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Sensitivity of CE-MRI in detecting local recurrence after radical prostatectomy

  • URO-GENITAL RADIOLOGY
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Abstract

Aim

The aim of our study was to evaluate the sensitivity of contrast-enhanced magnetic resonance (CE-MR) with phased array coil in the diagnosis of local recurrence in patients with prostate cancer after radical prostatectomy and referred for salvage radiotherapy (SRT).

Materials and methods

This retrospective study included 73 patients treated with SRT after radical prostatectomy in the period between September 2006 and November 2017. All patients performed a CE-MRI with phased array coil before the start of SRT. A total of 213 patients treated at the ASST Grande Ospedale Metropolitano Niguarda in the period between September 2006 and November 2017 with SRT after radical prostatectomy were reviewed. Seventy-three patients with a CE-MRI with phased array coil of the pelvis before the start of SRT were included in the present study.

Results

At imaging review, recurrence local recurrent disease was diagnosed in 48 of 73 patients. By considering as reference standard the decrease in prostate-specific antigen (PSA) value after radiotherapy, we defined: 41 true positive (patients with MRI evidence of local recurrence and PSA value decreasing after SRT), 7 false positive (patients with MRI evidence of local recurrence without biochemical response after SRT), 3 true negative (patients without MRI evidence of local recurrence and stable or increased PSA value after SRT) and 22 false negative (patients without MRI evidence of local recurrence and PSA value decreasing after SRT) cases. The sensitivity values were calculated in relation to the PSA value before the start of treatment, obtaining a value of 74% for PSA above 0.2 ng/mL.

Conclusion

The sensitivity of CE-MRI in local recurrence detection after radical prostatectomy increases with increasing PSA values. CE-MRI with phased array coil can detect local recurrences after radical prostatectomy with a good sensitivity in patients with pre-RT PSA value above 0.2 ng/mL.

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References

  1. Cooperberg MR, Broering JM, Carroll PR (2010) Time trends and local variation in primary treatment of localized prostate cancer. J Clin Oncol 28(7):1117–1123

    Article  PubMed  PubMed Central  Google Scholar 

  2. Lu-Yao GL, Yao SL (1997) Population-based study of long-term survival in patients with clinically localised prostate cancer. Lancet (London, England) 349(9056):906–910

    Article  CAS  Google Scholar 

  3. Herman CM, Kattan MW, Ohori M, Scardino PT, Wheeler TM (2001) Primary Gleason pattern as a predictor of disease progression in gleason score 7 prostate cancer: a multivariate analysis of 823 men treated with radical prostatectomy. Am J Surg Pathol 25(5):657–660

    Article  CAS  PubMed  Google Scholar 

  4. Simon MA, Kim S, Soloway MS (2006) Prostate specific antigen recurrence rates are low after radical retropubic prostatectomy and positive margins. J Urol 175(1):140–144

    Article  PubMed  Google Scholar 

  5. Stephenson AJ, Wood DP, Kattan MW, Klein EA, Scardino PT, Eastham JA et al (2009) Location, extent and number of positive surgical margins do not improve accuracy of predicting prostate cancer recurrence after radical prostatectomy. J Urol 182:1357–1363

    Article  PubMed  Google Scholar 

  6. Swanson GP, Hussey MA, Tangen CM, Chin J, Messing E, Canby-Hagino E et al (2007) Predominant treatment failure in postprostatectomy patients is local: analysis of patterns of treatment failure in SWOG 8794. J Clin Oncol 25(16):2225–2229

    Article  PubMed  Google Scholar 

  7. Stephenson AJ, Kattan MW, Eastham JA, Dotan ZA, Bianco FJ, Lilja H et al (2006) Defining biochemical recurrence of prostate cancer after radical prostatectomy: a proposal for a standardized definition. J Clin Oncol 24(24):3973–3978

    Article  CAS  PubMed  Google Scholar 

  8. Roach M, Hanks G, Thames H, Schellhammer P, Shipley WU, Sokol GH et al (2006) Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO Phoenix Consensus Conference. Int J Radiat Oncol Biol Phys 65(4):965–974

    Article  Google Scholar 

  9. Barret E, Harvey-Bryan K-A, Sanchez-Salas R, Rozet F, Galiano M, Cathelineau X (2014) How to diagnose and treat focal therapy failure and recurrence? Curr Opin Urol 24(3):241–246

    Article  PubMed  Google Scholar 

  10. Mohler JL, Armstrong AJ, Bahnson RR, Boston B, Busby JE, Amico AVD et al (2012) Prostate Cancer, Version 3. 2012 Featured Updates to the NCCN Guidelines. Cancer 10(9):1081–1087

    CAS  Google Scholar 

  11. King CR, Spiotto MT (2008) Improved outcomes with higher doses for salvage radiotherapy after prostatectomy. Int J Radiat Oncol Biol Phys 71(1):23–27

    Article  PubMed  Google Scholar 

  12. Ohri N, Dicker AP, Trabulsi EJ, Showalter TN (2012) Can early implementation of salvage radiotherapy for prostate cancer improve the therapeutic ratio? A systematic review and regression meta-analysis with radiobiological modelling. Eur J Cancer 48(6):837–844

    Article  PubMed  Google Scholar 

  13. Pfister D, Bolla M, Briganti A, Carroll P, Cozzarini C, Joniau S et al (2014) Early salvage radiotherapy following radical prostatectomy. Eur Urol 65(6):1034–1043

    Article  PubMed  Google Scholar 

  14. Beresford MJ, Gillatt D, Benson RJ, Ajithkumar T (2010) A systematic review of the role of imaging before salvage radiotherapy for post-prostatectomy biochemical recurrence. Clin Oncol 22(1):46–55

    Article  CAS  Google Scholar 

  15. Sandgren K, Westerlinck P, Jonsson JH, Blomqvist L, Thellenberg Karlsson C, Nyholm T et al (2019) Imaging for the detection of locoregional recurrences in biochemical progression after radical prostatectomy—a systematic review. Eur Urol Focus 5:550–560

    Article  PubMed  Google Scholar 

  16. De Visschere PJ, De Meerleer GO, Fütterer JJ, Villeirs GM (2010) Role of MRI in follow-up after focal therapy for prostate carcinoma. Am J Roentgenol 194(6):1427–1433

    Article  Google Scholar 

  17. Sella T, Schwartz LH, Swindle PW, Onyebuchi CN, Scardino PT, Scher HI et al (2004) Suspected local recurrence after radical prostatectomy: endorectal coil MR imaging. Radiology 231(2):379–385

    Article  PubMed  Google Scholar 

  18. Park JJ, Kim CK, Park SY, Park BK, Lee HM, Cho SW (2014) Prostate cancer: role of pretreatment multiparametric 3-T MRI in predicting biochemical recurrence after radical prostatectomy. Am J Roentgenol 202(5):459–465

    Article  Google Scholar 

  19. Cirillo S, Petracchini M, Scotti L, Gallo T, Macera A, Bona MC et al (2009) 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(3):761–769

    Article  PubMed  Google Scholar 

  20. Loblaw DA, Mendelson DS, Talcott JA, Virgo KS, Somerfield MR, Ben-Josef E et al (2004) American Society of Clinical Oncology recommendations for the initial hormonal management of androgen-sensitive metastatic, recurrent, or progressive prostate cancer. J Clin Oncol 22(14):2927–2941

    Article  PubMed  Google Scholar 

  21. Partin AW, Pearson JD, Landis PK, Carter HB, Pound CR, Clemens JQ et al (1994) Evaluation of serum prostate-specific antigen velocity after radical prostatectomy to distinguish local recurrance from distant metastasis. Urology 43:649–659

    Article  CAS  PubMed  Google Scholar 

  22. Stephenson AJ, Scardino PT, Kattan MW, Pisansky TM, Slawin KM, Klein EA et al (2007) Predicting the outcome of salvage radiation therapy for recurrent prostate cancer after radical prostatectomy. J Clin Oncol 25(15):2035–2041

    Article  PubMed  PubMed Central  Google Scholar 

  23. Leventis AK, Shariat SF, Slawin KM (2001) Local recurrence after radical prostatectomy: correlation of us features with prostatic fossa biopsy findings. Radiology 219(2):432–439

    Article  CAS  PubMed  Google Scholar 

  24. 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(3):707–709

    Article  CAS  PubMed  Google Scholar 

  25. Alfarone A, Panebianco V, Schillaci O, Salciccia S, Cattarino S, Mariotti G et al (2012) Comparative analysis of multiparametric magnetic resonance and PET-CT in the management of local recurrence after radical prostatectomy for prostate cancer. Crit Rev Oncol Hematol 84(1):109–121

    Article  PubMed  Google Scholar 

  26. Fuccio C, Rubello D, Castellucci P, Marzola MC, Fanti S (2011) Choline PET/CT for prostate cancer: main clinical applications. Eur J Radiol 80(2):50–56

    Article  Google Scholar 

  27. 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(1):9–17

    Article  PubMed  Google Scholar 

  28. Schmidt-Hegemann NS, Fendler WP, Ilhan H, Herlemann A, Buchner A, Stief C et al (2018) Outcome after PSMA PET/CT based radiotherapy in patients with biochemical persistence or recurrence after radical prostatectomy. Radiat Oncol 13(1):1–9

    Article  Google Scholar 

  29. Gaur S, Turkbey B (2018) Prostate MR imaging for posttreatment evaluation and recurrence. Radiol Clin North Am 56(2):263–275

    Article  PubMed  Google Scholar 

  30. Cha D, Kim CK, Park SY, Park JJ, Park BK (2015) Evaluation of suspected soft tissue lesion in the prostate bed after radical prostatectomy using 3T multiparametric magnetic resonance imaging. Magn Reson Imaging 33(4):407–412

    Article  PubMed  Google Scholar 

  31. Lopes Dias J, Lucas R, Magalhães Pina J, João R, Costa NV, Leal C et al (2015) Post-treated prostate cancer: normal findings and signs of local relapse on multiparametric magnetic resonance imaging. Abdom Imaging 40(7):2814–2838

    Article  PubMed  Google Scholar 

  32. Grant K, Lindenberg ML, Shebel H, Pang Y, Agarwal HK, Bernardo M et al (2013) Functional and molecular imaging of localized and recurrent prostate cancer. Eur J Nucl Med Mol Imaging 40(Suppl 1):48–59

    Article  CAS  Google Scholar 

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

    Article  CAS  Google Scholar 

  34. Barchetti F, Panebianco V (2014) Multiparametric MRI for recurrent prostate cancer post radical prostatectomy and post radiation therapy. Biomed Res Int 2014:1–24

    Google Scholar 

  35. Casciani E, Polettini E, Carmenini E, Floriani I, Masselli G, Bertini L et al (2008) Endorectal and dynamic contrast-enhanced MRI for detection of local recurrence after radical prostatectomy. Am J Roentgenol 190(5):1187–1192

    Article  Google Scholar 

  36. Rischke HC, Schäfer AO, Nestle U, Volegova-Neher N, Henne K, Benz MR et al (2012) Detection of local recurrent prostate cancer after radical prostatectomy in terms of salvage radiotherapy using dynamic contrast enhanced-MRI without endorectal coil. Radiat Oncol 7(1):185

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Panebianco V, Barchetti F, Sciarra A, Musio D, Forte V, Gentile V et al (2013) Prostate cancer recurrence after radical prostatectomy: the role of 3-T diffusion imaging in multi-parametric magnetic resonance imaging. Eur Radiol 23(6):1745–1752

    Article  PubMed  Google Scholar 

  38. Roy C, Foudi F, Charton J, Jung M, Lang H, Saussine C et al (2013) Comparative sensitivities of functional MRI sequences in detection of local recurrence of prostate carcinoma after radical prostatectomy or external-beam radiotherapy. Am J Roentgenol 200(4):361–368

    Article  Google Scholar 

  39. Sciarra A, Panebianco V, Salciccia S, Osimani M, Lisi D, Ciccariello M et al (2008) Role of dynamic contrast-enhanced magnetic resonance (MR) imaging and proton MR spectroscopic imaging in the detection of local recurrence after radical prostatectomy for prostate cancer. Eur Urol 54(3):589–600

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. University of Milan, Milan, Italy

    Alessandra Coppola, Giulia Platania & Cristina De Mattia

  2. Department of Radiology, Grande Ospedale Metropolitano Niguarda, Milan, Italy

    Cristiana Ticca

  3. Unit of Radiotherapy, Grande Ospedale Metropolitano Niguarda, Milan, Italy

    Barbara Bortolato & Mauro F. Palazzi

  4. Department of Oncology and Hemato-Oncology, Grande Ospedale Metropolitano Niguarda, University of Milan, Milan, Italy

    Angelo Vanzulli

Authors
  1. Alessandra Coppola
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  2. Giulia Platania
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  3. Cristiana Ticca
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  4. Cristina De Mattia
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Correspondence to Alessandra Coppola.

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The authors declare that there is no conflict of interest and have not any financial relationship with any sponsoring organization.

Ethical approval

All procedures performed in studies involving human 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 standards.

Informed consent

Written informed consent to the MR examination was obtained from all subjects in this study. Approval by the ethics committee was obtained, and patient’s informed consent was obtained by the ethics committee.

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Coppola, A., Platania, G., Ticca, C. et al. Sensitivity of CE-MRI in detecting local recurrence after radical prostatectomy. Radiol med 125, 683–690 (2020). https://doi.org/10.1007/s11547-020-01149-3

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