Factors predicting cancer detection in biopsy of the prostatic fossa after radical prostatectomy

Saleem, Mohamed; Sanders, Holt; Naser, Mohammad; El-Galley, Rizk

doi:10.1016/s0090-4295(97)00509-8

Cited by 63 publications

(7 citation statements)

References 16 publications

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“…Detection rates of recurrent disease using ultrasound or MRI guided biopsies are reported to be low (range 30%–66%) with a positive biopsy in less than 30% in patients with PSA levels <1ng/ml [29, 30]. The increased sensitivity (80%) of MR-TRUS fusion is in part because the spatial accuracy of such biopsies is 2.4 ± 1.2 mm [31], whereas the mean lesion size in our population was 8.4mm (IQR 5mm–9mm).…”

Section: 0 Discussionmentioning

confidence: 99%

Multiparametric magnetic resonance imaging-transrectal ultrasound fusion–assisted biopsy for the diagnosis of local recurrence after radical prostatectomy

Muller

Kaushal

Sankineni

et al. 2015

Urologic Oncology: Seminars and Original Investigations

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Objective Approximately 15% of patients who undergo radical prostatectomy (RP) for prostate cancer develop local recurrence which is heralded by a rise in serum prostate specific antigen (PSA) levels. Early detection and treatment of recurrence improves the outcome of salvage treatment. We investigated the ability of multiparametric (mp) MRI -Transrectal Ultrasound (TRUS) fusion-guided biopsy combined with “cognitive biopsy” to confirm local recurrence of prostate cancer after RP. Materials and Methods In this retrospective study conducted between January 2010 and December 2014, patients with rising PSA levels after RP who had no known evidence of distant metastases underwent mpMRI including T2 weighted imaging (T2WI), Diffusion Weighted Imaging (DWI), Dynamic Contrast Enhanced (DCE) MRI at 3 Tesla and subsequent MRI-Ultrasound fusion biopsy with cognitive assistance. The detection rate of locally recurrent disease was determined. Results 10 patients (mean age 67y, mean PSA 3.44ng/ml) met the inclusion criteria. Of the 10 patients, all had positive findings suspicious for local recurrence on mpMRI per entrance criteria. The most important features on mpMRI were early enhancement on DCE MRI and hypointensity on T2WI. Average lesion diameter on mpMRI was 1.12 cm (range 0.40cm – 2.20cm). All suspicious lesions (16/16, 100%) were positive on T2W MRI, 14 (89%) showed positive features on ADC maps of DWI, and 16 (100%) were positive on DCE-MRI. MRI-TRUS fusion-guided biopsies were positive in 10/16 lesions (62.5%) and 8/10 (80%) patients. Conclusion MRI-TRUS fusion-guided biopsy with cognitive assistance is able to detect and diagnose locally recurrent lesions after RP, even at low PSA levels. This may facilitate early detection of recurrent disease, and improve salvage treatment outcomes.

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Section: 0 Discussionmentioning

confidence: 99%

Multiparametric magnetic resonance imaging-transrectal ultrasound fusion–assisted biopsy for the diagnosis of local recurrence after radical prostatectomy

Muller

Kaushal

Sankineni

et al. 2015

Urologic Oncology: Seminars and Original Investigations

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“…However, detection rates using ultrasound or MRI guided biopsy are reported to be low (range, 30 – 66%), with a positive biopsy of less than 30% in patients with PSA levels <1 ng/mL [5,8,23-25]. …”

Section: Discussionmentioning

confidence: 99%

Detection of local recurrent prostate cancer after radical prostatectomy in terms of salvage radiotherapy using dynamic contrast enhanced-MRI without endorectal coil

et al. 2012

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PurposeTo evaluate the value of dynamic contrast enhanced Magnetic Resonance Imaging (DCE-MRI) without endorectal coil (EC) in the detection of local recurrent prostate cancer (PC) after radical prostatectomy (RP).Material and methodsThirty-three patients with recurrent PC underwent DCE-MRI without EC before salvage radiotherapy (RT). At median 15 (mean 16±4.9, range 12–27) months after completion of RT all patients showed complete biochemical response. Additional follow up post RT DCE-MRI scans were available. Prostate specific antigen (PSA) levels at the time of imaging were correlated to the imaging findings.ResultsIn 22/33 patients (67%) early contrast enhancing nodules were detected in the post-prostatectomy fossa on pre-RT DCE-MRI images. The average pre-RT PSA level of the 22 patients with positive pre-RT DCE-MRI findings was significantly higher (mean, 0.74±0.64 ng/mL) compared to the pre-RT PSA level of the 11 patients with negative pre-RT DCE-MRI (mean, 0.24±0.13 ng/mL) (p<0.001). All post-RT DCE-MRI images showed complete resolution of initial suspicious lesions. A pre-RT PSA cut-off value of ≥0.54 ng/ml readily predicted a positive DCE-MRI finding.ConclusionsThis is the first study that shows that DCE-MRI without EC can detect local recurrent PC with an estimated accuracy of 83% at low PSA levels. All false negative DCE-MRI scans were detected using a PSA cut-off of ≥0.54 ng/mL.

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“…Although CT and bone scintigraphy are used to identify distant metastases in the lymph nodes and bones, respectively, transrectal ultrasound or endorectal MRI is used to identify local recurrence [16]. Biopsy of the prostatic fossa is not routinely recommended, especially during early phase relapse with low PSA values (< 0.5 ng/mL), because of a low detection rate [17–19]. …”

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The Incremental Value of Contrast-Enhanced MRI in the Detection of Biopsy-Proven Local Recurrence of Prostate Cancer After Radical Prostatectomy: Effect of Reader Experience

Wassberg

Akın

Vargas

et al. 2012

American Journal of Roentgenology

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OBJECTIVE The purpose of this study is to retrospectively assess the incremental value of contrast-enhanced MRI (CE-MRI) to T2-weighted MRI in the detection of postsurgical local recurrence of prostate cancer by readers of different experience levels, using biopsy as the reference standard. MATERIALS AND METHODS Fifty-two men with biochemical recurrence after prostatectomy underwent 1.5-T endorectal MRI with multiphase contrast-enhanced imaging and had biopsy within 3 months of MRI. Two radiologists (reader 1 had 1 year and reader 2 had 6 years of experience) independently reviewed each MRI study and classified the likelihood of recurrent cancer on a 5-point scale. Areas under receiver operating characteristic curves (Az) were calculated to assess readers’ diagnostic performance with T2-weighted MRI alone and combined with CE-MRI. Interobserver agreement was assessed using Cohen kappa statistics. RESULTS Thirty-three patients (63%) had biopsy-proven local recurrence of prostate cancer. With the addition of CE-MRI to T2-weighted imaging, the Az for cancer detection increased significantly for reader 1 (0.77 vs 0.85; p = 0.0435) but not for reader 2 (0.86 vs 0.88; p = 0.7294). The use of CE-MRI improved interobserver agreement from fair (κ = 0.39) to moderate (κ = 0.58). CONCLUSION CE-MRI increased interobserver agreement and offered incremental value to T2-weighted MRI in the detection of locally recurrent prostate cancer for the relatively inexperienced reader.

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Factors predicting cancer detection in biopsy of the prostatic fossa after radical prostatectomy

Cited by 63 publications

References 16 publications

Multiparametric magnetic resonance imaging-transrectal ultrasound fusion–assisted biopsy for the diagnosis of local recurrence after radical prostatectomy

Multiparametric magnetic resonance imaging-transrectal ultrasound fusion–assisted biopsy for the diagnosis of local recurrence after radical prostatectomy

Detection of local recurrent prostate cancer after radical prostatectomy in terms of salvage radiotherapy using dynamic contrast enhanced-MRI without endorectal coil

The Incremental Value of Contrast-Enhanced MRI in the Detection of Biopsy-Proven Local Recurrence of Prostate Cancer After Radical Prostatectomy: Effect of Reader Experience

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