Sensitivity of CE-MRI in detecting local recurrence after radical prostatectomy
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URO-GENITAL RADIOLOGY
Sensitivity of CE‑MRI in detecting local recurrence after radical prostatectomy Alessandra Coppola1 · Giulia Platania1 · Cristiana Ticca2 · Cristina De Mattia1 · Barbara Bortolato3 · Mauro F. Palazzi3 · Angelo Vanzulli4 Received: 20 September 2018 / Accepted: 6 February 2020 © Italian Society of Medical Radiology 2020
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. Keywords Prostate cancer · Radical prostatectomy · Salvage radiotherapy · Magnetic resonance
* Alessandra Coppola [email protected]
Angelo Vanzulli [email protected]
Giulia Platania [email protected]
1
University of Milan, Milan, Italy
2
Department of Radiology, Grande Ospedale Metropolitano Niguarda, Milan, Italy
3
Unit of Radiotherapy, Grande Ospedale Metropolitano Niguarda, Milan, Italy
4
Department of Oncology and Hemato‑Oncology, Grande Ospedale Metropolitano Niguarda, University of Milan, Milan, Italy
Cristiana Ticca [email protected] Cristina De Mattia [email protected] Barbara Bortolato [email protected] Mauro F. Palazzi mauro
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