title: Early localization of recurrent prostate cancer after prostatectomy by endorectal coil magnetic resonance imaging.
abstract: BACKGROUND
  To evaluate the ability of endorectal coil (e-coil) magnetic resonance imaging (MRI) to identify early prostatic fossa recurrence after radical prostatectomy.
  
  
  METHODS
  We identified 187 patients from 2005-2011 who underwent e-coil MRI with dynamic gadolinium-contrast enhancement followed by transrectal ultrasound (TRUS) guided prostatic fossa biopsy for possible local prostate cancer recurrence. For analysis, local recurrence was defined as a negative evaluation for distant metastatic disease with a positive prostatic fossa biopsy, decreased prostate-specific antigen (PSA) following salvage radiation therapy, or increased lesion size on serial imaging.
  
  
  RESULTS
  Local recurrence was identified in 132 patients, with 124 (94%) detected on e-coil MRI. The median PSA was 0.59 ng/mL (range < 0.1-13.1), and median lesion size on MRI was 1 cm. The sensitivity of MRI was 91%, with a specificity of 45%. The positive predictive value was 85%, with a negative predictive value of 60%. For patients with a PSA < 0.4 ng/mL the sensitivity of e-coil MRI was 86%. When a lesion was identified on MRI, the positive biopsy rate was 65% and lesion size was a significant predictor of positive biopsies. The positive biopsy rates were 51%, 74%, and 88% when the lesion was < 1 cm, 1 cm-2 cm, or > 2 cm, respectively (p = 0.0006).
  
  
  CONCLUSIONS
  E-coil MRI has a high level of sensitivity in identifying local recurrence of prostate cancer following radical prostatectomy, even at low PSA levels. E-coil MRI should be considered as the first imaging evaluation for biochemical recurrence for identifying patients suitable for localized salvage therapy.
authors: Mayo Clinic, Rochester, Minnesota, USA.
authors: Brian J
authors: BJ
authors: Linder
authors: Akira
authors: A
authors: Kawashima
authors: David A
authors: DA
authors: Woodrum
authors: Matthew K
authors: MK
authors: Tollefson
authors: Jeffrey
authors: J
authors: Karnes
authors: Brian J
authors: BJ
authors: Davis
authors: Laureano J
authors: LJ
authors: Rangel
authors: Bernard F
authors: BF
authors: King
authors: Lance A
authors: LA
authors: Mynderse
mesh_terms: D000368:Aged; D001706:Biopsy; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D011237:Predictive Value of Tests; D011467:Prostate / Q000473:pathology* / Q000601:surgery; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D011878:Radiotherapy; D012007:Rectum; D012189:Retrospective Studies; D016879:Salvage Therapy; D012680:Sensitivity and Specificity
chemical_list: D017430:Prostate-Specific Antigen