title: Prostate cancer recurrence after radical prostatectomy: the role of 3-T diffusion imaging in multi-parametric magnetic resonance imaging.
abstract: OBJECTIVE
  To validate the role of 3-T diffusion-weighted imaging (DWI) in the detection of local prostate cancer recurrence after radical prostatectomy (RP).
  
  
  METHODS
  T2-weighted imaging, DWI and dynamic contrast-enhanced MRI (DCE-MRI) were performed with a 3-T magnet in 262 patients after RP. Twenty out of 262 patients evaluated were excluded. MRI results were validated by prostate-specific antigen (PSA) reduction after external beam radiotherapy in group A (126 patients, local recurrence size range 4-8 mm) and by transrectal ultrasound biopsy in group B (116 patients, local recurrence size range 9-15 mm).
  
  
  RESULTS
  In group A combined T2-weighted and DCE-MRI (T2+DCE) shows 98 % sensitivity, 94 % specificity and 93 % accuracy in identifying local recurrence; combined T2-weighted and DWI with a b value of 3,000 s/mm(2) (T2+DW3) displays 97 % sensitivity, 95 % specificity and 92 % accuracy, while with a b value of 1,000 s/mm(2) (T2+DW1) affords 93 % sensitivity, 89 % specificity and 88 % accuracy. In group B T2+DCE shows 100 % sensitivity, 97 % specificity and 91 % accuracy in detecting local cancer recurrence; T2+DW3 displays 98 % sensitivity, 96 % specificity and 89 % accuracy; T2+DW1 has 94 % sensitivity, 92 % specificity and 86 % accuracy.
  
  
  CONCLUSIONS
  DCE-MRI is the most reliable technique in detecting local prostate cancer recurrence after RP, though DWI can be proposed as a reliable alternative.
  
  
  CONCLUSIONS
  • Diffusion-weighted magnetic resonance imaging (DWI-MRI) is being increasingly used in oncology. • PSA analysis does not distinguish prostate cancer recurrence from distant metastasis. • DWI-MR can diagnose local prostate cancer recurrence after radical prostatectomy. • DWI-MR is almost comparable to DCE-MRI in detecting local recurrence.
authors: Department of Radiological Sciences, Oncology and Pathology, Sapienza, University of Rome, V.le Regina Elena, 324, 00161 Rome, Italy. valeria.panebianco@uniroma1.it
authors: Valeria
authors: V
authors: Panebianco
authors: Flavio
authors: F
authors: Barchetti
authors: Alessandro
authors: A
authors: Sciarra
authors: Daniela
authors: D
authors: Musio
authors: Valerio
authors: V
authors: Forte
authors: Vincenzo
authors: V
authors: Gentile
authors: Vincenzo
authors: V
authors: Tombolini
authors: Carlo
authors: C
authors: Catalano
mesh_terms: D000368:Aged; D019540:Area Under Curve; D016477:Artifacts; D003287:Contrast Media / Q000494:pharmacology; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D012372:ROC Curve; D012008:Recurrence; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D017430:Prostate-Specific Antigen
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