Men who have received treatment for prostate cancer need to be monitored for its recurrence.
This is often done by following PSA levels. A rising PSA level implies treatment failure and recurrent disease. Models have been developed based on how fast the PSA is rising, the original stage and grade of the cancer, a man’s age, and other factors to give a probability of recurrent disease.
If recurrent disease is suspected, these models can provide a probability of the recurrent cancer being local (i.e. within or adjacent to the prostate treatment bed) or distant (metastatic) to other sites such as the bones or lymph nodes. This information is vital to plan the most effective treatment while minimizing quality of life treatment complications.
Multiparametric MRI is best known for its ability to accurately detect prostate cancer and to stage the disease prior to treatment such has extracapsular extension or local spread of tumor. It is also increasingly being used in men who have been treated for prostate cancer and now have suspected recurrent local disease.
A multiparametric 3T MRI scan of the type that is provided at Partners Imaging Center will help to localize the size and location of the recurrent local cancer.
Although it is difficult with any imaging method to detect very small or microscopic disease, a high resolution 3T MRI can detect very low volume tumor in and around the prostate treatment area. This information is useful to plan the most effective therapy to target the tumor and to avoid using more aggressive therapies or larger treatment areas that have the potential of being less effective with greater complications.
MRI, CT, Bone scans, and PET/CT are used in evaluating for distant or metastatic disease. In 2018, Partners Imaging now perform Axumin PET Scans (Fluciclovine F18). This is an FDA approved Medicare approved scan that can achieve early detection of recurrent prostate cancer after surgery or radiation.