Valeria Panebianco MD, Presenter: Nothing to Disclose

Marcello Osimani, Abstract Co-Author: Nothing to Disclose

Danilo Lisi, Abstract Co-Author: Nothing to Disclose

Alessandro Sciarra, Abstract Co-Author: Nothing to Disclose

Eleonora Santucci, Abstract Co-Author: Nothing to Disclose

Roberto Passariello MD, Abstract Co-Author: Nothing to Disclose

To our knowledge, no prior studies have evaluated the sensitivity and specificity of MR spectroscopic imaging (1H-MRSI) and dynamic contrast-enhanced MR (DCEMR), alone and in combination, in the detection of prostate cancer recurrence. Therefore, the purpose of this study was to perform this analysis, in order to investigate the capability of a combined MR approach in the depiction of local prostate cancer recurrence in selected patients with biochemical progression after radical prostatectomy (RRP) and small suspected foci.

1H-MRSI and DCEMRI were performed on a 1.5 T scanner in 70 patients at high risk of local recurrence after RRP. The population was divided on the basis of a suitable trans-rectal US biopsy (TRUS biopsy) examination in a group of 50 patients (Group A) and the PSA serum level restitution after external beam radiotherapy, in a group of 20 patients (Group B), in whom the size of suspected recurrence did not permit a suitable biopsy. MR diagnostic accuracy level was displayed in receiver operating characteristic (ROC) curves for each technique and for a combination of both.

In Group A, 1H-MRSI analysis alone showed a sensitivity of 84% and a specificity of 88%; the DCEMR analysis alone a sensitivity of 71% and a specificity of 94% ; combined 1HMRSI-DCEMR a sensitivity of 87% and specificity of 94%. Areas under the ROC curve for 1HMRSI, DCEMR, and combined 1HMRSI /DCEMR were 0.942, 0.931 and 0.964, respectively. In group B,1HMRSI alone showed a sensitivity of 71% and a specificity of 83%; DCEMR, a sensitivity of 79% and a specificity of 100%; combined 1HMRSI and DCEMR, a sensitivity of 86% and a specificity of 100%. Areas under the ROC curve for each of these groups were 0.81, 0.923 and 0.94, respectively.

Our results showed that combined 1H-MRSI and DCEMR approach is an accurate method to identify local prostate cancer recurrence in patients with biochemical progression after RRP. This may be particularly useful in patients with lower PSA rise, in whom volume of tumor may be predicted to be small and difficult to evaluate with others methods.

Combinated approach may be particularly useful in patients with lower PSA rise, in whom volume of tumor may be predicted to be small and difficult to evaluate with TRUS biopsy.

Panebianco, V, Osimani, M, Lisi, D, Sciarra, A, Santucci, E, Passariello, R, Prostate Cancer Local Recurrence after Radical Prostatectomy: Role of Dynamic Contrast-enhanced MR Imaging and Proton MR Spectroscopic Imaging in the Clinical Follow-up.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6009481.html