University of Milan, Milan, Italy.
Department of Radiology, Grande Ospedale Metropolitano Niguarda, Milan, Italy.
Radiol Med. 2020 Jul;125(7):683-690. doi: 10.1007/s11547-020-01149-3. Epub 2020 Feb 20.
The aim of our study was to evaluate the sensitivity of contrast-enhanced magnetic resonance (CE-MR) with phased array coil in the diagnosis of local recurrence in patients with prostate cancer after radical prostatectomy and referred for salvage radiotherapy (SRT).
This retrospective study included 73 patients treated with SRT after radical prostatectomy in the period between September 2006 and November 2017. All patients performed a CE-MRI with phased array coil before the start of SRT. A total of 213 patients treated at the ASST Grande Ospedale Metropolitano Niguarda in the period between September 2006 and November 2017 with SRT after radical prostatectomy were reviewed. Seventy-three patients with a CE-MRI with phased array coil of the pelvis before the start of SRT were included in the present study.
At imaging review, recurrence local recurrent disease was diagnosed in 48 of 73 patients. By considering as reference standard the decrease in prostate-specific antigen (PSA) value after radiotherapy, we defined: 41 true positive (patients with MRI evidence of local recurrence and PSA value decreasing after SRT), 7 false positive (patients with MRI evidence of local recurrence without biochemical response after SRT), 3 true negative (patients without MRI evidence of local recurrence and stable or increased PSA value after SRT) and 22 false negative (patients without MRI evidence of local recurrence and PSA value decreasing after SRT) cases. The sensitivity values were calculated in relation to the PSA value before the start of treatment, obtaining a value of 74% for PSA above 0.2 ng/mL.
The sensitivity of CE-MRI in local recurrence detection after radical prostatectomy increases with increasing PSA values. CE-MRI with phased array coil can detect local recurrences after radical prostatectomy with a good sensitivity in patients with pre-RT PSA value above 0.2 ng/mL.
本研究旨在评估经直肠相控阵线圈增强磁共振（CE-MR）在根治性前列腺切除术后局部复发并接受挽救性放疗（SRT）的前列腺癌患者中的诊断灵敏度。
本回顾性研究纳入了 2006 年 9 月至 2017 年 11 月期间在 ASST Grande Ospedale Metropolitano Niguarda 接受 SRT 治疗的 73 例患者。所有患者在开始 SRT 前均进行了经直肠相控阵线圈 CE-MRI 检查。对 2006 年 9 月至 2017 年 11 月期间在 ASST Grande Ospedale Metropolitano Niguarda 接受根治性前列腺切除术后 SRT 治疗的 213 例患者进行了回顾性分析。本研究纳入了 73 例在开始 SRT 前进行了经直肠相控阵线圈骨盆 CE-MRI 检查的患者。
在影像学复查中，48 例/73 例患者诊断为局部复发。以放疗后前列腺特异性抗原（PSA）值下降为参考标准，我们定义了：41 例真阳性（MRI 显示局部复发且 SRT 后 PSA 值下降的患者）、7 例假阳性（MRI 显示局部复发但 SRT 后无生化反应的患者）、3 例真阴性（MRI 显示无局部复发且 SRT 后 PSA 值稳定或升高的患者）和 22 例假阴性（MRI 显示无局部复发且 SRT 后 PSA 值下降的患者）。根据治疗前 PSA 值计算了灵敏度值，得出 PSA 值＞0.2ng/mL 时灵敏度为 74%。
经直肠相控阵线圈 CE-MRI 对根治性前列腺切除术后局部复发的检测灵敏度随 PSA 值的升高而增加。在 PSA 值＞0.2ng/mL 的 SRT 前患者中，经直肠相控阵线圈 CE-MRI 对根治性前列腺切除术后局部复发的检测具有较高的灵敏度。
