El papel de la resonancia magnética multiparamétrica en el diagnóstico de la recidiva local tras la prostatectomía radical y antes de la radioterapia de rescate |
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| Institution: | 1. Department of Radiology, University of Rome Campus Bio-Medico, Rome, Italia;2. Department of Urology, University of Rome Campus Bio-Medico, Rome, Italia;3. Department of Radiotherapy, University of Rome Campus Bio-Medico, Rome, Italia;1. Department of Urology, Istanbul Medeniyet University, Istanbul, Turkey;2. Department of Urology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey;3. Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey;1. Department of Urology, Jiangyan Hospital of Traditional Chinese Medicine, Taizhou, Jiangsu, China;2. Department of Urology, Linyi Third People''s Hospital, Linyi, Shandong, China;3. Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egipto;4. Department of Emergency Medicine, Wuhan Hospital of Traditional Chinese Medicine, Wuhan, Hubei, China;1. Department of Urology, Faculdade de Medicina do ABC, São Paulo, Brasil;2. Department of Anesthesiology, Hospital Israelita Albert Einstein, São Paulo, Brasil;3. Department of General Surgery, Hospital do Servidor Público Estadual, São Paulo, Brasil;1. Departamento de Urología, Hospital del Pueblo Putuo, Universidad Tongji, Shanghai, China;2. Departamento de Urología, Hospital del Pueblo Tenth, Tongji University School of Medicine, Shanghai, China |
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| Abstract: | PurposeAssess multiparametric-MRI (mp-MRI) diagnostic accuracy in the detection of local recurrence of prostate cancer (PCa) after radical prostatectomy (PR) and before radiation therapy (RT).Materials and methodsA total of 188 patients underwent 1.5-T mp-MRI after RP before RT. Patients were divided into 2 groups: with biochemical recurrence (group A) and without but with high risk of local recurrence (group B). Continuous variables were compared between 2 groups using Student-t test; categoric variables were analyzed using Pearson chi-square. ROC analysis was performed considering PSA before RT, ISUP, pT and pN as grouping variables.ResultsPCa recurrence (reduction of PSA levels after RT) was 89.8% in group A and 80.3% in group B. Comparing patients with and without PCa recurrence, there was a significant difference in PSA values before RT for group A and for PSA values before RT and after RT for group B. In group A, there was a significant correlation between PSA before RT and diameter of recurrence and between PSA before RT and time spent before recurrence. The mp-MRI diagnostic accuracy in detecting PCa local recurrence after RP is of 62.2% in group A and 38% in group B. Diffusion weighted imaging is the most specific MRI-sequence and dynamic contrast enhanced the most sensitive. For PSA = 0.5 ng/ml, the AUC decreases while sensitivity and accuracy increase for each MRI-sequence. For PSA = 0.9 ng/ml, dynamic contrast enhanced-AUC increases significantly.Conclusionmp-MRI should always be performed before RT when a recurrence is suspected. New scenarios can be opened considering the role of diffusion weighted imaging for PSA ≤ 0.5 ng/ml. |
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| Keywords: | Multiparametric-MRI Prostate cancer Biochemical recurrence Radical prostatectomy Radiation therapy |
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