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Prostate carcinoma: MR imaging findings after cryosurgery
C L Kalbhen1, H Hricak, K Shinohara
1Department of Radiology, University of California, San Francisco 94143, USA.
Radiology
|March 1, 1996
Summary
Prostate cryosurgery causes significant morphologic changes, including gland shrinkage and loss of zonal differentiation. These post-treatment alterations make magnetic resonance (MR) imaging unreliable for detecting residual prostate cancer.
Area of Science:
- Urology
- Radiology
- Oncology
Background:
- Prostate cryosurgery is a treatment for localized prostate cancer.
- Assessing treatment effectiveness and detecting residual disease post-cryosurgery is crucial.
Purpose of the Study:
- To evaluate morphologic changes in the prostate gland after cryosurgery.
- To determine the diagnostic value of magnetic resonance (MR) imaging in identifying residual tumor post-cryosurgery.
Main Methods:
- Endorectal MR imaging was performed on 27 patients with prostate carcinoma post-cryosurgery.
- MR findings were correlated with clinical data, prostate-specific antigen levels, and biopsy results.
- Eighteen patients had pre-cryosurgery MR imaging for comparison.
Main Results:
- Prostate volume decreased by 52% at 8 weeks or more post-cryosurgery.
- Loss of zonal differentiation occurred in 81% of patients; intraprostatic necrosis was seen in 52%.
- MR assessment for recurrent tumor had a positive predictive value of 44% and a negative predictive value of 73%.
Conclusions:
- Cryosurgery induces significant prostatic morphologic changes.
- These changes, including necrosis and altered gland structure, compromise the reliability of MR imaging for detecting residual prostate cancer.