Prostatectomy bed MRI possibly predictive in recurrent prostate cancer

Investigators suggested that the higher spatial resolution of MRI versus molecular PET imaging allows for more precise localization of local recurrence in the prostatectomy bed for salvage radiation or focal ablation.

Eight hundred ninety-six patients with PSA of 0.2ng/mL or higher or rising after RP were identified.  At baseline, the men had no known distant metastases or salvage treatment with androgen deprivation therapy and/or radiation.  On pelvic MRI, 441 (49%) had a locally recurrent lesion in the prostatectomy bed and 455 patients (51%) did not.

Positive vs. negative MRI findings were significantly associated with a 3.1-fold higher risk for cancer-specific death, reported by Takashi Tanaka, MD of Mayo Clinic in Scottsdale Arizona in The Journal of Urology.  Larger lesion size was also associated with an increased risk of cancer-specific death.  As progression-free survival was worse among patients with negative MRI, men with negative findings may have had occult metastases and might have benefited from positron emission tomography (PET) with prostate cancer-specific radiotracer.

J Urol. Published online January 4, 2022. doi:10.1097/JU.0000000000002421.