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Urinary Imaging

E3104. Multiparametric MRI in the Evaluation of Prostate Cancer Recurrence: A Case-Based Review

Ward R,  Purysko A. Cleveland Clinic, Cleveland, OH

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Background Information: Prostate cancer is a major cause of morbidity and mortality in men. Radical prostatectomy, brachytherapy, cryotherapy, external beam radiation, and androgen deprivation therapy are available treatment options, selected based on initial clinical stage, patient, and physician factors. While most therapies are curative, a minority of patients will experience recurrence. Advances in MRI have shown great potential in detecting these recurrent lesions. In this exhibit, we use cases to demonstrate the utility of MRI in identifying prostate cancer recurrence.

Educational Goals/Teaching Points: We describe the various treatment options for prostate cancer, discuss the utility of multiparametric MRI in the evaluation of suspected recurrence, and illustrate the expected posttreatment changes and patterns of recurrence on multiparametric MRI.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: We present case examples of prostate cancer recurrence after radical prostatectomy, brachytherapy, cryotherapy, and external beam radiation. After each case, we describe the expected posttreatment changes as well as the patterns and typical locations for disease recurrence.

Conclusion: Multiparametric MRI has great utility in the identification and characterization of recurrent prostate cancer. With careful examination, the interpreting radiologist can reliably differentiate recurrent disease from posttreatment changes.