Associação Portuguesa de Investigação em Cancro
Post-treated prostate cancer: normal findings and signs of local relapse on multiparametric magnetic resonance imaging
Post-treated prostate cancer: normal findings and signs of local relapse on multiparametric magnetic resonance imaging
Authors and Affiliations:
1Department of Radiology, Hospital de S. José, Rua José António Serrano, 1150-199, Lisbon, Portugal
2, Rua Herculano Rodrigues, n15, 2esq, 2695-044, Lisbon, Portugal
3Faculdade de Ciências Médicas, Nova Medica School, Lisbon, Portugal
4Department of Radiology, Hospital de Santo António dos Capuchos, Alameda de Santo António dos Capuchos, 1169-050, Lisbon, Portugal
5Department of Urology, Hospital de S. José, Rua José António Serrano, 1150-199, Lisbon, Portugal
6Faculdade de Ciências Médicas, Nova Medica School, Lisbon, Portugal
7Department of Radiology, Hospital de S. José, Rua José António Serrano, 1150-199, Lisbon, Portugal
8Department of Radiology, Hospital de Santa Marta, Rua de Santa Marta, 1169-1024, Lisbon, Portugal
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.
Journal: Abdominal Imaging
Link: http://link.springer.com/article/10.1007%2Fs00261-015-0473-1