PracticeUpdate: Haematology & Oncology

ECCO2017 13

MultiparametricMRI is superior to PET and CT scanning for diagnosing prostate cancer recurrence after radical prostatectomy M ultiparameteric MRI has been shown to be superior to PET and CT scanning in patients with biochemical recurrence of prostate cancer after radical prostatectomy. • Additional tissue size 4–8 mm in the zone of removed prostate • Hypointense signal on T2-weighted imaging of the tumour is suspected at the site of removed prostate, multiparametricMRI allows for the choice of therapy.

Relapses of prostate cancer were characterised by hypointense signal on T2-weighted imaging, diffusion-weighted imaging, and decreased diffusion coefficient on the apparent diffusion coefficient, high-speed storage coefficient, and absolute maximum signal intensity on dynamic contrast- enhanced MRI. The results showed that the full complex of MRI methods increased the efficiency of diagnosis of local recurrence of prostate cancer after radical prostatectomy. Dr Kossov concluded that, whendiagnosing local recurrence of prostate cancer in the early stages of recurrence, multiparametric MRI is superior to PET andCT scanning.MultiparametricMRI is optimal in patients with biochemical relapse when local tumour recurrence is suspected, even amid negative results of integrated transrectal ultrasonography. Multiparametric MRI helps assess the dynamics of local prostate cancer recurrence after radiotherapy.

• Hyperintense signal on diffusion-weighted imaging with high b value and hypointense signal on apparent diffusion coefficient mapping • Fast and high local uptake during dynamic contrast-enhanced MRI. MR contrast agent pharmacokinetics changed dramatically in the background of hormone therapy. PET and CT scanning showed bone metastasis in 18 patients from 45 cases in which multiparametric MRI had not revealed local prostate recurrence. The combination of hormone therapy and subsequent salvage radi- otherapy improved the efficacy of treatment for local prostate cancer recurrence. Multiparametric MRI is unique among diagnostic radiationmethods for the evaluation of patients with biochemical recurrence of prostate cancer after radical prostatectomy. Salvage radiotherapy also serves as a method for verifying the diagnosis. If local recurrence

This was the outcome of a comparative study of diagnostic imaging methods in patients with suspected local relapse of prostate cancer after radical prostatectomy. Multiparametric MRI is one of the best methods of identifying local manifestations of disease progression. Such identification is particularly relevant in patients suitable for salvage radiotherapy.

F. Kossov, MD, of the Russian Onkology Research Center, Moscow, explained that clinical suspicion of local recurrence of prostate cancer after radical prostatectomy

PracticeUpdate Editorial Team

is based on the onset of biochemical failure. Multiparametric MRI is one of the best methods of identifying local manifestations of disease progression. Such identification is particularly relevant in patients suitable for salvage radiotherapy. P r o s t a t e T2 - we i g h t e d imaging, diffusion-weighted imaging with apparent diffusion coefficient, and dynamic contrast-enhanced T1-weighted imaging were obtained (diffusion-weighted imaging, b = 50–1000–1500; and b = 50–1500–2000) in patients suspicious for local relapse of prostate cancer after radical prostatectomy before salvage radiotherapy. Eighty-seven patients with bio- chemical relapse of prostate cancer after radical prosta- tectomy were examined by multiparametric MRI. Local recurrence of prostate cancer was diagnosed in 42 cases. MRI characteristics of can- cer recurrence were the same as for the primary prostate cancer:

© ECCO2017 European Cancer Congress

VOL. 2 • NO. 2 • 2017