A Systematic Review of the Role of Imaging before Salvage Radiotherapy for Post-prostatectomy Biochemical Recurrence

Abstract A substantial proportion of patients who have undergone a radical prostatectomy for localised prostate cancer will have either persistently detectable prostate-specific antigen (PSA) levels or a delayed rise in PSA. The optimum treatment for these situations is not known. The key question i...

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Published inClinical oncology (Royal College of Radiologists (Great Britain)) Vol. 22; no. 1; pp. 46 - 55
Main Authors Beresford, M.J, Gillatt, D, Benson, R.J, Ajithkumar, T
Format Journal Article
LanguageEnglish
Published England Elsevier Ltd 01.02.2010
Subjects
Biochemical recurrence
bone scan
Combined Modality Therapy
Diagnostic Imaging
Hematology, Oncology and Palliative Medicine
Humans
Magnetic Resonance Imaging
Male
Neoplasm Recurrence, Local - diagnosis
PET-CT
Positron-Emission Tomography
prostascint
prostate cancer
Prostate-Specific Antigen - blood
Prostatic Neoplasms - blood
Prostatic Neoplasms - diagnosis
Prostatic Neoplasms - radiotherapy
Radiology
salvage radiotherapy
Salvage Therapy
Tomography, X-Ray Computed
salvage radiotherapy
PET-CT
prostate cancer
Biochemical recurrence
bone scan
prostascint
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Summary:Abstract A substantial proportion of patients who have undergone a radical prostatectomy for localised prostate cancer will have either persistently detectable prostate-specific antigen (PSA) levels or a delayed rise in PSA. The optimum treatment for these situations is not known. The key question is whether the PSA is reflective of local or distant progression. For salvage radiotherapy to be most effective, treatment should be considered before the PSA level is allowed to rise too high, when disease is more likely to be confined to the prostate bed. However, at low PSA levels, current imaging techniques are poor at detecting disease, making it difficult to differentiate local and distant recurrences and to target the radiotherapy appropriately. We review current and investigational imaging techniques, including bone scan, computed tomography, magnetic resonance imaging, positron emission tomography and Prostascint, assessing their utility in the situation of biochemical recurrence after radical prostatectomy.
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ISSN:0936-6555
1433-2981
DOI:10.1016/j.clon.2009.10.015