Early localization of recurrent prostate cancer after prostatectomy by endorectal coil magnetic resonance imaging

Brian J. Linder, Akira Kawashima, David A Woodrum, Matthew K. Tollefson, Robert Jeffrey Karnes, Brian J. Davis, Laureano J. Rangel, Bernard Francis King, Lance A. Mynderse

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Introduction: To evaluate the ability of endorectal coil (e-coil) magnetic resonance imaging (MRI) to identify early prostatic fossa recurrence after radical prostatectomy. Materials and methods: We identified 187 patients from 2005-2011 who underwent e-coil MRI with dynamic gadolinium-contrast enhancement followed by transrectal ultrasound (TRUS) guided prostatic fossa biopsy for possible local prostate cancer recurrence. For analysis, local recurrence was defined as a negative evaluation for distant metastatic disease with a positive prostatic fossa biopsy, decreased prostate-specific antigen (PSA) following salvage radiation therapy, or increased lesion size on serial imaging. Results: Local recurrence was identified in 132 patients, with 124 (94%) detected on e-coil MRI. The median PSA was 0.59 ng/mL (range < 0.1-13.1), and median lesion size on MRI was 1 cm. The sensitivity of MRI was 91%, with a specificity of 45%. The positive predictive value was 85%, with a negative predictive value of 60%. For patients with a PSA < 0.4 ng/mL the sensitivity of e-coil MRI was 86%. When a lesion was identified on MRI, the positive biopsy rate was 65% and lesion size was a significant predictor of positive biopsies. The positive biopsy rates were 51%, 74%, and 88% when the lesion was < 1 cm, 1 cm-2 cm, or > 2 cm, respectively (p = 0.0006). Conclusions: E-coil MRI has a high level of sensitivity in identifying local recurrence of prostate cancer following radical prostatectomy, even at low PSA levels. E-coil MRI should be considered as the first imaging evaluation for biochemical recurrence for identifying patients suitable for localized salvage therapy.

Original languageEnglish (US)
Pages (from-to)7283-7289
Number of pages7
JournalCanadian Journal of Urology
Volume21
Issue number3
StatePublished - 2014

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Prostatectomy
Prostatic Neoplasms
Magnetic Resonance Imaging
Recurrence
Prostate-Specific Antigen
Salvage Therapy
Biopsy
Gadolinium
Radiotherapy

Keywords

  • Biopsy
  • Magnetic resonance imaging
  • Prostate cancer
  • Recurrence

ASJC Scopus subject areas

  • Urology
  • Medicine(all)

Cite this

Early localization of recurrent prostate cancer after prostatectomy by endorectal coil magnetic resonance imaging. / Linder, Brian J.; Kawashima, Akira; Woodrum, David A; Tollefson, Matthew K.; Karnes, Robert Jeffrey; Davis, Brian J.; Rangel, Laureano J.; King, Bernard Francis; Mynderse, Lance A.

In: Canadian Journal of Urology, Vol. 21, No. 3, 2014, p. 7283-7289.

Research output: Contribution to journalArticle

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title = "Early localization of recurrent prostate cancer after prostatectomy by endorectal coil magnetic resonance imaging",
abstract = "Introduction: To evaluate the ability of endorectal coil (e-coil) magnetic resonance imaging (MRI) to identify early prostatic fossa recurrence after radical prostatectomy. Materials and methods: We identified 187 patients from 2005-2011 who underwent e-coil MRI with dynamic gadolinium-contrast enhancement followed by transrectal ultrasound (TRUS) guided prostatic fossa biopsy for possible local prostate cancer recurrence. For analysis, local recurrence was defined as a negative evaluation for distant metastatic disease with a positive prostatic fossa biopsy, decreased prostate-specific antigen (PSA) following salvage radiation therapy, or increased lesion size on serial imaging. Results: Local recurrence was identified in 132 patients, with 124 (94{\%}) detected on e-coil MRI. The median PSA was 0.59 ng/mL (range < 0.1-13.1), and median lesion size on MRI was 1 cm. The sensitivity of MRI was 91{\%}, with a specificity of 45{\%}. The positive predictive value was 85{\%}, with a negative predictive value of 60{\%}. For patients with a PSA < 0.4 ng/mL the sensitivity of e-coil MRI was 86{\%}. When a lesion was identified on MRI, the positive biopsy rate was 65{\%} and lesion size was a significant predictor of positive biopsies. The positive biopsy rates were 51{\%}, 74{\%}, and 88{\%} when the lesion was < 1 cm, 1 cm-2 cm, or > 2 cm, respectively (p = 0.0006). Conclusions: E-coil MRI has a high level of sensitivity in identifying local recurrence of prostate cancer following radical prostatectomy, even at low PSA levels. E-coil MRI should be considered as the first imaging evaluation for biochemical recurrence for identifying patients suitable for localized salvage therapy.",
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AU - Kawashima, Akira

AU - Woodrum, David A

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AU - Karnes, Robert Jeffrey

AU - Davis, Brian J.

AU - Rangel, Laureano J.

AU - King, Bernard Francis

AU - Mynderse, Lance A.

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N2 - Introduction: To evaluate the ability of endorectal coil (e-coil) magnetic resonance imaging (MRI) to identify early prostatic fossa recurrence after radical prostatectomy. Materials and methods: We identified 187 patients from 2005-2011 who underwent e-coil MRI with dynamic gadolinium-contrast enhancement followed by transrectal ultrasound (TRUS) guided prostatic fossa biopsy for possible local prostate cancer recurrence. For analysis, local recurrence was defined as a negative evaluation for distant metastatic disease with a positive prostatic fossa biopsy, decreased prostate-specific antigen (PSA) following salvage radiation therapy, or increased lesion size on serial imaging. Results: Local recurrence was identified in 132 patients, with 124 (94%) detected on e-coil MRI. The median PSA was 0.59 ng/mL (range < 0.1-13.1), and median lesion size on MRI was 1 cm. The sensitivity of MRI was 91%, with a specificity of 45%. The positive predictive value was 85%, with a negative predictive value of 60%. For patients with a PSA < 0.4 ng/mL the sensitivity of e-coil MRI was 86%. When a lesion was identified on MRI, the positive biopsy rate was 65% and lesion size was a significant predictor of positive biopsies. The positive biopsy rates were 51%, 74%, and 88% when the lesion was < 1 cm, 1 cm-2 cm, or > 2 cm, respectively (p = 0.0006). Conclusions: E-coil MRI has a high level of sensitivity in identifying local recurrence of prostate cancer following radical prostatectomy, even at low PSA levels. E-coil MRI should be considered as the first imaging evaluation for biochemical recurrence for identifying patients suitable for localized salvage therapy.

AB - Introduction: To evaluate the ability of endorectal coil (e-coil) magnetic resonance imaging (MRI) to identify early prostatic fossa recurrence after radical prostatectomy. Materials and methods: We identified 187 patients from 2005-2011 who underwent e-coil MRI with dynamic gadolinium-contrast enhancement followed by transrectal ultrasound (TRUS) guided prostatic fossa biopsy for possible local prostate cancer recurrence. For analysis, local recurrence was defined as a negative evaluation for distant metastatic disease with a positive prostatic fossa biopsy, decreased prostate-specific antigen (PSA) following salvage radiation therapy, or increased lesion size on serial imaging. Results: Local recurrence was identified in 132 patients, with 124 (94%) detected on e-coil MRI. The median PSA was 0.59 ng/mL (range < 0.1-13.1), and median lesion size on MRI was 1 cm. The sensitivity of MRI was 91%, with a specificity of 45%. The positive predictive value was 85%, with a negative predictive value of 60%. For patients with a PSA < 0.4 ng/mL the sensitivity of e-coil MRI was 86%. When a lesion was identified on MRI, the positive biopsy rate was 65% and lesion size was a significant predictor of positive biopsies. The positive biopsy rates were 51%, 74%, and 88% when the lesion was < 1 cm, 1 cm-2 cm, or > 2 cm, respectively (p = 0.0006). Conclusions: E-coil MRI has a high level of sensitivity in identifying local recurrence of prostate cancer following radical prostatectomy, even at low PSA levels. E-coil MRI should be considered as the first imaging evaluation for biochemical recurrence for identifying patients suitable for localized salvage therapy.

KW - Biopsy

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