To determine the local treatment-related endorectal magnetic resonance (MR) imaging findings after brachytherapy for prostate cancer.
Endorectal MR imaging was performed in 35 consecutive patients at a mean interval of 12 months (range, 1-31 months) after brachytherapy for prostate cancer. Transverse T1-weighted and high-spatial-resolution transverse and coronal T2-weighted images were acquired. Two readers reviewed MR image quality and findings, with discrepancies resolved by consensus. Posttreatment urinary symptoms in patients (n = 24) were documented by using chart review.
All studies were of diagnostic quality. On T2-weighted images, prostatic findings consisted of diffuse low signal intensity (n = 35) and indistinct zonal anatomy (n = 34). Intra- and extraprostatic seed locations could be distinguished. The most common extraprostatic site of seed implantation was the neurovascular bundles (n = 35, bilateral in 32). The most common extraprostatic tissue finding was increased signal intensity on T2-weighted images in the levator ani muscle (n = 34) and the genitourinary diaphragm (n = 28). Postbrachytherapy urinary symptoms showed no demonstrable correlation with periurethral or genitourinary diaphragm seed implantation or with signal intensity change in the genitourinary diaphragm.
Endorectal MR imaging can be used to evaluate seed distribution and to demonstrate treatment-related changes after brachytherapy for prostate cancer.
"At present MRI is widely considered to be the state of the art in detecting and localizing PCa recurrence in patients with BP after definitive RT (Figure 4). After RT, the entire prostate and the SVs show decreased size and diffusely decreased SI on T2WI, and the peripheral, central, and transition zones appear less distinct from each other . PCas also show changes, which may include decreased size, reduced capsular bulging, capsular irregularity, or decreased extracapsular extension. "
[Show abstract][Hide abstract] ABSTRACT: The clinical suspicion of local recurrence of prostate cancer (PCa) after radical prostatectomy (RP) and after radiation therapy (RT) is based on the onset of biochemical failure. The aim of this paper was to review the current role of multiparametric-MRI (mp-MRI) in the detection of locoregional recurrence. A systematic literature search using the Medline and Cochrane Library databases was performed from January 1995 up to November 2013. Bibliographies of retrieved and review articles were also examined. Only those articles reporting complete data with clinical relevance for the present review were selected. This review article is divided into two major parts: the first one considers the role of mp-MRI in the detection of PCa local recurrence after RP; the second part provides an insight about the impact of mp-MRI in the depiction of locoregional recurrence after RT (interstitial or external beam). Published data indicate an emerging role for mp-MRI in the detection and localization of locally recurrent PCa both after RP and RT which represents an information of paramount importance to perform focal salvage treatments.
BioMed Research International 05/2014; 2014(1):316272. DOI:10.1155/2014/316272 · 2.71 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Parce qu’il existe des solutions de rattrapage, il est important de dépister tôt les récidives locales du cancer de prostate. Le premier signe est la réascension du taux de PSA (« récidive biologique »). La définition de la récidive biologique varie suivant le traitement initial : PSA supérieur à 0,2 ng/mL après prostatectomie, nadir + 2 ng/mL après radiothérapie. La définition de la récidive biologique après cryothérapie, ultrasons focalisés ou curiethérapie n’est pas standardisée. L’IRM (notamment dynamique) peut détecter les récidives locales avec une bonne sensibilité. Le rôle de la spectroscopie reste discuté. Les techniques échographiques sont moins performantes que l’IRM pour l’instant.
"In addition, the use of MRI in detecting recurrence after therapy is not well established, partly because the exact site of local, regional, or distant recurrence in patients with rising PSA is, in most cases, uncertain, which in turn makes the targeting of an imaging site difficult . The ability of MRI to depict residual/recurrent disease after radiotherapy is limited because of posttreatment changes, including prostatic shrinkage, development of diffuse low T 2 -weighted signal intensity in the gland, and indistinctness of normal zonal anatomy . In addition, even if the tumor is detected, MRI does not have the ability to distinguish active tumor from treated tumor. "
[Show abstract][Hide abstract] ABSTRACT: Prostatic neoplasms are not uniformly distributed within the prostate volume. With recent developments in three-dimensional intensity-modulated and image-guided radiation therapy, it is possible to treat different volumes within the prostate to different thresholds of doses. This approach has the potential to adapt the dose to the biologic aggressiveness of various clusters of tumor cells within the gland. The definition of tumor burden volume in prostate cancer can be facilitated by the use of magnetic resonance spectroscopy (MRS). The increasing sensitivity and specificity of MRS to the prostate is causing new interest in its potential role in the definition of target subvolumes at higher risk of failure following radical radiotherapy. Prostate MRS might also play a role as a noninvasive predictive factor for tumor response and treatment outcome. We review the use of MRS in radiation therapy for prostate cancer by evaluating its accuracy in the classification of aggressive cancer regions and target definition; its current role in the radiotherapy planning process, with special interest in technical issues behind the successful inclusion of MRS in clinical use; and available early experiences as a prognostic tool.
Neoplasia (New York, N.Y.) 07/2007; 9(6):455-63. DOI:10.1593/neo.07277 · 4.25 Impact Factor
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