Login to Access Video or Poster Abstract: MP70-04
Sources of Funding: Department of Urology, Winthrop University Hospital

Introduction

Biochemical recurrence (BCR) after primary focal cryosurgery (PFC) is determined using criteria (Phoenix, ASTRO) designed for post radiation patients. These criteria are limiting, hence the need for PFC-specific BCR criteria. We report on MRI characteristics of post-PFC patients with suspected BCR.

Methods

We retrospectively reviewed patients who underwent PFC. Prostate specific antigen (PSA) nadir was determined using ≥2 PSA values. BCR was determined using Phoenix criteria (nadir + 2 ng/ml). Pre- and post-PFC multiparametric MRIs (mpMRI) were obtained and biopsies were performed.

Results

Ninety (51.1%) of 176 patients who underwent PFC had more than 2 post-PFC PSAs. Of those who experienced BCR (41.1%) (median time to BCR 19.9 months), 27 (73.0%) underwent mpMRI (Table 1). Seventeen (45.9%) mpMRIs were found with a suspicious lesion, 58.8% were ipsilateral compared to pre-PFC mpMRI and location of pre-PFC positive cores. 35.3% of lesions were located in the central gland of the prostate. Five of 11 patients with positive post-PFC MRI were positive on biopsy. Seven of 17 patients with positive MRIs received definitive treatment.

Conclusions

Post-PFC MRI at suspected BCR may help identify a significant number of patients failing PFC.

Funding

Department of Urology, Winthrop University Hospital