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Fennessy FM, Maier SE. Quantitative diffusion MRI in prostate cancer: Image quality, what we can measure and how it improves clinical assessment. Eur J Radiol 2023; 167:111066. [PMID: 37651828 PMCID: PMC10623580 DOI: 10.1016/j.ejrad.2023.111066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/19/2023] [Accepted: 08/24/2023] [Indexed: 09/02/2023]
Abstract
Diffusion-weighted imaging is a dependable method for detection of clinically significant prostate cancer. In prostate tissue, there are several compartments that can be distinguished from each other, based on different water diffusion decay signals observed. Alterations in cell architecture, such as a relative increase in tumor infiltration and decrease in stroma, will influence the observed diffusion signal in a voxel due to impeded random motion of water molecules. The amount of restricted diffusion can be assessed quantitatively by measuring the apparent diffusion coefficient (ADC) value. This is traditionally calculated using a monoexponential decay formula represented by the slope of a line produced between the logarithm of signal intensity decay plotted against selected b-values. However, the choice and number of b-values and their distribution, has a significant effect on the measured ADC values. There have been many models that attempt to use higher-order functions to better describe the observed diffusion signal decay, requiring an increased number and range of b-values. While ADC can probe heterogeneity on a macroscopic level, there is a need to optimize advanced diffusion techniques to better interrogate prostate tissue microstructure. This could be of benefit in clinical challenges such as identifying sparse tumors in normal prostate tissue or better defining tumor margins. This paper reviews the principles of diffusion MRI and novel higher order diffusion signal analysis techniques to improve the detection of prostate cancer.
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Affiliation(s)
- Fiona M Fennessy
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
| | - Stephan E Maier
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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2
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Connor MJ, Gorin MA, Eldred-Evans D, Bass EJ, Desai A, Dudderidge T, Winkler M, Ahmed HU. Landmarks in the evolution of prostate biopsy. Nat Rev Urol 2023; 20:241-258. [PMID: 36653670 DOI: 10.1038/s41585-022-00684-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2022] [Indexed: 01/19/2023]
Abstract
Approaches and techniques used for diagnostic prostate biopsy have undergone considerable evolution over the past few decades: from the original finger-guided techniques to the latest MRI-directed strategies, from aspiration cytology to tissue core sampling, and from transrectal to transperineal approaches. In particular, increased adoption of transperineal biopsy approaches have led to reduced infectious complications and improved antibiotic stewardship. Furthermore, as image fusion has become integral, these novel techniques could be incorporated into prostate biopsy methods in the future, enabling 3D-ultrasonography fusion reconstruction, molecular targeting based on PET imaging and autonomous robotic-assisted biopsy.
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Affiliation(s)
- Martin J Connor
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, W6 8RF, London, UK. .,Imperial Urology, Imperial College Healthcare NHS Trust, London, UK.
| | - Michael A Gorin
- Milton and Carroll Petrie Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - David Eldred-Evans
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, W6 8RF, London, UK.,Imperial Urology, Imperial College Healthcare NHS Trust, London, UK
| | - Edward J Bass
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, W6 8RF, London, UK.,Imperial Urology, Imperial College Healthcare NHS Trust, London, UK
| | - Ankit Desai
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, W6 8RF, London, UK
| | - Tim Dudderidge
- Department of Urology, University Hospital Southampton, Southampton, UK
| | - Mathias Winkler
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, W6 8RF, London, UK.,Imperial Urology, Imperial College Healthcare NHS Trust, London, UK
| | - Hashim U Ahmed
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, W6 8RF, London, UK.,Imperial Urology, Imperial College Healthcare NHS Trust, London, UK
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Siddiqui K, Magsi K, Iqbal J, Ahmed A, Fazal A, Siddiqui I, Khan S. To Determine the Diagnostic Accuracy of Diffusion-Weighted Imaging in the Diagnosis of Prostate Carcinoma Taking Histopathology As the Gold Standard. Cureus 2021; 13:e19508. [PMID: 34912645 PMCID: PMC8666136 DOI: 10.7759/cureus.19508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2021] [Indexed: 11/05/2022] Open
Abstract
Introduction Carcinoma of the prostate is the most common malignancy among males. Serum prostate-specific antigen (PSA) levels and digital rectal examination (DRE) are the initial investigations for the detection of prostate cancer. In recent years, some investigators have used color Doppler ultrasound and diffusion-weighted imaging (DWI) for the diagnosis of prostate cancer and avoided invasive and painful investigation, i.e., biopsy. The purpose of the study is to determine the validity of DWI in detecting prostatic cancer taking histopathology as the gold standard. Material and methods This cross-sectional study was conducted prospectively in the radiology department of a tertiary care hospital from January 1, 2019, to December 31, 2020. This study was approved by the Departmental Research Committee. A total of 272 male patients were included in our study who have elevated PSA levels (>4.0 ng/ml) with symptoms of hematuria and urinary retention. All included subjects were sent to the radiology department for DWI imaging. The DWI imaging was analyzed for prostate cancer and the results were correlated with histopathological diagnosis. Results The average age of patients was 50.28±9.93 years. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of DWI in the diagnoses of prostate cancer were 86.7%, 87.8%, 75.8%, 93.8%, and 87.5%, respectively. Conclusion DWI is an informative and non-invasive imaging modality with high diagnostic accuracy for the diagnosis of prostate carcinoma.
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Affiliation(s)
| | - Kausar Magsi
- Radiology, Sindh Institute of Urology and Transplantation, Karachi, PAK
| | - Junaid Iqbal
- Radiology, Aga Khan University Hospital, Karachi, PAK
| | - Anwar Ahmed
- Radiology, The Aga Khan University, Karachi, PAK
| | - Adnan Fazal
- Cardiology, National Institute of Cardiovascular Diseases, Karachi, PAK
| | | | - Shahmeer Khan
- Radiology, Aga Khan University Hospital, Karachi, PAK
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Syversen IF, Elschot M, Sandsmark E, Bertilsson H, Bathen TF, Goa PE. Exploring the diagnostic potential of adding T2 dependence in diffusion-weighted MR imaging of the prostate. PLoS One 2021; 16:e0252387. [PMID: 34043735 PMCID: PMC8158951 DOI: 10.1371/journal.pone.0252387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/14/2021] [Indexed: 12/02/2022] Open
Abstract
Background Magnetic resonance imaging (MRI) is essential in the detection and staging of prostate cancer. However, improved tools to distinguish between low-risk and high-risk cancer are needed in order to select the appropriate treatment. Purpose To investigate the diagnostic potential of signal fractions estimated from a two-component model using combined T2- and diffusion-weighted imaging (T2-DWI). Material and methods 62 patients with prostate cancer and 14 patients with benign prostatic hyperplasia (BPH) underwent combined T2-DWI (TE = 55 and 73 ms, b-values = 50 and 700 s/mm2) following clinical suspicion of cancer, providing a set of 4 measurements per voxel. Cancer was confirmed in post-MRI biopsy, and regions of interest (ROIs) were delineated based on radiology reporting. Signal fractions of the slow component (SFslow) of the proposed two-component model were calculated from a model fit with 2 free parameters, and compared to conventional bi- and mono-exponential apparent diffusion coefficient (ADC) models. Results All three models showed a significant difference (p<0.0001) between peripheral zone (PZ) tumor and normal tissue ROIs, but not between non-PZ tumor and BPH ROIs. The area under the receiver operating characteristics curve distinguishing tumor from prostate voxels was 0.956, 0.949 and 0.949 for the two-component, bi-exponential and mono-exponential models, respectively. The corresponding Spearman correlation coefficients between tumor values and Gleason Grade Group were fair (0.370, 0.499 and -0.490), but not significant. Conclusion Signal fraction estimates from a two-component model based on combined T2-DWI can differentiate between tumor and normal prostate tissue and show potential for prostate cancer diagnosis. The model performed similarly to conventional diffusion models.
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Affiliation(s)
- Ingrid Framås Syversen
- Kavli Institute for Systems Neuroscience, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- * E-mail:
| | - Mattijs Elschot
- Department of Circulation and Medical Imaging, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Radiology and Nuclear Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Elise Sandsmark
- Department of Radiology and Nuclear Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Helena Bertilsson
- Department of Urology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Tone Frost Bathen
- Department of Circulation and Medical Imaging, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Pål Erik Goa
- Department of Physics, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
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5
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Li Y, Kim M, Lawrence TS, Parmar H, Cao Y. Microstructure Modeling of High b-Value Diffusion-Weighted Images in Glioblastoma. ACTA ACUST UNITED AC 2021; 6:34-43. [PMID: 32280748 PMCID: PMC7138521 DOI: 10.18383/j.tom.2020.00018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Apparent diffusion coefficient has limits to differentiate solid tumor from normal tissue or edema in glioblastoma (GBM). This study investigated a microstructure model (MSM) in GBM using a clinically available diffusion imaging technique. The MSM was modified to integrate with bi-polar diffusion gradient waveforms, and applied to 30 patients with newly diagnosed GBM. Diffusion-weighted (DW) images acquired on a 3 T scanner with b-values from 0 to 2500 s/mm2 were fitted in volumes of interest (VOIs) of solid tumor to obtain the apparent restriction size of intracellular water (ARS), the fractional volume of intracellular water (Vin), and extracellular (Dex) water diffusivity. The parameters in solid tumor were compared with those of other tissue types by Students’ t test. For comparison, DW images were fitted by conventional mono-exponential and bi-exponential models. ARS, Dex, and Vin from the MSM in tumor VOIs were significantly greater than those in WM, GM, and edema (P values of .01–.001). ARS values in solid tumors (from 21.6 to 34.5 um) had absolutely no overlap with those in all other tissue types (from 0.9 to 3.5 um). Vin values showed a descending order from solid tumor (from 0.32 to 0.52) to WM, GM, and edema (from 0.05 to 0.25), consisting with the descending cellularity in these tissue types. The parameters from mono-exponential and bi-exponential models could not significantly differentiate solid tumor from all other tissue types, particularly from edema. Further development and histopathological validation of the MSM will warrant its role in clinical management of GBM.
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Affiliation(s)
- Yuan Li
- Departments of Radiation Oncology, Radiology, and Biomedical Engineering, University of Michigan, Ann Arbor, MI
| | - Michelle Kim
- Departments of Radiation Oncology, Radiology, and Biomedical Engineering, University of Michigan, Ann Arbor, MI
| | - Theodore S Lawrence
- Departments of Radiation Oncology, Radiology, and Biomedical Engineering, University of Michigan, Ann Arbor, MI
| | - Hemant Parmar
- Departments of Radiation Oncology, Radiology, and Biomedical Engineering, University of Michigan, Ann Arbor, MI
| | - Yue Cao
- Departments of Radiation Oncology, Radiology, and Biomedical Engineering, University of Michigan, Ann Arbor, MI
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Roccia E, Neji R, Benkert T, Kiefer B, Goh V, Dregely I. Distortion-free 3D diffusion imaging of the prostate using a multishot diffusion-prepared phase-cycled acquisition and dictionary matching. Magn Reson Med 2020; 85:1441-1454. [PMID: 32989765 DOI: 10.1002/mrm.28527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/27/2020] [Accepted: 08/31/2020] [Indexed: 11/06/2022]
Abstract
PURPOSE To achieve three-dimensional (3D) distortion-free apparent diffusion coefficient (ADC) maps for prostate imaging using a multishot diffusion prepared-gradient echo (msDP-GRE) sequence and ADC dictionary matching. METHODS The msDP-GRE sequence is combined with a 3D Cartesian, centric k-space trajectory with center oversampling. Oversampled k-space center averaging and phase cycling are used to address motion- and eddy current-induced magnitude corruption. Extended-phase-graph (EPG) simulations and ADC dictionary matching are used to compensate for T1 effects. To shorten the acquisition time, each volume is undersampled by a factor of two and reconstructed using iterative sensitivity encoding. The proposed approach is characterized using simulations and validated in a kiwifruit phantom, comparing the msDP-GRE ADC maps obtained using both standard monoexponential fitting and dictionary matching with the clinical standard single-shot diffusion weighted-echo planar imaging (ssDW-EPI) ADC. Initial in vivo feasibility is tested in three healthy subjects, and geometric distortion is compared with anatomical T2 -weighted-turbo spin echo. RESULTS In the kiwifruit phantom experiment, the signal magnitude could be recovered using k-space center averaging and phase cycling. No statistically significant difference was observed in the ADC values estimated using msDP-GRE with dictionary matching and clinical standard DW-EPI (P < .05). The in vivo prostate msDP-GRE scans were free of geometric distortion caused by off-resonance susceptibility, and the ADC values in the prostate were in agreement with values found in the published literature. CONCLUSION Nondistorted 3D ADC maps of the prostate can be achieved using a msDP sequence and dictionary matching.
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Affiliation(s)
- Elisa Roccia
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Radhouene Neji
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,MR Research Collaboration, Siemens Healthcare Limited, Frimley, United Kingdom
| | - Thomas Benkert
- Oncology Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Berthold Kiefer
- Oncology Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Vicky Goh
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,Department of Radiology, Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Isabel Dregely
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
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7
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Evaluation of whole-body MRI with diffusion-weighted sequences in the staging of pediatric cancer patients. PLoS One 2020; 15:e0238166. [PMID: 32853252 PMCID: PMC7451574 DOI: 10.1371/journal.pone.0238166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 08/11/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The purpose of this study was to determine whether whole-body MRI (WBMRI) with diffusion-weighted sequences, which is free of ionizing radiation, can perform as well as traditional methods when used alone for staging or follow-up of pediatric cancer patients. METHODS After obtaining approval from our institutional research ethics committee and appropriate informed consent, we performed 34 examinations in 32 pediatric patients. The examinations were anonymized and analyzed by two radiologists with at least 10 years' experience. RESULTS The sensitivity and specificity findings, respectively, were as follows: 100% and 100% for primary tumor; 100% and 86% for bone metastasis; 33% and 100% for lung metastasis; 85% and 100% for lymph node metastasis; and 100% and 62% for global investigation of primary or secondary neoplasias. We observed excellent interobserver agreement for WBMRI and excellent agreement with standard staging examination results. CONCLUSIONS Our results suggest that pediatric patients can be safely imaged with WBMRI, although not as the only tool but in association with low-dose chest CT (for subcentimeter pulmonary nodules). However, additional exams with ionizing radiation may be necessary for patients who tested positive to correctly quantify and locate the lesions.
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8
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Bergen RV, Ryner L, Essig M. Field-map correction in read-out segmented echo planar imaging for reduced spatial distortion in prostate DWI for MRI-guided radiotherapy applications. Magn Reson Imaging 2019; 67:43-49. [PMID: 31843418 DOI: 10.1016/j.mri.2019.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 11/15/2019] [Accepted: 12/07/2019] [Indexed: 11/15/2022]
Abstract
Diffusion-weighted echo planar imaging (DW-EPI) suffers from geometric distortion due to low phase-encoding bandwidth. Read-out segmented echo planar imaging (RS-EPI) reduces distortion but residual distortion remains in extreme cases. Additional corrections need to be applied, especially for radiotherapy applications where a high degree of accuracy is needed. In this study the use of magnetic field map corrections are assessed in DW-EPI and RS-EPI, to reduce geometric uncertainty for MRI-guided radiotherapy applications. Magnetic field maps were calculated from gradient echo images and distortion corrections were applied to RS-EPI images. Distortions were assessed in a prostate phantom by comparing to the known geometry, and in vivo using a modified Hausdorff distance metric using a T2-weighted spin echo as ground truth. Across 10 patients, field map-corrected RS-EPI reduced maximum distortion by 5 mm on average compared to DW-EPI (σ = 1.9 mm). Geometric distortions were also reduced significantly using field mapping with RS-EPI, compared to RS-EPI alone (p ≤ 0.05). The increased geometric accuracy of these techniques can potentially allow diffusion-weighted images to be fused with other MR or CT images for radiotherapy treatment purposes.
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Affiliation(s)
- Robert V Bergen
- Department of Physics & Astronomy, University of Manitoba, Canada; Medical Physics, CancerCare Manitoba, Canada
| | - Lawrence Ryner
- Department of Physics & Astronomy, University of Manitoba, Canada; Medical Physics, CancerCare Manitoba, Canada.
| | - Marco Essig
- Department of Radiology, University of Manitoba, Canada
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Willmitzer F, Del Chicca F, Kircher PR, Wang-Leandro A, Kronen PW, Verdino D, Rüfenacht D, Porcellini B, Richter H. Diffusion-weighted and perfusion-weighted magnetic resonance imaging of the prostate gland of healthy adult dogs. Am J Vet Res 2019; 80:832-839. [PMID: 31449441 DOI: 10.2460/ajvr.80.9.832] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe diffusion and perfusion characteristics of the prostate gland of healthy sexually intact adult dogs as determined by use of diffusion-weighted and perfusion-weighted MRI. ANIMALS 12 healthy sexually intact adult Beagles. PROCEDURES Ultrasonography of the prostate gland was performed. Subsequently, each dog was anesthetized, and morphological, diffusion-weighted, and perfusion-weighted MRI of the caudal aspect of the abdomen was performed. The apparent diffusion coefficient was calculated for the prostate gland parenchyma in diffusion-weighted MRI images in the central ventral and peripheral dorsal areas. Perfusion variables were examined in multiple regions of interest (ROIs) in the ventral and dorsal areas of the prostate gland and in the gluteal musculature. Signal intensity was determined, and a time-intensity curve was generated for each ROI. RESULTS Results of ultrasonographic examination of the prostate gland revealed no abnormalities for any dog. Median apparent diffusion coefficient of the prostate gland was 1.51 × 10-3 mm2/s (range, 1.04 × 10-3 mm2/s to 1.86 × 10-3 mm2/s). Perfusion-weighted MRI variables for the ROIs differed between the prostate gland parenchyma and gluteal musculature. CONCLUSIONS AND CLINICAL RELEVANCE Results provided baseline information about diffusion and perfusion characteristics of the prostate gland in healthy sexually intact adult dogs. Additional studies with dogs of various ages and breeds, with and without abnormalities of the prostate gland, will be necessary to validate these findings and investigate clinical applications.
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10
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Giganti F, Rosenkrantz AB, Villeirs G, Panebianco V, Stabile A, Emberton M, Moore CM. The Evolution of MRI of the Prostate: The Past, the Present, and the Future. AJR Am J Roentgenol 2019; 213:384-396. [PMID: 31039022 DOI: 10.2214/ajr.18.20796] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE. The purpose of this article is to discuss the evolution of MRI in prostate cancer from the early 1980s to the current day, providing analysis of the key studies on this topic. CONCLUSION. The rapid diffusion of MRI technology has meant that residual variability remains between centers regarding the quality of acquisition and the quality and standardization of reporting.
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Affiliation(s)
- Francesco Giganti
- 1 Department of Radiology, University College London Hospital NHS Foundation Trust, London, United Kingdom
- 2 Division of Surgery and Interventional Science, University College London, 3rd Fl, Charles Bell House, 43-45 Foley St, London W1W 7TS, United Kingdom
| | | | - Geert Villeirs
- 4 Department of Radiology and Nuclear Medicine, Ghent University Hospital, Ghent, Belgium
| | - Valeria Panebianco
- 5 Department of Radiological Sciences, Oncology, and Pathology, Sapienza University of Rome, Rome, Italy
| | - Armando Stabile
- 2 Division of Surgery and Interventional Science, University College London, 3rd Fl, Charles Bell House, 43-45 Foley St, London W1W 7TS, United Kingdom
- 6 Department of Urology, Division of Experiemental Oncology, Vita-Salute San Raffaele University, Milan, Italy
| | - Mark Emberton
- 2 Division of Surgery and Interventional Science, University College London, 3rd Fl, Charles Bell House, 43-45 Foley St, London W1W 7TS, United Kingdom
- 7 Department of Urology, University College London Hospital NHS Foundation Trust, London, United Kingdom
| | - Caroline M Moore
- 2 Division of Surgery and Interventional Science, University College London, 3rd Fl, Charles Bell House, 43-45 Foley St, London W1W 7TS, United Kingdom
- 7 Department of Urology, University College London Hospital NHS Foundation Trust, London, United Kingdom
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11
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Barrett T, Rajesh A. Special issue on prostate imaging. Clin Radiol 2019; 74:821-822. [PMID: 31345556 DOI: 10.1016/j.crad.2019.06.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 06/27/2019] [Indexed: 12/13/2022]
Affiliation(s)
- T Barrett
- Department of Radiology, Addenbrooke's Hospital and the University of Cambridge, Cambridge, CB2 0QQ, UK.
| | - A Rajesh
- Department of Radiology, University Hospitals of Leicester NHS Trust, Gwendolen Road, Leicester, LE5 4PW, UK
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12
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Abstract
The initial diagnosis of prostate cancer has been traditionally performed using systematic core biopsies with the use of magnetic resonance imaging (MRI) reserved to problem-solving scenarios. There is currently an ongoing paradigm shift towards the use of MRI prior to targeted biopsy as the standard approach. Prostate cancer therefore does not remain the last solid tumor entity diagnosed by non-targeted techniques but joins other solid tumor entities for which targeted diagnostic approaches have existed for a while. However, the complexity of the background tissue signal in the prostate makes lesion detection challenging. This article will provide an overview of the components of multiparametric prostate MRI and their interpretation using structured interpretation according to the current PI-RADSv2 (Prostate Imaging Reporting and Data System version 2) guidelines and of novel ultrasound techniques for primary diagnosis.
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13
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Pi S, Cao R, Qiang JW, Guo YH. Utility of DWI with quantitative ADC values in ovarian tumors: a meta-analysis of diagnostic test performance. Acta Radiol 2018; 59:1386-1394. [PMID: 29463093 DOI: 10.1177/0284185118759708] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Diffusion-weighted imaging (DWI) and quantitative apparent diffusion coefficient (ADC) values are widely used in the differential diagnosis of ovarian tumors. Purpose To assess the diagnostic performance of quantitative ADC values in ovarian tumors. Material and Methods PubMed, Embase, the Cochrane Library, and local databases were searched for studies assessing ovarian tumors using quantitative ADC values. We quantitatively analyzed the diagnostic performances for two clinical problems: benign vs. malignant tumors and borderline vs. malignant tumors. We evaluated diagnostic performances by the pooled sensitivity and specificity values and by summary receiver operating characteristic (SROC) curves. Subgroup analyses were used to analyze study heterogeneity. Results From the 742 studies identified in the search results, 16 studies met our inclusion criteria. A total of ten studies evaluated malignant vs. benign ovarian tumors and six studies assessed malignant vs. borderline ovarian tumors. Regarding the diagnostic accuracy of quantitative ADC values for distinguishing between malignant and benign ovarian tumors, the pooled sensitivity and specificity values were 0.91 and 0.91, respectively. The area under the SROC curve (AUC) was 0.96. For differentiating borderline from malignant tumors, the pooled sensitivity and specificity values were 0.89 and 0.79, and the AUC was 0.91. The methodological quality of the included studies was moderate. Conclusion Quantitative ADC values could serve as useful preoperative markers for predicting the nature of ovarian tumors. Nevertheless, prospective trials focused on standardized imaging parameters are needed to evaluate the clinical value of quantitative ADC values in ovarian tumors.
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Affiliation(s)
- Shan Pi
- Department of Radiology, Jinshan Hospital, Shanghai Medical College, Fudan University, Shanghai, PR China
| | - Rong Cao
- Department of Radiology, Jinshan Hospital, Shanghai Medical College, Fudan University, Shanghai, PR China
| | - Jin Wei Qiang
- Department of Radiology, Jinshan Hospital, Shanghai Medical College, Fudan University, Shanghai, PR China
| | - Yan Hui Guo
- Department of Radiology, Jinshan Hospital, Shanghai Medical College, Fudan University, Shanghai, PR China
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14
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Steensma BR, Voogt I, van der Werf AJ, van den Berg CA, Luijten PR, Klomp DW, Raaijmakers AJ. Design of a forward view antenna for prostate imaging at 7 T. NMR IN BIOMEDICINE 2018; 31:e3993. [PMID: 30022543 PMCID: PMC6175442 DOI: 10.1002/nbm.3993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 06/07/2018] [Accepted: 06/08/2018] [Indexed: 05/19/2023]
Abstract
PURPOSE To design a forward view antenna for prostate imaging at 7 T, which is placed between the legs of the subject in addition to a dipole array. MATERIALS AND METHODS The forward view antenna is realized by placing a cross-dipole antenna at the end of a small rectangular waveguide. Quadrature drive of the cross-dipole can excite a circularly polarized wave propagating along the axial direction to and from the prostate region. Functioning of the forward view antenna is validated by comparing measurements and simulations. Antenna performance is evaluated by numerical simulations and measurements at 7 T. RESULTS Simulations of B1+ on a phantom are in good correspondence with measurements. Simulations on a human model indicate that the signal-to-noise ratio (SNR), specific absorption rate (SAR) efficiency and SAR increase when adding the forward view antenna to a previously published dipole array. The SNR increases by up to 18% when adding the forward view antenna as a receive antenna to an eight-channel dipole array in vivo. CONCLUSIONS A design for a forward view antenna is presented and evaluated. SNR improvements up to 18% are demonstrated when adding the forward view antenna to a dipole array.
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Affiliation(s)
| | - Ingmar Voogt
- University Medical Center UtrechtUtrechtthe Netherlands
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15
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Lahoti AM, Lakhotiya AR, Ingole SM, Dhok AP, Mudaliar PN. Role and Application of Diffusion-weighted Imaging in Evaluation of Prostate Cancer. Indian J Med Paediatr Oncol 2018. [DOI: 10.4103/ijmpo.ijmpo_41_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Abstract
Introduction: Diffusion-weighted imaging (DWI) is an important part of magnetic resonance imaging (MRI) in the evaluation of specific organs, including the breast, kidney, liver, and prostate. Prostate cancer lesions are composed of tightly packed cells with reduced extracellular space, which can be visualized on DWIs as areas of restricted diffusion (i.e., high-signal intensity), with corresponding low-signal intensity on apparent diffusion coefficient (ADC) maps and low mean ADC value. Objective: The objective of this study is to identify the appropriate cutoff and mean ADC value to diagnose neoplastic prostatic lesions in central India. Materials and Methods: Sixty-six patients with suspected prostatic pathology were included in this study. All patients underwent MRI on a 1.5-T scanner with a phased-array body coil. MRIs were evaluated compared with the histopathological staging. Results:: The diagnostic accuracy of DWI in predicting malignancy was 39/41, i.e., 95.12%, which is the positive predicted value. The mean ADC for benign category was 1.14 with standard deviation (SD) of 0.14 while mean for prostatitis was 0.91 with SD of 0.26 and for carcinoma was 0.75 with SD of 0.19. The difference in the means was statistically highly significant. Conclusion: DWI demonstrates the restriction of diffusion and the reduction of ADC values in neoplastic tissue and improves the diagnostic accuracy in lesion characterization. This technique allows short acquisition time and provides high-contrast resolution between neoplastic and normal tissue. This technique can be a useful adjunct to the established dynamic contrast-enhanced-MRI.
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Affiliation(s)
- Amol Madanlal Lahoti
- Department of Radiology, NKP Sims and Lata Mangeshkar Hospital, Nagpur, Maharashtra, India
| | | | - Sarang Manohar Ingole
- Department of Radiology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Avinash Parshuram Dhok
- Department of Radiology, NKP Sims and Lata Mangeshkar Hospital, Nagpur, Maharashtra, India
| | - Prashant N Mudaliar
- Department of Radiology, NKP Sims and Lata Mangeshkar Hospital, Nagpur, Maharashtra, India
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Zhang XQ, Yu XR, Du ZL, Miao XF, Lu J, Zhou Q. Three-dimensional proton magnetic resonance spectroscopy and diffusion-weighted imaging in the differentiation of incidental prostate carcinoma from benign prostate hyperplasia. Oncol Lett 2018; 15:6541-6546. [PMID: 29616121 DOI: 10.3892/ol.2018.8131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 01/17/2018] [Indexed: 11/06/2022] Open
Abstract
The present study evaluated three-dimensional proton magnetic resonance spectroscopy (MRS) and diffusion-weighted imaging (DWI) features in differentiating incidental prostate carcinoma (IPCa) and benign prostate hyperplasia (BPH) in the central gland of the prostate. The clinical and imaging data of 9 patients with IPCa, 118 patients with BPH [including those with glandular hyperplasia (GH), stromal hyperplasia (SH) and mixed hyperplasia (MH)], were retrospectively analyzed. The mean (choline + creatine)/citrate (CC/C) value of 3D MRS, the apparent diffusion coefficient (ADC) value and the minimal ADC value of DWI were compared between carcinoma and non-carcinoma tissues. The mean CC/C values were 1.04±0.28, and 1.09±0.58 in IPCa and BPH, respectively (t=-0.205, P=0.838). No significant difference in CC/C values (χ2=2.595, P=0.458) could be detected between IPCa, GH, SH and MH groups. The ADC values of the central gland only differed between IPCa (1.48±0.18) ×10-3 and GH (1.60±0.16) ×10-3 mm2/sec (P=0.037). The minimal ADC values were similar between IPCa (1.15±0.10) ×10-3 and BPH (1.14±0.11) ×10-3 mm2/sec, no significant differences could be detected between IPCa and GH (P=0.930), IPCa and SH (P=0.192), and IPCa and MH (P=0.544). Although the ADC values of the central gland of the prostate differed between IPCa and GH, the findings of the present study therefore indicate that combining 3D MRS with DWI cannot potentially improve the detection of IPCa.
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Affiliation(s)
- Xue-Qin Zhang
- Department of Radiology, The Third People's Hospital of Nantong, Nantong, Jiangsu 226006, P.R. China
| | - Xiang-Rong Yu
- Department of Radiology, Zhuhai Hospital of Jinan University, Zhuhai People's Hospital, Zhuhai, Guangdong 519000, P.R. China
| | - Zhong-Li Du
- Department of Radiology, Zhuhai Hospital of Jinan University, Zhuhai People's Hospital, Zhuhai, Guangdong 519000, P.R. China
| | - Xiao-Fen Miao
- Department of Radiology, The Third People's Hospital of Nantong, Nantong, Jiangsu 226006, P.R. China
| | - Jian Lu
- Department of Radiology, The Third People's Hospital of Nantong, Nantong, Jiangsu 226006, P.R. China
| | - Quan Zhou
- Department of Radiology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510000, P.R. China
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Zhang Y, Holmes J, Rabanillo I, Guidon A, Wells S, Hernando D. Quantitative diffusion MRI using reduced field-of-view and multi-shot acquisition techniques: Validation in phantoms and prostate imaging. Magn Reson Imaging 2018; 51:173-181. [PMID: 29678540 DOI: 10.1016/j.mri.2018.04.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 04/14/2018] [Indexed: 01/22/2023]
Abstract
PURPOSE To evaluate the reproducibility of quantitative diffusion measurements obtained with reduced Field of View (rFOV) and Multi-shot EPI (msEPI) acquisitions, using single-shot EPI (ssEPI) as a reference. METHODS Diffusion phantom experiments, and prostate diffusion-weighted imaging in healthy volunteers and patients with known or suspected prostate cancer were performed across the three different sequences. Quantitative diffusion measurements of apparent diffusion coefficient, and diffusion kurtosis parameters (healthy volunteers), were obtained and compared across diffusion sequences (rFOV, msEPI, and ssEPI). Other possible confounding factors like b-value combinations and acquisition parameters were also investigated. RESULTS Both msEPI and rFOV have shown reproducible quantitative diffusion measurements relative to ssEPI; no significant difference in ADC was observed across pulse sequences in the standard diffusion phantom (p = 0.156), healthy volunteers (p ≥ 0.12) or patients (p ≥ 0.26). The ADC values within the non-cancerous central gland and peripheral zone of patients were 1.29 ± 0.17 × 10-3 mm2/s and 1.74 ± 0.23 × 10-3 mm2/s respectively. However, differences in quantitative diffusion parameters were observed across different number of averages for rFOV, and across b-value groups and diffusion models for all the three sequences. CONCLUSION Both rFOV and msEPI have the potential to provide high image quality with reproducible quantitative diffusion measurements in prostate diffusion MRI.
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Affiliation(s)
- Yuxin Zhang
- Department of Medical Physics, University of Wisconsin Madison, Madison, WI, United States; Department of Radiology, School of Medicine and Public Health, University of Wisconsin Madison, Madison, WI, United States
| | - James Holmes
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin Madison, Madison, WI, United States
| | - Iñaki Rabanillo
- Laboratorio MR de Procesado de Imagen, Universidad de Valladolid, Valladolid, Spain
| | - Arnaud Guidon
- Applications and Workflow, GE Healthcare, Boston, MA, United States
| | - Shane Wells
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin Madison, Madison, WI, United States
| | - Diego Hernando
- Department of Medical Physics, University of Wisconsin Madison, Madison, WI, United States; Department of Radiology, School of Medicine and Public Health, University of Wisconsin Madison, Madison, WI, United States.
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Kumar V, Bora GS, Kumar R, Jagannathan NR. Multiparametric (mp) MRI of prostate cancer. PROGRESS IN NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY 2018; 105:23-40. [PMID: 29548365 DOI: 10.1016/j.pnmrs.2018.01.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 01/17/2018] [Accepted: 01/28/2018] [Indexed: 06/08/2023]
Abstract
Prostate cancer (PCa) is one of the most prevalent cancers in men. A large number of men are detected with PCa; however, the clinical behavior ranges from low-grade indolent tumors that never develop into a clinically significant disease to aggressive, invasive tumors that may rapidly progress to metastatic disease. The challenges in clinical management of PCa are at levels of screening, diagnosis, treatment, and follow-up after treatment. Magnetic resonance imaging (MRI) methods have shown a potential role in detection, localization, staging, assessment of aggressiveness, targeting biopsies, etc. in PCa patients. Multiparametric MRI (mpMRI) is emerging as a better option compared to the individual imaging methods used in the evaluation of PCa. There are attempts to improve the reproducibility and reliability of mpMRI by using an objective scoring system proposed in the prostate imaging reporting and data system (PIRADS) for standardized reporting. Prebiopsy mpMRI may be used to detect PCa in men with elevated prostate-specific antigen or abnormal digital rectal examination and to enable targeted biopsies. mpMRI can also be used to decide on clinical management of patients, for example active surveillance, and may help in detecting only the pathology that requires detection. It can potentially not only guide patient selection for initial and repeat biopsy but also reduce false-negative biopsies. This review presents a description of the MR methods most commonly applied for investigations of prostate. The anatomical, functional and metabolic parameters obtained from these MR methods are discussed with regard to their physical basis and their contribution to mpMRI investigations of PCa.
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Affiliation(s)
- Virendra Kumar
- Department of NMR & MRI Facility, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
| | - Girdhar S Bora
- Department of Urology, Post-Graduate Institute of Medical Sciences, Chandigarh 160012, India
| | - Rajeev Kumar
- Department of Urology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Naranamangalam R Jagannathan
- Department of NMR & MRI Facility, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
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Taha Ali TF, ElHariri MA, Riad MM. Diffusion-weighted MRI in prostatic lesions: Diagnostic performance of normalized ADC using normal peripheral prostatic zone as a reference. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2018. [DOI: 10.1016/j.ejrnm.2017.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
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20
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The Value of Diffusion-Weighted Imaging in Combination With Conventional Magnetic Resonance Imaging for Improving Tumor Detection for Early Cervical Carcinoma Treated With Fertility-Sparing Surgery. Int J Gynecol Cancer 2018; 27:1761-1768. [PMID: 28930805 DOI: 10.1097/igc.0000000000001113] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the value of diffusion-weighted imaging (DWI) in combination with conventional magnetic resonance imaging (MRI) for improving tumor detection in young patients treated with fertility-sparing surgery because of early cervical carcinoma. METHODS Fifty-four patients with stage Ia or Ib1 cervical carcinoma were enrolled into this study. Magnetic resonance examinations were performed for these patients using conventional MRI (including T1-weighted imaging, T2-weighted imaging, and dynamic contrast-enhanced MRI) and DWI. The apparent diffusion coefficient (ADC) values of cervical carcinoma were analyzed quantitatively and compared with that of adjacent epithelium. Sensitivity, positive predictive value, and accuracy of 2 sets of MRI sequences were calculated on the basis of histologic results, and the diagnostic ability of conventional MRI/DWI combinations was compared with that of conventional MRI. RESULTS The mean ADC value from cervical carcinoma (mean, 786 × 10 mm/s ± 100) was significantly lower than that from adjacent epithelium (mean, 1352 × 10 mm/s ± 147) (P = 0.01). When the threshold ADC value set as 1010 × 10 mm/s, the sensitivity and specificity for differentiating cervical carcinoma from nontumor epithelium were 78.2% and 67.2%, respectively. The sensitivity and accuracy of conventional MRI for tumor detection were 76.0% and 70.4%, whereas the sensitivity and accuracy of conventional MRI/DWI combinations were 91.7% and 90.7%, respectively. Conventional MRI/DWI combinations revealed a positive predictive value of 97.8% and only 4 false-negative findings. CONCLUSIONS The addition of DWI to conventional MRI considerably improves the sensitivity and accuracy of tumor detection in young patients treated with fertility-sparing surgery, which supports the inclusion quantitative analysis of ADC value in routine MRI protocol before fertility-sparing surgery.
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Papadopoulos I, Phillips J, Evans R, Fenn N, Shermer S. Evaluation of diffusion weighted imaging in the context of multi-parametric MRI of the prostate in the assessment of suspected low volume prostatic carcinoma. Magn Reson Imaging 2017; 47:131-136. [PMID: 29183816 DOI: 10.1016/j.mri.2017.11.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 11/21/2017] [Indexed: 01/14/2023]
Abstract
Data from a multi-parametric MRI study of patients with possible early-stage prostate cancer was assessed with a view to creating a more efficient clinical protocol. Based on a correlation analysis suggesting that diffusion-weighted imaging (DWI) scores are more strongly correlated with overall PIRADS scores than other modalities such as dynamic contrast enhanced imaging or spectroscopy, we investigate the combination of T2-weighted imaging (T2w) and DWI as a potential diagnostic tool for prostate cancer detection, staging and guided biopsies. Quantification of the noise floor in the DWI images and careful fitting of the data suggests that the mono-exponential model provides a very good fit to the data and there is no evidence of non-Gaussian diffusion for b-values up to 1000s/mm2. This precludes the use of kurtosis or other non-Gaussian measures as a biomarker for prostate cancer in our case. However, the ADC scores for healthy and probably malignant regions are significantly lower for the latter in all 20 but one patient. The results suggest that a simplified mp-MRI protocol combining T2w and DWI may be a good compromise for a cost and time efficient, early-stage prostate cancer diagnostic programme, combining robust MR biomarkers for prostate cancer that can be reliably quantified and appear well-suited for general clinical practice.
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Affiliation(s)
- Ioannis Papadopoulos
- College of Science (Physics), Swansea University, Singleton Park, Swansea SA2 8PP, United Kingdom; Institute of Life Science, Medical School, Swansea University, Singleton Park, Swansea SA2 8PP, United Kingdom.
| | - Jonathan Phillips
- Institute of Life Science, Medical School, Swansea University, Singleton Park, Swansea SA2 8PP, United Kingdom
| | - Rhodri Evans
- Institute of Life Science, Medical School, Swansea University, Singleton Park, Swansea SA2 8PP, United Kingdom
| | - Neil Fenn
- Morriston Hospital, Heol Maes Eglwys, Morriston, Swansea SA6 6NL, United Kingdom
| | - Sophie Shermer
- College of Science (Physics), Swansea University, Singleton Park, Swansea SA2 8PP, United Kingdom
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Hill DK, Heindl A, Zormpas-Petridis K, Collins DJ, Euceda LR, Rodrigues DN, Moestue SA, Jamin Y, Koh DM, Yuan Y, Bathen TF, Leach MO, Blackledge MD. Non-Invasive Prostate Cancer Characterization with Diffusion-Weighted MRI: Insight from In silico Studies of a Transgenic Mouse Model. Front Oncol 2017; 7:290. [PMID: 29250485 PMCID: PMC5717839 DOI: 10.3389/fonc.2017.00290] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 11/13/2017] [Indexed: 12/02/2022] Open
Abstract
Diffusion-weighted magnetic resonance imaging (DWI) enables non-invasive, quantitative staging of prostate cancer via measurement of the apparent diffusion coefficient (ADC) of water within tissues. In cancer, more advanced disease is often characterized by higher cellular density (cellularity), which is generally accepted to correspond to a lower measured ADC. A quantitative relationship between tissue structure and in vivo measurements of ADC has yet to be determined for prostate cancer. In this study, we establish a theoretical framework for relating ADC measurements with tissue cellularity and the proportion of space occupied by prostate lumina, both of which are estimated through automatic image processing of whole-slide digital histology samples taken from a cohort of six healthy mice and nine transgenic adenocarcinoma of the mouse prostate (TRAMP) mice. We demonstrate that a significant inverse relationship exists between ADC and tissue cellularity that is well characterized by our model, and that a decrease of the luminal space within the prostate is associated with a decrease in ADC and more aggressive tumor subtype. The parameters estimated from our model in this mouse cohort predict the diffusion coefficient of water within the prostate-tissue to be 2.18 × 10-3 mm2/s (95% CI: 1.90, 2.55). This value is significantly lower than the diffusion coefficient of free water at body temperature suggesting that the presence of organelles and macromolecules within tissues can drastically hinder the random motion of water molecules within prostate tissue. We validate the assumptions made by our model using novel in silico analysis of whole-slide histology to provide the simulated ADC (sADC); this is demonstrated to have a significant positive correlation with in vivo measured ADC (r2 = 0.55) in our mouse population. The estimation of the structural properties of prostate tissue is vital for predicting and staging cancer aggressiveness, but prostate tissue biopsies are painful, invasive, and are prone to complications such as sepsis. The developments made in this study provide the possibility of estimating the structural properties of prostate tissue via non-invasive virtual biopsies from MRI, minimizing the need for multiple tissue biopsies and allowing sequential measurements to be made for prostate cancer monitoring.
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Affiliation(s)
- Deborah K. Hill
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- St. Olavs University Hospital, Trondheim, Norway
| | - Andreas Heindl
- Division of Molecular Pathology, Centre for Evolution and Cancer, Centre for Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
| | - Konstantinos Zormpas-Petridis
- CRUK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - David J. Collins
- CRUK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Leslie R. Euceda
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Daniel N. Rodrigues
- Prostate Cancer Targeted Therapy Group, Drug Development Unit, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Siver A. Moestue
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Pharmacy, Nord University, Namsos, Norway
- Department of Laboratory Medicine, Women’s and Children’s Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Yann Jamin
- CRUK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Dow-Mu Koh
- CRUK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Yinyin Yuan
- Division of Molecular Pathology, Centre for Evolution and Cancer, Centre for Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
| | - Tone F. Bathen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Martin O. Leach
- CRUK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Matthew D. Blackledge
- CRUK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, United Kingdom
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Ultrasound Elastography of the Prostate Using an Unconstrained Modulus Reconstruction Technique: A Pilot Clinical Study. Transl Oncol 2017; 10:744-751. [PMID: 28735201 PMCID: PMC5522957 DOI: 10.1016/j.tranon.2017.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/15/2017] [Accepted: 06/15/2017] [Indexed: 12/04/2022] Open
Abstract
A novel full-inversion-based technique for quantitative ultrasound elastography was investigated in a pilot clinical study on five patients for non-invasive detection and localization of prostate cancer and quantification of its extent. Conventional-frequency ultrasound images and radiofrequency (RF) data (~5 MHz) were collected during mechanical stimulation of the prostate using a transrectal ultrasound probe. Pre and post-compression RF data were used to construct the strain images. The Young's modulus (YM) images were subsequently reconstructed using the derived strain images and the stress distribution estimated iteratively using finite element (FE) analysis. Tumor regions determined based on the reconstructed YM images were compared to whole-mount histopathology images of radical prostatectomy specimens. Results indicated that tumors were significantly stiffer than the surrounding tissue, demonstrating a relative YM of 2.5 ± 0.8 compared to normal prostate tissue. The YM images had a good agreement with the histopathology images in terms of tumor location within the prostate. On average, 76% ± 28% of tumor regions detected based on the proposed method were inside respective tumor areas identified in the histopathology images. Results of a linear regression analysis demonstrated a good correlation between the disease extents estimated using the reconstructed YM images and those determined from whole-mount histopathology images (r2 = 0.71). This pilot study demonstrates that the proposed method has a good potential for detection, localization and quantification of prostate cancer. The method can potentially be used for prostate needle biopsy guidance with the aim of decreasing the number of needle biopsies. The proposed technique utilizes conventional ultrasound imaging system only while no additional hardware attachment is required for mechanical stimulation or data acquisition. Therefore, the technique may be regarded as a non-invasive, low cost and potentially widely-available clinical tool for prostate cancer diagnosis.
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Maurer MH, Heverhagen JT. Diffusion weighted imaging of the prostate-principles, application, and advances. Transl Androl Urol 2017; 6:490-498. [PMID: 28725591 PMCID: PMC5503962 DOI: 10.21037/tau.2017.05.06] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
This review article aims to provide an overview on the principles of diffusion-weighted magnetic resonance imaging (DW-MRI) and its applications in the imaging of the prostate. DW-MRI with regards to different applications for prostate cancer (PCa) detection and characterization, local staging as well as for active surveillance (AS) and tumor recurrence after radical prostatectomy (RP) will be discussed. Furthermore, advances in DW-MRI techniques like diffusion kurtosis imaging (DKI) will be presented.
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Affiliation(s)
- Martin H Maurer
- Department of Radiology, Inselspital, Bern University Hospital, University of Bern, Bern 3010, Switzerland
| | - Johannes T Heverhagen
- Department of Radiology, Inselspital, Bern University Hospital, University of Bern, Bern 3010, Switzerland
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Borofsky S, Haji-Momenian S, Shah S, Taffel M. Multiparametric MRI of the prostate gland: technical aspects. Future Oncol 2016; 12:2445-2462. [DOI: 10.2217/fon-2016-0218] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
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Gilani N, Malcolm P, Johnson G. A model describing diffusion in prostate cancer. Magn Reson Med 2016; 78:316-326. [PMID: 27439379 DOI: 10.1002/mrm.26340] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 06/08/2016] [Accepted: 06/20/2016] [Indexed: 12/15/2022]
Abstract
PURPOSE Quantitative diffusion MRI has frequently been studied as a means of grading prostate cancer. Interpretation of results is complicated by the nature of prostate tissue, which consists of four distinct compartments: vascular, ductal lumen, epithelium, and stroma. Current diffusion measurements are an ill-defined weighted average of these compartments. In this study, prostate diffusion is analyzed in terms of a model that takes explicit account of tissue compartmentalization, exchange effects, and the non-Gaussian behavior of tissue diffusion. METHOD The model assumes that exchange between the cellular (ie, stromal plus epithelial) and the vascular and ductal compartments is slow. Ductal and cellular diffusion characteristics are estimated by Monte Carlo simulation and a two-compartment exchange model, respectively. Vascular pseudodiffusion is represented by an additional signal at b = 0. Most model parameters are obtained either from published data or by comparing model predictions with the published results from 41 studies. Model prediction error is estimated using 10-fold cross-validation. RESULTS Agreement between model predictions and published results is good. The model satisfactorily explains the variability of ADC estimates found in the literature. CONCLUSION A reliable model that predicts the diffusion behavior of benign and cancerous prostate tissue of different Gleason scores has been developed. Magn Reson Med 78:316-326, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Nima Gilani
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Paul Malcolm
- Norfolk and Norwich University Hospital, Norwich, United Kingdom
| | - Glyn Johnson
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
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Application of an unsupervised multi-characteristic framework for intermediate-high risk prostate cancer localization using diffusion-weighted MRI. Magn Reson Imaging 2016; 34:1227-1234. [PMID: 27451403 DOI: 10.1016/j.mri.2016.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 06/14/2016] [Accepted: 06/26/2016] [Indexed: 12/22/2022]
Abstract
PURPOSE The aim of this proof-of-concept work is to propose an unsupervised framework that combines multiple parameters, in "positive-if-all-positive" manner, from different models to localize tumors. METHODS A voxel-by-voxel analysis of the DW-MRI images of whole prostate was performed to obtain parametric maps for D*, D, f, and K using the IVIM and kurtosis models. Ten patients with moderate or high-risk prostate cancer were included in study. The mean age and serum PSA for these 10 patients were 65years (range 54-78) and 21.9ng/mL (range 4.84-44.81), respectively. These patients were scanned using a DW spin-echo sequence with echo-planar readout with 16 equidistantly spaced b-values in the range of 0-2000s/mm2 (TE=58ms; TR=3990ms; spatial resolution 2.19×2.19×2.73mm3, slices =26, FOV=140×140mm, slice gap =0.27mm, NSA=2). RESULTS The proposed framework detected 24 lesions of which 14 were true positive with 58% tumor detection rate on lesion-based analysis with sensitivity of 100%. The mpMRI evaluation (PIRADSv2) identified 12 of 14 true positive lesions with sensitivity of 86%; positive predictive value of mpMRI was 92%. The index lesions were visible on all framework maps and were coded as the most suspicious in 9 of 10 patients. CONCLUSION Preliminary results of the proposed framework indicate high patient-based sensitivity with 100% detection rate for identifying moderate-high risk aggressive index lesions.
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Short-term reproducibility of apparent diffusion coefficient estimated from diffusion-weighted MRI of the prostate. ACTA ACUST UNITED AC 2016; 40:2523-8. [PMID: 25805558 DOI: 10.1007/s00261-015-0396-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE The purpose of the study is to determine short-term reproducibility of apparent diffusion coefficient (ADC) estimated from diffusion-weighted magnetic resonance (DW-MR) imaging of the prostate. METHODS Fourteen patients with biopsy-proven prostate cancer were studied under an Institutional Review Board-approved protocol. Each patient underwent two, consecutive and identical DW-MR scans on a 3T system. ADC values were calculated from each scan and a deformable registration was performed to align corresponding images. The prostate and cancerous regions of interest (ROIs) were independently analyzed by two radiologists. The prostate volume was analyzed by sextant. Per-voxel absolute and relative percentage variations in ADC were compared between sextants. Per-voxel and per-ROI variations in ADC were calculated for cancerous ROIs. RESULTS Per-voxel absolute difference in ADC in the prostate ranged from 0 to 1.60 × 10(-3) mm(2)/s (per-voxel relative difference 0% to 200%, mean 10.5%). Variation in ADC was largest in the posterior apex (0% to 200%, mean 11.6%). Difference in ADC variation between sextants was not statistically significant. Cancer ROIs' per-voxel variation in ADC ranged from 0.001 × 10(-3) to 0.841 × 10(-3) mm(2)/s (0% to 67.4%, mean 11.2%) and per-ROI variation ranged from 0 to 0.463 × 10(-3) mm(2)/s (mean 0.122 × 10(-3) mm(2)/s). CONCLUSIONS Variation in ADC within the human prostate is reasonably small, and is on the order of 10%.
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Selnæs KM, Vettukattil R, Bertilsson H, Wright AJ, Heerschap A, Angelsen A, Tessem MB, Bathen TF. Tissue Microstructure Is Linked to MRI Parameters and Metabolite Levels in Prostate Cancer. Front Oncol 2016; 6:146. [PMID: 27379208 PMCID: PMC4905954 DOI: 10.3389/fonc.2016.00146] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 05/30/2016] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Magnetic resonance imaging (MRI) can portray spatial variations in tumor heterogeneity, architecture, and its microenvironment in a non-destructive way. The objective of this study was to assess the relationship between MRI parameters measured on patients in vivo, individual metabolites measured in prostatectomy tissue ex vivo, and quantitative histopathology. MATERIALS AND METHODS Fresh frozen tissue samples (n = 53 from 15 patients) were extracted from transversal prostate slices and linked to in vivo MR images, allowing spatially matching of ex vivo measured metabolites with in vivo MR parameters. Color-based segmentation of cryosections of each tissue sample was used to identify luminal space, stroma, and nuclei. RESULTS Cancer samples have significantly lower area percentage of lumen and higher area percentage of nuclei than non-cancer samples (p ≤ 0.001). Apparent diffusion coefficient is significantly correlated with percentage area of lumen (ρ = 0.6, p < 0.001) and percentage area of nuclei (ρ = -0.35, p = 0.01). There is a positive correlation (ρ = 0.31, p = 0.053) between citrate and percentage area of lumen. Choline is negatively correlated with lumen (ρ = -0.38, p = 0.02) and positively correlated with percentage area of nuclei (ρ = 0.38, p = 0.02). CONCLUSION Microstructures that are observed by histopathology are linked to MR characteristics and metabolite levels observed in prostate cancer.
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Affiliation(s)
- Kirsten Margrete Selnæs
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway; St. Olavs Hospital, Trondheim, Norway
| | - Riyas Vettukattil
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology , Trondheim , Norway
| | - Helena Bertilsson
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Department of Urology, St. Olavs Hospital, Trondheim, Norway
| | - Alan J Wright
- Cancer Research UK Cambridge Institute, University of Cambridge , Cambridge , UK
| | - Arend Heerschap
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center , Nijmegen , Netherlands
| | - Anders Angelsen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology , Trondheim , Norway
| | - May-Britt Tessem
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology , Trondheim , Norway
| | - Tone Frost Bathen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology , Trondheim , Norway
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Sharma U, Sah RG, Agarwal K, Parshad R, Seenu V, Mathur SR, Hari S, Jagannathan NR. Potential of Diffusion-Weighted Imaging in the Characterization of Malignant, Benign, and Healthy Breast Tissues and Molecular Subtypes of Breast Cancer. Front Oncol 2016; 6:126. [PMID: 27242965 PMCID: PMC4876309 DOI: 10.3389/fonc.2016.00126] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 05/09/2016] [Indexed: 12/26/2022] Open
Abstract
The role of apparent diffusion coefficient (ADC) in the diagnosis of breast cancer and its association with molecular biomarkers was investigated in 259 patients with breast cancer, 67 with benign pathology, and 54 healthy volunteers using diffusion-weighted imaging (DWI) at 1.5 T. In 59 breast cancer patients, dynamic contrast-enhanced MRI (DCEMRI) was also acquired. Mean ADC of malignant lesions was significantly lower (1.02 ± 0.17 × 10−3 mm2/s) compared to benign (1.57 ± 0.26 × 10−3 mm2/s) and healthy (1.78 ± 0.13 × 10−3 mm2/s) breast tissues. A cutoff ADC value of 1.23 × 10−3 mm2/s (sensitivity 92.5%; specificity 91.1%; area under the curve 0.96) to differentiate malignant from benign diseases was arrived by receiver operating curve analysis. In 10/59 breast cancer patients, indeterminate DCE curve was seen, while their ADC value was indicative of malignancy, implying the potential of the addition of DWI in increasing the specificity of DCEMRI data. Further, the association of ADC with tumor volume, stage, hormonal receptors [estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor (HER2)], and menopausal status was investigated. A significant difference was seen in tumor volume between breast cancer patients of stages IIA and IIIA, IIB and IIIA, and IIB and III (B + C), respectively (P < 0.05). Patients with early breast cancer (n = 52) had significantly lower ADC and tumor volume than those with locally advanced breast cancer (n = 207). No association was found in ADC and tumor volume with the menopausal status. Breast cancers with ER−, PR−, and triple-negative (TN) status showed a significantly larger tumor volume compared to ER+, PR+, and non-triple-negative (nTN) cancers, respectively. Also, TN tumors showed a significantly higher ADC compared to ER+, PR+, and nTN cancers. Patients with ER− and TN cancers were younger than those with ER+ and nTN cancers. The present study demonstrated that ADC may increase the diagnostic specificity of DCEMRI and be useful for treatment management in clinical setting. Additionally, it provides an insight into characterization of molecular types of breast cancer and may serve as an indicator of metabolic reprograming underlying tumor proliferation.
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Affiliation(s)
- Uma Sharma
- Department of Nuclear Magnetic Resonance, All India Institute of Medical Sciences , New Delhi , India
| | - Rani G Sah
- Department of Nuclear Magnetic Resonance, All India Institute of Medical Sciences , New Delhi , India
| | - Khushbu Agarwal
- Department of Nuclear Magnetic Resonance, All India Institute of Medical Sciences , New Delhi , India
| | - Rajinder Parshad
- Department of Surgical Disciplines, All India Institute of Medical Sciences , New Delhi , India
| | - Vurthaluru Seenu
- Department of Surgical Disciplines, All India Institute of Medical Sciences , New Delhi , India
| | - Sandeep R Mathur
- Department of Pathology, All India Institute of Medical Sciences , New Delhi , India
| | - Smriti Hari
- Department of Radiodiagnosis, All India Institute of Medical Sciences , New Delhi , India
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Abstract
Currently, the findings of imaging procedures used for detection or staging of prostate cancer depend on morphology of lymph nodes or bone metabolism and do not always meet diagnostic needs. Prostate-specific membrane antigen (PSMA), a transmembrane protein that has considerable overexpression on most prostate cancer cells, has gained increasing interest as a target molecule for imaging. To date, several small compounds for labelling PSMA have been developed and are currently being investigated as imaging probes for PET with the (68)Ga-labelled PSMA inhibitor Glu-NH-CO-NH-Lys(Ahx)-HBED-CC being the most widely studied agent. (68)Ga-PSMA-PET imaging in combination with multiparametric MRI (mpMRI) might provide additional molecular information on cancer localization within the prostate. In patients with primary prostate cancer of intermediate-risk to high-risk, PSMA-based imaging has been reported to improve detection of metastatic disease compared with CT or mpMRI, rendering additional cross-sectional imaging or bone scintigraphy unnecessary. Furthermore, in patients with biochemically recurrent prostate cancer, use of (68)Ga-PSMA-PET imaging has been shown to increase detection of metastatic sites, even at low serum PSA values, compared with conventional imaging or PET examination with different tracers. Thus, although current knowledge is still limited and derived mostly from retrospective series, PSMA-based imaging holds great promise to improve prostate cancer management.
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Jafar MM, Parsai A, Miquel ME. Diffusion-weighted magnetic resonance imaging in cancer: Reported apparent diffusion coefficients, in-vitro and in-vivo reproducibility. World J Radiol 2016; 8:21-49. [PMID: 26834942 PMCID: PMC4731347 DOI: 10.4329/wjr.v8.i1.21] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 11/10/2015] [Accepted: 12/07/2015] [Indexed: 02/06/2023] Open
Abstract
There is considerable disparity in the published apparent diffusion coefficient (ADC) values across different anatomies. Institutions are increasingly assessing repeatability and reproducibility of the derived ADC to determine its variation, which could potentially be used as an indicator in determining tumour aggressiveness or assessing tumour response. In this manuscript, a review of selected articles published to date in healthy extra-cranial body diffusion-weighted magnetic resonance imaging is presented, detailing reported ADC values and discussing their variation across different studies. In total 115 studies were selected including 28 for liver parenchyma, 15 for kidney (renal parenchyma), 14 for spleen, 13 for pancreatic body, 6 for gallbladder, 13 for prostate, 13 for uterus (endometrium, myometrium, cervix) and 13 for fibroglandular breast tissue. Median ADC values in selected studies were found to be 1.28 × 10(-3) mm(2)/s in liver, 1.94 × 10(-3) mm(2)/s in kidney, 1.60 × 10(-3) mm(2)/s in pancreatic body, 0.85 × 10(-3) mm(2)/s in spleen, 2.73 × 10(-3) mm(2)/s in gallbladder, 1.64 × 10(-3) mm(2)/s and 1.31 × 10(-3) mm(2)/s in prostate peripheral zone and central gland respectively (combined median value of 1.54×10(-3) mm(2)/s), 1.44 × 10(-3) mm(2)/s in endometrium, 1.53 × 10(-3) mm(2)/s in myometrium, 1.71 × 10(-3) mm(2)/s in cervix and 1.92 × 10(-3) mm(2)/s in breast. In addition, six phantom studies and thirteen in vivo studies were summarized to compare repeatability and reproducibility of the measured ADC. All selected phantom studies demonstrated lower intra-scanner and inter-scanner variation compared to in vivo studies. Based on the findings of this manuscript, it is recommended that protocols need to be optimised for the body part studied and that system-induced variability must be established using a standardized phantom in any clinical study. Reproducibility of the measured ADC must also be assessed in a volunteer population, as variations are far more significant in vivo compared with phantom studies.
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Anterior Prostate Cancer: Diagnostic Performance of T2-Weighted MRI and an Apparent Diffusion Coefficient Map. AJR Am J Roentgenol 2015. [DOI: 10.2214/ajr.14.13392] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Yang L, Xie Y, Li B, Xie M, Wang X, Zhang J. Symmetry based prostate cancer detection. Br J Radiol 2015; 88:20150132. [PMID: 25899893 DOI: 10.1259/bjr.20150132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To retrospectively assess the value of left and right half symmetry analysis in prostate T2 weighted images (T2WI) for improving prostate cancer (PCa) screening. METHODS T2WI and other data of a total of 66 males were collected; the control group and cancer group had 33 patients each. Thresholding geometric active contours algorithm was used for prostate region segmentation, and the measure of local reflectional symmetry algorithm was applied to extract the longitudinal symmetry axes. After that, cross-correlation coefficients (CCs) of the left and right halves of each prostate were obtained. RESULTS Data analysis showed that the mean and variance of the value of the left and right half CCs of prostate T2WI in the cancer group and control group were 0.73 ± 0.05 and 0.82 ± 0.06, respectively. The area under the receiver operating characteristic curve was 0.87, and the specificity and the sensitivity were 91% and 70%, respectively. The p < 0.001 indicated that the value of CCs of the prostates between the two groups was significantly different. CONCLUSION The symmetry in T2WI is a potential useful index for PCa screening and has a potential value for PCa detection and localizations of tumours for biopsy. ADVANCES IN KNOWLEDGE Texture bilateral symmetry of prostate T2WI is employed to screen the suspected prostate tumour.
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Affiliation(s)
- L Yang
- 1 College of Electronic Engineering, Chengdu University of Information Technology, Chengdu, Sichuan, China
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Uribe CF, Jones EC, Chang SD, Goldenberg SL, Reinsberg SA, Kozlowski P. In vivo 3T and ex vivo 7T diffusion tensor imaging of prostate cancer: Correlation with histology. Magn Reson Imaging 2015; 33:577-83. [PMID: 25721995 DOI: 10.1016/j.mri.2015.02.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 01/26/2015] [Accepted: 02/18/2015] [Indexed: 02/08/2023]
Abstract
The purpose of this work was to test whether fractional anisotropy (FA) can contribute to the diagnosis and grading of prostate cancer. Turbo spin echo T2-weighted (T2W) and single shot echo planar imaging diffusion tensor imaging (EPI DTI) data were collected from 13 subjects with biopsy proven prostate cancer prior to surgical removal of the gland. Rapid acquisition with relaxation enhancement (RARE) T2W and spin-echo DTI data were acquired ex-vivo from the fixed prostatectomy specimens. Digitized whole mount histology sections, examined and annotated by a pathologist, were registered to the in-vivo and ex-vivo DTI data, and the average values of apparent diffusion coefficient (ADC) and FA were calculated from ROIs encompassing normal and cancerous peripheral zone (PZ). In addition, Monte Carlo simulations were carried out to assess the dependence of the apparent FA on the ADC values for different signal to noise ratios (SNRs). ADC values were significantly lower in tumors than in normal PZ both in-vivo and ex-vivo, while the difference in FA values between tumors and normal PZ was significant only in-vivo. Paired t-test showed significant difference between in-vivo and ex-vivo FA values in tumors, but not in the normal PZ. The simulations showed that lower SNR results in an increasing overestimation of the FA values with decreasing ADC. These results suggest that the in-vivo increase in FA values in tumors is due to low SNR, rather than the presence of cancer. The results of this study suggest that FA does not contribute significantly to the diagnostic capabilities of DTI in prostate cancer.
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Affiliation(s)
- Carlos F Uribe
- Department of Physics and Astronomy, University of British Columbia, Vancouver, Canada; MRI Research Centre, University of British Columbia, Vancouver, Canada
| | - Edward C Jones
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Silvia D Chang
- Department of Radiology, University of British Columbia, Vancouver, Canada; Vancouver Prostate Centre, Vancouver, Canada
| | - S Larry Goldenberg
- Vancouver Prostate Centre, Vancouver, Canada; Department of Urologic Sciences, University of British Columbia, Vancouver, Canada
| | - Stefan A Reinsberg
- Department of Physics and Astronomy, University of British Columbia, Vancouver, Canada
| | - Piotr Kozlowski
- MRI Research Centre, University of British Columbia, Vancouver, Canada; Department of Radiology, University of British Columbia, Vancouver, Canada; Vancouver Prostate Centre, Vancouver, Canada; Department of Urologic Sciences, University of British Columbia, Vancouver, Canada.
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Shinmoto H, Oshio K, Tamura C, Soga S, Okamura T, Yamada K, Kaji T, Mulkern RV. Diffusion-weighted imaging of prostate cancer using a statistical model based on the gamma distribution. J Magn Reson Imaging 2014; 42:56-62. [DOI: 10.1002/jmri.24761] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 09/02/2014] [Indexed: 01/24/2023] Open
Affiliation(s)
- Hiroshi Shinmoto
- Department of Radiology; National Defense Medical College; Saitama Japan
| | - Koichi Oshio
- Department of Diagnostic Radiology; Keio University School of Medicine; Tokyo Japan
| | - Chiharu Tamura
- Department of Radiology; National Defense Medical College; Saitama Japan
| | - Shigeyoshi Soga
- Department of Radiology; National Defense Medical College; Saitama Japan
| | - Teppei Okamura
- Department of Radiology; National Defense Medical College; Saitama Japan
| | - Kentaro Yamada
- Department of Radiology; National Defense Medical College; Saitama Japan
| | - Tastumi Kaji
- Department of Radiology; National Defense Medical College; Saitama Japan
| | - Robert V. Mulkern
- Department of Radiology, Children's Hospital; Harvard Medical School; Boston Massachusetts USA
- Department of Radiology, Brigham and Women's Hospital; Harvard Medical School; Boston Massachusetts USA
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37
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Shebel H, Elhawary G, Sheir K, Sultan A. Characterization of upper urinary tract urothelial lesions in patients with gross hematuria using diffusion-weighted MRI: A prospective study. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2014. [DOI: 10.1016/j.ejrnm.2014.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
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Functional MRI in prostate cancer detection. BIOMED RESEARCH INTERNATIONAL 2014; 2014:590638. [PMID: 25215284 PMCID: PMC4158139 DOI: 10.1155/2014/590638] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 07/15/2014] [Indexed: 12/20/2022]
Abstract
Multiparametric magnetic resonance imaging (MP-MRI) has emerged as a promising method for the detection of prostate cancer. The functional MRI components of the MP-MRI consist of the diffusion weighted MRI, dynamic contrast enhanced MRI, and magnetic resonance spectroscopic imaging. The purpose of this paper is to review the existing literature about the use of functional MRI in prostate cancer detection.
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Quantitative evaluation of computed high B value diffusion-weighted magnetic resonance imaging of the prostate. Invest Radiol 2014; 48:779-86. [PMID: 23907102 DOI: 10.1097/rli.0b013e31829705bb] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Computed diffusion-weighted magnetic resonance imaging (cDWI) refers to the synthesizing of arbitrary b value diffusion-weighted images (DWI) from a set of measured b value images by voxelwise fitting. The objectives of this study were to quantitatively analyze the noise and the contrast-to-noise ratio (CNR) in cDWI as a function of b value by numerical simulations and by measurements in patients with prostate cancer and to compare cDWI to directly measured DWI at a b value of 1400 s/mm2. MATERIALS AND METHODS Numerical simulations were performed to assess image noise and CNR in both cDWI and regular DWI. Forty-two patients with prostate cancer (age, 51-73 years; prostate specific antigen level, 0.5-30 ng/mL; and biopsy Gleason score, 6-9) received 2 DWI examinations at 3.0 T (one with b values of 100, 500, and 1400 s/mm2 and another with b values of 0, 100, 400, and 800 s/mm2) to create cDWI images at arbitrary b values, both with and without incorporating a b value of 0 s/mm2 in their calculation. Regions of interest were drawn to compare the scan time adjusted CNR (CNR eff) between cDWI and directly measured DWI at b = 1400 s/mm2 on tumor-suspicious lesions and normal-appearing regions. RESULTS In the numerical simulations, noise depended strongly on the b value, the diffusion coefficient, and the signal intensity at a b value of 0 s/mm2 in cDWI but not in regular DWI. The CNR between simulated tumor and normal regions showed a continuous increase with increasing b value. Both these findings were also observed in tumor-suspicious and normal-appearing regions in in vivo data. In vivo prostate DWI at a b value of 1400 s/mm2 showed a similar CNR eff between the tumor-suspicious regions and the normal-appearing tissue in cDWI as in the directly measured DWI (P = 0.395). CONCLUSIONS The CNR eff between tumor-suspicious and normal-appearing prostate tissue in DWI images at a b value of 1400 s/mm2 is comparable in cDWI and directly measured DWI. Computed DWI at even higher b values, calculated from measured images with b values between 0 and 800 s/mm2, yields higher CNR eff than measured DWI, which may be of clinical aid in the management of prostate cancer.
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Vourganti S, Donaldson J, Johnson L, Turkbey B, Bratslavsky G, Kotula L. Defining the radiobiology of prostate cancer progression: An important question in translational prostate cancer research. Exp Biol Med (Maywood) 2014; 239:805-812. [PMID: 24879423 DOI: 10.1177/1535370214536669] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Prostate cancer is one of the most common malignancies affecting men worldwide. High mortality rates from advanced and metastatic prostate cancer in the United States are contrasted by a relatively indolent course in the majority of cases. This gives hope for finding methods that could direct personalized diagnostic, preventative, and treatment approaches to patients with prostate cancer. Recent advances in multiparametric magnetic resonance imaging (MP-MRI) offer a noninvasive diagnostic intervention which allows correlation of prostate tumor image characteristics with underlying biologic evidence of tumor progression. The power of MP-MRI includes examination of both local invasion and nodal disease and might overcome the challenges of analyzing the multifocal nature of prostate cancer. Future directions include a careful analysis of the genomic signature of individual prostatic lesions utilizing image-guided biopsies. This review examines the diagnostic potential of MRI in prostate cancer.
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Affiliation(s)
- Srinivas Vourganti
- Department of Urology, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - Jeffrey Donaldson
- Department of Urology, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - Linda Johnson
- Molecular Imaging Program, Urologic Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Baris Turkbey
- Molecular Imaging Program, Urologic Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Gennady Bratslavsky
- Department of Urology, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - Leszek Kotula
- Department of Urology, SUNY Upstate Medical University, Syracuse, NY 13210, USA Department of Biochemistry and Molecular Biology, SUNY Upstate Medical University, Syracuse, NY 13210, USA
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Johnson LM, Turkbey B, Figg WD, Choyke PL. Multiparametric MRI in prostate cancer management. Nat Rev Clin Oncol 2014; 11:346-53. [PMID: 24840072 DOI: 10.1038/nrclinonc.2014.69] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Prostate cancer is the second most common cancer in men worldwide. The clinical behaviour of prostate cancer ranges from low-grade indolent tumours that never develop into clinically significant disease to aggressive, invasive tumours that may progress rapidly to metastatic disease and death. Therefore, there is an urgent clinical need to detect high-grade cancers and to differentiate them from the indolent, slow-growing tumours. Conventional methods of cancer detection-such as levels of prostate-specific antigen (PSA) in serum, digital rectal examination, and random biopsies-are limited in their sensitivity, specificity, or both. The combination of conventional anatomical MRI and functional magnet resonance sequences-known as multiparametric MRI (mp-MRI)-is emerging as an accurate tool for identifying clinically relevant tumours owing to its ability to localize them. In this Review, we discuss the value of mp-MRI in localized and metastatic prostate cancer, highlighting its role in the detection, staging, and treatment planning of prostate cancer.
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Affiliation(s)
- Linda M Johnson
- Molecular Pharmacology Section, Medical Oncology Branch, National Cancer Institute, 10 Center Drive, MSC 1182 Building 10, Bethesda, MD 20892-1088, USA
| | - Baris Turkbey
- Molecular Imaging Program, National Cancer Institute, 10 Center Drive, MSC 1182 Building 10, Bethesda, MD 20892-1088, USA
| | - William D Figg
- Clinical Pharmacology Program, Center for Cancer Research, National Cancer Institute, 10 Center Drive, MSC 1182 Building 10, Bethesda, MD 20892-1088, USA
| | - Peter L Choyke
- Molecular Imaging Program, National Cancer Institute, 10 Center Drive, MSC 1182 Building 10, Bethesda, MD 20892-1088, USA
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Apparent diffusion coefficient for prostate cancer imaging: impact of B values. AJR Am J Roentgenol 2014; 202:W247-53. [PMID: 24555621 DOI: 10.2214/ajr.13.10917] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The purpose of this article is to investigate the effect of b values on apparent diffusion coefficient (ADC) values estimated from 1.5-T diffusion-weighted MRI (DWI) of the prostate acquired with an endorectal coil in distinguishing prostate cancer from normal-tissue regions of interest (ROIs) and the correlation of ADC values with the tumor Gleason score. MATERIALS AND METHODS Pretreatment DWI studies were analyzed retrospectively in 51 consecutive patients with prostate cancer with either two (b=0 and 1000 s/mm2; n=26 patients) or five (b=0, 50, 200, 1500, and 2000 s/mm2; n=25 patients) b values. In 45 normal peripheral-zone ROIs and 65 prostate cancer ROIs (14 in the central gland), ADC values were estimated by use of several combinations of two or five b values and a monoexponential model. We used the area under the receiver operating characteristic curve to characterize the effectiveness of ADC values in distinguishing prostate cancer from normal-tissue ROIs, and we calculated Spearman rank-order correlation between ADC values and the Gleason score. RESULTS ADC values were often significantly different (p<0.001) when estimated from different combinations of two or five b values. However, except when both b values were less than or equal to 200 mm2/s or greater than or equal to 1500 mm2/s, the AUC value for distinguishing prostate cancer from normal-tissue ROIs was similar (0.88-0.93). The correlation coefficients between ADC values and the Gleason score were between -0.30 and -0.68. CONCLUSION The choice of b values can significantly affect ADC estimates. ADC values can produce a similar discriminant performance in distinguishing prostate cancer from normal-tissue ROIs and in correlation with the Gleason score, but an appropriate ADC cutoff value needs to be selected specifically for each b-value combination.
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Maurer T, Eiber M, Krause BJ. [Molecular multimodal hybrid imaging in prostate and bladder cancer]. Urologe A 2014; 53:469-83. [PMID: 24700188 DOI: 10.1007/s00120-014-3440-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Since the introduction of combined radiologic-nuclear imaging procedures like PET/CT and PET/MRI, new and promising diagnostic tools in bladder and prostate cancer imaging are available to physicians. Although PET-based hybrid imaging in bladder cancer is currently utilized only in selected cases, an increase in PET imaging can be observed in prostate cancer due to the development of cancer-specific PET tracers. Especially novel ligands of prostate-specific membrane antigen (PSMA) exhibit great potential to effectively influence future staging of prostate cancer. However, before recommendations for implication in routine staging can be given, evaluation in the context of prospective multicenter clinical trials are mandatory.
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Affiliation(s)
- T Maurer
- Urologische Klinik und Poliklinik, Technische Universität München, Klinikum rechts der Isar, Ismaninger Straße 22, 81671, München, Deutschland,
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Assessment of apparent diffusion coefficient values as predictor of aggressiveness in peripheral zone prostate cancer: comparison with Gleason score. ISRN RADIOLOGY 2014; 2014:263417. [PMID: 24967293 PMCID: PMC4045556 DOI: 10.1155/2014/263417] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2013] [Accepted: 12/19/2013] [Indexed: 11/30/2022]
Abstract
Purpose. To determine association between apparent diffusion coefficient value on diffusion-weighted imaging and Gleason score in patients with prostate cancer.
Methods. This retrospective case series was conducted at Radiology Department of Aga Khan University between June 2009 and June 2011. 28 patients with biopsy-proven prostate cancer were included who underwent ultrasound guided sextant prostate biopsy and MRI. MRI images were analyzed on diagnostic console and regions of interest were drawn. Data were entered and analyzed on SPSS 20.0. ADC values were compared with Gleason score using one-way ANOVA test. Results. In 28 patients, 168 quadrants were biopsied and 106 quadrants were positive for malignancy. 89 lesions with proven malignancy showed diffusion restriction. The mean ADC value for disease with a Gleason score of 6 was 935 mm2/s (SD = 248.4 mm2/s); Gleason score of 7 was 837 mm2/s (SD = 208.5 mm2/s); Gleason score of 8 was 614 mm2/s (SD = 108 mm2/s); and Gleason score of 9 was 571 mm2/s (SD = 82 mm2/s). Inverse relationship was observed between Gleason score and mean ADC values. Conclusion. DWI and specifically quantitative ADC values may help differentiate between low-risk (Gleason score, 6), intermediate-risk (Gleason score, 7), and high-risk (Gleason score 8 and 9) prostate cancers, indirectly determining the aggressiveness of the disease.
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Tamada T, Sone T, Jo Y, Yamamoto A, Ito K. Diffusion-weighted MRI and its role in prostate cancer. NMR IN BIOMEDICINE 2014; 27:25-38. [PMID: 23712781 DOI: 10.1002/nbm.2956] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Revised: 02/28/2013] [Accepted: 03/05/2013] [Indexed: 06/02/2023]
Abstract
In the last 5 years, the multiparametric approach has been investigated as the method for the MRI of prostate cancer. In multiparametric MRI of the prostate, at least two functional MRI techniques, such as diffusion-weighted MRI (DW-MRI) and dynamic contrast-enhanced MRI, are combined with conventional MRI, such as T2 -weighted imaging. DW-MRI has the ability to qualitatively and quantitatively represent the diffusion of water molecules by the apparent diffusion coefficient, which indirectly reflects tissue cellularity. DW-MRI is characterized by a short acquisition time without the administration of contrast medium. Thus, DW-MRI has the potential to become established as a noninvasive diagnostic method for tumor detection and localization, tumor aggressiveness, local staging and local recurrence after various therapies. Accordingly, radiologists should recognize the principles of DW-MRI, the methods of image acquisition and the pitfalls of image interpretation.
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Affiliation(s)
- Tsutomu Tamada
- Department of Radiology, Kawasaki Medical School, Kurashiki City, Okayama, Japan
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Lagemaat MW, Scheenen TWJ. Role of high-field MR in studies of localized prostate cancer. NMR IN BIOMEDICINE 2014; 27:67-79. [PMID: 23703839 DOI: 10.1002/nbm.2967] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 03/12/2013] [Accepted: 03/28/2013] [Indexed: 06/02/2023]
Abstract
Magnetic resonance imaging is attracting increasing attention from the uroradiological community as a modality to guide the management of prostate cancer. With the high incidence of prostate cancer it might come as a surprise that for a very long time (and in many places even at present) treatment decisions were being made without the use of detailed anatomical and functional imaging of the prostate gland at hand. Although T2 -weighted MRI can provide great anatomical detail, by itself it is not specific enough to discriminate cancer from benign disease, so other functional MRI techniques have been explored to aid in detection, localization, staging and risk assessment of prostate cancer. With the current evolution of clinical MR systems from 1.5 to 3 T it is important to understand the advantages and the challenges of the higher magnetic field strength for the different functional MR techniques most used in the prostate: T2 -weighted MRI, diffusion-weighted MRI, MR spectroscopic imaging and dynamic contrast-enhanced imaging. In addition to this, the use of the endorectal coil at different field strengths is discussed in this review, together with an outlook of the possibilities of ultra-high-field MR for the prostate.
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Affiliation(s)
- Miriam W Lagemaat
- Department of Radiology (766), Radboud University Nijmegen Medical Centre, The Netherlands
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Ghafoori M, Alavi M, Aliyari Ghasabeh M. MRI in prostate cancer. IRANIAN RED CRESCENT MEDICAL JOURNAL 2013; 15:e16620. [PMID: 24693403 PMCID: PMC3955518 DOI: 10.5812/ircmj.16620] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 09/19/2013] [Accepted: 09/25/2013] [Indexed: 12/12/2022]
Abstract
Imaging studies play an important role in detection and management of prostate cancer and MRI especially with the use of endorectal coil because of high contrast resolution is recognized as the best imaging modality in evaluation of prostate cancer. Multiparametric MR study including T1 and T2 weighted images, diffusion weighted images, dynamic contrast study and MR spectroscopy is useful for detection and local staging of prostate cancer as well as posts treatment evaluation of patients either after surgery or radiation therapy for detection of local recurrence.
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Affiliation(s)
- Mahyar Ghafoori
- Department of Radiology, Department of Radiology, Hazrat Rasoul Akram University Hospital, School of Medicine, Iran University of Medical Sciences, Advanced Diagnostic and Interventional Radiology Research Center, Tehran, IR Iran
- Corresponding Author: Mahyar Ghafoori, Department of Radiology, Hazrat Rasoul Akram University Hospital, School of Medicine, Iran University of Medical Sciences, Advanced Diagnostic and Interventional Radiology Research Center, Tehran, IR Iran. Tel: +98-9123483501, E-mail:
| | - Manijeh Alavi
- Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, IR Iran
| | - Mounes Aliyari Ghasabeh
- Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
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Hegde JV, Mulkern RV, Panych LP, Fennessy FM, Fedorov A, Maier SE, Tempany CMC. Multiparametric MRI of prostate cancer: an update on state-of-the-art techniques and their performance in detecting and localizing prostate cancer. J Magn Reson Imaging 2013; 37:1035-54. [PMID: 23606141 DOI: 10.1002/jmri.23860] [Citation(s) in RCA: 170] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Accepted: 09/04/2012] [Indexed: 12/15/2022] Open
Abstract
Magnetic resonance (MR) examinations of men with prostate cancer are most commonly performed for detecting, characterizing, and staging the extent of disease to best determine diagnostic or treatment strategies, which range from biopsy guidance to active surveillance to radical prostatectomy. Given both the exam's importance to individual treatment plans and the time constraints present for its operation at most institutions, it is essential to perform the study effectively and efficiently. This article reviews the most commonly employed modern techniques for prostate cancer MR examinations, exploring the relevant signal characteristics from the different methods discussed and relating them to intrinsic prostate tissue properties. Also, a review of recent articles using these methods to enhance clinical interpretation and assess clinical performance is provided. J. Magn. Reson. Imaging 2013;37:1035-1054. © 2013 Wiley Periodicals, Inc.
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Affiliation(s)
- John V Hegde
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
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Chen XL, Chen TW, Zhang XM, Li ZL, Li H, Zeng NL, Tang HJ, Pu Y, Chen N, Yang Q, Li L, Xie XY, Hu J. Spleen magnetic resonance diffusion-weighted imaging for quantitative staging hepatic fibrosis in miniature pigs: An initial study. Hepatol Res 2013; 43:1231-40. [PMID: 23421793 DOI: 10.1111/hepr.12076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2012] [Revised: 01/15/2013] [Accepted: 01/16/2013] [Indexed: 02/05/2023]
Abstract
AIM To determine whether spleen diffusion-weighted imaging (DWI) parameters might classify liver fibrosis stage. METHODS Sixteen miniature pigs were prospectively used to model liver fibrosis, and underwent spleen DWI by using b = 300, 500 and 800 s/mm(2) on 0, 5th, 9th, 16th and 21st weekend after the beginning of modeling. Signal intensity ratio of spleen to paraspinous muscles (S/M), spleen exponential apparent diffusion coefficient (eADC) and apparent diffusion coefficient (ADC) for each b-value were statistically analyzed. RESULTS With increasing stages of fibrosis, S/M for all b-values showed a downward trend; and spleen eADC and ADC for b = 300 s/mm(2) showed downward and upward trends, respectively (all P < 0.05). The area under the receiver-operator curve (AUC) of spleen DWI parameters was 0.777 or more by S/M for classifying each fibrosis stage, and 0.65 or more by eADC and 0.648 or more by ADC for classifying stage ≥3 or cirrhosis. Among the spleen DWI parameters, S/M for b = 300 s/mm(2) was the best parameter in classifying stage 1 or more, 2 or more and 3 or more with AUC of 0.875, 0.851 and 0.843, respectively; and spleen eADC for b = 300 s/mm(2) was best in classifying stage 4 with an AUC of 0.988. CONCLUSION Spleen DWI may be used to stage liver fibrosis.
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Affiliation(s)
- Xiao-Li Chen
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
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Mazaheri Y, Vargas HA, Nyman G, Shukla-Dave A, Akin O, Hricak H. Diffusion-weighted MRI of the prostate at 3.0T: Comparison of endorectal coil (ERC) MRI and phased-array coil (PAC) MRI—The impact of SNR on ADC measurement. Eur J Radiol 2013; 82:e515-20. [DOI: 10.1016/j.ejrad.2013.04.041] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Revised: 03/06/2013] [Accepted: 04/02/2013] [Indexed: 12/17/2022]
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