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Imaging Biochemical Recurrence After Prostatectomy: Where Are We Headed?
Peeyush Bhargava1,2, Gregory Ravizzini3, Brian F Chapin4
1Department of Radiology, 301 University Blvd, Galveston, TX 77555.
AJR. American Journal of Roentgenology
|March 5, 2020
Summary
Imaging plays a key role in detecting prostate cancer recurrence after surgery. Multiparametric MRI (mpMRI) and PET/CT scans help identify local or distant metastasis, guiding further treatment.
Area of Science:
- Radiology
- Oncology
- Nuclear Medicine
Background:
- Biochemical recurrence after prostatectomy is a common challenge in prostate cancer management.
- Accurate staging and localization of recurrent disease are crucial for effective treatment planning.
Purpose of the Study:
- To review the current and emerging roles of various imaging modalities for evaluating biochemical recurrence after prostatectomy.
- To compare the utility of different imaging techniques in detecting locoregional and distant metastases.
Main Methods:
- Discussion of multiparametric MRI (mpMRI) for assessing the postsurgical bed, lymph nodes, and bones.
- Review of PET/CT imaging using tracers like 18F-fluciclovine, 11C-choline, and prostate-specific membrane antigen (PSMA) ligands.
- Exploration of the potential of PET/MRI for comprehensive staging.
Main Results:
- mpMRI is effective for localizing recurrence in patients with a low risk of metastasis.
- PET/CT scans are valuable for detecting both locoregional and distant metastatic disease.
- Combined mpMRI and PET/CT may be beneficial for high-risk patients.
Conclusions:
- Multiple imaging modalities are available for evaluating prostate cancer recurrence.
- The choice of imaging depends on the patient's risk of metastasis.
- PET/MRI shows promise as a single-modality solution for recurrence evaluation.
