Antonio Westphalen1, Fergus V. Coakley, Vivian Weinberg, Mack Roach III, Jane Z. Wang, John Kurhanewicz
1University of California, San Francisco, San Francisco, CA, United States
The addition of MR spectroscopic imaging to T2-weighted MR imaging significantly improves the detection of locally recurrent prostate cancer after definitive external beam radiotherapy. The resulting information may assist the clinician to advise patients about subsequent clinical evaluation, selecting those for whom targeted hemi-prostate biopsy is appropriate to confirm disease. Although targeted therapies may be offered to patients in whom very minimal recurrent disease is diagnosed, hemi-prostate imaging evaluation is sufficiently accurate to obviate the need for sextant localization, since the most commonly recommended salvage treatments (radical retropubic prostatectomy and permanent LDR brachytherapy) treat the entire gland.