Prostate MRI

for Previously Treated Patients Presenting with BCE (Biochemical Recurrance).

Post-treatment prostate MRI is not part of PI-RADS.

DCE (Dynamic Contrast Enhancement) is the dominate sequence.

DCE is considered positive when the enhancement is early. Early is within 10 seconds of the femoral artery or earlier than the rest of the prostate.

Sites of early contrast enhancement are the potential sites of local recurrance.

DWI is the next most important sequence particularly if the patient cannot have IV Gadolinium.

The most likely areas for locally recurrrent disease are:
  1. Peri-anastomotic
  2. Bladder neck
  3. Seminal Vessicle Bed