MRI Highly Effective in Identifying Prostate Cancer Recurrence Even at Low PSA Levels

According to a study conducted by researchers at MD Anderson Cancer Center in Houston, 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.

For prostate cancer patients with rising PSA, a scan is typically performed after a prostatectomy and before salvage radiation therapy treatment.  This is to determine the potential recurrence and the location of the recurrence.  Researchers were not surprised that high rates of cancer recurrence were picked up by the MRI than the traditional CT scan as an MRI is able to differentiate between soft tissues better.  The surprise was the low PSA levels at which the MRI could determine recurrent disease.

Lead author of the study and assistant professor of radiation oncology at MD Anderson Cancer Center in Houston said “Being able to identify such patients is beneficial, as it would be predictive of response to salvage radiation therapy.  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 study evaluated 389 post prostatectomy 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.  Of those patients, 35 had suspicious MRI findings suggesting a local recurrence where 26 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.

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May 2011
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