Endorectal and Dynamic Contrast-Enhanced MRI for Detection of Local Recurrence After Radical Prostatectomy
Emanuele Casciani1,
Elisabetta Polettini1,
Enrico Carmenini2,
Irene Floriani3,
Gabriele Masselli1,
Luca Bertini1 and
Gian Franco Gualdi1
1 Department of Radiology, University of Rome "La Sapienza," Via del
Policlinico, 155, 00166 Rome, Italy.
2 U.O.C. Osservazione Medica, Ospedale M. G. Vannini, Rome, Italy.
3 Istituto di Ricerche Farmacologiche "Mario Negri," Milan,
Italy.
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Fig. 1 —Diagram shows time–signal intensity curves from dynamic
contrast-enhanced MRI for determination of initial signal increase and
postinitial signal behavior; x-axis shows time in seconds and
y-axis shows signal intensity in percent.
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Fig. 2A —Endorectal coil pelvic MR images obtained in 61-year-old man
who had undergone radical prostatectomy 4 years earlier and had undetectable
prostate-specific antigen level and unremarkable clinical examination.
Transverse T2-weighted image reveals small moderately hyperintense nodule
(arrow) posterior to vesicourethral anastomosis.
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Fig. 2B —Endorectal coil pelvic MR images obtained in 61-year-old man
who had undergone radical prostatectomy 4 years earlier and had undetectable
prostate-specific antigen level and unremarkable clinical examination.
Transverse T1-weighted 3D spoiled gradient-echo image during IV bolus
injection of paramagnetic gadolinium chelate at same level as A shows
signal increase.
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Fig. 2C —Endorectal coil pelvic MR images obtained in 61-year-old man
who had undergone radical prostatectomy 4 years earlier and had undetectable
prostate-specific antigen level and unremarkable clinical examination.
Time–signal intensity curve from dynamic contrast-enhanced MRI shows
faster and stronger enhancement and washout of small nodule posterior to
vesicourethral anastomosis. Signal intensity on T2-weighted sequence and
dynamic contrast-enhanced MRI behavior of nodule suggest recurrence of
prostatic cancer. Transrectal ultrasonography (TRUS)–guided biopsy was
positive for recurrence of prostatic cancer.
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Fig. 3A — Endorectal coil pelvic MR images obtained in 65-year-old man
who had undergone radical prostatectomy 1 year earlier. PSA level was 0.5
ng/dL. Transverse T2-weighted image reveals small hypointense nodule
(arrow) posterior to bladder.
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Fig. 3B — Endorectal coil pelvic MR images obtained in 65-year-old man
who had undergone radical prostatectomy 1 year earlier. PSA level was 0.5
ng/dL. Transverse T1-weighted 3D spoiled gradient-echo image during IV bolus
injection of paramagnetic gadolinium chelate at same level as A shows
signal increase.
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Fig. 3C — Endorectal coil pelvic MR images obtained in 65-year-old man
who had undergone radical prostatectomy 1 year earlier. PSA level was 0.5
ng/dL. Time–signal intensity curve from dynamic contrast-enhanced MRI
shows moderate initial signal increase and postinitial continuous increase.
Signal intensity on T2-weighted sequence and dynamic contrast-enhanced MRI
behavior of nodule suggest scar tissue with inflammatory changes. Transrectal
ultrasonography (TRUS)–guided biopsy was negative for recurrence of
prostatic cancer.
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Copyright © 2008 by the American Roentgen Ray Society.
