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Prostate cancer recurrence after radical prostatectomy: the role of 3-T diffusion imaging in multi-parametric magnetic resonance imaging

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Abstract

Objectives

To validate the role of 3-T diffusion-weighted imaging (DWI) in the detection of local prostate cancer recurrence after radical prostatectomy (RP).

Methods

T2-weighted imaging, DWI and dynamic contrast-enhanced MRI (DCE-MRI) were performed with a 3-T magnet in 262 patients after RP. Twenty out of 262 patients evaluated were excluded. MRI results were validated by prostate-specific antigen (PSA) reduction after external beam radiotherapy in group A (126 patients, local recurrence size range 4–8 mm) and by transrectal ultrasound biopsy in group B (116 patients, local recurrence size range 9–15 mm).

Results

In group A combined T2-weighted and DCE-MRI (T2+DCE) shows 98 % sensitivity, 94 % specificity and 93 % accuracy in identifying local recurrence; combined T2-weighted and DWI with a b value of 3,000 s/mm2 (T2+DW3) displays 97 % sensitivity, 95 % specificity and 92 % accuracy, while with a b value of 1,000 s/mm2 (T2+DW1) affords 93 % sensitivity, 89 % specificity and 88 % accuracy. In group B T2+DCE shows 100 % sensitivity, 97 % specificity and 91 % accuracy in detecting local cancer recurrence; T2+DW3 displays 98 % sensitivity, 96 % specificity and 89 % accuracy; T2+DW1 has 94 % sensitivity, 92 % specificity and 86 % accuracy.

Conclusion

DCE-MRI is the most reliable technique in detecting local prostate cancer recurrence after RP, though DWI can be proposed as a reliable alternative.

Key Points

• Diffusion-weighted magnetic resonance imaging (DWI-MRI) is being increasingly used in oncology.

• PSA analysis does not distinguish prostate cancer recurrence from distant metastasis.

• DWI-MR can diagnose local prostate cancer recurrence after radical prostatectomy.

• DWI-MR is almost comparable to DCE-MRI in detecting local recurrence.

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Authors and Affiliations

  1. Department of Radiological Sciences, Oncology and Pathology, Sapienza, University of Rome, V.le Regina Elena, 324, 00161, Rome, Italy

    Valeria Panebianco, Flavio Barchetti, Daniela Musio, Valerio Forte & Carlo Catalano

  2. Department of Radiological Sciences, Oncology and Pathology, SPENCER-LORILLARD FOUNDATION (V.T.), Sapienza, University of Rome, V.le Regina Elena, 324, 00161, Rome, Italy

    Vincenzo Tombolini

  3. Department of Urology, Sapienza University of Rome, Rome, Italy

    Alessandro Sciarra & Vincenzo Gentile

Authors
  1. Valeria Panebianco
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  2. Flavio Barchetti
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  3. Alessandro Sciarra
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  4. Daniela Musio
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  8. Carlo Catalano
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Correspondence to Valeria Panebianco.

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Panebianco, V., Barchetti, F., Sciarra, A. et al. Prostate cancer recurrence after radical prostatectomy: the role of 3-T diffusion imaging in multi-parametric magnetic resonance imaging. Eur Radiol 23, 1745–1752 (2013). https://doi.org/10.1007/s00330-013-2768-3

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  • DOI: https://doi.org/10.1007/s00330-013-2768-3

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