Using the magnitude of PSA bounce after MRI-guided prostate brachytherapy to distinguish recurrence, benign precipitating factors, and idiopathic bounce

Prediction of PSA bounce after permanent prostate brachytherapy for localized prostate cancer

“…Prior studies used different isotopes and administered EBRT with or without brachytherapy. 4,5,8,9,18,19 PSA bounce is a common phenomenon after brachytherapy. PSA bounce has previously been defi ned as an increase of more than 0.1 ng/ml, 3,5,8,9,12 followed by a subsequent decrease to less than that level; as an increase of more than 0.2 ng/ml, 2,3,6,7,11 followed by a decline or a minimal rise of 0.4 ng/ml 3,5,12 during a 3-6 month period, followed by a drop of any magnitude; or as a more than 35% elevation 5,12 in PSA compared with the most recent value, followed by a decline to a level at or less than the prebounce value.…”

“…2 Approximately 15%-60% of hormone-naive patients show a temporary PSA elevation after brachytherapy. [2][3][4][5][6][7][8][9][10][11][12] It has been proposed that this PSA "bounce" is probably the result of some mechanism compromising membrane integrity; that is, radiation-induced prostatitis, in PSA-producing epithelium. In 1997, the American Society for Therapeutic Radiology and Oncology (ASTRO) consensus conference recommended three consecutive increases in PSA levels after the nadir, with readings spaced 3-6 months apart, as the defi nition of biochemical failure.…”

Clinical implications of a prostate-specific antigen bounce after radiation therapy for prostate cancer

“…An alternative management approach is to recommend no antibiotics for patients with an increasing PSA bounce and to simply follow their PSAs [24]. Known precipitating factors of a PSA bounce are recent ejaculation, proctitis, or instrumentation [25]. In the absence of these factors, a PSA bounce is referred to as being idiopathic [25].…”

“…Known precipitating factors of a PSA bounce are recent ejaculation, proctitis, or instrumentation [25]. In the absence of these factors, a PSA bounce is referred to as being idiopathic [25].…”

MR‐guided prostate interventions

“…Subsequent reports from the same team indicated that MRI-guided brachytherapy is a safe alternative to USguided brachytherapy (35)(36)(37)(38)(39).…”