Advanced Imaging for the Early Diagnosis of Local Recurrence Prostate Cancer after Radical Prostatectomy
Figure 2
Multiparametric-MR images of a 71-year-old man with prostate-specific antigen progression (PSA serum level 0.47 ng/mL) after radical retropubic prostatectomy, with suspected local recurrence. (a) Axial T2-weighted fast spin-echo and (b) axial T2-weighted fat saturated fast spin-echo images show, on the zone previously occupied by the right seminal vesicle, a slightly hyperintense lobulated tissue (white arrow). (c) Axial native DWI image with value of 1000 s/mm2 and (d) ADC map reconstructed from images obtained at values of 0, 500, and 1000 s/mm2 show a dark area corresponding to the abnormal hyperintense tissue seen on T2-weighted images. (e) Gradient-echo T1-weighted color map image shows a well-defined area of marked enhancement (white arrow) on the same location as the nodular tissue seen on T2-weighted images. (f) 1H-magnetic resonance spectroscopic imaging reveals a high choline peak with a choline-plus-creatine-to-citrate ratio greater than 1. All these findings are consistent with local recurrence.
