Multiparametric MRI for Recurrent Prostate Cancer Post Radical Prostatectomy and Postradiation Therapy
Figure 3
Multiparametric-MR images of a 69-year-old man with prostate-specific antigen progression (PSA serum level 0.6 ng/mL) after radical retropubic prostatectomy, with suspected local recurrence. (a) Axial T2-weighted fast spin-echo image shows a solid nodular tissue of about 8 mm in size on the right posterior perianastomotic location in front of the rectal wall at about 14 mm from the ureteral meatus which is slightly hyperintense compared to pelvic muscles (white arrow). (b) Axial gradient-echo T1-weighted subtracted image shows no signs of enhancement of the abnormal tissue detected on T2-weighted images (white arrow). (c) Axial ADC map reconstructed from images obtained at values of 0, 500, and 1,000 s/mm2 shows a bright area corresponding to the abnormal hyperintense tissue seen on T2-weighted images (white arrow). (d) 1H-magnetic resonance spectroscopic imaging reveals a choline-plus-creatine-to-citrate ratio lower than 0.3. All these findings are consistent with residual glandular healthy tissue.
