Imaging assessment of local recurrence of prostate cancer after radical prostatectomy

Value of PET imaging for radiation therapy

“…Before the introduction of PSMA-PET/CT, usually no extensive imaging workup was indicated in low-level biochemical recurrence (increasing PSA out of the undetectable range) after radical prostatectomy (RP) or a persisting PSA after RP before salvage radiotherapy (SRT, start of RT at a PSA-level < 0.5 ng/ml) due to the known limited accuracy of conventional staging with CT and bone scintigraphy [166][167][168]. An exception is MRI with dynamic contrast enhanced MRI (DCE-MRI) which shows excellent results for identifying small areas of local recurrence, however has not been widely used in clinical routine up to now [169,170]. The situation has changed substantially with PSMA-specific PET radiotracers, which show superior sensitivity and specificity for detecting recurrent prostate cancer compared with conventional imaging and also compared to other radiotracers such as choline-based substances or fluciclovine [171][172][173].…”

Value of PET imaging for radiation therapy

“…Before the introduction of PSMA-PET/CT, usually no extensive imaging workup was indicated in low-level biochemical recurrence (increasing PSA out of the undetectable range) after radical prostatectomy (RP) or a persisting PSA after RP before salvage radiotherapy (SRT, start of RT at a PSA-level < 0.5 ng/ml) due to the known limited accuracy of conventional staging with CT and bone scintigraphy [166][167][168]. An exception is MRI with dynamic contrast enhanced MRI (DCE-MRI) which shows excellent results for identifying small areas of local recurrence, however has not been widely used in clinical routine up to now [169,170]. The situation has changed substantially with PSMA-specific PET radiotracers, which show superior sensitivity and specificity for detecting recurrent prostate cancer compared with conventional imaging and also compared to other radiotracers such as cholinebased substances or fluciclovine [171][172][173].…”

Multiparametric magnetic resonance imaging in diagnosis of local prostate cancer recurrence after radiation therapy and radical prostatectomy: a unified PI-RR reporting system

“…В случаях БХР поэтапный мультимодальный подход к визуализации обеспечивает получение максимальной диагностической информации в отношении как локального рецидива, так и лимфогенного прогрессирования и/или отдаленного метастазирования. При подозрении на рецидив РПЖ для выявления системного прогрессирования методом выбора является позитронно-эмиссионная томография, совмещенная с компьютерной томографией (ПЭТ/КТ), с радиомеченными лигандами к простатическому специфическому мембранному антигену (ПСМА) [6,11,13].…”