title: Detection of local recurrent prostate cancer after radical prostatectomy in terms of salvage radiotherapy using dynamic contrast enhanced-MRI without endorectal coil.
abstract: OBJECTIVE
  To 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).
  
  
  METHODS
  Thirty-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.
  
  
  RESULTS
  In 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.
  
  
  CONCLUSIONS
  This 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.
authors.affiliation: Department of Radiation Oncology, University of Freiburg, Robert Koch Str. 3, Freiburg 79106, Germany. hans.christian.rischke@uniklinik-freiburg.de
authors.forename: Hans Christian
authors.initials: HC
authors.lastname: Rischke
authors.forename: Arnd O
authors.initials: AO
authors.lastname: Schäfer
authors.forename: Ursula
authors.initials: U
authors.lastname: Nestle
authors.forename: Natalja
authors.initials: N
authors.lastname: Volegova-Neher
authors.forename: Karl
authors.initials: K
authors.lastname: Henne
authors.forename: Matthias R
authors.initials: MR
authors.lastname: Benz
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schultze-Seemann
authors.forename: Mathias
authors.initials: M
authors.lastname: Langer
authors.forename: Anca L
authors.initials: AL
authors.lastname: Grosu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000532:radiotherapy / Q000601:surgery; D012189:Retrospective Studies; D016879:Salvage Therapy; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D017430:Prostate-Specific Antigen