The role of multiparametric mri in the diagnosis of local recurrence after radical prostatectomy and before salvage radiotherapy.

Autor: Faiella E; Department of Radiology, University of Rome Campus Bio-medico, Rome, Italy. Electronic address: e.faiella@policlinicocampus.it., Santucci D; Department of Radiology, University of Rome Campus Bio-medico, Rome, Italy., Vertulli D; Department of Radiology, University of Rome Campus Bio-medico, Rome, Italy., Esperto F; Department of Urology, University of Rome Campus Bio-medico, Rome, Italy., Messina L; Department of Radiology, University of Rome Campus Bio-medico, Rome, Italy., Castiello G; Department of Radiology, University of Rome Campus Bio-medico, Rome, Italy., Papalia R; Department of Urology, University of Rome Campus Bio-medico, Rome, Italy., Flammia G; Department of Urology, University of Rome Campus Bio-medico, Rome, Italy., Scarpa RM; Department of Urology, University of Rome Campus Bio-medico, Rome, Italy., Fiore M; Department of Radiotherapy, University of Rome Campus Bio-medico, Rome, Italy., Trodella LE; Department of Radiotherapy, University of Rome Campus Bio-medico, Rome, Italy., Ramella S; Department of Radiotherapy, University of Rome Campus Bio-medico, Rome, Italy., Grasso RF; Department of Radiology, University of Rome Campus Bio-medico, Rome, Italy., Beomonte Zobel B; Department of Radiology, University of Rome Campus Bio-medico, Rome, Italy.
Jazyk: English; Spanish; Castilian
Zdroj: Actas urologicas espanolas [Actas Urol Esp (Engl Ed)] 2022 Sep; Vol. 46 (7), pp. 397-406. Date of Electronic Publication: 2022 Jun 28.
DOI: 10.1016/j.acuroe.2021.12.011
Abstrakt: Purpose: Assess multiparametric-MRI (mp-MRI) diagnostic accuracy in the detection of local recurrence of Prostate Cancer (PCa) after Radical Prostatectomy (PR) and before Radiation Therapy (RT).
Materials and Methods: A total of 188 patients underwent 1.5-T mp-MRI after RP before RT. Patients were divided into two groups: with biochemical recurrence (group A) and without but with high risk of local recurrence (group B). Continuous variables were compared between two groups using T-Student; categoric variables were analyzed using Pearson chi-square. ROC analysis was performed considering PSA before RT, ISUP, pT and pN as grouping variables.
Results: PCa recurrence (reduction of PSA levels after RT) was 89.8% in the group A and 80.3% in the group B. Comparing patients with and without PCa recurrence, there was a significant difference in PSA values before RT for group A and for PSA values before RT and after RT for group B. In group A, there was a significant correlation between PSA before RT and diameter of recurrence and between PSA before RT and time spent before recurrence. The mp-MRI diagnostic accuracy in detecting PCa local recurrence after RP is of 62.2% in group A and 38% in group B. DWI is the most specific MRI-sequence and DCE the most sensitive. For PSA = 0.5 ng/ml, the AUC decreases while sensitivity and accuracy increase for each MRI-sequence. For PSA = 0.9 ng/ml, DCE-AUC increases significantly.
Conclusion: mp-MRI should always be performed before RT when a recurrence is suspected. New scenarios can be opened considering the role of DWI for PSA ≤ 0.5 ng/ml.
(Copyright © 2022 AEU. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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