Prior MRI-imaging impact of patients submitted to brachytherapy for prostate cancer

Abstract

IntroductionBrachytherapy for the treatment of prostate cancer is a well-established option. Use of Multiparametric Magnetic Resonance Imaging (mpMRI) for staging and diagnosis of prostate cancer has come to change the current paradigm. In this study we aim to assess the impact of performing mpMRI to evaluate the presence of extracapsular lesions before brachytherapy in patients with prostate cancer concerning biochemical recurrence and time to nadir. MethodsReview data from 73 patients submitted to brachytherapy. The following factors were evaluated: age, initial PSA, MRI local staging results, ISUP, nadir, time to nadir, PSA at one-year, biochemical recurrence, and time to recurrence. ResultsMedian age was 68 years (51–72) and median follow-up 53 months (30–72). Concerning imaging modality 30,1% (n = 22) patients performed mpMRI. In the mpMRI group, 90.9% (n = 20) had at least one suspect lesion on mpMRI. Time to nadir was 27 months (3–64) in patients where mpMRI was not performed and 23.5 months (2–48) in patients submitted to mpMRI (P = .244). The median value of nadir was 0.42 ng/mL (<0.001–2) in patients submitted to mpMRI and vs 0.28 ng/mL (<0.001–4) in patients without MRI (P = .062) Recurrence utilizing Phoenix criteria was 9% (n = 2) in patients with MRI and 9.2% (n = 5) without mpMRI (P = .456), median follow-up of 43 months (12–72) for the MRI group with 58 months (30–78) for the non-mpMRI group. Both groups were statistically similar. ConclusionOur results allow us to conclude that in our series MRI did not influence biochemical recurrence, time to nadir, or nadir value.