title: Endorectal magnetic resonance imaging at 1.5 Tesla to assess local recurrence following radical prostatectomy using T2-weighted and contrast-enhanced imaging.
abstract: To evaluate diagnostic performance of endorectal magnetic resonance (eMR) for diagnosing local recurrence of prostate cancer (PC) in patients with previous radical prostatectomy (RP) and to assess whether contrast-enhanced (CE)-eMR improved diagnostic accuracy in comparison to unenhanced study. Unenhanced eMR data of 72 male patients (mean of total PSA: 1.23 +/- 1.3 ng/ml) with previous RP were interpreted retrospectively and classified either as normal or suspicious for local recurrence. All eMR examinations were re-evaluated also on CE-eMR 4 months after the first reading. Images were acquired on a 1.5-T system. These data were compared to the standard of reference for local recurrence: prostatectomy bed biopsy results; choline positron emission tomography results; PSA reduction or increase after pelvic radiotherapy; PSA modification during active surveillance. Sensitivity, specificity, predictive positive value, negative predictive value and accuracy were 61.4%, 82.1%, 84.4%, 57.5% and 69.4% for unenhanced eMR and 84.1%, 89.3%, 92.5%, 78.1% and 86.1% for CE-eMR. A statistically significant difference was found between accuracy and sensitivity of the two evaluations (chi(2) = 5.33; p = 0.02 and chi(2) = 9.00; p = 0.0027). EMR had great accuracy for visualizing local recurrence of PC after RP. CE-eMR improved diagnostic performance in comparison with T2-weighted imaging alone.
authors.affiliation: Unit of Radiology, Institute for Cancer Research and Treatment, Candiolo, Torino, Italy. stefano.cirillo@ircc.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Cirillo
authors.forename: Massimo
authors.initials: M
authors.lastname: Petracchini
authors.forename: Lorenza
authors.initials: L
authors.lastname: Scotti
authors.forename: Teresa
authors.initials: T
authors.lastname: Gallo
authors.forename: Annalisa
authors.initials: A
authors.lastname: Macera
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Bona
authors.forename: Cinzia
authors.initials: C
authors.lastname: Ortega
authors.forename: Pietro
authors.initials: P
authors.lastname: Gabriele
authors.forename: Daniele
authors.initials: D
authors.lastname: Regge
mesh_terms: D000368:Aged; D003287:Contrast Media / Q000494:pharmacology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000096:biosynthesis; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D012008:Recurrence; D012016:Reference Values; D015203:Reproducibility of Results; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; D017430:Prostate-Specific Antigen