We retrospectively reviewed all patients at our institution who had undergone PFC. Prostate-specific antigen nadir was determined using 2 or more post-PFC values. Suspicion of BCR was determined using the Phoenix criteria (nadir + 2 ng/ml). At the discretion of the physician, pre-and post-PFC 3-T mpMRIs were obtained and in a few cases biopsies were performed.

Results

Ninety (58.4%) of 154 consecutive patients who underwent PFC were included in our analysis and had a median (range) age and prostate volume of 66.5 (48–82) years and 40.5 (16–175) ml, respectively. Of those suspected of BCR (37/90, 41.1%), with a median time to BCR of 19.9 (7.0–38.5) months, 27 patients (73.0%) underwent a post-PFC mpMRI. Twenty-two (81.5%) of these mpMRIs were found with 24 suspicious lesions. A considerable number (9/24, 37.5%) of these lesions were located in the central gland of the prostate. Seven of 24 lesions exhibited adverse mpMRI characteristic; 4 (16.7%) had capsular contact, 2 (8.2%) showed frank extracapsular extension, and 1 (4.2%) showed seminal vesicle invasion. Five (45.5%) of 11 patients with positive post-PFC mpMRIs were positive on biopsy (4/5, 80% were clinically significant prostate cancer).

Conclusion

Post-PFC mpMRI, at Phoenix suspicion of BCR, may help identify a significant number of patients failing post-PFC.

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Abbreviations

mpMRI:

Multiparametric magnetic resonance image

T2W:

T-2 weighted image

DWI:

Diffusion weighted image

DCE:

Dynamic contrast enhancement

ADC:

Apparent diffusion coefficient

TCC:

Tumor capsular contact

ECE:

Extracapsular extension

PIRADS:

Prostate image reporting and data system

PFC:

Primary focal cryosurgery

HIFU:

High-intensity focused ultrasound

PCa:

Prostate cancer

LR:

Low risk

IR:

Intermediate risk

HR:

High risk

TZ:

Transition zone

CZ:

Central zone

CG:

Central gland

PZ:

Peripheral zone

BCR:

Biochemical recurrence

PSA:

Prostate-specific antigen

AS:

Active surveillance

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Authors’ contribution

MK was involved in protocol, project development and manuscript writing. DMH was involved in the data collection/management. DJH was involved in the data collection/management. CCL read the MRIs, provided manuscript MRI images and edited the manuscript. KEK was involved in the data interpretation and manuscript editing. ATC edited the manuscript. AEK was involved in the manuscript editing and supervision.

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Authors and Affiliations

  1. Department of Urology, NYU-Winthrop University, 1300 Franklin Ave, Garden City, Mineola, NY, USA

    Michael Kongnyuy, Daniel M. Halpern, Kaitlin E. Kosinski, Anthony T. Corcoran & Aaron E. Katz

  2. Department of Radiology, NYU-Winthrop University, Mineola, NY, USA

    Corinne C. Liu

  3. St George’s University School of Medicine, St. George’s, Grenada

    David J. Habibian

Authors
  1. Michael Kongnyuy
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  2. Daniel M. Halpern
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  3. Corinne C. Liu
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  4. Kaitlin E. Kosinski
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  5. David J. Habibian
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  6. Anthony T. Corcoran
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  7. Aaron E. Katz
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Corresponding author

Correspondence to Michael Kongnyuy.

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The authors declare that they do not have any conflict of interest.

Funding

The Department of Urology at Winthrop University Hospital provided the funds needed for the study.

Ethical approval

All procedures performed in studies involving participants were in accordance with the ethical standards of the institutional and or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standard.

Informed consent

Informed consent was obtained from all individual participants involved in the study.

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Kongnyuy, M., Halpern, D.M., Liu, C.C. et al. 3-T multiparametric MRI characteristics of prostate cancer patients suspicious for biochemical recurrence after primary focal cryosurgery (hemiablation). Int Urol Nephrol 49, 1947–1954 (2017). https://doi.org/10.1007/s11255-017-1670-3

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  • DOI: https://doi.org/10.1007/s11255-017-1670-3

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