Localizing sites of disease in patients with rising serum prostate-specific antigen up to 1 ng/ml following prostatectomy: How much information can conventional imaging provide?

Hebert Alberto Vargas, Alexandre G. Martin-Malburet, Toshikazu Takeda, Renato B. Corradi, James Eastham, Andreas Wibmer, Evis Sala, Michael J. Zelefsky, Wolfgang A. Weber, Hedvig Hricak

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Purpose Accurate identification of the source of a detectable serum prostate-specific antigen (PSA) in the postprostatectomy setting is a major challenge among the urologic community. The aim of this study was to assess positivity rates of imaging examinations performed in patients with early PSA rise after prostatectomy and to summarize the management strategies adopted in this clinical scenario. Methods Institutional Review Board-approved retrospective study of 142 postprostatectomy patients with PSA rise up to 1 ng/ml who underwent evaluation with combination of multiparametric pelvic magnetic resonance imaging (MRI)±whole-body or bone MRI, bone scintigraphy, computed tomography (CT) chest-abdomen-pelvis, 18F-fludeoxyglucose-positron emission tomography (PET)/CT or 18F-sodium fluoride-PET/CT at a single tertiary cancer center. Imaging results were summarized per modality and compared with pathology findings. Results Pelvic MRI was positive in 15/142 (11%) patients (14 patients with local recurrence in the surgical bed and 1 patient with pelvic osseous metastases). Of these 15, 10 patients underwent additional imaging examinations; none revealed positive findings. Of the 127 patients with negative pelvic MRI, 54 (43%) underwent additional imaging examinations; only 1/54 had positive findings (false-positive T8 lesion on bone scintigraphy and FDG-PET/CT; biopsy was negative for cancer). Overall, 12/16 patients with positive imaging findings and 75/126 (60%) patients with negative imaging received treatment (radiation, hormones or chemotherapy). Conclusion The conventional imaging identified sites of disease, almost always in the form of local recurrence, in a minority of patients with early PSA rise postprostatectomy.

Original languageEnglish
Pages (from-to)482.e5-482.e10
JournalUrologic Oncology: Seminars and Original Investigations
Volume34
Issue number11
DOIs
Publication statusPublished - 2016 Nov 1
Externally publishedYes

Fingerprint

Prostate-Specific Antigen
Prostatectomy
Serum
Magnetic Resonance Imaging
Bone and Bones
Radionuclide Imaging
Recurrence
Sodium Fluoride
Research Ethics Committees
Pelvis
Abdomen
Neoplasms
Thorax
Retrospective Studies
Tomography
Hormones
Radiation
Pathology
Neoplasm Metastasis
Biopsy

Keywords

  • Bone scan
  • CT
  • MRI
  • PET
  • Prostate cancer
  • Recurrence

ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this

Localizing sites of disease in patients with rising serum prostate-specific antigen up to 1 ng/ml following prostatectomy : How much information can conventional imaging provide? / Vargas, Hebert Alberto; Martin-Malburet, Alexandre G.; Takeda, Toshikazu; Corradi, Renato B.; Eastham, James; Wibmer, Andreas; Sala, Evis; Zelefsky, Michael J.; Weber, Wolfgang A.; Hricak, Hedvig.

In: Urologic Oncology: Seminars and Original Investigations, Vol. 34, No. 11, 01.11.2016, p. 482.e5-482.e10.

Research output: Contribution to journalArticle

Vargas, Hebert Alberto ; Martin-Malburet, Alexandre G. ; Takeda, Toshikazu ; Corradi, Renato B. ; Eastham, James ; Wibmer, Andreas ; Sala, Evis ; Zelefsky, Michael J. ; Weber, Wolfgang A. ; Hricak, Hedvig. / Localizing sites of disease in patients with rising serum prostate-specific antigen up to 1 ng/ml following prostatectomy : How much information can conventional imaging provide?. In: Urologic Oncology: Seminars and Original Investigations. 2016 ; Vol. 34, No. 11. pp. 482.e5-482.e10.
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abstract = "Purpose Accurate identification of the source of a detectable serum prostate-specific antigen (PSA) in the postprostatectomy setting is a major challenge among the urologic community. The aim of this study was to assess positivity rates of imaging examinations performed in patients with early PSA rise after prostatectomy and to summarize the management strategies adopted in this clinical scenario. Methods Institutional Review Board-approved retrospective study of 142 postprostatectomy patients with PSA rise up to 1 ng/ml who underwent evaluation with combination of multiparametric pelvic magnetic resonance imaging (MRI)±whole-body or bone MRI, bone scintigraphy, computed tomography (CT) chest-abdomen-pelvis, 18F-fludeoxyglucose-positron emission tomography (PET)/CT or 18F-sodium fluoride-PET/CT at a single tertiary cancer center. Imaging results were summarized per modality and compared with pathology findings. Results Pelvic MRI was positive in 15/142 (11{\%}) patients (14 patients with local recurrence in the surgical bed and 1 patient with pelvic osseous metastases). Of these 15, 10 patients underwent additional imaging examinations; none revealed positive findings. Of the 127 patients with negative pelvic MRI, 54 (43{\%}) underwent additional imaging examinations; only 1/54 had positive findings (false-positive T8 lesion on bone scintigraphy and FDG-PET/CT; biopsy was negative for cancer). Overall, 12/16 patients with positive imaging findings and 75/126 (60{\%}) patients with negative imaging received treatment (radiation, hormones or chemotherapy). Conclusion The conventional imaging identified sites of disease, almost always in the form of local recurrence, in a minority of patients with early PSA rise postprostatectomy.",
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T1 - Localizing sites of disease in patients with rising serum prostate-specific antigen up to 1 ng/ml following prostatectomy

T2 - How much information can conventional imaging provide?

AU - Vargas, Hebert Alberto

AU - Martin-Malburet, Alexandre G.

AU - Takeda, Toshikazu

AU - Corradi, Renato B.

AU - Eastham, James

AU - Wibmer, Andreas

AU - Sala, Evis

AU - Zelefsky, Michael J.

AU - Weber, Wolfgang A.

AU - Hricak, Hedvig

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Purpose Accurate identification of the source of a detectable serum prostate-specific antigen (PSA) in the postprostatectomy setting is a major challenge among the urologic community. The aim of this study was to assess positivity rates of imaging examinations performed in patients with early PSA rise after prostatectomy and to summarize the management strategies adopted in this clinical scenario. Methods Institutional Review Board-approved retrospective study of 142 postprostatectomy patients with PSA rise up to 1 ng/ml who underwent evaluation with combination of multiparametric pelvic magnetic resonance imaging (MRI)±whole-body or bone MRI, bone scintigraphy, computed tomography (CT) chest-abdomen-pelvis, 18F-fludeoxyglucose-positron emission tomography (PET)/CT or 18F-sodium fluoride-PET/CT at a single tertiary cancer center. Imaging results were summarized per modality and compared with pathology findings. Results Pelvic MRI was positive in 15/142 (11%) patients (14 patients with local recurrence in the surgical bed and 1 patient with pelvic osseous metastases). Of these 15, 10 patients underwent additional imaging examinations; none revealed positive findings. Of the 127 patients with negative pelvic MRI, 54 (43%) underwent additional imaging examinations; only 1/54 had positive findings (false-positive T8 lesion on bone scintigraphy and FDG-PET/CT; biopsy was negative for cancer). Overall, 12/16 patients with positive imaging findings and 75/126 (60%) patients with negative imaging received treatment (radiation, hormones or chemotherapy). Conclusion The conventional imaging identified sites of disease, almost always in the form of local recurrence, in a minority of patients with early PSA rise postprostatectomy.

AB - Purpose Accurate identification of the source of a detectable serum prostate-specific antigen (PSA) in the postprostatectomy setting is a major challenge among the urologic community. The aim of this study was to assess positivity rates of imaging examinations performed in patients with early PSA rise after prostatectomy and to summarize the management strategies adopted in this clinical scenario. Methods Institutional Review Board-approved retrospective study of 142 postprostatectomy patients with PSA rise up to 1 ng/ml who underwent evaluation with combination of multiparametric pelvic magnetic resonance imaging (MRI)±whole-body or bone MRI, bone scintigraphy, computed tomography (CT) chest-abdomen-pelvis, 18F-fludeoxyglucose-positron emission tomography (PET)/CT or 18F-sodium fluoride-PET/CT at a single tertiary cancer center. Imaging results were summarized per modality and compared with pathology findings. Results Pelvic MRI was positive in 15/142 (11%) patients (14 patients with local recurrence in the surgical bed and 1 patient with pelvic osseous metastases). Of these 15, 10 patients underwent additional imaging examinations; none revealed positive findings. Of the 127 patients with negative pelvic MRI, 54 (43%) underwent additional imaging examinations; only 1/54 had positive findings (false-positive T8 lesion on bone scintigraphy and FDG-PET/CT; biopsy was negative for cancer). Overall, 12/16 patients with positive imaging findings and 75/126 (60%) patients with negative imaging received treatment (radiation, hormones or chemotherapy). Conclusion The conventional imaging identified sites of disease, almost always in the form of local recurrence, in a minority of patients with early PSA rise postprostatectomy.

KW - Bone scan

KW - CT

KW - MRI

KW - PET

KW - Prostate cancer

KW - Recurrence

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