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12 - Imaging recurrent prostate cancer

Published online by Cambridge University Press:  23 December 2009

By
Tamar Sella  and
Darko Pucar
Edited by
Hedvig Hricak  and
Peter Scardino
Hedvig Hricak
Affiliation:
Memorial Sloan-Kettering Cancer Center
Peter Scardino
Affiliation:
Memorial Sloan-Kettering Cancer Center
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Summary

Introduction

In the setting of recurrent prostate cancer (PCa), awareness and understanding of clinical findings are essential for accurate imaging interpretation. Accordingly, this text will first address the principles of recurrent PCa management. Subsequently, the principles of recurrent PCa evaluation with computed tomography (CT), magnetic resonance imaging (MRI), transrectal ultrasound (TRUS), and TRUS-guided biopsy will be described. Nuclear medicine methods are reviewed in Chapter 11.

Management principles of recurrent prostate cancer

General principles

Prostate cancer is usually suspected based on the detection of an abnormal serum prostate-specific antigen (PSA) value (≥4 ng/ml is the most commonly used criterion) and diagnosed by TRUS-guided systematic prostate biopsy [1]. With systematic biopsy, one or more cores are obtained from each prostate sextant regardless of TRUS findings [2]. Although optional additional cores can be obtained from regions that are abnormal on TRUS or other imaging modalities, image-guided biopsy is currently accepted only as an adjunct to systematic biopsy [2]. Biopsy results are used to assign the Gleason grade [3]. Digital rectal examination (DRE) findings are used to determine clinical tumor stage; however, due to earlier detection by PSA testing, PCa is now non-palpable in about two-thirds of patients and the clinical stage often underestimates the pathologic tumor stage [4, 5] (Table 12.1).

Newly diagnosed PCa is designated as “primary” PCa and its treatment modalities are designated as “primary” treatments.

Type
Chapter
Information
Prostate Cancer , pp. 195 - 222
Publisher: Cambridge University Press
Print publication year: 2008

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References

Thompson, I. M., Ankerst, D. P., Prostate-specific antigen in the early detection of prostate cancer. CMAJ, 176:13 (2007), 1853–8.CrossRefGoogle ScholarPubMed
Hricak, H., Choyke, P. L., Eberhardt, S. C., et al., Imaging prostate cancer: a multidisciplinary perspective. Radiology, 243:1 (2007), 28–53.CrossRefGoogle ScholarPubMed
Epstein, J. I., Allsbrook, Jr W. C.., Amin, M. B., et al., Update on the Gleason grading system for prostate cancer: results of an international consensus conference of urologic pathologists. Adv Anat Pathol, 1 (2006), 57–9.CrossRefGoogle Scholar
Mohler, J., Babaian, R. J., Bahnson, R. R., NCCN Clinical Practice Guidelines in Oncology – Prostate Cancer, v 1.2008. 2008.
Partin, A. W., Mangold, L. A., Lamm, D. M., et al., Contemporary update of prostate cancer staging nomograms (Partin Tables) for the new millennium. Urology, 58:6 (2001), 843–8.CrossRefGoogle ScholarPubMed
,American Cancer Society. Cancer facts and figures 2006. Atlanta, GA; 2006, Publication No. 500806.
Mettlin, C. J., Murphy, G. P., McDonald, C. J., et al., The National Cancer Database Report on increased use of brachytherapy for the treatment of patients with prostate carcinoma in the U.S. Cancer, 86:9 (1999), 1877–82.3.0.CO;2-5>CrossRefGoogle Scholar
Stephenson, A. J., Eastham, J. A., Role of salvage radical prostatectomy for recurrent prostate cancer after radiation therapy. J Clin Oncol 23:32 (2005), 8198–203.CrossRefGoogle ScholarPubMed
Stephenson, A. J., Scardino, P. T., Eastham, J. A., et al., Preoperative nomogram predicting the 10-year probability of prostate cancer recurrence after radical prostatectomy. J Natl Cancer Inst, 98:10 (2006), 715–17.CrossRefGoogle ScholarPubMed
Roach, M., 3rd, Hanks, G., Thames, Jr H.., et al., Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO Phoenix Consensus Conference. Int J Radiat Oncol Biol Phys, 65:4 (2006), 965–74.CrossRefGoogle ScholarPubMed
Stephenson, A. J., Shariat, S. F., Zelefsky, M. J., et al., Salvage radiotherapy for recurrent prostate cancer after radical prostatectomy. JAMA, 291:11 (2004), 1325–32.CrossRefGoogle ScholarPubMed
Chaussy, C., Thuroff, S., Rebillard, X., et al., Technology insight: high-intensity focused ultrasound for urologic cancers. Natl Clin Pract Urol, 2:4 (2005), 191–8.CrossRefGoogle ScholarPubMed
Touma, N. J., Izawa, J. I., Chin, J. L., Current status of local salvage therapies following radiation failure for prostate cancer. J Urol, 173:2 (2005), 373–9.CrossRefGoogle ScholarPubMed
Grossfeld, G. D., Li, Y. P., Carroll, PR. Patterns of failure after primary local therapy for prostate cancer and rationale for secondary therapy. Urology, 60:3 Suppl. 1 (2002), 57–62; discussion 62–3.CrossRefGoogle ScholarPubMed
McLeod, D. G., Hormonal therapy: historical perspective to future directions. Urology, 61:2 Suppl 1 (2003), 3–7.CrossRefGoogle ScholarPubMed
Cher, M. L., Bianco, Jr F. J.., Lam, J. S., et al., Limited role of radionuclide bone scintigraphy in patients with prostate specific antigen elevations after radical prostatectomy. J Urol, 160:4 (1998), 1387–91.CrossRefGoogle ScholarPubMed
Hricak, H., Schoder, H., Pucar, D., et al., Advances in imaging in the postoperative patient with a rising prostate-specific antigen level. Semin Oncol, 30:5 (2003), 616–34.CrossRefGoogle ScholarPubMed
Epstein, J. I., Pizov, G., Walsh, P. C., Correlation of pathologic findings with progression after radical retropubic prostatectomy. Cancer, 71:11 (1993), 3582–93.3.0.CO;2-Y>CrossRefGoogle ScholarPubMed
Flocks, R. H., Culp, D., Porto, R., Lymphatic spread from prostatic cancer. J Urol, 81:1 (1959), 194–6.CrossRefGoogle ScholarPubMed
Rorvik, J., Halvorsen, O. J., Albrektsen, G., et al., Lymphangiography combined with biopsy and computer tomography to detect lymph node metastases in localized prostate cancer. Scand J Urol Nephrol, 32:2 (1998), 116–19.Google ScholarPubMed
Walsh, J. W., Amendola, M. A., Konerding, K. F., et al., Computed tomographic detection of pelvic and inguinal lymph-node metastases from primary and recurrent pelvic malignant disease. Radiology, 137:1 Pt 1 (1980), 157–66.CrossRefGoogle ScholarPubMed
Wolf, Jr J. S.., Cher, M., Dall'era, M., et al., The use and accuracy of cross-sectional imaging and fine needle aspiration cytology for detection of pelvic lymph node metastases before radical prostatectomy. J Urol, 153:3 Pt 2 (1995), 993–9.CrossRefGoogle ScholarPubMed
Oyen, R. H., Poppel, H. P., Ameye, F. E., et al., Lymph node staging of localized prostatic carcinoma with CT and CT-guided fine-needle aspiration biopsy: prospective study of 285 patients. Radiology, 190:2 (1994), 315–22.CrossRefGoogle ScholarPubMed
Barentsz, J. O., Futterer, J. J., Takahashi, S., Use of ultrasmall superparamagnetic iron oxide in lymph node MR imaging in prostate cancer patients. Eur J Radiol, 63:3 (2007), 369–72.CrossRefGoogle ScholarPubMed
Warren, K. S., Chodak, G. W., See, W. A., et al., Are bone scans necessary in men with low prostate specific antigen levels following localized therapy?J Urol, 176:1 (2006), 70–3; discussion 73–4.CrossRefGoogle ScholarPubMed
Freedman, G. M., Negendank, W. G., Hudes, G. R., et al., Preliminary results of a bone marrow magnetic resonance imaging protocol for patients with high-risk prostate cancer. Urology, 54:1 (1999), 118–23.CrossRefGoogle ScholarPubMed
Rosenthal, D. I., Radiologic diagnosis of bone metastases. Cancer, 80:8 Suppl (1997), 1595–607.3.0.CO;2-V>CrossRefGoogle ScholarPubMed
Lecouvet, F. E., Geukens, D., Stainier, A., et al., Magnetic resonance imaging of the axial skeleton for detecting bone metastases in patients with high-risk prostate cancer: diagnostic and cost-effectiveness and comparison with current detection strategies. J Clin Oncol, 25:22 (2007), 3281–7.CrossRefGoogle ScholarPubMed
Zagars, G. K., Pollack, A., Eschenbach, A. C., Prostate cancer and radiation therapy – the message conveyed by serum prostate-specific antigen. Int J Radiat Oncol Biol Phys, 33:1 (1995), 23–35.CrossRefGoogle ScholarPubMed
Cheng, L., Cheville, J. C., Bostwick, D. G., Diagnosis of prostate cancer in needle biopsies after radiation therapy. Am J Surg Pathol, 23:10 (1999), 1173–83.CrossRefGoogle ScholarPubMed
Crook, J., Malone, S., Perry, G., et al., Postradiotherapy prostate biopsies: what do they really mean? Results for 498 patients. Int J Radiat Oncol Biol Phys, 48:2 (2000), 355–67.CrossRefGoogle ScholarPubMed
Crook, J., Robertson, S., Collin, G., et al., Clinical relevance of trans-rectal ultrasound, biopsy, and serum prostate-specific antigen following external beam radiotherapy for carcinoma of the prostate. Int J Radiat Oncol Biol Phys, 27:1 (1993), 31–7.CrossRefGoogle ScholarPubMed
Rogers, E., Ohori, M., Kassabian, V. S., et al., Salvage radical prostatectomy: outcome measured by serum prostate specific antigen levels. J Urol, 153:1 (1995), 104–10.CrossRefGoogle ScholarPubMed
Pucar, D., Shukla-Dave, A., Hricak, H., et al., Prostate cancer: correlation of MR imaging and MR spectroscopy with pathologic findings after radiation therapy-initial experience. Radiology, 236:2 (2005), 545–53.CrossRefGoogle Scholar
Mullerad, M., Hricak, H., Kuroiwa, K., et al., Comparison of endorectal magnetic resonance imaging, guided prostate biopsy and digital rectal examination in the preoperative anatomical localization of prostate cancer. J Urol, 174:6 (2005), 2158–63.CrossRefGoogle ScholarPubMed
Arrive, L., Chang, Y. C., Hricak, H., et al., Radiation-induced uterine changes: MR imaging. Radiology, 170:1 Pt 1 (1989), 55–8.CrossRefGoogle ScholarPubMed
Sugimura, K., Carrington, B. M., Quivey, J. M., et al., Postirradiation changes in the pelvis: assessment with MR imaging. Radiology, 175:3 (1990), 805–13.CrossRefGoogle ScholarPubMed
Coakley, F. V., Hricak, H., Wefer, A. E., et al., Brachytherapy for prostate cancer: endorectal MR imaging of local treatment-related changes. Radiology, 219:3 (2001), 817–21.CrossRefGoogle ScholarPubMed
Haider, M. A., Chung, P., Sweet, J., et al., Dynamic contrast-enhanced magnetic resonance imaging for localization of recurrent prostate cancer after external beam radiotherapy. Int J Radiat Oncol Biol Phys, 70:2 (2008), 425–30.CrossRefGoogle ScholarPubMed
Rouviere, O., Valette, O., Grivolat, S., et al., Recurrent prostate cancer after external beam radiotherapy: value of contrast-enhanced dynamic MRI in localizing intraprostatic tumor – correlation with biopsy findings. Urology, 63:5 (2004), 922–7.CrossRefGoogle ScholarPubMed
Sala, E., Eberhardt, S. C., Akin, O., et al., Endorectal MR imaging before salvage prostatectomy: tumor localization and staging. Radiology, 238:1 (2006), 176–83.CrossRefGoogle ScholarPubMed
Coakley, F. V., Teh, H. S., Qayyum, A., et al., Endorectal MR imaging and MR spectroscopic imaging for locally recurrent prostate cancer after external beam radiation therapy: preliminary experience. Radiology, 233:2 (2004), 441–8.CrossRefGoogle Scholar
Cellini, N., Morganti, A. G., Mattiucci, G. C., et al., Analysis of intraprostatic failures in patients treated with hormonal therapy and radiotherapy: implications for conformal therapy planning. Int J Radiat Oncol Biol Phys, 53:3 (2002), 595–9.CrossRefGoogle ScholarPubMed
Pucar, D., Hricak, H., Shukla-Dave, A., et al., Clinically significant prostate cancer local recurrence after radiation therapy occurs at the site of primary tumor: magnetic resonance imaging and step-section pathology evidence. Int J Radiat Oncol Biol Phys, 69:1 (2007), 62–9.CrossRefGoogle ScholarPubMed
Kupelian, P., Meyer, J. L., Prostate cancer: image guidance and adaptive therapy. Front Radiat Ther Oncol, 40 (2007), 289–314.CrossRefGoogle Scholar
Pickett, B., Kurhanewicz, J., Pouliot, J., et al., Three-dimensional conformal external beam radiotherapy compared with permanent prostate implantation in low-risk prostate cancer based on endorectal magnetic resonance spectroscopy imaging and prostate-specific antigen level. Int J Radiat Oncol Biol Phys, 65:1 (2006), 65–72.CrossRefGoogle ScholarPubMed
Wasserman, N. F., Kapoor, D. A., Hildebrandt, W. C., et al., Transrectal US in evaluation of patients after radical prostatectomy. Part I. Normal postoperative anatomy. Radiology, 185:2 (1992), 361–6.CrossRefGoogle ScholarPubMed
Wasserman, N. F., Kapoor, D. A., Hildebrandt, W. C., et al., Transrectal US in evaluation of patients after radical prostatectomy. Part II. Transrectal US and biopsy findings in the presence of residual and early recurrent prostatic cancer. Radiology, 185:2 (1992), 367–72.CrossRefGoogle ScholarPubMed
Leventis, A. K., Shariat, S. F., Slawin, K. M., Local recurrence after radical prostatectomy: correlation of US features with prostatic fossa biopsy findings. Radiology, 219:2 (2001), 432–9.CrossRefGoogle ScholarPubMed
Scattoni, V., Roscigno, M., Raber, M., et al., Multiple vesico-urethral biopsies following radical prostatectomy: the predictive roles of TRUS, DRE, PSA and the pathological stage. Eur Urol, 44:4 (2003), 407–14.CrossRefGoogle ScholarPubMed
Deliveliotis, C., Manousakas, T., Chrisofos, M., et al., Diagnostic efficacy of transrectal ultrasound-guided biopsy of the prostatic fossa in patients with rising PSA following radical prostatectomy. World J Urol, 25:3 (2007), 309–13.CrossRefGoogle ScholarPubMed
Shekarriz, B., Upadhyay, J., Wood, Jr D. P.., et al., Vesicourethral anastomosis biopsy after radical prostatectomy: predictive value of prostate-specific antigen and pathologic stage. Urology, 54:6 (1999), 1044–8.CrossRefGoogle ScholarPubMed
Sudakoff, G. S., Smith, R., Vogelzang, N. J., et al., Color Doppler imaging and transrectal sonography of the prostatic fossa after radical prostatectomy: early experience. AJR Am J Roentgenol, 167:4 (1996), 883–8.CrossRefGoogle ScholarPubMed
Tamsel, S., Killi, R., Apaydin, E., et al., The potential value of power Doppler ultrasound imaging compared with grey-scale ultrasound findings in the diagnosis of local recurrence after radical prostatectomy. Clin Radiol, 61:4 (2006), 325–30; discussion 323–4.CrossRefGoogle Scholar
Drudi, F. M., Giovagnorio, F., Carbone, A., et al., Transrectal colour Doppler contrast sonography in the diagnosis of local recurrence after radical prostatectomy – comparison with MRI. Ultraschall Med, 27:2 (2006), 146–51.CrossRefGoogle Scholar
Fowler, Jr J. E.., Brooks, J., Pandey, P., et al., Variable histology of anastomotic biopsies with detectable prostate specific antigen after radical prostatectomy. J Urol, 153:3 Pt 2 (1995), 1011–14.CrossRefGoogle ScholarPubMed
Wood, D. P., Jr., Peretsman, S. J., Seay, T. M., Incidence of benign and malignant prostate tissue in biopsies of the bladder neck after a radical prostatectomy. J Urol, 154:4 (1995), 1443–6.CrossRefGoogle ScholarPubMed
Sella, T., Schwartz, L. H., Swindle, P. W., et al., Suspected local recurrence after radical prostatectomy: endorectal coil MR imaging. Radiology, 231:2 (2004), 379–85.CrossRefGoogle ScholarPubMed
Boni, R. A. Huch, Meyenberger, C., Lundquist, J. Pok, et al., Value of endorectal coil versus body coil MRI for diagnosis of recurrent pelvic malignancies. Abdom Imaging, 21:4 (1996), 345–52.Google Scholar
Miralbell, R., Vees, H., Lozano, J., et al., Endorectal MRI assessment of local relapse after surgery for prostate cancer: a model to define treatment field guidelines for adjuvant radiotherapy in patients at high risk for local failure. Int J Radiat Oncol Biol Phys, 67:2 (2007), 356–61.CrossRefGoogle ScholarPubMed
Silverman, J. M., Krebs, T. L., MR imaging evaluation with a transrectal surface coil of local recurrence of prostatic cancer in men who have undergone radical prostatectomy. AJR Am J Roentgenol, 168:2 (1997), 379–85.CrossRefGoogle ScholarPubMed
Maki, D. D., Banner, M. P., Ramchandani, P., et al., Injected periurethral collagen for postprostatectomy urinary incontinence: MR and CT appearance. Abdom Imaging, 25:6 (2000), 658–62.CrossRefGoogle ScholarPubMed
Sella, T., Schwartz, L. H., Hricak, H., Retained seminal vesicles after radical prostatectomy: frequency, MRI characteristics, and clinical relevance. AJR Am J Roentgenol, 186:2 (2006), 539–46.CrossRefGoogle ScholarPubMed
Hofer, C, Laubenbacher, C., Block, T., et al., Fluorine-18-fluorodeoxyglucose positron emission tomography is useless for the detection of local recurrence after radical prostatectomy. Eur Urol, 36:1 (1999), 31–5.CrossRefGoogle ScholarPubMed
Schoder, H., Herrmann, K., Gonen, M., et al., 2-[18F]Fluoro-2-deoxyglucose positron emission tomography for the detection of disease in patients with prostate-specific antigen relapse after radical prostatectomy. Clin Cancer Res, 11:13 (2005), 4761–9.CrossRefGoogle ScholarPubMed
Albrecht, S., Buchegger, F., Soloviev, D., et al., (11)C-acetate PET in the early evaluation of prostate cancer recurrence. Eur J Nucl Med Mol Imaging, 34:2 (2007), 185–96.CrossRefGoogle ScholarPubMed
Cimitan, M., Bortolus, R., Morassut, S., et al., [(18)F]fluorocholine PET/CT imaging for the detection of recurrent prostate cancer at PSA relapse: experience in 100 consecutive patients. Eur J Nucl Med Mol Imaging, 33:12 (2006), 1387–98.CrossRefGoogle ScholarPubMed
Scattoni, V., Picchio, M., Suardi, N., et al., Detection of lymph-node metastases with integrated [(11)C]choline PET/CT in patients with PSA failure after radical retropubic prostatectomy: results confirmed by open pelvic-retroperitoneal lymphadenectomy. Eur Urol, 52:2 (2007), 423–9.CrossRefGoogle ScholarPubMed
Schuster, D. M., Votaw, J. R., Nieh, P. T., et al., Initial experience with the radiotracer anti-1-amino-3-18F-fluorocyclobutane-1-carboxylic acid with PET/CT in prostate carcinoma. J Nucl Med, 48:1 (2007), 56–63.Google ScholarPubMed
Bander, N. H., Technology insight: monoclonal antibody imaging of prostate cancer. Nat Clin Pract Urol, 3:4 (2006), 216–25.CrossRefGoogle ScholarPubMed

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