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Guljaš S, Dupan Krivdić Z, Drežnjak Madunić M, Šambić Penc M, Pavlović O, Krajina V, Pavoković D, Šmit Takač P, Štefančić M, Salha T. Dynamic Contrast-Enhanced Study in the mpMRI of the Prostate-Unnecessary or Underutilised? A Narrative Review. Diagnostics (Basel) 2023; 13:3488. [PMID: 37998624 PMCID: PMC10670922 DOI: 10.3390/diagnostics13223488] [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: 08/26/2023] [Revised: 10/30/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023] Open
Abstract
The aim of this review is to summarise recent scientific literature regarding the clinical use of DCE-MRI as a component of multiparametric resonance imaging of the prostate. This review presents the principles of DCE-MRI acquisition and analysis, the current role of DCE-MRI in clinical practice with special regard to its role in presently available categorisation systems, and an overview of the advantages and disadvantages of DCE-MRI described in the current literature. DCE-MRI is an important functional sequence that requires intravenous administration of a gadolinium-based contrast agent and gives information regarding the vascularity and capillary permeability of the lesion. Although numerous studies have confirmed that DCE-MRI has great potential in the diagnosis and monitoring of prostate cancer, its role is still inadequate in the PI-RADS categorisation. Moreover, there have been numerous scientific discussions about abandoning the intravenous application of gadolinium-based contrast as a routine part of MRI examination of the prostate. In this review, we summarised the recent literature on the advantages and disadvantages of DCE-MRI, focusing on an overview of currently available data on bpMRI and mpMRI, as well as on studies providing information on the potential better usability of DCE-MRI in improving the sensitivity and specificity of mpMRI examinations of the prostate.
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Affiliation(s)
- Silva Guljaš
- Clinical Department of Radiology, University Hospital Centre, 31000 Osijek, Croatia; (S.G.); (Z.D.K.)
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (M.D.M.); (M.Š.P.); (O.P.); (V.K.); (D.P.)
| | - Zdravka Dupan Krivdić
- Clinical Department of Radiology, University Hospital Centre, 31000 Osijek, Croatia; (S.G.); (Z.D.K.)
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (M.D.M.); (M.Š.P.); (O.P.); (V.K.); (D.P.)
| | - Maja Drežnjak Madunić
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (M.D.M.); (M.Š.P.); (O.P.); (V.K.); (D.P.)
- Department of Oncology, University Hospital Centre, 31000 Osijek, Croatia
| | - Mirela Šambić Penc
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (M.D.M.); (M.Š.P.); (O.P.); (V.K.); (D.P.)
- Department of Oncology, University Hospital Centre, 31000 Osijek, Croatia
| | - Oliver Pavlović
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (M.D.M.); (M.Š.P.); (O.P.); (V.K.); (D.P.)
- Department of Urology, University Hospital Centre, 31000 Osijek, Croatia
| | - Vinko Krajina
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (M.D.M.); (M.Š.P.); (O.P.); (V.K.); (D.P.)
- Department of Urology, University Hospital Centre, 31000 Osijek, Croatia
| | - Deni Pavoković
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (M.D.M.); (M.Š.P.); (O.P.); (V.K.); (D.P.)
- Department of Urology, University Hospital Centre, 31000 Osijek, Croatia
| | - Petra Šmit Takač
- Clinical Department of Surgery, Osijek University Hospital Centre, 31000 Osijek, Croatia;
| | - Marin Štefančić
- Department of Radiology, National Memorial Hospital Vukovar, 32000 Vukovar, Croatia;
| | - Tamer Salha
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (M.D.M.); (M.Š.P.); (O.P.); (V.K.); (D.P.)
- Department of Teleradiology and Artificial Intelligence, Health Centre Osijek-Baranja County, 31000 Osijek, Croatia
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
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Akkaya H, Dilek O, Özdemir S, Taş ZA, Öztürk İS, Gülek B. Can the Gleason score be predicted in patients with prostate cancer? A dynamic contrast-enhanced MRI, (68)Ga-PSMA PET/CT, PSA, and PSA-density comparison study. Diagn Interv Radiol 2023; 29:647-655. [PMID: 37395389 PMCID: PMC10679545 DOI: 10.4274/dir.2023.232186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/22/2023] [Indexed: 07/04/2023]
Abstract
PURPOSE The present study aims to evaluate whether perfusion parameters in prostate magnetic resonance imaging (MRI), (68)Ga-prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT), prostate-specific antigen (PSA), and PSA density can be used to predict the lesion grade in patients with prostate cancer (PCa). METHODS The study included a total of 137 PCa cases in which 12-quadrant transrectal ultrasound-guided prostate biopsy (TRUSBx) was performed, the Gleason score (GS) was determined, and pre-biopsy multiparametric prostate MRI and (68)Ga-PSMA PET/CT examinations were undertaken. The patient population was evaluated in three groups according to the GS: (1) low risk; (2) intermediate risk; (3) high risk. The PSA, PSA density, pre-TRUSBx (68)Ga-PSMA PET/CT maximum standardized uptake value (SUVmax), perfusion MRI parameters [maximum enhancement, maximum relative enhancement, T0 (s), time to peak (s), wash-in rate (s-1), and wash-out rate (s-1)] were retrospectively evaluated. RESULTS There was no significant difference between the three groups in relation to the PSA, PSA density, and (68)Ga-PSMA PET/CT SUVmax (P > 0.05). However, the values of maximum enhancement, maximum relative enhancement (%), T0 (s), time to peak (s), wash-in rate (s-1), and wash-out rate (s-1) significantly differed among the groups. A moderate positive correlation was found among the prostate volume, PSA (r = 0.490), and (68)Ga-PSMA SUVmax (r = 0.322) in the patients. The wash-out rate (s-1) and wash-in rate (s-1) had the best diagnostic test performance (area under the curve: 89.1% and 78.4%, respectively). CONCLUSION No significant correlation was found between the (68)Ga-PSMA PET/CT SUVmax and the GS. The wash-out rate was more successful in estimating the pretreatment GS than the (68)Ga-PSMA PET/CT SUVmax.
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Affiliation(s)
- Hüseyin Akkaya
- Clinic of Radiology, University of Health Sciences Turkey, Adana City Training and Research Hospital, Adana, Turkey
| | - Okan Dilek
- Clinic of Radiology, University of Health Sciences Turkey, Adana City Training and Research Hospital, Adana, Turkey
| | - Selim Özdemir
- Clinic of Radiology, University of Health Sciences Turkey, Adana City Training and Research Hospital, Adana, Turkey
| | - Zeynel Abidin Taş
- Clinic of Pathology, University of Health Sciences Turkey, Adana City Training and Research Hospital, Adana, Turkey
| | - İhsan Sabri Öztürk
- Clinic of Nuclear Medicine, University of Health Sciences Turkey, Adana City Training and Research Hospital, Adana, Turkey
| | - Bozkurt Gülek
- Clinic of Radiology, University of Health Sciences Turkey, Adana City Training and Research Hospital, Adana, Turkey
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Hellstern M, Martinez C, Wallenhorst C, Beyersdorff D, Lüdemann L, Grimm MO, Teichgräber U, Franiel T. Optimal length and temporal resolution of dynamic contrast-enhanced MR imaging for the differentiation between prostate cancer and normal peripheral zone tissue. PLoS One 2023; 18:e0287651. [PMID: 37352312 PMCID: PMC10289347 DOI: 10.1371/journal.pone.0287651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 06/12/2023] [Indexed: 06/25/2023] Open
Abstract
The value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in the detection of prostate cancer is controversial. There are currently insufficient peer reviewed published data or expert consensus to support routine adoption of DCE-MRI for clinical use. Thus, the objective of this study was to explore the optimal temporal resolution and measurement length for DCE-MRI to differentiate cancerous from normal prostate tissue of the peripheral zone of the prostate by non-parametric MRI analysis and to compare with a quantitative MRI analysis. Predictors of interest were onset time, relative signal intensity (RSI), wash-in slope, peak enhancement, wash-out and wash-out slope determined from non-parametric characterisation of DCE-MRI intensity-time profiles. The discriminatory power was estimated from C-statistics based on cross validation. We analyzed 54 patients with 97 prostate tissue specimens (47 prostate cancer, 50 normal prostate tissue) of the peripheral zone, mean age 63.8 years, mean prostate-specific antigen 18.9 ng/mL and mean of 10.5 days between MRI and total prostatectomy. When comparing prostate cancer tissue with normal prostate tissue, median RSI was 422% vs 330%, and wash-in slope 0.870 vs 0.539. The peak enhancement of 67 vs 42 was higher with prostate cancer tissue, while wash-out (-30% vs -23%) and wash-out slope (-0.037 vs -0.029) were lower, and the onset time (32 seconds) was comparable. The optimal C-statistics was 0.743 for temporal resolution of 8.0 seconds and measurement length of 2.5 minutes compared with 0.656 derived from a quantitative MRI analysis. This study provides evidence that the use of a non-parametric approach instead of a more established parametric approach resulted in greater precision to differentiate cancerous from normal prostate tissue of the peripheral zone of the prostate.
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Affiliation(s)
- Marius Hellstern
- Bürgerhospital und Clementin Kinderhospital gGmbH, Frankfurt am Main, Germany
| | - Carlos Martinez
- Institute for Epidemiology, Statistics and Informatics GmbH, Frankfurt am Main, Germany
| | | | - Dirk Beyersdorff
- Department of Diagnostic and Interventional Radiology, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | - Lutz Lüdemann
- Department of Medical Physics, Essen University Hospital, Essen, Germany
| | - Marc-Oliver Grimm
- Klinik und Poliklinik für Urologie Universitätsklinikum Jena, Jena, Germany
| | - Ulf Teichgräber
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Jena, Jena, Germany
| | - Tobias Franiel
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Jena, Jena, Germany
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Development of Preclinical Ultrasound Imaging Techniques to Identify and Image Sentinel Lymph Nodes in a Cancerous Animal Model. Cancers (Basel) 2022; 14:cancers14030561. [PMID: 35158829 PMCID: PMC8833694 DOI: 10.3390/cancers14030561] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 01/19/2022] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Bowel cancer is the fourth most common cancer in the UK. Treatment is dominated by major surgery because current imaging modalities cannot accurately determine lymph node involvement or vascular invasion. Although potentially curative, surgery carries a high risk of short- and long-term morbidity, including stoma formation. Optimized pre-treatment imaging would decrease the number of bowel cancer patients requiring major surgery. Such imaging would also be equally applicable to other cancers where local resection could significantly improve patient quality of life without compromising long-term outcomes (e.g., melanoma, head and neck cancers, gastro-esophageal, bladder). In this study, we created two mouse models (tumor and control) and used the resolution of high-frequency ultrasound imaging and parameters calculated from dynamically contrast-enhanced ultrasound to predict the likelihood of draining lymph nodes to be involved in the disease. Abstract Lymph nodes (LNs) are believed to be the first organs targeted by colorectal cancer cells detached from a primary solid tumor because of their role in draining interstitial fluids. Better detection and assessment of these organs have the potential to help clinicians in stratification and designing optimal design of oncological treatments for each patient. Whilst highly valuable for the detection of primary tumors, CT and MRI remain limited for the characterization of LNs. B-mode ultrasound (US) and contrast-enhanced ultrasound (CEUS) can improve the detection of LNs and could provide critical complementary information to MRI and CT scans; however, the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) guidelines advise that further evidence is required before US or CEUS can be recommended for clinical use. Moreover, knowledge of the lymphatic system and LNs is relatively limited, especially in preclinical models. In this pilot study, we have created a mouse model of metastatic cancer and utilized 3D high-frequency ultrasound to assess the volume, shape, and absence of hilum, along with CEUS to assess the flow dynamics of tumor-free and tumor-bearing LNs in vivo. The aforementioned parameters were used to create a scoring system to predict the likelihood of a disease-involved LN before establishing post-mortem diagnosis with histopathology. Preliminary results suggest that a sum score of parameters may provide a more accurate diagnosis than the LN size, the single parameter currently used to predict the involvement of an LN in disease.
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Han BH, Park SB. Usefulness of Contrast-enhanced Ultrasound in the Evaluation of Chronic Kidney Disease. Curr Med Imaging 2021; 17:1003-1009. [PMID: 33504313 PMCID: PMC8653424 DOI: 10.2174/1573405617666210127101926] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 11/19/2020] [Accepted: 12/03/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Contrast-enhanced ultrasound (CEUS) can provide more improved images of renal blood flow and much more information of both macro- and microcirculation of the kidney as compared to Doppler US. OBJECTIVE To investigate the usefulness of CEUS by analyzing differences in perfusion-related parameters among the three chronic kidney disease (CKD) subgroups and the control group. METHODS Thirty-eight patients with CKD and 21 controls who were age-matched (20-49 years) were included. Included CKD patients were stratified into three groups according to their eGFR: group I, eGFR ≥ 60 ml/min/1.73 m2 (GFR category I and II); group II, 30 ml/min/1.73 m2 ≤ eGFR < 60 ml/min/1.73 m2 (GFR category III); and group III, eGFR < 30 ml/min/1.73 m2 (GFR category IV and V). Comparisons with the controls (eGFR > 90 ml/min/1.73 m2) were performed. Real-time and dynamic renal cortex imaging was performed using CEUS. Time-intensity curves and several bolus model quantitative perfusion parameters were created using the VueBox® quantification software. We compared the parameters among the CKD subgroups and between the CKD and control groups. RESULTS Eight patients were included in group I, 12 patients in group II, and 18 patients in group III. Significant differences were noted in the wash-in and wash-out rates between the CKD and control groups (p = 0.027 and p = 0.018, respectively), but not between those of the CKD subgroups. There were no significant differences of other perfusion parameters among the CKD subgroups and between the CKD and control groups. CONCLUSION A few perfusion related CEUS parameters (WiR and WoR) can be used as markers of renal microvascular perfusion relating renal function. CEUS can effectively and quantitatively exhibit the renal microvascular perfusion in patients with CKD as well as normal control participants.
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Affiliation(s)
- Byoung Hee Han
- Department of Radiology, Gangneung Asan Hospital, College of Medicine, University of Ulsan, Gangneung, Korea
| | - Sung Bin Park
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
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Ingole SM, Mehta RU, Kazi ZN, Bhuyar RV. Multiparametric Magnetic Resonance Imaging in Evaluation of Clinically Significant Prostate Cancer. Indian J Radiol Imaging 2021; 31:65-77. [PMID: 34316113 PMCID: PMC8299509 DOI: 10.1055/s-0041-1730093] [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] [Indexed: 12/05/2022] Open
Abstract
Aim
In this prospective study, we evaluate the role of multiparametric magnetic resonance imaging (mp-MRI) in the assessment of clinically significant prostate cancer at 1.5 T without endorectal coil (ERC).
Materials and Methods
Forty-five men with clinical suspicion of prostate cancer (prostate-specific antigen [PSA] level > 4 ng/mL, hard prostate on digital rectal examination, and suspicious area at transrectal ultrasound [TRUS]) were evaluated using the mp-MRI protocol over a period of 24 months. All cases were interpreted using the Prostate Imaging Reporting and Data System (PI-RADS) version 2 guidelines and correlated with histopathology.
Statistical Analysis Used
A chi-squared test was used for analysis of nominal/categorical variables and receiver operating characteristic (ROC) curve and one-way analysis of variance (ANOVA) test for continuous variables.
Results
The mean age was 67 years and the mean PSA was 38.2 ng/mL. Eighty percent had prostate cancer and 20% were benign (11% benign prostatic hyperplasia [BPH] and 9% chronic prostatitis). Eighty-six percent of all malignancies were in the peripheral zone. The PI-RADS score for T2-weighted (T2W) imaging showed good sensitivity (81%) but low specificity (67%). The PI-RADS score for diffusion weighted imaging (DWI) with sensitivity of 92% and specificity of 78% had a better accuracy overall than T2W imaging alone. The mean apparent diffusion coefficient (ADC) value (×10
–6
mm
2
/s) was 732 ± 160 in prostate cancer, 1,009 ± 161 in chronic prostatitis, 1,142 ± 82 in BPH, and 663 in a single case of granulomatous prostatitis. Low ADC values (<936) have shown good correlation (area under curve [AUC]: 0.87) with the presence of cancer foci. Inverse correlation was observed between Gleason scores and ADC values. Dynamic contrast-enhanced (DCE) imaging has shown 100% sensitivity/negative predictive value (NPV), but moderate specificity (67%) in predicting malignancy. The final PI-RADS score had 100% sensitivity and NPV with good overall positive predictive value (PPV) of 95%.
Conclusions
T2W imaging and DWI remain the mainstays in diagnosis of prostate cancer with mp-MRI. DCE-MRI can be a problem-solving tool in case of equivocal findings. Because assessment with mp-MRI can be subjective, use of the newly developed PI-RADS version 2 scoring system is helpful in accurate interpretation.
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Affiliation(s)
- Sarang M Ingole
- Department of Imaging Sciences and Pathology, Saifee Hospital, Mumbai, Maharashtra, India
| | - Rajeev U Mehta
- Department of Imaging Sciences and Pathology, Saifee Hospital, Mumbai, Maharashtra, India
| | - Zubair N Kazi
- Department of Imaging Sciences and Pathology, Saifee Hospital, Mumbai, Maharashtra, India
| | - Rutuja V Bhuyar
- Department of Imaging Sciences and Pathology, Saifee Hospital, Mumbai, Maharashtra, India
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Beer L, Polanec SH, Baltzer PAT, Schatzl G, Georg D, Schestak C, Dutschke A, Herrmann H, Mazal P, Brendel AK, Shariat SF, Ringl H, Helbich TH, Apfaltrer P. 4D perfusion CT of prostate cancer for image-guided radiotherapy planning: A proof of concept study. PLoS One 2019; 14:e0225673. [PMID: 31856177 PMCID: PMC6922381 DOI: 10.1371/journal.pone.0225673] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 11/08/2019] [Indexed: 12/26/2022] Open
Abstract
Purpose Advanced forms of prostate cancer (PCa) radiotherapy with either external beam therapy or brachytherapy delivery techniques aim for a focal boost and thus require accurate lesion localization and lesion segmentation for subsequent treatment planning. This study prospectively evaluated dynamic contrast-enhanced computed tomography (DCE-CT) for the detection of prostate cancer lesions in the peripheral zone (PZ) using qualitative and quantitative image analysis compared to multiparametric magnet resonance imaging (mpMRI) of the prostate. Methods With local ethics committee approval, 14 patients (mean age, 67 years; range, 57–78 years; PSA, mean 8.1 ng/ml; range, 3.5–26.0) underwent DCE-CT, as well as mpMRI of the prostate, including standard T2, diffusion-weighted imaging (DWI), and DCE-MRI sequences followed by transrectal in-bore MRI-guided prostate biopsy. Maximum intensity projections (MIP) and DCE-CT perfusion parameters (CTP) were compared between healthy and malignant tissue. Two radiologists independently rated image quality and the tumor lesion delineation quality of PCa using a five-point ordinal scale. MIP and CTP were compared using visual grading characteristics (VGC) and receiver operating characteristics (ROC)/area under the curve (AUC) analysis. Results The PCa detection rate ranged between 57 to 79% for the two readers for DCE-CT and was 92% for DCE-MRI. DCE-CT perfusion parameters in PCa tissue in the PZ were significantly different compared to regular prostate tissue and benign lesions. Image quality and lesion visibility were comparable between DCE-CT and DCE-MRI (VGC: AUC 0.612 and 0.651, p>0.05). Conclusion Our preliminary results suggest that it is feasible to use DCE-CT for identification and visualization, and subsequent segmentation for focal radiotherapy approaches to PCa.
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Affiliation(s)
- Lucian Beer
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
- Department of Radiology and Cancer Research UK Cambridge Center, Cambridge, United Kingdom
| | - Stephan H. Polanec
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Pascal A. T. Baltzer
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Georg Schatzl
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Dietmar Georg
- Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria
- Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University Vienna, Austria
| | - Christian Schestak
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Anja Dutschke
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Harald Herrmann
- Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria
| | - Peter Mazal
- Clinical Institute of Pathology, Medical University of Vienna, Vienna, Austria
| | | | | | - Helmut Ringl
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Thomas H. Helbich
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Paul Apfaltrer
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
- Department of Neuroradiology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- * E-mail:
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Lee JE, Diederich CJ, Bok R, Sriram R, Santos RD, Noworolski SM, Salgaonkar VA, Adams MS, Vigneron DB, Kurhanewicz J. Assessing high-intensity focused ultrasound treatment of prostate cancer with hyperpolarized 13 C dual-agent imaging of metabolism and perfusion. NMR IN BIOMEDICINE 2019; 32:e3962. [PMID: 30022550 PMCID: PMC6338537 DOI: 10.1002/nbm.3962] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 05/17/2018] [Accepted: 05/19/2018] [Indexed: 05/05/2023]
Abstract
The goal of the study was to establish early hyperpolarized (HP) 13 C MRI metabolic and perfusion changes that predict effective high-intensity focused ultrasound (HIFU) ablation and lead to improved adjuvant treatment of partially treated regions. To accomplish this a combined HP dual-agent (13 C pyruvate and 13 C urea) 13 C MRI/multiparametric 1 H MRI approach was used to measure prostate cancer metabolism and perfusion 3-4 h, 1 d, and 5 d after exposure to ablative and sub-lethal doses of HIFU within adenocarcinoma of mouse prostate tumors using a focused ultrasound applicator designed for murine studies. Pathologic and immunohistochemical analysis of the ablated tumor demonstrated fragmented, non-viable cells and vasculature consistent with coagulative necrosis, and a mixture of destroyed tissue and highly proliferative, poorly differentiated tumor cells in tumor tissues exposed to sub-lethal heat doses in the ablative margin. In ablated regions, the intensity of HP 13 C lactate or HP 13 C urea and dynamic contrast-enhanced (DCE) MRI area under the curve images were reduced to the level of background noise by 3-4 h after treatment with no recovery by the 5 d time point in either case. In the tissues that received sub-lethal heat dose, there was a significant 60% ± 12.4% drop in HP 13 C lactate production and a significant 30 ± 13.7% drop in urea perfusion 3-4 h after treatment, followed by recovery to baseline by 5 d after treatment. DCE MRI Ktrans showed a similar trend to HP 13 C urea, demonstrating a complete loss of perfusion with no recovery in the ablated region, while having a 40%-50% decrease 3-4 h after treatment followed by recovery to baseline values by 5 d in the margin region. The utility of the HP 13 C MR measures of perfusion and metabolism in optimizing focal HIFU, either alone or in combination with adjuvant therapy, deserves further testing in future studies.
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Affiliation(s)
- Jessie E. Lee
- Department of Radiology and Biomedical Imaging, University of California, San Francisco
- University of California, Berkeley, and University of California, San Francisco Joint Graduate Program in Bioengineering
| | - Chris J. Diederich
- Department of Radiology and Biomedical Imaging, University of California, San Francisco
- University of California, Berkeley, and University of California, San Francisco Joint Graduate Program in Bioengineering
- Department of Radiation Oncology, University of California, San Francisco
| | - Robert Bok
- Department of Radiology and Biomedical Imaging, University of California, San Francisco
| | - Renuka Sriram
- Department of Radiology and Biomedical Imaging, University of California, San Francisco
| | - Romelyn Delos Santos
- Department of Radiology and Biomedical Imaging, University of California, San Francisco
| | - Susan M. Noworolski
- Department of Radiology and Biomedical Imaging, University of California, San Francisco
- University of California, Berkeley, and University of California, San Francisco Joint Graduate Program in Bioengineering
| | | | - Matthew S. Adams
- University of California, Berkeley, and University of California, San Francisco Joint Graduate Program in Bioengineering
- Department of Radiation Oncology, University of California, San Francisco
| | - Daniel B. Vigneron
- Department of Radiology and Biomedical Imaging, University of California, San Francisco
- University of California, Berkeley, and University of California, San Francisco Joint Graduate Program in Bioengineering
| | - John Kurhanewicz
- Department of Radiology and Biomedical Imaging, University of California, San Francisco
- University of California, Berkeley, and University of California, San Francisco Joint Graduate Program in Bioengineering
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Heterogeneous Enhancement Pattern in DCE-MRI Reveals the Morphology of Normal Lymph Nodes: An Experimental Study. CONTRAST MEDIA & MOLECULAR IMAGING 2019; 2019:4096706. [PMID: 31089325 PMCID: PMC6476144 DOI: 10.1155/2019/4096706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 02/07/2019] [Accepted: 02/27/2019] [Indexed: 12/04/2022]
Abstract
Purpose To investigate the heterogeneous enhancement pattern in normal lymph nodes of healthy mice by different albumin-binding contrast agents. Methods The enhancement of normal lymph nodes was assessed in mice by dynamic contrast-enhanced MRI (DCE-MRI) after the administration of two contrast agents characterized by different albumin-binding properties: gadopentetate dimeglumine (Gd-DTPA) and gadobenate dimeglumine (Gd-BOPTA). To take into account potential heterogeneities of the contrast uptake in the lymph nodes, k-means cluster analysis was performed on DCE-MRI data. Cluster spatial distribution was visually assessed. Statistical comparison among clusters and contrast agents was performed on semiquantitative parameters (AUC, wash-in rate, and wash-out rate) and on the relative size of the segmented clusters. Results Cluster analysis of DCE-MRI data revealed at least two main clusters, localized in the outer portion and in the inner portion of each lymph node. With both contrast agents, AUC (p < 0.01) and wash-in (p < 0.05) rates were greater in the inner cluster, which also showed a steeper wash-out rate than the outer cluster (Gd-BOPTA, p < 0.01; Gd-DTPA, p=0.056). The size of the outer cluster was greater than that of the inner cluster by Gd-DTPA (p < 0.05) and Gd-BOPTA (p < 0.01). The enhancement pattern of Gd-DTPA was not significantly different from the enhancement pattern of Gd-BOPTA. Conclusion DCE-MRI in normal lymph nodes shows a characteristic heterogeneous pattern, discriminating the periphery and the central portion of the lymph nodes. Such a pattern deserves to be investigated as a diagnostic marker for lymph node staging.
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Raeside M, Low A, Cohen P, Sutherland P, Gormly K. Prostate MRI evolution in clinical practice: Audit of tumour detection and staging versus prostatectomy with staged introduction of multiparametric MRI and Prostate Imaging Reporting and Data System v2 reporting. J Med Imaging Radiat Oncol 2019; 63:487-494. [DOI: 10.1111/1754-9485.12878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 03/02/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Mitchell Raeside
- Dr Jones & Partners Medical Imaging Eastwood South Australia Australia
| | - Andrew Low
- Royal Adelaide Hospital Adelaide South Australia Australia
| | | | | | - Kirsten Gormly
- Dr Jones & Partners Medical Imaging Eastwood South Australia Australia
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11
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Sung K. Modified MR dispersion imaging in prostate dynamic contrast-enhanced MRI. J Magn Reson Imaging 2019; 50:1307-1317. [PMID: 30773769 DOI: 10.1002/jmri.26685] [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: 10/23/2018] [Accepted: 02/05/2019] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND An estimation of an intravascular dispersion parameter was previously proposed to improve the overall accuracy and precision of the model parameters, but the high computation complexity can limit its practical usability in prostate dynamic contrast-enhanced MRI (DCE-MRI). PURPOSE To compare and evaluate the model fitting uncertainty and error in the model parameter estimation using different DCE-MRI analysis models and to evaluate the ability of the intravascular dispersion parameter to delineate between noncancerous and cancerous prostate tissue in the transition and peripheral zones. STUDY TYPE Retrospective. POPULATION Fifty-three patients who underwent radical prostatectomy. FIELD STRENGTH/SEQUENCE 3 T/3D RF-spoiled gradient echo sequence. ASSESSMENT The coefficient of variation was used to assess the model fitting uncertainty by adding random noise to the time-concentration curves, and the Akaike information criterion was used to assess the model fitting error. The parametric maps derived from four DCE-MRI analysis models were evaluated by evaluating the delineation between noncancerous tissue and prostate cancer or clinically significant prostate cancer. STATISTICAL TESTS The receiver operating curve analysis was performed to compare the ability to delineate between noncancerous and prostate cancer tissue in the transition and peripheral zones. RESULTS Both MR dispersion imaging (MRDI) and Weinmann analysis models had the maximum coefficient of variation in different tissue types, while the model fitting uncertainty of modified (m)MRDI was similar to the standard Toft model. In mMRDI, the model fitting error was minimum, and the delineation between noncancerous and clinically significant prostate cancer tissue was improved in both transition (area under the curve [AUC] = 0.92) and peripheral zones (AUC = 0.92), in comparison with MRDI (AUC = 0.89 and AUC = 0.85, respectively). DATA CONCLUSION The mMRDI showed promising results in detecting prostate cancer while maintaining a similar model fitting uncertainty. LEVEL OF EVIDENCE 3 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;50:1307-1317.
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Affiliation(s)
- Kyunghyun Sung
- Department of Radiological Sciences, UCLA, Los Angeles, California, USA
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12
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Parra NA, Lu H, Li Q, Stoyanova R, Pollack A, Punnen S, Choi J, Abdalah M, Lopez C, Gage K, Park JY, Kosj Y, Pow-Sang JM, Gillies RJ, Balagurunathan Y. Predicting clinically significant prostate cancer using DCE-MRI habitat descriptors. Oncotarget 2018; 9:37125-37136. [PMID: 30647849 PMCID: PMC6324677 DOI: 10.18632/oncotarget.26437] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Accepted: 11/16/2018] [Indexed: 12/16/2022] Open
Abstract
Prostate cancer diagnosis and treatment continues to be a major public health challenge. The heterogeneity of the disease is one of the major factors leading to imprecise diagnosis and suboptimal disease management. The improved resolution of functional multi-parametric magnetic resonance imaging (mpMRI) has shown promise to improve detection and characterization of the disease. Regions that subdivide the tumor based on Dynamic Contrast Enhancement (DCE) of mpMRI are referred to as DCE-Habitats in this study. The DCE defined perfusion curve patterns on the identified tumor habitat region are used to assess clinical significance. These perfusion curves were systematically quantified using seven features in association with the patient biopsy outcome and classifier models were built to find the best discriminating characteristics between clinically significant and insignificant prostate lesions defined by Gleason score (GS). Multivariable analysis was performed independently on one institution and validated on the other, using a multi-parametric feature model, based on DCE characteristics and ADC features. The models had an intra institution Area under the Receiver Operating Characteristic (AUC) of 0.82. Trained on Institution I and validated on the cohort from Institution II, the AUC was also 0.82 (sensitivity 0.68, specificity 0.95).
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Affiliation(s)
- N Andres Parra
- Department of Cancer Physiology, H.L. Moffitt Cancer Center, Tampa, FL, USA
| | - Hong Lu
- Department of Cancer Physiology, H.L. Moffitt Cancer Center, Tampa, FL, USA.,Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Qian Li
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Radka Stoyanova
- Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Alan Pollack
- Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sanoj Punnen
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jung Choi
- Department of Radiology, H.L. Moffitt Cancer Center, Tampa, FL, USA
| | - Mahmoud Abdalah
- Department of Cancer Physiology, H.L. Moffitt Cancer Center, Tampa, FL, USA
| | - Christopher Lopez
- Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Kenneth Gage
- Department of Radiology, H.L. Moffitt Cancer Center, Tampa, FL, USA
| | - Jong Y Park
- Department of Cancer Epidemiology, H.L. Moffitt Cancer Center, Tampa, FL, USA
| | - Yamoah Kosj
- Department of Cancer Epidemiology, H.L. Moffitt Cancer Center, Tampa, FL, USA.,Department of Radiation Oncology, H.L. Moffitt Cancer Center, Tampa, FL, USA
| | - Julio M Pow-Sang
- Department of Urology, H.L. Moffitt Cancer Center, Tampa, FL, USA
| | - Robert J Gillies
- Department of Cancer Physiology, H.L. Moffitt Cancer Center, Tampa, FL, USA.,Department of Radiology, H.L. Moffitt Cancer Center, Tampa, FL, USA
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13
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Influence of arterial input function (AIF) on quantitative prostate dynamic contrast-enhanced (DCE) MRI and zonal prostate anatomy. Magn Reson Imaging 2018; 53:28-33. [DOI: 10.1016/j.mri.2018.06.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 06/07/2018] [Accepted: 06/10/2018] [Indexed: 11/23/2022]
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14
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Assessment of Correlation between Intravoxel Incoherent Motion Diffusion Weighted MR Imaging and Dynamic Contrast-Enhanced MR Imaging of Sacroiliitis with Ankylosing Spondylitis. BIOMED RESEARCH INTERNATIONAL 2017; 2017:8135863. [PMID: 29445743 PMCID: PMC5763214 DOI: 10.1155/2017/8135863] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 11/07/2017] [Accepted: 12/03/2017] [Indexed: 12/18/2022]
Abstract
The relationships between IVIM and DCE-MRI parameters in AS are not clear. We explore the correlation between intravoxel incoherent motion (IVIM) diffusion weighted imaging (DWI) and dynamic contrast-enhanced (DCE) parameters obtained on MR images in patients with ankylosing spondylitis (AS). Forty-four patients with AS were prospectively examined using a 1.5-T MR system. IVIM DWI was performed with 11 b values (range, 0–800 s/mm2) for all patients. The correlation coefficients between IVIM and DCE-MRI parameters were analyzed using Spearman's method. Our results showed that intra- and interobserver reproducibility were excellent to relatively good (ICC = 0.804–0.981; narrow width of 95% limits of agreement). Moderate positive correlations were observed between pure molecular diffusion (Ds) and maximum enhancement (ME) and relative enhancement (RE) (r = 0.700, P < 0.001; r = 0.607, P < 0.001, resp.). Perfusion-related diffusion (Df) showed negative moderate correlation with ME (r = −0.608, P < 0.001). However, no correlation was observed between perfusion fraction (f) and any parameters of ME, RE, TTP, and BE (r = −0.093–0.213; P > 0.165). In conclusion, the IVIM parameters, especially f, might play a critical role in detecting the progression of AS, because it can provide more perfusion information compared with DCE-MRI; besides the IVIM MRI is a noninvasive method.
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15
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Fusco R, Sansone M, Granata V, Setola SV, Petrillo A. A systematic review on multiparametric MR imaging in prostate cancer detection. Infect Agent Cancer 2017; 12:57. [PMID: 29093748 PMCID: PMC5663098 DOI: 10.1186/s13027-017-0168-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 10/23/2017] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Literature data suggest that multi-parametric Magnetic Resonance Imaging (MRI), including morphologic T2-weigthed images (T2-MRI) and functional approaches such as Dynamic Contrast Enhanced-MRI (DCE-MRI), Diffusion Weighted Imaging (DWI) and Magnetic Resonance Spectroscopic Imaging (MRSI), give an added value in the prostate cancer localization and local staging. METHODS We performed a systematic review of literature about the role and the potentiality of morphological and functional MRI in prostate cancer, also in a multimodal / multiparametric approach, and we reported the diagnostic accuracy results for different imaging modalities and for different MR coil settings: endorectal coil (ERC) and phased array coil (PAC). Forest plots and receiver operating characteristic curves were performed. Risk of bias and the applicability at study level were calculated. RESULTS Thirty three papers were identified for the systematic review. Sensitivity and specificity values were, respectively, for T2-MRI of 75% and of 60%, for DCE-MRI of 80% and of 72%, for MRSI of 89% and of 69%, for combined T2-MRI and DCE-MRI of 87% and of 46%, for combined T2-MRI and MRSI of 79% and of 57%, for combined T2-MRI, DWI and DCE-MRI of 81% and of 84%, and for combined MRSI and DCE-MRI of 83% and of 83%. For MRI studies performed with ERC we obtained a pooled sensitivity and specificity of 81% and of 66% while the pooled values for MRI studies performed with PAC were of 78% and of 64%, respectively (p>0.05 at McNemar test). No studies were excluded from the analysis based on the quality assessment. CONCLUSIONS ERC use yielded no additional benefit in terms of prostate cancer detection accuracy compared to multi-channel PAC use (71% versus 68%) while the use of additional functional imaging techniques (DCE-MRI, DWI and MRSI) in a multiparametric MRI protocol improves the accuracy of prostate cancer detection allowing both the early cure and the guidance of biopsy.
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Affiliation(s)
- Roberta Fusco
- Radiology Unit, “Dipartimento di supporto ai percorsi oncologici Area Diagnostica, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale”, Via Mariano Semmola, Naples, Italy
| | - Mario Sansone
- Department of Electrical Engineering and Information Technologies, University “Federico II” of Naples, Via Claudio, Naples, Italy
| | - Vincenza Granata
- Radiology Unit, “Dipartimento di supporto ai percorsi oncologici Area Diagnostica, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale”, Via Mariano Semmola, Naples, Italy
| | - Sergio Venanzio Setola
- Radiology Unit, “Dipartimento di supporto ai percorsi oncologici Area Diagnostica, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale”, Via Mariano Semmola, Naples, Italy
| | - Antonella Petrillo
- Radiology Unit, “Dipartimento di supporto ai percorsi oncologici Area Diagnostica, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale”, Via Mariano Semmola, Naples, Italy
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16
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Chen Z, Zheng Y, Ji G, Liu X, Li P, Cai L, Guo Y, Yang J. Accuracy of dynamic contrast-enhanced magnetic resonance imaging in the diagnosis of prostate cancer: systematic review and meta-analysis. Oncotarget 2017; 8:77975-77989. [PMID: 29100440 PMCID: PMC5652829 DOI: 10.18632/oncotarget.20316] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 08/04/2017] [Indexed: 01/23/2023] Open
Abstract
The goals of this meta-analysis were to assess the effectiveness of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in patients with prostate carcinoma (PCa) and to explore the risk profiles with the highest benefit. Systematic electronic searched were conducted in database. We used patient-based and biopsy-based pooled weighted estimates of the sensitivity, specificity, and a summary receiver operating characteristic (SROC) curve for assessing the diagnostic performance of DCE. We performed direct and indirect comparisons of DCE and other methods of imaging. A total of 26 articles met the inclusion criteria for the analysis. DCE-MRI pooled sensitivity was 0.53 (95% CI 0.39 to 0.67), with a specificity of 0.88 (95% CI 0.83 to 0.92) on whole gland. The peripheral zone pooled sensitivity was 0.70 (95% CI 0.46 to 0.86), with a specificity of 0.88 (95% CI 0.76 to 0.94). Compared with T2-weighted imaging (T2WI), DCE was statistically superior to T2. In conclusion, DCE had relatively high specificity in detecting PCa but relatively low sensitivity as a complementary functional method. DCE-MRI might help clinicians exclude cases of normal tissue and serve as an adjunct to conventional imaging when seeking to identify tumor foci in patients with PCa.
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Affiliation(s)
- Zhiqiang Chen
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
- Radiology Department of The General Hospital, Ningxia Medical University, Yinchuan 750004, Ningxia, China
| | - Yi Zheng
- Radiology Department of The General Hospital, Ningxia Medical University, Yinchuan 750004, Ningxia, China
| | - Guanghai Ji
- Radiology Department of The General Hospital, Ningxia Medical University, Yinchuan 750004, Ningxia, China
| | - Xinxin Liu
- Department of Diagnostic Imaging, Honghui Hospital, Health Science Center of Xi'an Jiaotong University, Xi'an 750004, Shaanxi, China
| | - Peng Li
- Radiology Department of The General Hospital, Ningxia Medical University, Yinchuan 750004, Ningxia, China
| | - Lei Cai
- Radiology Department of The General Hospital, Ningxia Medical University, Yinchuan 750004, Ningxia, China
| | - Yulin Guo
- Radiology Department of The General Hospital, Ningxia Medical University, Yinchuan 750004, Ningxia, China
| | - Jian Yang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
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17
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Quantitative effects of acquisition duration and temporal resolution on the measurement accuracy of prostate dynamic contrast-enhanced MRI data: a phantom study. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2017; 30:461-471. [DOI: 10.1007/s10334-017-0619-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 03/31/2017] [Accepted: 04/03/2017] [Indexed: 10/19/2022]
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18
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Wu LM, Yao QY, Zhu J, Lu Q, Suo ST, Liu Q, Xu JR, Chen XX, Haacke EM, Hu J. T2* mapping combined with conventional T2-weighted image for prostate cancer detection at 3.0T MRI: a multi-observer study. Acta Radiol 2017; 58:114-120. [PMID: 26917785 DOI: 10.1177/0284185116633916] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 01/22/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND T2* relaxation is a primary determinant of image contrast with Gradient echo (GRE) sequences, and it has been widely used across body regions. PURPOSE To compare the diagnostic performance of T2* mapping in combination with T2-weighted (T2W) imaging to T2W imaging alone for prostate cancer (PCa) detection. MATERIAL AND METHODS The study included 31 patients (mean age, 62 ± 3 years; age range, 45-78 years) who underwent magnetic resonance imaging (MRI) at 3.0T and histological examination. Three observers with varying experience levels reviewed T2W imaging alone, T2* mapping alone, and T2W imaging combined with T2* mapping. A five-point scale was used to assess the probability of PCa in each segment on MR images. Statistical analysis was performed using Z tests after adjusting for data clustering. RESULTS The area under the curve (AUC) of T2W imaging and T2* mapping data (observer 1, 0.93; observer 2, 0.90; observer 3, 0.77) was higher than T2W imaging (observer 1, 0.84; observer 2, 0.79; observer 3, 0.69) for all observers (P < 0.01 in all comparisons). The AUC of T2W imaging and T2* mapping data was higher for observers 1 and 2 than for observer 3 (P < 0.01). The sensitivity and specificity of T2W imaging and T2* mapping data (observer 1, 95%, 85%; observer 2, 90%, 83%; and observer 3, 82%, 63%, respectively) was higher than T2W imaging (observer 1, 78%, 79%; observer 2, 76%, 72%; observer 3, 74%, 51%, respectively) for all observers (P < 0.01 for observer 1; P < 0.01 for observers 2 and 3). CONCLUSION The addition of T2* mapping to T2W imaging improved the diagnostic performance of MRI in PCa detection.
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Affiliation(s)
- Lian-Ming Wu
- Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Qiu-Ying Yao
- Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Jiong Zhu
- Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Qing Lu
- Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Si-Teng Suo
- Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Qiang Liu
- Department of Pathology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Jian-Rong Xu
- Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Xiao-Xi Chen
- Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - EM Haacke
- Department of Radiology, Wayne State University, Detroit, Michigan, USA
| | - Jiani Hu
- Department of Radiology, Wayne State University, Detroit, Michigan, USA
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19
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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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20
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Knight SP, Browne JE, Meaney JF, Smith DS, Fagan AJ. A novel anthropomorphic flow phantom for the quantitative evaluation of prostate DCE-MRI acquisition techniques. Phys Med Biol 2016; 61:7466-7483. [PMID: 27694709 DOI: 10.1088/0031-9155/61/20/7466] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
A novel anthropomorphic flow phantom device has been developed, which can be used for quantitatively assessing the ability of magnetic resonance imaging (MRI) scanners to accurately measure signal/concentration time-intensity curves (CTCs) associated with dynamic contrast-enhanced (DCE) MRI. Modelling of the complex pharmacokinetics of contrast agents as they perfuse through the tumour capillary network has shown great promise for cancer diagnosis and therapy monitoring. However, clinical adoption has been hindered by methodological problems, resulting in a lack of consensus regarding the most appropriate acquisition and modelling methodology to use and a consequent wide discrepancy in published data. A heretofore overlooked source of such discrepancy may arise from measurement errors of tumour CTCs deriving from the imaging pulse sequence itself, while the effects on the fidelity of CTC measurement of using rapidly-accelerated sequences such as parallel imaging and compressed sensing remain unknown. The present work aimed to investigate these features by developing a test device in which 'ground truth' CTCs were generated and presented to the MRI scanner for measurement, thereby allowing for an assessment of the DCE-MRI protocol to accurately measure this curve shape. The device comprised a four-pump flow system wherein CTCs derived from prior patient prostate data were produced in measurement chambers placed within the imaged volume. The ground truth was determined as the mean of repeat measurements using an MRI-independent, custom-built optical imaging system. In DCE-MRI experiments, significant discrepancies between the ground truth and measured CTCs were found for both tumorous and healthy tissue-mimicking curve shapes. Pharmacokinetic modelling revealed errors in measured K trans, v e and k ep values of up to 42%, 31%, and 50% respectively, following a simple variation of the parallel imaging factor and number of signal averages in the acquisition protocol. The device allows for the quantitative assessment and standardisation of DCE-MRI protocols (both existing and emerging).
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Affiliation(s)
- Silvin P Knight
- National Centre for Advanced Medical Imaging (CAMI), St James's Hospital/School of Medicine, Trinity College University of Dublin, Dublin, Ireland
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21
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Abstract
This article discusses MR imaging of the normal prostate and of disease conditions of the prostate including prostatitis, cystic lesions, amyloidosis, calculi, hematospermia, benign prostatic hyperplasia, and malignancy.
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Affiliation(s)
- Ekta Gupta
- Department of Radiology, Hospital of the University of Pennsylvania, University of Pennsylvania School of Medicine, 3400 Spruce Street, Philadelphia, PA 19104, USA
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22
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Starobinets O, Korn N, Iqbal S, Noworolski SM, Zagoria R, Kurhanewicz J, Westphalen AC. Practical aspects of prostate MRI: hardware and software considerations, protocols, and patient preparation. Abdom Radiol (NY) 2016; 41:817-30. [PMID: 27193785 DOI: 10.1007/s00261-015-0590-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The use of multiparametric MRI scans for the evaluation of men with prostate cancer has increased dramatically and is likely to continue expanding as new developments come to practice. However, it has not yet gained the same level of acceptance of other imaging tests. Partly, this is because of the use of suboptimal protocols, lack of standardization, and inadequate patient preparation. In this manuscript, we describe several practical aspects of prostate MRI that may facilitate the implementation of new prostate imaging programs or the expansion of existing ones.
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Affiliation(s)
- Olga Starobinets
- Graduate Group of Bioengineering, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Box 0946, San Francisco, CA, 94143, USA
| | - Natalie Korn
- Graduate Group of Bioengineering, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Box 0946, San Francisco, CA, 94143, USA
| | - Sonam Iqbal
- Graduate Group of Bioengineering, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Box 0946, San Francisco, CA, 94143, USA
| | - Susan M Noworolski
- Graduate Group of Bioengineering, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Box 0946, San Francisco, CA, 94143, USA
| | - Ronald Zagoria
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Avenue, M372, Box 0628, San Francisco, CA, 94143, USA
| | - John Kurhanewicz
- Graduate Group of Bioengineering, Department of Radiology and Biomedical Imaging, University of California San Francisco, 1700 4th Street, Ste. 203, San Francisco, CA, 94158, USA
| | - Antonio C Westphalen
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Avenue, M372, Box 0628, San Francisco, CA, 94143, USA.
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23
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You MW, Kim MH, Kim JK, Cho KS. The characteristics and spatial distributions of initially missed and rebiopsy-detected prostate cancers. Ultrasonography 2016; 35:226-33. [PMID: 27048261 PMCID: PMC4939716 DOI: 10.14366/usg.15065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Revised: 02/04/2016] [Accepted: 02/12/2016] [Indexed: 12/22/2022] Open
Abstract
Purpose: The purpose of this study was to analyze the characteristics of initially missed and rebiopsy-detected prostate cancers following 12-core transrectal biopsy. Methods: A total of 45 patients with prostate cancers detected on rebiopsy and 45 patients with prostate cancers initially detected on transrectal ultrasound-guided biopsy were included in the study. For result analysis, the prostate was divided into six compartments, and the cancer positive rates, estimated tumor burden, and agreement rates between biopsy and surgical specimens, along with clinical data, were evaluated. Results: The largest mean tumor burden was located in the medial apex in both groups. There were significantly more tumors in this location in the rebiopsy group (44.9%) than in the control group (30.1%, P=0.015). The overall sensitivity of biopsy was significantly lower in the rebiopsy group (22.5% vs. 43.4%, P<0.001). The agreement rate of cancer positive cores between biopsy and surgical specimens was significantly lower in the medial apex in the rebiopsy group compared with that of the control group (50.0% vs. 65.6%, P=0.035). The cancer positive rates of target biopsy cores and premalignant lesions in the rebiopsy group were 63.1% and 42.3%, respectively. Conclusion: Rebiopsy-detected prostate cancers showed different spatial distribution and lower cancer detection rate of biopsy cores compared with initially diagnosed cancers. To overcome lower cancer detection rate, target biopsy of abnormal sonographic findings, premalignant lesions and medial apex which revealed larger tumor burden would be recommended when performing rebiopsy.
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Affiliation(s)
- Myung-Won You
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Department of Radiology, Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Mi-Hyun Kim
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeong Kon Kim
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyoung-Sik Cho
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Hoang Dinh A, Melodelima C, Souchon R, Lehaire J, Bratan F, Mège-Lechevallier F, Ruffion A, Crouzet S, Colombel M, Rouvière O. Quantitative Analysis of Prostate Multiparametric MR Images for Detection of Aggressive Prostate Cancer in the Peripheral Zone: A Multiple Imager Study. Radiology 2016; 280:117-27. [PMID: 26859255 DOI: 10.1148/radiol.2016151406] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Purpose To assess the intermanufacturer variability of quantitative models in discriminating cancers with a Gleason score of at least 7 among peripheral zone (PZ) lesions seen at 3-T multiparametric magnetic resonance (MR) imaging. Materials and Methods An institutional review board-approved prospective database of 257 patients who gave written consent and underwent T2-weighted, diffusion-weighted, and dynamic contrast material-enhanced imaging before prostatectomy was retrospectively reviewed. It contained outlined lesions found to be suspicious for malignancy by two independent radiologists and classified as malignant or benign after correlation with prostatectomy whole-mount specimens. One hundred six patients who underwent imaging with 3-T MR systems from two manufacturers were selected (data set A, n = 72; data set B, n = 34). Eleven parameters were calculated in PZ lesions: normalized T2-weighted signal intensity, skewness and kurtosis of T2-weighted signal intensity, T2 value, wash-in rate, washout rate, time to peak (TTP), mean apparent diffusion coefficient (ADC), 10th percentile of the ADC, and skewness and kurtosis of the histogram of the ADC values. Parameters were selected on the basis of their specificity for a sensitivity of 0.95 in diagnosing cancers with a Gleason score of at least 7, and the area under the receiver operating characteristic curve (AUC) for the models was calculated. Results The model of the 10th percentile of the ADC with TTP yielded the highest AUC in both data sets. In data set A, the AUC was 0.90 (95% confidence interval [CI]: 0.85, 0.95) or 0.89 (95% CI: 0.82, 0.94) when it was trained in data set A or B, respectively. In data set B, the AUC was 0.84 (95% CI: 0.74, 0.94) or 0.86 (95% CI: 0.76, 0.95) when it was trained in data set A or B, respectively. No third variable added significantly independent information in any data set. Conclusion The model of the 10th percentile of the ADC with TTP yielded accurate results in discriminating cancers with a Gleason score of at least 7 among PZ lesions at 3 T in data from two manufacturers. (©) RSNA, 2016 Online supplemental material is available for this article.
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Affiliation(s)
- Au Hoang Dinh
- From INSERM, U1032, LabTau, Lyon, France (A.H.D., R.S., J.L., F.B., S.C., O.R.); CNRS, UMR 5553, BP 53, Grenoble, France (C.M.); Laboratoire d'Ecologie Alpine, Université Joseph Fourier, Grenoble, France (C.M.); Department of Urinary and Vascular Imaging (F.B., O.R.), Department of Pathology (F.M.L.), and Department of Urology (S.C., M.C.), Hospices Civils de Lyon, Hôpital Edouard Herriot, Pavillon P Radio, 5 place d'Arsonval, Lyon 69003, France; Université Lyon 1, Faculté de Médecine Lyon Est, Lyon, France (F.B., S.C., M.C., O.R.); and Department of Urology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre Bénite, France (A.R.)
| | - Christelle Melodelima
- From INSERM, U1032, LabTau, Lyon, France (A.H.D., R.S., J.L., F.B., S.C., O.R.); CNRS, UMR 5553, BP 53, Grenoble, France (C.M.); Laboratoire d'Ecologie Alpine, Université Joseph Fourier, Grenoble, France (C.M.); Department of Urinary and Vascular Imaging (F.B., O.R.), Department of Pathology (F.M.L.), and Department of Urology (S.C., M.C.), Hospices Civils de Lyon, Hôpital Edouard Herriot, Pavillon P Radio, 5 place d'Arsonval, Lyon 69003, France; Université Lyon 1, Faculté de Médecine Lyon Est, Lyon, France (F.B., S.C., M.C., O.R.); and Department of Urology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre Bénite, France (A.R.)
| | - Rémi Souchon
- From INSERM, U1032, LabTau, Lyon, France (A.H.D., R.S., J.L., F.B., S.C., O.R.); CNRS, UMR 5553, BP 53, Grenoble, France (C.M.); Laboratoire d'Ecologie Alpine, Université Joseph Fourier, Grenoble, France (C.M.); Department of Urinary and Vascular Imaging (F.B., O.R.), Department of Pathology (F.M.L.), and Department of Urology (S.C., M.C.), Hospices Civils de Lyon, Hôpital Edouard Herriot, Pavillon P Radio, 5 place d'Arsonval, Lyon 69003, France; Université Lyon 1, Faculté de Médecine Lyon Est, Lyon, France (F.B., S.C., M.C., O.R.); and Department of Urology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre Bénite, France (A.R.)
| | - Jérôme Lehaire
- From INSERM, U1032, LabTau, Lyon, France (A.H.D., R.S., J.L., F.B., S.C., O.R.); CNRS, UMR 5553, BP 53, Grenoble, France (C.M.); Laboratoire d'Ecologie Alpine, Université Joseph Fourier, Grenoble, France (C.M.); Department of Urinary and Vascular Imaging (F.B., O.R.), Department of Pathology (F.M.L.), and Department of Urology (S.C., M.C.), Hospices Civils de Lyon, Hôpital Edouard Herriot, Pavillon P Radio, 5 place d'Arsonval, Lyon 69003, France; Université Lyon 1, Faculté de Médecine Lyon Est, Lyon, France (F.B., S.C., M.C., O.R.); and Department of Urology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre Bénite, France (A.R.)
| | - Flavie Bratan
- From INSERM, U1032, LabTau, Lyon, France (A.H.D., R.S., J.L., F.B., S.C., O.R.); CNRS, UMR 5553, BP 53, Grenoble, France (C.M.); Laboratoire d'Ecologie Alpine, Université Joseph Fourier, Grenoble, France (C.M.); Department of Urinary and Vascular Imaging (F.B., O.R.), Department of Pathology (F.M.L.), and Department of Urology (S.C., M.C.), Hospices Civils de Lyon, Hôpital Edouard Herriot, Pavillon P Radio, 5 place d'Arsonval, Lyon 69003, France; Université Lyon 1, Faculté de Médecine Lyon Est, Lyon, France (F.B., S.C., M.C., O.R.); and Department of Urology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre Bénite, France (A.R.)
| | - Florence Mège-Lechevallier
- From INSERM, U1032, LabTau, Lyon, France (A.H.D., R.S., J.L., F.B., S.C., O.R.); CNRS, UMR 5553, BP 53, Grenoble, France (C.M.); Laboratoire d'Ecologie Alpine, Université Joseph Fourier, Grenoble, France (C.M.); Department of Urinary and Vascular Imaging (F.B., O.R.), Department of Pathology (F.M.L.), and Department of Urology (S.C., M.C.), Hospices Civils de Lyon, Hôpital Edouard Herriot, Pavillon P Radio, 5 place d'Arsonval, Lyon 69003, France; Université Lyon 1, Faculté de Médecine Lyon Est, Lyon, France (F.B., S.C., M.C., O.R.); and Department of Urology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre Bénite, France (A.R.)
| | - Alain Ruffion
- From INSERM, U1032, LabTau, Lyon, France (A.H.D., R.S., J.L., F.B., S.C., O.R.); CNRS, UMR 5553, BP 53, Grenoble, France (C.M.); Laboratoire d'Ecologie Alpine, Université Joseph Fourier, Grenoble, France (C.M.); Department of Urinary and Vascular Imaging (F.B., O.R.), Department of Pathology (F.M.L.), and Department of Urology (S.C., M.C.), Hospices Civils de Lyon, Hôpital Edouard Herriot, Pavillon P Radio, 5 place d'Arsonval, Lyon 69003, France; Université Lyon 1, Faculté de Médecine Lyon Est, Lyon, France (F.B., S.C., M.C., O.R.); and Department of Urology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre Bénite, France (A.R.)
| | - Sébastien Crouzet
- From INSERM, U1032, LabTau, Lyon, France (A.H.D., R.S., J.L., F.B., S.C., O.R.); CNRS, UMR 5553, BP 53, Grenoble, France (C.M.); Laboratoire d'Ecologie Alpine, Université Joseph Fourier, Grenoble, France (C.M.); Department of Urinary and Vascular Imaging (F.B., O.R.), Department of Pathology (F.M.L.), and Department of Urology (S.C., M.C.), Hospices Civils de Lyon, Hôpital Edouard Herriot, Pavillon P Radio, 5 place d'Arsonval, Lyon 69003, France; Université Lyon 1, Faculté de Médecine Lyon Est, Lyon, France (F.B., S.C., M.C., O.R.); and Department of Urology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre Bénite, France (A.R.)
| | - Marc Colombel
- From INSERM, U1032, LabTau, Lyon, France (A.H.D., R.S., J.L., F.B., S.C., O.R.); CNRS, UMR 5553, BP 53, Grenoble, France (C.M.); Laboratoire d'Ecologie Alpine, Université Joseph Fourier, Grenoble, France (C.M.); Department of Urinary and Vascular Imaging (F.B., O.R.), Department of Pathology (F.M.L.), and Department of Urology (S.C., M.C.), Hospices Civils de Lyon, Hôpital Edouard Herriot, Pavillon P Radio, 5 place d'Arsonval, Lyon 69003, France; Université Lyon 1, Faculté de Médecine Lyon Est, Lyon, France (F.B., S.C., M.C., O.R.); and Department of Urology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre Bénite, France (A.R.)
| | - Olivier Rouvière
- From INSERM, U1032, LabTau, Lyon, France (A.H.D., R.S., J.L., F.B., S.C., O.R.); CNRS, UMR 5553, BP 53, Grenoble, France (C.M.); Laboratoire d'Ecologie Alpine, Université Joseph Fourier, Grenoble, France (C.M.); Department of Urinary and Vascular Imaging (F.B., O.R.), Department of Pathology (F.M.L.), and Department of Urology (S.C., M.C.), Hospices Civils de Lyon, Hôpital Edouard Herriot, Pavillon P Radio, 5 place d'Arsonval, Lyon 69003, France; Université Lyon 1, Faculté de Médecine Lyon Est, Lyon, France (F.B., S.C., M.C., O.R.); and Department of Urology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre Bénite, France (A.R.)
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Zidan S, Tantawy HI. Prostate carcinoma: Accuracy of diagnosis and differentiation with Dynamic Contrast-Enhanced MRI and Diffusion Weighted Imaging. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2015. [DOI: 10.1016/j.ejrnm.2015.06.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Lemaître G, Martí R, Freixenet J, Vilanova JC, Walker PM, Meriaudeau F. Computer-Aided Detection and diagnosis for prostate cancer based on mono and multi-parametric MRI: a review. Comput Biol Med 2015; 60:8-31. [PMID: 25747341 DOI: 10.1016/j.compbiomed.2015.02.009] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 02/11/2015] [Accepted: 02/12/2015] [Indexed: 12/30/2022]
Abstract
Prostate cancer is the second most diagnosed cancer of men all over the world. In the last few decades, new imaging techniques based on Magnetic Resonance Imaging (MRI) have been developed to improve diagnosis. In practise, diagnosis can be affected by multiple factors such as observer variability and visibility and complexity of the lesions. In this regard, computer-aided detection and computer-aided diagnosis systems have been designed to help radiologists in their clinical practice. Research on computer-aided systems specifically focused for prostate cancer is a young technology and has been part of a dynamic field of research for the last 10 years. This survey aims to provide a comprehensive review of the state-of-the-art in this lapse of time, focusing on the different stages composing the work-flow of a computer-aided system. We also provide a comparison between studies and a discussion about the potential avenues for future research. In addition, this paper presents a new public online dataset which is made available to the research community with the aim of providing a common evaluation framework to overcome some of the current limitations identified in this survey.
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Affiliation(s)
- Guillaume Lemaître
- LE2I-UMR CNRS 6306, Université de Bourgogne, 12 rue de la Fonderie, 71200 Le Creusot, France; ViCOROB, Universitat de Girona, Campus Montilivi, Edifici P4, 17071 Girona, Spain.
| | - Robert Martí
- ViCOROB, Universitat de Girona, Campus Montilivi, Edifici P4, 17071 Girona, Spain.
| | - Jordi Freixenet
- ViCOROB, Universitat de Girona, Campus Montilivi, Edifici P4, 17071 Girona, Spain.
| | - Joan C Vilanova
- Department of Magnetic Resonance, Clínica Girona, Lorenzana 36, 17002 Girona, Spain
| | - Paul M Walker
- LE2I-UMR CNRS 6306, Université de Bourgogne, Avenue Alain Savary, 21000 Dijon, France.
| | - Fabrice Meriaudeau
- LE2I-UMR CNRS 6306, Université de Bourgogne, 12 rue de la Fonderie, 71200 Le Creusot, France.
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Hoang Dinh A, Souchon R, Melodelima C, Bratan F, Mège-Lechevallier F, Colombel M, Rouvière O. Characterization of prostate cancer using T2 mapping at 3T: a multi-scanner study. Diagn Interv Imaging 2014; 96:365-72. [PMID: 25547670 DOI: 10.1016/j.diii.2014.11.016] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
RATIONALE AND OBJECTIVES To assess the prostate T2 value as a predictor of malignancy on two different 3T scanners. PATIENTS AND METHODS Eighty-three pre-prostatectomy multiparametric MRIs were retrospectively evaluated [67 obtained on a General Electric MRI (scanner 1) and 16 on a Philips MRI (scanner 2)]. After correlation with prostatectomy specimens, readers measured the T2 value of regions-of-interest categorized as "cancers", "false positive lesions", or "normal tissue". RESULTS On scanner 1, in PZ, cancers had significantly lower T2 values than false positive lesions (P=0.02) and normal tissue (P=2×10(-9)). Gleason≥6 cancers had similar T2 values than false positive lesions and significantly higher T2 values than Gleason≥7 cancers (P=0.009). T2 values corresponding to a 25% and 75% risk of Gleason≥7 malignancy were respectively 132 ms (95% CI: 129-135 ms) and 77 ms (95% CI: 74-81 ms). In TZ, cancers had significantly lower T2 values than normal tissue (P=0.008), but not than false positive findings. Mean T2 values measured on scanner 2 were not significantly different than those measured on scanner 1 for all tissue classes. CONCLUSION All tested tissue classes had similar mean T2 values on both scanners. In PZ, the T2 value was a significant predictor of Gleason≥7 cancers.
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Affiliation(s)
| | - R Souchon
- Inserm, U1032, LabTau, Lyon 69003, France
| | - C Melodelima
- Université Joseph-Fourier, laboratoire d'écologie Alpine, BP 53, Grenoble 38041, France; CNRS, UMR 5553, BP 53, Grenoble 38041, France
| | - F Bratan
- Inserm, U1032, LabTau, Lyon 69003, France; Hospices civils de Lyon, department of urinary and vascular radiology, hôpital Édouard-Herriot, Lyon 69437, France; Université de Lyon, Lyon 69003, France; Université Lyon 1, faculté de médecine Lyon Est, Lyon 69003, France
| | - F Mège-Lechevallier
- Hospices civils de Lyon, department of pathology, hôpital Édouard-Herriot, Lyon, 69437, France
| | - M Colombel
- Université de Lyon, Lyon 69003, France; Université Lyon 1, faculté de médecine Lyon Est, Lyon 69003, France; Hospices civils de Lyon, department of urology, hôpital Édouard-Herriot, Lyon, 69437, France
| | - O Rouvière
- Inserm, U1032, LabTau, Lyon 69003, France; Hospices civils de Lyon, department of urinary and vascular radiology, hôpital Édouard-Herriot, Lyon 69437, France; Université de Lyon, Lyon 69003, France; Université Lyon 1, faculté de médecine Lyon Est, Lyon 69003, France.
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Mitsumori LM, Bhargava P, Essig M, Maki JH. Magnetic resonance imaging using gadolinium-based contrast agents. Top Magn Reson Imaging 2014; 23:51-69. [PMID: 24477166 DOI: 10.1097/rmr.0b013e31829c4686] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The purpose of this article was to review the basic properties of available gadolinium-based magnetic resonance contrast agents, discuss their fundamental differences, and explore common and evolving applications of gadolinium-based magnetic resonance contrast throughout the body excluding the central nervous system. A more specific aim of this article was to explore novel uses of these gadolinium-based contrast agents and applications where a particular agent has been demonstrated to behave differently or be better suited for certain applications than the other contrast agents in this class.
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Magnetic Resonance Dispersion Imaging for Localization of Angiogenesis and Cancer Growth. Invest Radiol 2014; 49:561-9. [DOI: 10.1097/rli.0000000000000056] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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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: 105] [Impact Index Per Article: 10.5] [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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Abstract
OBJECTIVE The purpose of this article is to review the many evolving facets of MRI in the evaluation of prostate cancer. We will discuss the roles of multiparametric MRI, including diffusion-weighted MRI, dynamic contrast-enhanced MRI, and MR spectroscopy, as adjuncts to morphologic T2-weighted imaging in detection, staging, treatment planning, and surveillance of prostate cancer. CONCLUSION Radiologists need to understand the advantages, limitations, and potential pitfalls of the different sequences to provide optimal assessment of prostate cancer.
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Chaussy C, Thüroff S. High-intensity focused ultrasound in the management of prostate cancer. Expert Rev Med Devices 2014; 7:209-17. [DOI: 10.1586/erd.09.66] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Thomas MA, Nagarajan R, Huda A, Margolis D, Sarma MK, Sheng K, Reiter RE, Raman SS. Multidimensional MR spectroscopic imaging of prostate cancer in vivo. NMR IN BIOMEDICINE 2014; 27:53-66. [PMID: 23904127 DOI: 10.1002/nbm.2991] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 04/12/2013] [Accepted: 05/21/2013] [Indexed: 06/02/2023]
Abstract
Prostate cancer (PCa) is the second most common type of cancer among men in the United States. A major limitation in the management of PCa is an inability to distinguish, early on, cancers that will progress and become life threatening. One-dimensional (1D) proton ((1)H) MRS of the prostate provides metabolic information such as levels of choline (Ch), creatine (Cr), citrate (Cit), and spermine (Spm) that can be used to detect and diagnose PCa. Ex vivo high-resolution magic angle spinning (HR-MAS) of PCa specimens has revealed detection of more metabolites such as myo-inositol (mI), glutamate (Glu), and glutamine (Gln). Due to the J-modulation and signal overlap, it is difficult to quantitate Spm and other resonances in the prostate clearly by single- and multivoxel-based 1D MR spectroscopy. This limitation can be minimized by adding at least one more spectral dimension by which resonances can be spread apart, thereby increasing the spectral dispersion. However, recording of multivoxel-based two-dimensional (2D) MRS such as J-resolved spectroscopy (JPRESS) and correlated spectroscopy (L-COSY) combined with 2D or three-dimensional (3D) magnetic resonance spectroscopic imaging (MRSI) using conventional phase-encoding can be prohibitively long to be included in a clinical protocol. To reduce the long acquisition time required for spatial encoding, the echo-planar spectroscopic imaging (EPSI) technique has been combined with correlated spectroscopy to give four-dimensional (4D) echo-planar correlated spectroscopic imaging (EP-COSI) as well as J-resolved spectroscopic imaging (EP-JRESI) and the multi-echo (ME) variants. Further acceleration can be achieved using non-uniform undersampling (NUS) and reconstruction using compressed sensing (CS). Earlier versions of 2D MRS, theory of 2D MRS, spectral apodization filters, newer developments and the potential role of multidimensional MRS in PCa detection and management will be reviewed here.
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Affiliation(s)
- M Albert Thomas
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, 90095, USA
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Thompson J, Lawrentschuk N, Frydenberg M, Thompson L, Stricker P. The role of magnetic resonance imaging in the diagnosis and management of prostate cancer. BJU Int 2013; 112 Suppl 2:6-20. [PMID: 24127671 DOI: 10.1111/bju.12381] [Citation(s) in RCA: 107] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The diagnosis of prostate cancer has long been plagued by the absence of an imaging tool that reliably detects and localises significant tumours. Recent evidence suggests that multi-parametric MRI could improve the accuracy of diagnostic assessment in prostate cancer. This review serves as a background to a recent USANZ position statement. It aims to provide an overview of MRI techniques and to critically review the published literature on the clinical application of MRI in prostate cancer. TECHNICAL ASPECTS The combination of anatomical (T2-weighted) MRI with at least two of the three functional MRI parameters - which include diffusion-weighted imaging, dynamic contrast-enhanced imaging and spectroscopy - will detect greater than 90% of significant (moderate to high risk) tumours; however MRI is less reliable at detecting tumours that are small (<0.5 cc), low grade (Gleason score 6) or in the transitional zone. The higher anatomical resolution provided by 3-Tesla magnets and endorectal coils may improve the accuracy, particularly in primary tumour staging. SCREENING The use of mpMRI to determine which men with an elevated PSA should undergo biopsy is currently the subject of two large clinical trials in Australia. MRI should be used with caution in this setting and then only in centres with established uro-radiological expertise and quality control mechanisms in place. There is sufficient evidence to justify using MRI to determine the need for repeat biopsy and to guide areas in which to focus repeat biopsy. IMAGE-DIRECTED BIOPSY MRI-directed biopsy is an exciting concept supported by promising early results, but none of the three proposed techniques have so far been proven superior to standard biopsy protocols. Further evidence of superior accuracy and core-efficiency over standard biopsy is required, before their costs and complexities in use can be justified. TREATMENT SELECTION AND PLANNING When used for primary-tumour staging (T-staging), MRI has limited sensitivity for T3 disease, but its specificity of greater than 95% may be useful in men with intermediate-high risk disease to identify those with advanced T3 disease not suitable for nerve sparing or for surgery at all. MRI appears to be of value in planning dosimetry in men undergoing radiotherapy, and in guiding selection for and monitoring on active surveillance.
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Affiliation(s)
- James Thompson
- St Vincents Prostate Cancer Centre, Garvan Institute of Medical Research, Department of Surgery Research, University of New South Wales, Sydney, New South Wales
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Puech P, Sufana-Iancu A, Renard B, Lemaitre L. Prostate MRI: can we do without DCE sequences in 2013? Diagn Interv Imaging 2013; 94:1299-311. [PMID: 24211261 DOI: 10.1016/j.diii.2013.09.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Multiparametric MRI (mp-MRI) of the prostate currently provides stable and reproducible performances. The usefulness of dynamic contrast-enhanced (DCE) sequences is currently challenged, as they sometimes only confirm what has already been observed on diffusion-weighted imaging (DWI) and require the additional purchase of a contrast agent. Eliminating these sequences may help accelerate the use of MRI in addition to, or in lieu of, prostate biopsies in selected patients. However, many studies show that these sequences can detect lesions invisible on T2-weighted and diffusion-weighted images, better assess cancer extension and aggressiveness, and finally help detecting recurrence after treatment. We present the various applications of dynamic MRI and discuss the possible consequences of its omission from the current protocol.
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Affiliation(s)
- P Puech
- Department of Uroradiology, Lille Hospital, 1, rue Michel-Polonovski, 59037 Lille cedex, France; University of Lille Nord de France, Lille 59800, France; Inserm U703, 59120 Loos, France.
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Hedgire SS, Oei TN, McDermott S, Cao K, Patel M Z, Harisinghani MG. Multiparametric magnetic resonance imaging of prostate cancer. Indian J Radiol Imaging 2013; 22:160-9. [PMID: 23599562 PMCID: PMC3624737 DOI: 10.4103/0971-3026.107176] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
In India, prostate cancer has an incidence rate of 3.9 per 100,000 men and is responsible for 9% of cancer-related mortality. It is the only malignancy that is diagnosed with an apparently blind technique, i.e., transrectal sextant biopsy. With increasing numbers of high-Tesla magnetic resonance imaging (MRI) equipment being installed in India, the radiologist needs to be cognizant about endorectal MRI and multiparametric imaging for prostate cancer. In this review article, we aim to highlight the utility of multiparamteric MRI in prostate cancer. It plays a crucial role, mainly in initial staging, restaging, and post-treatment follow-up.
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Affiliation(s)
- Sandeep S Hedgire
- Department of Abdominal Imaging and Intervention, Massachusetts General Hospital 55 Fruit St, Boston, 02114 Massachusetts, USA
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39
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Li B, Du Y, Yang H, Huang Y, Meng J, Xiao D. Magnetic resonance imaging for prostate cancer clinical application. Chin J Cancer Res 2013; 25:240-9. [PMID: 23592906 DOI: 10.3978/j.issn.1000-9604.2013.03.06] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2012] [Accepted: 12/14/2012] [Indexed: 01/16/2023] Open
Abstract
As prostate cancer is a biologically heterogeneous disease for which a variety of treatment options are available, the major objective of prostate cancer imaging is to achieve more precise disease characterization. In clinical practice, magnetic resonance imaging (MRI) is one of the imaging tools for the evaluation of prostate cancer, the fusion of MRI or dynamic contrast-enhanced MRI (DCE-MRI) with magnetic resonance spectroscopic imaging (MRSI) is improving the evaluation of cancer location, size, and extent, while providing an indication of tumor aggressiveness. This review summarizes the role of MRI in the application of prostate cancer and describes molecular MRI techniques (including MRSI and DCE-MRI) for aiding prostate cancer management.
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Affiliation(s)
- Bing Li
- Sichuan Key Laboratory of Medical Imaging, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China ; Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China
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40
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Jena A, Mehta SB, Taneja S. Optimizing MRI scan time in the computation of pharmacokinetic parameters (Ktrans) in breast cancer diagnosis. J Magn Reson Imaging 2013; 38:573-9. [DOI: 10.1002/jmri.24008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 11/29/2012] [Indexed: 11/07/2022] Open
Affiliation(s)
- Amarnath Jena
- MRI Department; Rajiv Gandhi Cancer Institute and Research Center; Rohini; New Delhi; India
| | - Shashi Bhushan Mehta
- MRI Department; Rajiv Gandhi Cancer Institute and Research Center; Rohini; New Delhi; India
| | - Sangeeta Taneja
- MRI Department; Rajiv Gandhi Cancer Institute and Research Center; Rohini; New Delhi; India
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41
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Talab SS, Preston MA, Elmi A, Tabatabaei S. Prostate cancer imaging: what the urologist wants to know. Radiol Clin North Am 2013; 50:1015-41. [PMID: 23122036 DOI: 10.1016/j.rcl.2012.08.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
No consensus exists at present regarding the use of imaging for the evaluation of prostate cancer. Ultrasonography is mainly used for biopsy guidance and magnetic resonance imaging is the mainstay in evaluating the extent of local tumor. Computed tomography and radionuclide bone scanning are mainly reserved for assessment of advanced disease. Positron emission tomography is gaining acceptance in the evaluation of treatment response and recurrence. The combination of anatomic, functional, and metabolic imaging modalities has promise to improve treatment. This article reviews current imaging techniques and touches on the evolving technologies being used for detection and follow-up of prostate cancer.
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Affiliation(s)
- Saman Shafaat Talab
- Department of Urology, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02114, USA
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Watanabe Y, Nagayama M, Araki T, Terai A, Okumura A, Amoh Y, Ishimori T, Nakashita S, Dodo Y. Targeted biopsy based on ADC map in the detection and localization of prostate cancer: a feasibility study. J Magn Reson Imaging 2012; 37:1168-77. [PMID: 23165993 PMCID: PMC3664425 DOI: 10.1002/jmri.23908] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Accepted: 09/25/2012] [Indexed: 11/18/2022] Open
Abstract
Purpose To investigate the feasibility of targeted biopsy based on an apparent diffusion coefficient (ADC) map in the detection and localization of prostate cancer. Materials and Methods This study included 288 consecutive patients with high or increasing serum prostate-specific antigen (PSA) levels who underwent prostatic magnetic resonance imaging (MRI) examination with an ADC map. Four core-targeted biopsies of low ADC lesions were performed under transrectal-ultrasound guidance with reference to ADC map. The positive predictive values (PPVs) of low ADC lesions were calculated and compared for the peripheral zone (PZ), transition zone (TZ), and anterior portion, respectively. Comparisons of ADC values and sizes between malignant and nonmalignant lesions were also performed. Results A total of 313 low ADC lesions were detected in 195 patients and sampled by targeted biopsies. The PPVs were 55.3% (95% confidence interval [CI]: 50–61) in total, 61.0% (95% CI: 53–69) for PZ, 50.6% (95% CI: 43–58) for TZ, and 90.9% (95% CI: 81–100) for the anterior portion. The most common nonmalignant pathology of low ADC lesions was hyperplasia, followed by chronic prostatitis. There were significant differences in ADC values and sizes between malignant and nonmalignant low ADC lesions. Conclusion Targeted biopsies could be capable of detecting cancers well wherever they may be in the prostate, although the PPVs varied depending on the location of low ADC lesions.
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Affiliation(s)
- Yuji Watanabe
- Department of Radiology, Kurashiki Central Hospital, Kurashiki, Japan.
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Valentini AL, Gui B, Cina A, Pinto F, Totaro A, Pierconti F, Bassi PF, Bonomo L. T2-weighted hypointense lesions within prostate gland: Differential diagnosis using wash-in rate parameter on the basis of dynamic contrast-enhanced magnetic resonance imaging—Hystopatology correlations. Eur J Radiol 2012; 81:3090-5. [DOI: 10.1016/j.ejrad.2012.05.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 05/15/2012] [Accepted: 05/16/2012] [Indexed: 01/09/2023]
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Overview of dynamic contrast-enhanced MRI in prostate cancer diagnosis and management. AJR Am J Roentgenol 2012; 198:1277-88. [PMID: 22623539 DOI: 10.2214/ajr.12.8510] [Citation(s) in RCA: 211] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE This article is a primer on the technical aspects of performing a high-quality dynamic contrast-enhanced MRI (DCE-MRI) examination of the prostate gland. CONCLUSION DCE-MRI is emerging as a useful clinical technique as part of a multi-parametric approach for evaluating the extent of primary and recurrent prostate cancer. Performing a high-quality DCE-MRI examination requires a good understanding of the technical aspects and limitations of image acquisition and postprocessing techniques.
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45
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Isebaert S, De Keyzer F, Haustermans K, Lerut E, Roskams T, Roebben I, Van Poppel H, Joniau S, Oyen R. Evaluation of semi-quantitative dynamic contrast-enhanced MRI parameters for prostate cancer in correlation to whole-mount histopathology. Eur J Radiol 2012; 81:e217-22. [DOI: 10.1016/j.ejrad.2011.01.107] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Accepted: 01/28/2011] [Indexed: 10/18/2022]
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YAMAZOE S, TAKAHARA T, SHIMIZU K, OUCHI K, MOGAMI T, HARADA J, FUKUDA K. Diffusion-weighted Imaging with Relative Signal Intensity Statistical Thresholding for Delineating Prostate Cancer Tumors. Magn Reson Med Sci 2012; 11:1-8. [DOI: 10.2463/mrms.11.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Prostate cancer detection on dynamic contrast-enhanced MRI: computer-aided diagnosis versus single perfusion parameter maps. AJR Am J Roentgenol 2011; 197:1122-9. [PMID: 22021504 DOI: 10.2214/ajr.10.6062] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this article is to assess the value of computer-aided diagnosis (CAD) for prostate cancer detection on dynamic contrast-enhanced MRI (DCE-MRI). MATERIALS AND METHODS DCE-MRI examinations of 42 patients with prostate cancer were used to generate perfusion parameters, including baseline and peak signal intensities, initial slope, maximum slope within the initial 50 seconds after the contrast injection (slope(50)), wash-in rate, washout rate, time to peak, percentage of relative enhancement, percentage enhancement ratio, time of arrival, efflux rate constant from the extravascular extracellular space to the blood plasma (k(ep)), first-order rate constant for eliminating gadopentetate dimeglumine from the blood plasma (k(el)), and constant depending on the properties of the tissue and represented by the size of the extravascular extracellular space (A(H)). CAD for cancer detection was established by comprehensive evaluation of parameters using a support vector machine. The diagnostic accuracy of single perfusion parameters was estimated using receiver operating characteristic analysis, which determined threshold and parametric maps for cancer detection. The diagnostic performance of CAD for cancer detection was compared with those of T2-weighted imaging (T2WI) and single perfusion parameter maps, using histologic results as the reference standard. RESULTS The accuracy, sensitivity, and specificity of CAD were 83%, 77%, and 77%, respectively, in the entire prostate; 77%, 91%, and 64%, respectively, in the transitional zone; and 89%, 89%, and 89%, respectively, in the peripheral zone. Values for k(ep), k(el), initial slope, slope(50), wash-in rate, washout rate, and time to peak showed greater area under the curve values (0.803-0.888) than did the other parameters (0.545-0.665) (p < 0.01) and were compared with values for CAD. In the entire prostate, accuracy was greater for CAD than for all perfusion parameters or T2WI (63-77%); sensitivity was greater for CAD than for T2WI, initial slope, wash-in rate, slope(50), and washout rate (38-77%); and specificity was greater for CAD than for T2WI, k(ep), k(el), and time to peak (59-68%) (p < 0.05). CONCLUSION CAD can improve the diagnostic performance of DCE-MRI in prostate cancer detection, which may vary according to zonal anatomy.
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Guo J, Reddick WE, Glass JO, Ji Q, Billups CA, Wu J, Hoffer FA, Kaste SC, Jenkins JJ, Ortega Flores XC, Quintana J, Villarroel M, Daw NC. Dynamic contrast-enhanced magnetic resonance imaging as a prognostic factor in predicting event-free and overall survival in pediatric patients with osteosarcoma. Cancer 2011; 118:3776-85. [PMID: 22180392 DOI: 10.1002/cncr.26701] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Revised: 10/12/2011] [Accepted: 10/18/2011] [Indexed: 11/07/2022]
Abstract
BACKGROUND The objective of this study was to prospectively evaluate dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) as an early imaging indicator of tumor histologic response to preoperative chemotherapy and as a possible prognostic factor for event-free survival (EFS) and overall survival in pediatric patients with newly diagnosed, nonmetastatic osteosarcoma who were treated on a single, multi-institutional phase 2 trial. METHODS Three serial DCE-MRI examinations at week 0 (before treatment), week 9, and week 12 (tumor resection) were performed in 69 patients with nonmetastatic osteosarcoma to monitor the response to preoperative chemotherapy. Four DCE-MRI kinetic parameters (the influx volume transfer constant [K(trans) ], the efflux rate constant [k(ep) ], the relative extravascular extracellular space [v(e) ], and the relative vascular plasma space [v(p) ]) and the corresponding differences (ΔK(trans) , Δk(ep) , Δv(e) , and Δv(p) ) of averaged kinetic parameters between the outer and inner halves of tumors were calculated to assess their associations with tumor histologic response, EFS, and overall survival. RESULTS The parameters K(trans) , v(e) , v(p) , and k(ep) decreased significantly from week 0 to week 9 and week 12. The parameters K(trans) , v(p) , and Δk(ep) at week 9 were significantly different between responders and nonresponders (P = .046, P = .021, and P = .008, respectively). These 3 parameters were indicative of histologic response. The parameter Δv(e) at week 0 was a significant prognostic factor for both EFS (P = .02) and overall survival (P = .03). CONCLUSIONS DCE-MRI was identified as a prognostic factor for EFS and overall survival before treatment on this trial and was indicative of a histologic response to neoadjuvant therapy. Further studies are needed to verify these findings with other treatment regimens and establish the potential role of DCE-MRI in the development of risk-adapted therapy for osteosarcoma.
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Affiliation(s)
- Junyu Guo
- Department of Radiological Sciences, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105-3678, USA
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Yakar D, Debats OA, Bomers JG, Schouten MG, Vos PC, van Lin E, Fütterer JJ, Barentsz JO. Predictive value of MRI in the localization, staging, volume estimation, assessment of aggressiveness, and guidance of radiotherapy and biopsies in prostate cancer. J Magn Reson Imaging 2011; 35:20-31. [DOI: 10.1002/jmri.22790] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Determination of the cutoff level of apparent diffusion coefficient values for detection of prostate cancer. Jpn J Radiol 2011; 29:488-94. [PMID: 21882091 DOI: 10.1007/s11604-011-0586-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Accepted: 03/09/2011] [Indexed: 12/28/2022]
Abstract
PURPOSE The aim of this study was to determine the cutoff level of apparent diffusion coefficient (ADC) values for diagnosing prostate cancer. MATERIALS AND METHODS A total of 45 consecutive patients with prostate cancer who underwent diffusion-weighted magnetic resonance imaging (MRI) with ADC maps before radical prostatectomy were included in this retrospective study. MRI findings were correlated retrospectively with histopathological results of surgical specimens. Comparisons of ADC values between cancer and noncancer areas were performed with the two-tailed unequal variance t-test. The cutoff ADC level was determined in a way to achieve the best accuracy for detecting prostate cancer. RESULTS The mean ADC value of all the cancer lesions (n =60) was 1.04 ± 0.31 (×10(-3) mm(2)/s). In the peripheral zone, the mean ADC values of cancer lesions and noncancer areas were 1.07 ± 0.35 and 1.94 ± 0.31, respectively (P < 0.001). In the transition zone, the mean ADC values of cancer lesions and noncancer areas were 1.00 ± 0.22 and 1.56 ± 0.14, respectively (P<0.001). The cutoff level for the ADC value was determined to be 1.35×10(-3) mm(2)/s. It provided sensitivity, specificity, and accuracy of 88%, 96%, and 93%, respectively. CONCLUSION The cutoff ADC level determined on the basis of the results obtained from radical prostatectomy specimens can help differentiate malignant from nonmalignant lesions.
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