Multiparametric MRI for Recurrent Prostate Cancer Post Radical Prostatectomy and Postradiation Therapy
Figure 1
Multiparametric-MR images of a 64-year-old man with prostate-specific antigen progression (PSA serum level 0.75 ng/mL) after radical retropubic prostatectomy, with suspected local recurrence. (a) Axial T2-weighted fast spin-echo image shows a soft tissue nodule of 1 cm in size on posterior perianastomotic location in front of the rectal wall at about 40 mm from the ureteral meatus which is slightly hyperintense compared to pelvic muscles (white arrow). (b) Axial gradient-echo T1-weighted perfusion image showing a remarkable enhancement of the pathological tissue (white arrow). (c) Semiquantitative signal intensity-time curve showing a significant difference between pelvic muscle enhancement (ROI2, green curve) and the higher peak enhancement values of suspected area (ROI1, red curve). (d) Quantitative concentration-time curve of the hypervascular nodule showing a high area under the curve. (e) Color map of choline-creatine to citrate ratio and (f) analysis of spectra show an increased choline-creatine to citrate ratio 0.5. (g) Axial native DWI image at value = 3,000 s/mm2 and (h) axial ADC map reconstructed from images obtained at values of 0, 500, 1,000, and 3,000 s/mm2 showing marked restricted diffusion (white arrow). All these findings are consistent with locoregional relapse.
