Focal Salvage Guided by T{sub 2}-Weighted and Dynamic Contrast-Enhanced Magnetic Resonance Imaging for Prostate Cancer Recurrences

Journal Article · Mon Mar 01 04:00:00 EST 2010 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.02.055· OSTI ID:21372095

Boeken Kruger, Arto E ^[1]; Battermann, Jan J; Moerland, Marinus A; Heide, Uulke A. van der; Vulpen, Marco van ^[2]

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1. Department of Urology, University Medical Center Utrecht, Utrecht (Netherlands)
2. Department of Radiation Oncology, University Medical Center Utrecht, Utrecht (Netherlands)

Purpose: Salvage treatment of the entire prostate for local recurrent cancer after primary radiotherapy is associated with high toxicity rates. Our goal was to show that, using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for the visualization of a recurrence, focal salvage treatment can be performed, with, potentially, a reduction in toxicity. Methods and Materials: We performed MRI, including a DCE sequence, in 7 patients with biopsy-proven locally recurrent prostate cancer. The specific regions of interest suspect for containing tumor were delineated using DCE and T{sub 2}-weighted MRI scans. Subsequently, focal salvage high-dose-rate brachytherapy plans were created to illustrate the principle of focal salvage. Total salvage treatment plans were also created for comparison. Results: The transfer constant (K{sup trans}) values from the DCE were 0.33-0.67 min{sup -1} for areas suspect for tumor and 0.07-0.25 min{sup -1} for normal tissue. In 4 cases, a focal salvage plan could be generated; 93-100% of the gross tumor volume was covered with the prescribed dose, with relative sparing of the bladder, rectum, and urethra. In the total salvage plans, 24-53% of the gross tumor volume was covered, and the organs at risk received high doses. In 3 cases, a focal salvage plan could not be created because of multifocal tumor, seminal vesicle extension, or capsular extension. Conclusion: Focal salvage treatment plans can be created in patients with local recurrent prostate cancer after radiotherapy. DCE-MRI supports the localization of the target area. This could lead to less toxicity in patients with local recurrent prostate cancer.

• OSTI ID: 21372095
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 3 Vol. 76; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BODY
BRACHYTHERAPY
DIAGNOSTIC TECHNIQUES
DISEASES
GLANDS
MALE GENITALS
MEDICINE
NEOPLASMS
NMR IMAGING
NUCLEAR MEDICINE
ORGANS
PROSTATE
RADIOLOGY
RADIOTHERAPY
THERAPY
TOXICITY