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Endorectal and Dynamic Contrast-Enhanced MRI for Detection of Local Recurrence After Radical Prostatectomy

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.

OBJECTIVE. The objective of our study was to evaluate the sensitivity and specificity of endorectal MRI combined with dynamic contrast-enhanced MRI to detect local recurrence after radical prostatectomy.

MATERIALS AND METHODS. A total of 51 patients who had undergone radical prostatectomy for prostatic adenocarcinoma 10 months to 6 years before underwent a combined endorectal coil MRI and dynamic gadolinium-enhanced MRI before endorectal sonographically guided biopsy of the prostatic fossa. The MRI combined with MR dynamic imaging results were correlated with the presence of recurrence defined as a positive biopsy result or reduction in prostate-specific antigen level after radiation therapy.

RESULTS. Overall data of 46 (25 recurred, 21 nonrecurred) out of 51 evaluated patients were analyzed. All recurrences showed signal enhancement after gadolinium administration and, in particular, 22 of 24 patients (91%) showed rapid and early signal enhancement. The overall sensitivity and specificity of MR dynamic imaging was higher compared with MRI alone (88%, [95% CI] 69–98% and 100%, 84–100% compared with 48%, 28–69% and 52%, 30–74%). MRI combined with dynamic imaging allowed better identification of recurrences compared with MRI alone (McNemar test: chi-square₁ = 16.67; p = < 0.0001).

CONCLUSION. MRI combined with dynamic contrast-enhanced MRI showed a higher sensitivity and specificity compared with MRI alone in detecting local recurrences after radical prostatectomy.

Keywords: contrast-enhanced MRI • MRI • prostate neoplasm • recurrence

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