Prostate Cancer Role of Dynamic Contrast-Enhanced Magnetic Resonance (MR) Imaging and Proton MR Spectroscopic Imaging in the Detection of Local Recurrence after Radical Prostatectomy for Prostate Cancer Alessandro Sciarra a, *, Valeria Panebianco b , Stefano Salciccia a , Marcello Osimani b , Danilo Lisi b , Mauro Ciccariello b , Roberto Passariello b , Franco Di Silverio a , Vincenzo Gentile a a Department of Urology, University Sapienza, Rome, Italy b Department of Radiology, University Sapienza, Rome, Italy european urology xxx (2007) xxx–xxx available at www.sciencedirect.com journal homepage: www.europeanurology.com Article info Article history: Accepted December 14, 2007 Published online ahead of print on December 31, 2007 Keywords: Prostate cancer Radical prostatectomy Spectroscopy Magnetic resonance Abstract Objectives: To assess the accuracy of magnetic resonance (MR) spectroscopic imaging (1H-MRSI) and dynamic contrast-enhanced MR (DCEMR) in the depic- tion of local prostate cancer recurrence in patients with biochemical progres- sion after radical prostatectomy (RP). Materials and methods: 1H-MRSI and DCEMR were performed in 70 patients at high risk of local recurrence after RP. The population was divided on the basis of the clinical validation of MR results with the use of a transrectal ultrasound biopsy examination in a group of 50 patients (group A) and the prostate-specific antigen (PSA) serum level restitution after external beam radiotherapy, in a group of 20 patients (group B). Results: In group A, 1H-MRSI analysis alone showed a sensitivity of 84% and a specificity of 88%; the DCEMR analysis alone, a sensitivity of 71% and a specificity of 94%; combined 1HMRSI-DCEMR, a sensitivity of 87% and speci- ficity of 94%. Areas under the receiver operating characteristic (ROC) curve for 1HMRSI, DCEMR, and combined 1HMRSI /DCEMR were 0.942, 0.93,1 and 0.964, respectively. In group B, 1HMRSI alone showed a sensitivity of 71% and a specificity of 83%; DCEMR, a sensitivity of 79% and a specificity of 100%; combined 1HMRSI and DCEMR, a sensitivity of 86% and a specificity of 100%. Areas under the ROC curve for each of these groups were 0.81, 0.923, and 0.94, respectively. Conclusion: Our results show that combined 1H-MRSI and DCMRE is an accurate method to identify local prostate cancer recurrence in patients with biochemical progression after RP. # 2007 European Association of Urology. Published by Elsevier B.V. All rights reserved. * Corresponding author. Department of Urology, University Sapienza, Viale Policlinico 155, Rome, Italy. E-mail address: sciarrajr@hotmail.com (A. Sciarra). EURURO-2344; No of Pages 12 0302-2838/$ – see back matter # 2007 European Association of Urology. Published by Elsevier B.V. All rights reserved. doi:10.1016/j.eururo.2007.12.034 Please cite this article in press as: Sciarra A, et al., Role of Dynamic Contrast-Enhanced Magnetic Resonance (MR) Imaging and Proton MR Spectroscopic Imaging in the Detection ..., Eur Urol (2008), doi:10.1016/j.eururo.2007.12.034