Imaging Biochemical Recurrence After Prostatectomy: Where Are We Headed?

AJR. American Journal of Roentgenology
Peeyush BhargavaVikas Kundra

Abstract

OBJECTIVE. In this article, we discuss the evolving roles of imaging modalities in patients presenting with biochemical recurrence after prostatectomy. CONCLUSION. Multiple imaging modalities are currently available to evaluate patients with prostate cancer presenting with biochemical recurrence after prostatectomy. Multiparametric MRI (mpMRI) focuses on the postsurgical bed as well as regional lymph nodes and bones. PET/CT studies using 18F-fluciclovine, 11C-choline, and prostate-specific membrane antigen (PSMA) ligands are useful in detecting locoregional and distant metastasis. Multiparametric MRI is preferred for patients with low risk of metastasis for localizing recurrence in prostate bed as well as pelvic lymph node and bone recurrence. Moreover, mpMRI aids in guiding biopsy and additional salvage treatments. For patients with high risk of metastatic disease, both mpMRI and whole-body PET/CT may be performed. PET/MRI using 68Ga-PSMA has potential to enable a one-stop shop for local recurrence and metastatic disease evaluation, and clinical trials of PET/MRI are ongoing.

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Citations

Nov 14, 2020·International Journal of Radiation Oncology, Biology, Physics·Sophie RobinOlivier Chapet
Jan 8, 2021·Cancer Imaging : the Official Publication of the International Cancer Imaging Society·Aradhana M VenkatesanVikas Kundra
Feb 23, 2021·Frontiers in Oncology·Pierre DecazesPierre Vera
May 24, 2021·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·William G BreenThomas M Pisansky
Jul 17, 2021·Molecular Imaging and Biology : MIB : the Official Publication of the Academy of Molecular Imaging·Zhaoguo HanXilin Sun

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