title: Post-treated prostate cancer: normal findings and signs of local relapse on multiparametric magnetic resonance imaging.
abstract: The use of multiparametric magnetic resonance imaging (mp-MRI) for prostate cancer has increased over recent years, mainly for detection, staging, and active surveillance. However, suspicion of recurrence in the set of biochemical failure is becoming a significant reason for clinicians to request mp-MRI. Radiologists should be able to recognize the normal post-treatment MRI findings. Fibrosis and atrophic remnant seminal vesicles after prostatectomy are often found and must be differentiated from local relapse. Moreover, brachytherapy, external beam radiotherapy, cryosurgery, and hormonal therapy tend to diffusely decrease the signal intensity of the peripheral zone on T2-weighted images (T2WI) due to the loss of water content, consequently mimicking tumor and hemorrhage. The combination of T2WI and functional studies like diffusion-weighted imaging and dynamic contrast-enhanced improves the identification of local relapse. Tumor recurrence tends to restrict on diffusion images and avidly enhances after contrast administration either within or outside the gland. The authors provide a pictorial review of the normal findings and the signs of local tumor relapse after radical prostatectomy, external beam radiotherapy, brachytherapy, cryosurgery, and hormonal therapy.
authors.affiliation: Department of Radiology, Hospital de S. José, Rua José António Serrano, 1150-199, Lisbon, Portugal. joaolopesdias85@gmail.com.|, Rua Herculano Rodrigues, n15, 2esq, 2695-044, Lisbon, Portugal. joaolopesdias85@gmail.com.|Faculdade de Ciências Médicas, Nova Medica School, Lisbon, Portugal. joaolopesdias85@gmail.com.
authors.forename: João
authors.initials: J
authors.lastname: Lopes Dias
authors.affiliation: Department of Radiology, Hospital de Santo António dos Capuchos, Alameda de Santo António dos Capuchos, 1169-050, Lisbon, Portugal.
authors.forename: Rita
authors.initials: R
authors.lastname: Lucas
authors.affiliation: Department of Urology, Hospital de S. José, Rua José António Serrano, 1150-199, Lisbon, Portugal.|Faculdade de Ciências Médicas, Nova Medica School, Lisbon, Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Magalhães Pina
authors.affiliation: Department of Urology, Hospital de S. José, Rua José António Serrano, 1150-199, Lisbon, Portugal.|Faculdade de Ciências Médicas, Nova Medica School, Lisbon, Portugal.
authors.forename: Raquel
authors.initials: R
authors.lastname: João
authors.affiliation: Department of Radiology, Hospital de S. José, Rua José António Serrano, 1150-199, Lisbon, Portugal.|Faculdade de Ciências Médicas, Nova Medica School, Lisbon, Portugal.
authors.forename: Nuno Vasco
authors.initials: NV
authors.lastname: Costa
authors.affiliation: Department of Radiology, Hospital de Santa Marta, Rua de Santa Marta, 1169-1024, Lisbon, Portugal.|Faculdade de Ciências Médicas, Nova Medica School, Lisbon, Portugal.
authors.forename: Cecília
authors.initials: C
authors.lastname: Leal
authors.affiliation: Department of Radiology, Hospital de S. José, Rua José António Serrano, 1150-199, Lisbon, Portugal.|Faculdade de Ciências Médicas, Nova Medica School, Lisbon, Portugal.
authors.forename: Tiago
authors.initials: T
authors.lastname: Bilhim
authors.affiliation: Department of Radiology, Hospital de S. José, Rua José António Serrano, 1150-199, Lisbon, Portugal.|Faculdade de Ciências Médicas, Nova Medica School, Lisbon, Portugal.
authors.forename: Luís
authors.initials: L
authors.lastname: Campos Pinheiro
authors.affiliation: Department of Radiology, Hospital de S. José, Rua José António Serrano, 1150-199, Lisbon, Portugal.|Faculdade de Ciências Médicas, Nova Medica School, Lisbon, Portugal.
authors.forename: Rui
authors.initials: R
authors.lastname: Mateus Marques
mesh_terms: D000726:Androgen Antagonists / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D003452:Cryosurgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D011878:Radiotherapy
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal
keywords: Multiparametric resonance imaging; Prostate cancer; Recurrence