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MRI Locates Prostate Cancer Recurrence at
Extremely Low PSA Levels
Newswise, May 2, 2011 — A pelvic MRI scan
with IV contrast and rectal balloon is
highly effective in identifying local
recurrence even at low PSA values in
prostate cancer patients with a rising or
persistently elevated PSA after
prostatectomy, according to a study
presented April 29, 2011, at the Cancer
Imaging and Radiation Therapy Symposium in
Atlanta.
The symposium is co-sponsored by the
American Society for Radiation Oncology (ASTRO)
and the Radiological Society of North
America (RSNA).
Researchers at MD Anderson Cancer Center in
Houston evaluated 389 postprostatectomy
patients treated between January 2004 and
October 2010, with 143 receiving a pelvic
MRI to determine if cancer cells were still
present in the area of the surgical bed.
Thirty-five of those patients had suspicious
MRI findings suggesting local recurrence.
Twenty-six patients were then biopsied, with
23 showing cancer.
The study showed that about one-third of
patients with a biopsy-proven recurrence
after suspicious MRI finding had a PSA of
less than 1, with several having a PSA as
low as 0.3.
A scan of the surgical bed is typically
performed after a prostatectomy and before
salvage radiation therapy treatment in
prostate cancer patients with a rising PSA
to determine a potential recurrence and
location of recurrence. An MRI is able to
differentiate between soft tissues better
than a traditional CT scan, so the high
rates of cancer recurrence picked up by the
MRI were not surprising to researchers. What
was surprising was the low PSA levels at
which the MRI could determine recurrent
disease.
“Being able to identify such patients is
beneficial, as it would be predictive of
response to salvage radiation therapy,”
Seungtaek Choi, MD, lead author of the study
and an assistant professor of radiation
oncology at MD Anderson Cancer Center in
Houston, said. “It also may allow a
radiation oncologist to treat the area of
recurrent cancer to a higher radiation dose
with or without hormone ablation therapy to
increase the chance of cure.”
The abstract, “The Use of Dynamic Contrast
Enhanced (DCE) Endorectal Magnetic Resonance
Imaging (MRI) in the Evaluation of Patients
with Rising or Persistently Elevated PSA
after Radical Prostatectomy.”
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