Feasibility of 3T Dynamic Contrast-Enhanced Magnetic... : Investigative Radiology (original) (raw)

Original Articles

Feasibility of 3T Dynamic Contrast-Enhanced Magnetic Resonance-Guided Biopsy in Localizing Local Recurrence of Prostate Cancer After External Beam Radiation Therapy

Yakar, Derya MD*; Hambrock, Thomas MD*; Huisman, Henkjan PhD*; Hulsbergen-van de Kaa, Christina A. MD, PhD†; van Lin, Emile MD, PhD‡; Vergunst, Henk MD, PhD§; Hoeks, Caroline M.A. MD*; van Oort, Inge M. MD, PhD¶; Witjes, J Alfred MD, PhD¶; Barentsz, Jelle O. MD, PhD*; Fütterer, Jurgen J. MD, PhD*

From the Departments of *Radiology, †Pathology, and ‡Radiation Oncology, Nijmegen Medical Centre, Radboud University, Nijmegen, The Netherlands; §Department of Urology, Canisius Whilhemina Hospital, Nijmegen, The Netherlands; and ¶Department of Urology, Nijmegen Medical Centre, Radboud University, Nijmegen, The Netherlands.

Received July 16, 2009, and accepted for publication, after revision, October 24, 2009.

Reprints: Derya Yakar, MD, Department of Radiology, Radboud University, Nijmegen Medical Centre, Geert Grooteplein 10, 6500 HB, Nijmegen, The Netherlands. E-mail: [email protected].

Abstract

Objectives:

The objective of this study was to assess the feasibility of the combination of magnetic resonance (MR)-guided biopsy (MRGB) and diagnostic 3T MR imaging in the localization of local recurrence of prostate cancer (PCa) after external beam radiation therapy (EBRT).

Materials and Methods:

Twenty-four consecutive men with biochemical failure suspected of local recurrence after initial EBRT were enrolled prospectively in this study. All patients underwent a diagnostic 3T MR examination of the prostate. T2-weighted and dynamic contrast-enhanced MR images (DCE-MRI) were acquired. Two radiologists evaluated the MR images in consensus for tumor suspicious regions (TSRs) for local recurrence. Subsequently, these TSRs were biopsied under MR-guidance and histopathologically evaluated for the presence of recurrent PCa. Descriptive statistical analysis was applied.

Results:

Tissue sampling was successful in all patients and all TSRs. The positive predictive value on a per patient basis was 75% (15/20) and on a per TSR basis 68% (26/38). The median number of biopsies taken per patient was 3, and the duration of an MRGB session was 31 minutes. No intervention-related complications occurred.

Conclusions:

The combination of MRGB and diagnostic MR imaging of the prostate was a feasible technique to localize PCa recurrence after EBRT using a low number of cores in a clinically acceptable time.