Detection and Staging of Radio-recurrent Prostate Cancer Using Multiparametric MRI

Overview

Journal Br J Radiol

Publisher Oxford University Press

Specialty Radiology

Date 2021 Feb 15

PMID 33586998

Citations 4

Authors

Jie-Ying Kowa

Neil Soneji

S Aslam Sohaib

Erik Mayer

Stephen Hazell

Nicholas Butterfield

Joshua Shur

Derfel Ap Dafydd

Affiliations

Soon will be listed here.

Abstract

Objective: We determined the sensitivity and specificity of multiparametric magnetic resonance imaging (MP-MRI) in detection of locally recurrent prostate cancer and extra prostatic extension in the post-radical radiotherapy setting. Histopathological reference standard was whole-mount prostatectomy specimens. We also assessed for any added value of the dynamic contrast enhancement (DCE) sequence in detection and staging of local recurrence.

Methods: This was a single centre retrospective study. Participants were selected from a database of males treated with salvage prostatectomy for locally recurrent prostate cancer following radiotherapy. All underwent pre-operative prostate-specific antigen assay, positron emission tomography CT, MP-MRI and transperineal template prostate mapping biopsy prior to salvage prostatectomy. MP-MRI performance was assessed using both Prostate Imaging-Reporting and Data System v. 2 and a modified scoring system for the post-treatment setting.

Results: 24 patients were enrolled. Using Prostate Imaging-Reporting and Data System v. 2, sensitivity, specificity, positive predictive value and negative predictive value was 64%, 94%, 98% and 36%. MP-MRI under staged recurrent cancer in 63%. A modified scoring system in which DCE was used as a co-dominant sequence resulted in improved diagnostic sensitivity (61%-76%) following subgroup analysis.

Conclusion: Our results show MP-MRI has moderate sensitivity (64%) and high specificity (94%) in detecting radio-recurrent intraprostatic disease, though disease tends to be under quantified and under staged. Greater emphasis on dynamic contrast images in overall scoring can improve diagnostic sensitivity.

Advances In Knowledge: MP-MRI tends to under quantify and under stage radio-recurrent prostate cancer. DCE has a potentially augmented role in detecting recurrent tumour compared with the setting. This has relevance in the event of any future modified MP-MRI scoring system for the irradiated gland.

Citing Articles

Management strategies for radio-recurrent prostate cancer: a comprehensive review.

Rahman S, Kim H, Webb L, Diaz G, Leapman M, Sprenkle P Transl Cancer Res. 2024; 13(11):6473-6488.

PMID: 39697737 PMC: 11651831. DOI: 10.21037/tcr-24-245.

Diagnostic efficacy and interobserver agreement among readers with variable experience of the Prostate Imaging for Recurrence Reporting system with whole-mount histology after androgen deprivation therapy as a reference.

Chen Z, Zhou B, Liu W, Gan H, Chen R, Yang L Quant Imaging Med Surg. 2024; 14(4):3006-3017.

PMID: 38617164 PMC: 11007506. DOI: 10.21037/qims-23-1643.

Evaluation of Recurrent Disease after Radiation Therapy for Patients Considering Local Salvage Therapy: Past vs. Contemporary Management.

Adams E, Deivasigamani S, Mottaghi M, Huang J, Gupta R, Polascik T Cancers (Basel). 2023; 15(24).

PMID: 38136427 PMC: 10741753. DOI: 10.3390/cancers15245883.

Magnetic resonance imaging (MRI) for local staging before salvage radical prostatectomy: a meta-analysis.

Zapala P, Slusarczyk A, Rajwa P, Gandaglia G, Zapala L, Zattoni F World J Urol. 2023; 41(5):1275-1284.

PMID: 37019997 PMC: 10188391. DOI: 10.1007/s00345-023-04383-2.

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