Key Points:
- Mapping recurrent prostate cancer study addresses challenges in locating recurrence in patients with biochemical recurrence after prostatectomy, especially with low PSA levels.
- Combining C-11 choline PET and multiparametric MRI enables accurate identification of recurrence sites at an average PSA level of 2, improving treatment options.
- Nearly two-thirds of the studied men had recurrences confined to the pelvis, suggesting the potential for targeted radiation therapy.
Mapping recurrent prostate cancer
A team of Mayo Clinic researchers has, for the first time, successfully mapped patterns of prostate cancer recurrence, following surgery. Using C-11 choline PET imaging and multiparametric MRI, researchers found an anatomically diverse pattern of recurrence, which may help optimize the treatment of patients whose prostate cancer returns after surgery. Journal of Urology published this research findings.
Implications
“This study has important implications for men who have a rising prostate-specific antigen (PSA) test, also known as biochemical recurrence, after radical prostatectomy for prostate cancer,” says Jeffrey Karnes, M.D., a urological surgeon at Mayo Clinic. “In men with biochemical recurrence, determining where the disease has recurred is quite challenging, especially when the PSA level is low.”
According to Dr. Karnes, in the U.S., approximately 30 percent of patients who have had an initial prostate cancer surgically excised will suffer a recurrence and seek treatment. “Current imaging tests like conventional bone and CT scans are not sensitive enough to identify sites of recurrence, especially when the PSA value is lower than 10,” he says.
Dr. Karnes says the combination of C-11 choline PET scanning and multiparametric MRI, helps physicians accurately identify sites of recurrence at an average PSA of 2. More importantly, he says, “This type of staging allows us to identify sites of recurrent disease that can be potentially treated either surgically or with radiation.”
Dr. Karnes and his team also were able to describe patterns of prostate cancer recurrence. They found that nearly two-thirds of men in the study had recurrence limited to the pelvis. These patients can potentially be targeted for radiation therapy.
References
- Sobol, Ilya, Harras B. Zaid, Rimki Haloi, Lance A. Mynderse, Adam T. Froemming, Val J. Lowe, Brian J. Davis, Eugene D. Kwon, and R. Jeffrey Karnes. 2017. “Contemporary Mapping of Post-Prostatectomy Prostate Cancer Relapse with 11C-Choline Positron Emission Tomography and Multiparametric Magnetic Resonance Imaging.” Journal of Urology 197 (1): 129–34. https://doi.org/10.1016/j.juro.2016.07.073
- Press release: Mayo Clinic researchers map prostate cancer relapse using C-11 choline PET and MRI