TY - JOUR
T1 - Detection of local recurrence of prostate cancer after radical prostatectomy using endorectal coil MRI at 3 T
T2 - Addition of DWI and dynamic contrast enhancement to T2-weighted MRI
AU - Kitajima, Kazuhiro
AU - Hartman, Robert P.
AU - Froemming, Adam T.
AU - Hagen, Clinton E.
AU - Takahashi, Naoki
AU - Kawashima, Akira
N1 - Publisher Copyright:
© American Roentgen Ray Society.
PY - 2015/10/1
Y1 - 2015/10/1
N2 - OBJECTIVE. The purpose of this study was to assess the utility of DWI and dynamic contrast enhancement (DCE) in MRI at 3 T with an endorectal coil in identifying local prostate cancer recurrence after radical prostatectomy. MATERIALS AND METHODS. Eighty men underwent MRI for suspected local recurrence. The reference standards were histopathologic result, decrease in prostate-specific antigen level after salvage radiation therapy, and follow-up findings. Using a 5-point scoring system, two reviewers independently interpreted T2-weighted images alone (protocol A), a combination of T2-weighted and DW images (protocol B), a combination of T2-weighted and DCE images (protocol C), and a combination of T2-weighted, DW, and DCE images (protocol D). ROC analysis was used to compare the four protocols. RESULTS. Local recurrence was found in 57 of the 80 patients (71.3%). The ROC AUCs for protocols A, B, C, and D were 0.71, 0.72, 0.90, and 0.89 for reader 1 and 0.65, 0.62, 0.84, and 0.83 for reader 2. Protocols C and D had statistically better performance than protocols A and B for both readers (p < 0.001). For local recurrence lesions with a long-axis diameter less than 10 mm visualized with protocol C, protocol B had detection rates of 25.0-29.4% and for lesions measuring 10 mm or greater, 67.9-69.0%. The rates of detection of local recurrence with protocol C or D were 76.5-82.4% for prostate-specific antigen levels less than 0.4 ng/mL, 60-73.3% for 0.4-1.0 ng/mL, and 80-88.0% for greater than 1.0 ng/mL. CONCLUSION. Addition of DCE to T2-weighted imaging in 3-T MRI with an endorectal coil improves the accuracy of detection of local cancer recurrence after radical prostatectomy. The addition of DWI is of limited incremental value for detection, especially of small lesions.
AB - OBJECTIVE. The purpose of this study was to assess the utility of DWI and dynamic contrast enhancement (DCE) in MRI at 3 T with an endorectal coil in identifying local prostate cancer recurrence after radical prostatectomy. MATERIALS AND METHODS. Eighty men underwent MRI for suspected local recurrence. The reference standards were histopathologic result, decrease in prostate-specific antigen level after salvage radiation therapy, and follow-up findings. Using a 5-point scoring system, two reviewers independently interpreted T2-weighted images alone (protocol A), a combination of T2-weighted and DW images (protocol B), a combination of T2-weighted and DCE images (protocol C), and a combination of T2-weighted, DW, and DCE images (protocol D). ROC analysis was used to compare the four protocols. RESULTS. Local recurrence was found in 57 of the 80 patients (71.3%). The ROC AUCs for protocols A, B, C, and D were 0.71, 0.72, 0.90, and 0.89 for reader 1 and 0.65, 0.62, 0.84, and 0.83 for reader 2. Protocols C and D had statistically better performance than protocols A and B for both readers (p < 0.001). For local recurrence lesions with a long-axis diameter less than 10 mm visualized with protocol C, protocol B had detection rates of 25.0-29.4% and for lesions measuring 10 mm or greater, 67.9-69.0%. The rates of detection of local recurrence with protocol C or D were 76.5-82.4% for prostate-specific antigen levels less than 0.4 ng/mL, 60-73.3% for 0.4-1.0 ng/mL, and 80-88.0% for greater than 1.0 ng/mL. CONCLUSION. Addition of DCE to T2-weighted imaging in 3-T MRI with an endorectal coil improves the accuracy of detection of local cancer recurrence after radical prostatectomy. The addition of DWI is of limited incremental value for detection, especially of small lesions.
KW - DWI
KW - Dynamic contrast-enhanced imaging
KW - Local recurrence
KW - Prostate cancer
KW - Prostatectomy
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U2 - 10.2214/AJR.14.14275
DO - 10.2214/AJR.14.14275
M3 - Article
C2 - 26397329
AN - SCOPUS:84943644251
SN - 0361-803X
VL - 205
SP - 807
EP - 816
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
IS - 4
ER -