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Cindil E, Oner Y, Sendur HN, Ozdemir H, Gazel E, Tunc L, Cerit MN. The Utility of Diffusion-Weighted Imaging and Perfusion Magnetic Resonance Imaging Parameters for Detecting Clinically Significant Prostate Cancer. Can Assoc Radiol J 2020; 70:441-451. [DOI: 10.1016/j.carj.2019.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 06/30/2019] [Accepted: 07/10/2019] [Indexed: 01/26/2023] Open
Abstract
Introduction To establish the diagnostic performance of the parameters obtained from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging at 3T in discriminating between non-clinically significant prostate cancers (ncsPCa, Gleason score [GS] < 7) and clinically significant prostate cancers (csPCa, GS ≥ 7) in the peripheral zone. Materials and Methods Twenty-six male patients with peripheral zone prostate cancer (PCa) who had undergone 3T multiparametric magnetic resonance imaging (MRI) scan prior to biopsy were included in the study and evaluated retrospectively. The GS was obtained by both standard 12-core transrectal ultrasound guided biopsy and targeted MRI-US fusion biopsy and then confirmed by prostatectomy, if available. For each confirmed tumour focus, DCE-derived quantitative perfusion metrics (Ktrans, Kep, Ve, initial area under the curve [AUC]), the apparent diffusion coefficient (ADC) value, and normalized versions of quantitative metrics were measured and correlated with the GS. Results Ktrans had the highest diagnostic accuracy value of 82% among the DCE-MRI parameters (AUC 0.90), and ADC had the strongest diagnostic accuracy value of 87% among the overall parameters (AUC 0.92). The combination of ADC and Ktrans have higher diagnostic performance with the area under the receiver operating characteristic curve being 0.98 (sensitivity 0.94; specificity 0.89; accuracy 0.92) compared to the individual evaluation of each parameter alone. The GS showed strong negative correlations with ADC (r = −0.72) and normalized ADC (r = −0.69) as well as a significant positive correlation with Ktrans (r = 0.69). Conclusion The combination of Ktrans and ADC and their normalized versions may help differentiate between ncsPCa from csPCa in the peripheral zone.
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Affiliation(s)
- Emetullah Cindil
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Yusuf Oner
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Halit Nahit Sendur
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Hakan Ozdemir
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Eymen Gazel
- Department of Urology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Lutfi Tunc
- Department of Urology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Mahi Nur Cerit
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
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Willmitzer F, Del Chicca F, Kircher PR, Wang-Leandro A, Kronen PW, Verdino D, Rüfenacht D, Porcellini B, Richter H. Diffusion-weighted and perfusion-weighted magnetic resonance imaging of the prostate gland of healthy adult dogs. Am J Vet Res 2019; 80:832-839. [PMID: 31449441 DOI: 10.2460/ajvr.80.9.832] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe diffusion and perfusion characteristics of the prostate gland of healthy sexually intact adult dogs as determined by use of diffusion-weighted and perfusion-weighted MRI. ANIMALS 12 healthy sexually intact adult Beagles. PROCEDURES Ultrasonography of the prostate gland was performed. Subsequently, each dog was anesthetized, and morphological, diffusion-weighted, and perfusion-weighted MRI of the caudal aspect of the abdomen was performed. The apparent diffusion coefficient was calculated for the prostate gland parenchyma in diffusion-weighted MRI images in the central ventral and peripheral dorsal areas. Perfusion variables were examined in multiple regions of interest (ROIs) in the ventral and dorsal areas of the prostate gland and in the gluteal musculature. Signal intensity was determined, and a time-intensity curve was generated for each ROI. RESULTS Results of ultrasonographic examination of the prostate gland revealed no abnormalities for any dog. Median apparent diffusion coefficient of the prostate gland was 1.51 × 10-3 mm2/s (range, 1.04 × 10-3 mm2/s to 1.86 × 10-3 mm2/s). Perfusion-weighted MRI variables for the ROIs differed between the prostate gland parenchyma and gluteal musculature. CONCLUSIONS AND CLINICAL RELEVANCE Results provided baseline information about diffusion and perfusion characteristics of the prostate gland in healthy sexually intact adult dogs. Additional studies with dogs of various ages and breeds, with and without abnormalities of the prostate gland, will be necessary to validate these findings and investigate clinical applications.
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Wildeboer RR, van Sloun RJG, Huang P, Wijkstra H, Mischi M. 3-D Multi-parametric Contrast-Enhanced Ultrasound for the Prediction of Prostate Cancer. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:2713-2724. [PMID: 31300222 DOI: 10.1016/j.ultrasmedbio.2019.05.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/23/2019] [Accepted: 05/16/2019] [Indexed: 05/14/2023]
Abstract
Trans-rectal ultrasound-guided 12-core systematic biopsy (SBx) is the standard diagnostic pathway for prostate cancer (PCa) because of a lack of sufficiently accurate imaging. Quantification of 3-D dynamic contrast-enhanced ultrasound (US) might open the way for a targeted procedure in which biopsies are directed at lesions suspicious on imaging. This work describes the expansion of contrast US dispersion imaging algorithms to 3-D and compares its performance against malignant and benign disease. Furthermore, we examined the feasibility of a multi-parametric approach to predict SBx-core outcomes using machine learning. An area under the receiver operating characteristic (ROC) curve of 0.76 and 0.81 was obtained for all PCa and significant PCa, respectively, an improvement over previous US methods. We found that prostatitis, in particular, was a source of false-positive readings.
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Affiliation(s)
- Rogier R Wildeboer
- Lab of Biomedical Diagnostics, Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.
| | - Ruud J G van Sloun
- Lab of Biomedical Diagnostics, Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Pintong Huang
- Department of Ultrasonography, Second Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Hessel Wijkstra
- Lab of Biomedical Diagnostics, Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands; Department of Urology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Massimo Mischi
- Lab of Biomedical Diagnostics, Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
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Kim EY, Jin BR, Chung TW, Bae SJ, Park H, Ryu D, Jin L, An HJ, Ha KT. 6-sialyllactose ameliorates dihydrotestosterone-induced benign prostatic hyperplasia through suppressing VEGF-mediated angiogenesis. BMB Rep 2019. [PMID: 31383249 PMCID: PMC6774418 DOI: 10.5483/bmbrep.2019.52.9.113] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Benign prostatic hyperplasia (BPH), a common disease in elderly males, is accompanied by non-malignant growth of prostate tissues, subsequently causing hypoxia and angiogenesis. Although VEGF-related angiogenesis is one of the therapeutic targets of prostate cancer, there is no previous study targeting angiogenesis for treatment of BPH. Dihydrotestosterone (DHT)-induced expressions of vascular endothelial growth factor (VEGF) in prostate epithelial RWPE-1 cells and human umbilical vascular endothelial cells (HUVECs). Conditioned media (CM) from DHT-treated RWPE-1 cells were transferred to HUVECs. Then, 6SL inhibited proliferation, VEGFR-2 activation, and tube formation of HUVECs transferred with CM from DHT-treated RWPE-1 cells. In the rat BPH model, 6SL reduced prostate weight, size, and thickness of the prostate tissue. Formation of vessels in prostatic tissues were also reduced with 6SL treatment. We found that 6SL has an ameliorative effect on in vitro and in vivo the BPH model via inhibition of VEGFR-2 activation and subsequent angiogenesis. These results suggest that 6SL might be a candidate for development of novel BPH drugs.
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Affiliation(s)
- Eun-Yeong Kim
- Department of Korean Medical Science, School of Korean Medicine, Yangsan 50612, Korea
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan 50612, Korea
| | - Bo-Ram Jin
- Department of Pharmacology, College of Korean Medicine, Sangji University, Wonju 26339, Korea
| | - Tae-Wook Chung
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan 50612, Korea
| | - Sung-Jin Bae
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan 50612, Korea
| | - Hyerin Park
- Department of Korean Medical Science, School of Korean Medicine, Yangsan 50612, Korea
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan 50612, Korea
| | - Dongryeol Ryu
- Department of Molecular Cell Biology, Sungkyunkwan University School of Medicine, Suwon 16419, Korea
| | - Ling Jin
- Department of Korean Medical Science, School of Korean Medicine, Yangsan 50612, Korea
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan 50612, Korea
| | - Hyo-Jin An
- Department of Pharmacology, College of Korean Medicine, Sangji University, Wonju 26339, Korea
| | - Ki-Tae Ha
- Department of Korean Medical Science, School of Korean Medicine, Yangsan 50612, Korea
- Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan 50612, Korea
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Opacic T, Dencks S, Theek B, Piepenbrock M, Ackermann D, Rix A, Lammers T, Stickeler E, Delorme S, Schmitz G, Kiessling F. Motion model ultrasound localization microscopy for preclinical and clinical multiparametric tumor characterization. Nat Commun 2018. [PMID: 29670096 DOI: 10.1101/203935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023] Open
Abstract
Super-resolution imaging methods promote tissue characterization beyond the spatial resolution limits of the devices and bridge the gap between histopathological analysis and non-invasive imaging. Here, we introduce motion model ultrasound localization microscopy (mULM) as an easily applicable and robust new tool to morphologically and functionally characterize fine vascular networks in tumors at super-resolution. In tumor-bearing mice and for the first time in patients, we demonstrate that within less than 1 min scan time mULM can be realized using conventional preclinical and clinical ultrasound devices. In this context, next to highly detailed images of tumor microvascularization and the reliable quantification of relative blood volume and perfusion, mULM provides multiple new functional and morphological parameters that discriminate tumors with different vascular phenotypes. Furthermore, our initial patient data indicate that mULM can be applied in a clinical ultrasound setting opening avenues for the multiparametric characterization of tumors and the assessment of therapy response.
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Affiliation(s)
- Tatjana Opacic
- Institute for Experimental Molecular Imaging, University Clinic Aachen, RWTH Aachen University, CMBS, Forckenbeckstr. 55, 52074, Aachen, Germany
| | - Stefanie Dencks
- Chair for Medical Engineering, Department of Electrical Engineering and Information Technology, Ruhr University Bochum, Universitätsstr. 150, 44780, Bochum, Germany
| | - Benjamin Theek
- Institute for Experimental Molecular Imaging, University Clinic Aachen, RWTH Aachen University, CMBS, Forckenbeckstr. 55, 52074, Aachen, Germany
| | - Marion Piepenbrock
- Chair for Medical Engineering, Department of Electrical Engineering and Information Technology, Ruhr University Bochum, Universitätsstr. 150, 44780, Bochum, Germany
| | - Dimitri Ackermann
- Chair for Medical Engineering, Department of Electrical Engineering and Information Technology, Ruhr University Bochum, Universitätsstr. 150, 44780, Bochum, Germany
| | - Anne Rix
- Institute for Experimental Molecular Imaging, University Clinic Aachen, RWTH Aachen University, CMBS, Forckenbeckstr. 55, 52074, Aachen, Germany
| | - Twan Lammers
- Institute for Experimental Molecular Imaging, University Clinic Aachen, RWTH Aachen University, CMBS, Forckenbeckstr. 55, 52074, Aachen, Germany
| | - Elmar Stickeler
- Department of Obstetrics and Gynecology, University Clinic Aachen, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Stefan Delorme
- Department of Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Georg Schmitz
- Chair for Medical Engineering, Department of Electrical Engineering and Information Technology, Ruhr University Bochum, Universitätsstr. 150, 44780, Bochum, Germany.
| | - Fabian Kiessling
- Institute for Experimental Molecular Imaging, University Clinic Aachen, RWTH Aachen University, CMBS, Forckenbeckstr. 55, 52074, Aachen, Germany.
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6
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Motion model ultrasound localization microscopy for preclinical and clinical multiparametric tumor characterization. Nat Commun 2018; 9:1527. [PMID: 29670096 PMCID: PMC5906644 DOI: 10.1038/s41467-018-03973-8] [Citation(s) in RCA: 112] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 03/27/2018] [Indexed: 12/21/2022] Open
Abstract
Super-resolution imaging methods promote tissue characterization beyond the spatial resolution limits of the devices and bridge the gap between histopathological analysis and non-invasive imaging. Here, we introduce motion model ultrasound localization microscopy (mULM) as an easily applicable and robust new tool to morphologically and functionally characterize fine vascular networks in tumors at super-resolution. In tumor-bearing mice and for the first time in patients, we demonstrate that within less than 1 min scan time mULM can be realized using conventional preclinical and clinical ultrasound devices. In this context, next to highly detailed images of tumor microvascularization and the reliable quantification of relative blood volume and perfusion, mULM provides multiple new functional and morphological parameters that discriminate tumors with different vascular phenotypes. Furthermore, our initial patient data indicate that mULM can be applied in a clinical ultrasound setting opening avenues for the multiparametric characterization of tumors and the assessment of therapy response. The vascular structure of tumors impacts diagnosis, prognosis and drug response; however, imaging methods to analyse this important feature have been hindered by spatial resolution limitations. Here the authors present a tool called motion model ultrasound localization microscopy to morphologically and functionally characterize fine vascular networks in tumors at super-resolution.
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A direct comparison of contrast-enhanced ultrasound and dynamic contrast-enhanced magnetic resonance imaging for prostate cancer detection and prediction of aggressiveness. Eur Radiol 2017; 28:1949-1960. [PMID: 29238867 DOI: 10.1007/s00330-017-5192-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 11/07/2017] [Accepted: 11/10/2017] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) and contrast-enhanced ultrasound (CEUS) analyse tissue vascularization. We evaluated if CEUS can provide comparable information as DCE-MRI for the detection of prostate cancer (PCa) and prediction of its aggressiveness. MATERIAL AND METHODS A post-hoc evaluation of 92 patients was performed. In each patient CEUS and DCE-MRI parameters of the most suspicious lesion identified on MRI were analysed. The predictive values for discrimination between benign lesions, low-/intermediate- and high-grade PCa were evaluated. Results of targeted biopsy served as reference standard (benign lesions, n=51; low- and intermediate-grade PCa [Gleason grade group 1 and 2], n=22; high-grade PCa [≥ Gleason grade group 3], n=19). RESULTS In peripheral zone lesions of all tested CEUS parameters only time to peak (TTPCEUS) showed significant differences between benign lesions and PCa (AUC 0.65). Of all tested DCE-MRI parameters, rate constant (Kep) was the best discriminator of high-grade PCa in the whole prostate (AUC 0.83) and in peripheral zone lesions (AUC 0.89). CONCLUSION DCE-MRI showed a superior performance for detection of PCa and prediction of its aggressiveness. CEUS and DCE-MRI performed better in peripheral zone lesions than in transition zone lesions. KEY POINTS • DCE-MRI gathers information about vascularization and capillary permeability characteristics of tissues. • DCE-MRI can detect PCa and predict its aggressiveness. • CEUS also gathers information about vascularization of tissues. • For detection of PCa and prediction of aggressiveness DCE-MRI performed superiorly. • Both imaging techniques performed better in peripheral zone lesions.
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8
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Role of semi–quantitative dynamic contrast–enhanced MR imaging in characterization and grading of prostate cancer. Eur J Radiol 2017; 94:154-159. [DOI: 10.1016/j.ejrad.2017.06.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 05/16/2017] [Accepted: 06/26/2017] [Indexed: 11/21/2022]
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9
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Fütterer JJ. Multiparametric MRI in the Detection of Clinically Significant Prostate Cancer. Korean J Radiol 2017; 18:597-606. [PMID: 28670154 PMCID: PMC5447635 DOI: 10.3348/kjr.2017.18.4.597] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 02/20/2017] [Indexed: 11/15/2022] Open
Abstract
Prostate cancer is the most common cancer among men aged 50 years and older in developed countries and the third leading cause of cancer-related death in men. Multiparametric prostate MR imaging is currently the most accurate imaging modality to detect, localize, and stage prostate cancer. The role of multi-parametric MR imaging in the detection of clinically significant prostate cancer are discussed. In addition, insights are provided in imaging techniques, protocol, and interpretation.
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Affiliation(s)
- Jurgen J Fütterer
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen 6500HB, the Netherlands
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10
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Computed Tomography Perfusion of Prostate Cancer: Diagnostic Value of Quantitative Analysis. J Comput Assist Tomogr 2016; 40:740-5. [PMID: 27224230 DOI: 10.1097/rct.0000000000000432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of the study was to assess the diagnostic value of computed tomography perfusion (CTp) of prostate in distinguishing between normal tissue and malignant lesion by using quantitative threshold values of CTp parameters. MATERIALS AND METHODS Sixty-one consecutive men with indication for radical prostatectomy were prospectively enrolled. All patients were intravenously injected with 80-mL bolus of nonionic iodinated contrast medium during cine-mode acquisition protocol. Perfusion data sets were analyzed by a dedicated software system and values for each of the 4 CTp parameters (blood volume, blood flow, mean transit time, and permeability surface-area product measurements) were recorded. Receiver operating characteristic curves were calculated to find which CTp parameter and which cutoff value might reveal the best diagnostic accuracy. Histopathology was used as reference standard. RESULTS Statistical correlation between radiological and pathological results was performed on 48 patients using 3456 segmented squares. Blood volume and permeability surface revealed the best diagnostic accuracy for differentiating between malignant and benign squares, with cutoff values of 6.1 and 16.5, respectively, and a sensitivity of 84.8% and 81.8%, respectively. All parameters showed also a high negative predictive value: 97.1% for blood volume and 95.4% for permeability surface. CONCLUSIONS Blood volume and permeability surface are the 2 CTp parameters with the highest diagnostic accuracy in differentiating between normal tissue and prostatic neoplasia. Due to the extremely high negative predictive value, they are particularly valuable in excluding the presence of cancer and thus resulting potentially useful in assessing cancer response to adjuvant therapy.
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11
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Comte F, Cuenod C, Pensky M, Rozenholc Y. Laplace deconvolution on the basis of time domain data and its application to dynamic contrast‐enhanced imaging. J R Stat Soc Series B Stat Methodol 2016. [DOI: 10.1111/rssb.12159] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
| | - Charles‐A. Cuenod
- Université Paris Descartes and European Hospital G. Pompidou Paris France
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12
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Dynamic contrast-enhanced MRI for the detection of prostate cancer: meta-analysis. AJR Am J Roentgenol 2015; 204:W439-48. [PMID: 25794093 DOI: 10.2214/ajr.14.13373] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE The purpose of this study was to systematically review and meta-analyze dynamic contrast-enhanced MRI (DCE-MRI) for the detection of prostate cancer in comparison with standard evaluation with T2-weighted imaging. MATERIALS AND METHODS A PubMed electronic database search for the terms "dynamic contrast-enhanced," "prostate," and "MRI" was completed for articles up to September 17, 2013. All included studies had histopathologic correlation. Two by two contingency data were constructed for each study. A binormal bayesian ROC model was used to estimate and compare sensitivity, specificity, and AUC among eligible modalities. RESULTS Both DCE-MRI (0.82-0.86) and diffusion-weighted MRI (DWI) (0.84-0.88) yielded significantly better AUC than T2-weighted imaging (0.68-0.77). Moreover, partial AUC for the combination of DCE-MRI, DWI, and T2-weighted imaging was improved significantly (0.111; 0.103-0.119) when compared with DCE-MRI alone (0.079; 0.072-0.085) and T2-weighted imaging alone (0.079; 0.074-0.084) but not DWI alone (0.099; 0.091-0.108). Sensitivity and specificity were similar among the four modalities. CONCLUSION DCE-MRI improves AUC of tumor detection overall compared with T2-weighted imaging alone. Methods for DCE-MRI analysis require standardization, but visual analysis performs similar to semiquantitative methods. A two-parameter approach using DCE-MRI and T2-weighted imaging or DWI and T2-weighted imaging may be sufficient, and the latter may be more favorable for most routine prostate cancer imaging.
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Bittencourt LK, Hausmann D, Sabaneeff N, Gasparetto EL, Barentsz JO. Multiparametric magnetic resonance imaging of the prostate: current concepts. Radiol Bras 2015; 47:292-300. [PMID: 25741104 PMCID: PMC4341390 DOI: 10.1590/0100-3984.2013.1863] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 11/18/2013] [Indexed: 02/07/2023] Open
Abstract
Multiparametric MR (mpMR) imaging is rapidly evolving into the mainstay in prostate
cancer (PCa) imaging. Generally, the examination consists of T2-weighted sequences,
diffusion-weighted imaging (DWI), dynamic contrast-enhanced (DCE) evaluation, and
less often proton MR spectroscopy imaging (MRSI). Those functional techniques are
related to biological properties of the tumor, so that DWI correlates to cellularity
and Gleason scores, DCE correlates to angiogenesis, and MRSI correlates to cell
membrane turnover. The combined use of those techniques enhances the diagnostic
confidence and allows for better characterization of PCa. The present article reviews
and illustrates the technical aspects and clinical applications of each component of
mpMR imaging, in a practical approach from the urological standpoint.
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Affiliation(s)
- Leonardo Kayat Bittencourt
- PhD, Associate Professor of Radiology, Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil, Titular Member, Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), Radiologist at CDPI and Multi-Imagem Clinics, Rio de Janeiro, RJ, Brazil
| | - Daniel Hausmann
- MD, Resident, Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Natalia Sabaneeff
- Titular Member, Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), Radiologist at CDPI Clinic, Rio de Janeiro, RJ, Brazil
| | - Emerson Leandro Gasparetto
- PhD, Associate Professor, Department of Radiology, Universidade Federal do Rio de Janeiro (UFRJ), Radiologist at CDPI and Multi-Imagem Clinics, Rio de Janeiro, RJ, Brazil
| | - Jelle O Barentsz
- PhD, Chair of Research and Professor, Department of Radiology, Radboud University Medical Center, Nijmegen, Netherlands
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14
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Kawada H, Kanematsu M, Goshima S, Kondo H, Watanabe H, Noda Y, Tanahashi Y, Kawai N, Hoshi H. Multiphase contrast-enhanced magnetic resonance imaging features of Bacillus Calmette-Guérin-induced granulomatous prostatitis in five patients. Korean J Radiol 2015; 16:342-8. [PMID: 25741196 PMCID: PMC4347270 DOI: 10.3348/kjr.2015.16.2.342] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 11/24/2014] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the multiphase contrast-enhanced magnetic resonance (MR) imaging features of Bacillus Calmette-Guérin (BCG)-induced granulomatous prostatitis (GP). MATERIALS AND METHODS Magnetic resonance images obtained from five patients with histopathologically proven BCG-induced GP were retrospectively analyzed for tumor location, size, signal intensity on T2-weighted images (T2WI) and diffusion-weighted images (DWI), apparent diffusion coefficient (ADC) value, and appearance on gadolinium-enhanced multiphase images. MR imaging findings were compared with histopathological findings. RESULTS Bacillus Calmette-Guérin-induced GP (size range, 9-40 mm; mean, 21.2 mm) were identified in the peripheral zone in all patients. The T2WI showed lower signal intensity compared with the normal peripheral zone. The DWIs demonstrated high signal intensity and low ADC values (range, 0.44-0.68 × 10(-3) mm(2)/sec; mean, 0.56 × 10(-3) mm(2)/sec), which corresponded to GP. Gadolinium-enhanced multiphase MR imaging performed in five patients showed early and prolonged ring enhancement in all cases of GP. Granulomatous tissues with central caseation necrosis were identified histologically, which corresponded to ring enhancement and a central low intensity area on gadolinium-enhanced MR imaging. The findings on T2WI, DWI, and gadolinium-enhanced images became gradually obscured with time. CONCLUSION Bacillus Calmette-Guérin-induced GP demonstrates early and prolonged ring enhancement on gadolinium-enhanced MR imaging which might be a key finding to differentiate it from prostate cancer.
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Affiliation(s)
- Hiroshi Kawada
- Department of Radiology, Gifu University Hospital, Gifu 501-1194, Japan
| | - Masayuki Kanematsu
- Department of Radiology, Gifu University Hospital, Gifu 501-1194, Japan
- Department of Radiology Services, Gifu University Hospital, Gifu 501-1194, Japan
| | - Satoshi Goshima
- Department of Radiology, Gifu University Hospital, Gifu 501-1194, Japan
| | - Hiroshi Kondo
- Department of Radiology, Gifu University Hospital, Gifu 501-1194, Japan
| | - Haruo Watanabe
- Department of Radiology, Gifu University Hospital, Gifu 501-1194, Japan
| | - Yoshifumi Noda
- Department of Radiology, Gifu University Hospital, Gifu 501-1194, Japan
| | - Yukichi Tanahashi
- Department of Radiology, Gifu University Hospital, Gifu 501-1194, Japan
| | - Nobuyuki Kawai
- Department of Radiology, Gifu University Hospital, Gifu 501-1194, Japan
| | - Hiroaki Hoshi
- Department of Radiology, Gifu University Hospital, Gifu 501-1194, Japan
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15
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Łuczyńska E, Heinze-Paluchowska S, Blecharz P, Jereczek-Fossa B, Petralia G, Bellomi M, Stelmach A. Correlation between CT perfusion and clinico-pathological features in prostate cancer: a prospective study. Med Sci Monit 2015; 21:153-62. [PMID: 25582437 PMCID: PMC4301468 DOI: 10.12659/msm.891401] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background The aim of the study was to assess the correlation between computed tomography perfusion (PCT) parameters and PSA levels, Gleason score, and pTNM stage in patients with prostate cancer (PCa). Material/Methods One hundred twenty-five patients with localized PCa were prospectively enrolled in the study. All patients were diagnosed due to suspicious prostate findings and elevated PSA serum levels and underwent PCT followed by core biopsy and radical prostatectomy. Blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability-surface (PS) area product were computed in the suspected PCa area and normal prostatic tissue. Core biopsy followed by prostatectomy was performed 2–4 weeks after PCT. Correlation between PCT findings and PSA levels, Gleason score, and pTNM stage were analyzed. Results The mean age of patients was 64 years. All patients had elevated PSA levels (mean value 6.2 ng/ml). Nineteen patients (15.9%) were at low risk of recurrence, 91 (76.5%) were at moderate risk, and 9 (7.6%) were at high risk according to National Comprehensive Cancer Network criteria. PCa was visible on PCT as focal peripheral CT enhancement in 119 out of 125 patients (sensitivity 95.2%). Significant correlations between BV, BF, and PS values and PSA level were found (p<0.05), as well as a trend for difference between BV, BF, and PS in poorly and moderately differentiated tumors (according to Gleason score) in comparison with highly differentiated PCa (p<0.08). The analysis also revealed a correlation between mean perfusion values and BV, MTT, PS, and pTNM cancer stage (p<0.04). Conclusions Our study suggests that in low- and intermediate- risk patients, PCT parameters correlate with PSA values, Gleason score, and pTNM stage and can be useful for initial tumor staging.
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Affiliation(s)
- Elżbieta Łuczyńska
- Department of Radiology, Center of Oncology, M. Skłodowska-Curie Memorial Institute, Cracow, Poland
| | | | - Paweł Blecharz
- Department of Gynecologic Oncology, Center of Oncology, M. Skłodowska-Curie Memorial Institute, Cracow, Poland
| | | | - Giuseppe Petralia
- Department of Radiology, European Institute of Oncology, Milan, Italy
| | - Massimo Bellomi
- Department of Radiology, European Institute of Oncology, Milan, Italy
| | - Andrzej Stelmach
- Department of Surgery, Center of Oncology, M. Skłodowska-Curie Memorial Institute, Cracow, Poland
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Integrated CT-perfusion shows no meaningful correlation with PSA and presurgical Gleason score in patients with early prostate cancer. Clin Imaging 2014; 38:850-7. [DOI: 10.1016/j.clinimag.2014.07.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 07/08/2014] [Accepted: 07/22/2014] [Indexed: 01/18/2023]
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17
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Cullu N, Kantarci M, Ogul H, Adanur S, Okur A, Koc E, Pirimoglu B, Karaca L, Kizrak Y, Polat O. Feasibility study of CT perfusion imaging for prostate carcinoma. Eur Radiol 2014; 24:2236-44. [PMID: 24863884 DOI: 10.1007/s00330-014-3212-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 03/25/2014] [Accepted: 04/30/2014] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The aim of this feasibility study was to obtain initial data with which to assess the efficiency of perfusion CT imaging (CTpI) and to compare this with magnetic resonance imaging (MRI) in the diagnosis of prostate carcinoma. MATERIALS AND METHODS This prospective study involved 25 patients with prostate carcinoma undergoing MRI and CTpI. All analyses were performed on T2-weighted images (T2WI), apparent diffusion coefficient (ADC) maps, diffusion-weighted images (DWI) and CTp images. We compared the performance of T2WI combined with DWI and CTp alone. The study was approved by the local ethics committee, and written informed consent was obtained from all patients. RESULTS Tumours were present in 87 areas according to the histopathological results. The diagnostic performance of the T2WI+DWI+CTpI combination was significantly better than that of T2WI alone for prostate carcinoma (P < 0.001). The diagnostic value of CTpI was similar to that of T2WI+DWI in combination. There were statistically significant differences in the blood flow and permeability surface values between prostate carcinoma and background prostate on CTp images. CONCLUSION CTp may be a valuable tool for detecting prostate carcinoma and may be preferred in cases where MRI is contraindicated. If this technique is combined with T2WI and DWI, its diagnostic value is enhanced. KEY POINTS Perfusion CT is a helpful technique for prostate carcinoma diagnosis. •Colour maps allow easy and rapid visual assessment of the functional changes. Colour maps of prostate carcinoma provide information about in vivo tumoral vascularity. CTp images may be added into routine radiological examinations. CTp provides guidance for histopathological correlation if biopsy is scheduled.
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Affiliation(s)
- Nesat Cullu
- Department of Radiology, Muğla Sıtkı Koçman University, School of Medicine, Muğla, Turkey
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18
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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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19
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Brandão AC, Silva AO. Diseases of the female pelvis: advances in imaging evaluation. Magn Reson Imaging Clin N Am 2013; 21:447-69. [PMID: 23642562 DOI: 10.1016/j.mric.2013.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Magnetic resonance (MR) imaging has been widely accepted as a powerful imaging modality for the evaluation of the pelvis because of its intrinsic superior soft tissue contrast compared with that of computed tomography. In certain cases, however, the morphologic study provided by MR imaging may not be enough. Functional evaluation with perfusion and diffusion, which allow estimation of the microvascular characteristics and cellularity of the lesions, favors the differentiation of benign from malignant lesions. This article focuses on new magnetic resonance techniques and their contribution to the differentiation and characterization of pelvic pathologies.
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20
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Abramovich F, Pensky M, Rozenholc Y. Laplace deconvolution with noisy observations. Electron J Stat 2013. [DOI: 10.1214/13-ejs796] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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21
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Perfusion MDCT of Prostate Cancer: Correlation of Perfusion CT Parameters and Immunohistochemical Markers of Angiogenesis. AJR Am J Roentgenol 2012; 199:1042-8. [DOI: 10.2214/ajr.11.8267] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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22
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Russo G, Mischi M, Scheepens W, De la Rosette JJ, Wijkstra H. Angiogenesis in prostate cancer: onset, progression and imaging. BJU Int 2012; 110:E794-808. [DOI: 10.1111/j.1464-410x.2012.11444.x] [Citation(s) in RCA: 128] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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23
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Harvey CJ, Pilcher J, Richenberg J, Patel U, Frauscher F. Applications of transrectal ultrasound in prostate cancer. Br J Radiol 2012; 85 Spec No 1:S3-17. [PMID: 22844031 DOI: 10.1259/bjr/56357549] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Transrectal ultrasound (TRUS) was first developed in the 1970s. TRUS-guided biopsy, under local anaesthetic and prophylactic antibiotics, is now the most widely accepted method to diagnose prostate cancer. However, the sensitivity and specificity of greyscale TRUS in the detection of prostate cancer is low. Prostate cancer most commonly appears as a hypoechoic focal lesion in the peripheral zone on TRUS but the appearances are variable with considerable overlap with benign lesions. Because of the low accuracy of greyscale TRUS, TRUS-guided biopsies have become established in the acquisition of systematic biopsies from standard locations. The number of systematic biopsies has increased over the years, with 10-12 cores currently accepted as the minimum standard. This article describes the technique of TRUS and biopsy and its complications. Novel modalities including contrast-enhanced modes and elastography as well as fusion techniques for increasing the sensitivity of TRUS-guided prostate-targeted biopsies are discussed along with their role in the diagnosis and management of prostate cancer.
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Affiliation(s)
- C J Harvey
- Department of Imaging, Imperial Healthcare Trust, Hammersmith Hospital, London, UK.
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24
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Hoeks CMA, Barentsz JO, Hambrock T, Yakar D, Somford DM, Heijmink SWTPJ, Scheenen TWJ, Vos PC, Huisman H, van Oort IM, Witjes JA, Heerschap A, Fütterer JJ. Prostate cancer: multiparametric MR imaging for detection, localization, and staging. Radiology 2011; 261:46-66. [PMID: 21931141 DOI: 10.1148/radiol.11091822] [Citation(s) in RCA: 544] [Impact Index Per Article: 41.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This review presents the current state of the art regarding multiparametric magnetic resonance (MR) imaging of prostate cancer. Technical requirements and clinical indications for the use of multiparametric MR imaging in detection, localization, characterization, staging, biopsy guidance, and active surveillance of prostate cancer are discussed. Although reported accuracies of the separate and combined multiparametric MR imaging techniques vary for diverse clinical prostate cancer indications, multiparametric MR imaging of the prostate has shown promising results and may be of additional value in prostate cancer localization and local staging. Consensus on which technical approaches (field strengths, sequences, use of an endorectal coil) and combination of multiparametric MR imaging techniques should be used for specific clinical indications remains a challenge. Because guidelines are currently lacking, suggestions for a general minimal protocol for multiparametric MR imaging of the prostate based on the literature and the authors' experience are presented. Computer programs that allow evaluation of the various components of a multiparametric MR imaging examination in one view should be developed. In this way, an integrated interpretation of anatomic and functional MR imaging techniques in a multiparametric MR imaging examination is possible. Education and experience of specialist radiologists are essential for correct interpretation of multiparametric prostate MR imaging findings. Supportive techniques, such as computer-aided diagnosis are needed to obtain a fast, cost-effective, easy, and more reproducible prostate cancer diagnosis out of more and more complex multiparametric MR imaging data.
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Affiliation(s)
- Caroline M A Hoeks
- Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Bonekamp D, Jacobs MA, El-Khouli R, Stoianovici D, Macura KJ. Advancements in MR imaging of the prostate: from diagnosis to interventions. Radiographics 2011; 31:677-703. [PMID: 21571651 DOI: 10.1148/rg.313105139] [Citation(s) in RCA: 146] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Prostate cancer is the most frequently diagnosed cancer in males and the second leading cause of cancer-related death in men. Assessment of prostate cancer can be divided into detection, localization, and staging; accurate assessment is a prerequisite for optimal clinical management and therapy selection. Magnetic resonance (MR) imaging has been shown to be of particular help in localization and staging of prostate cancer. Traditional prostate MR imaging has been based on morphologic imaging with standard T1-weighted and T2-weighted sequences, which has limited accuracy. Recent advances include additional functional and physiologic MR imaging techniques (diffusion-weighted imaging, MR spectroscopy, and perfusion imaging), which allow extension of the obtainable information beyond anatomic assessment. Multiparametric MR imaging provides the highest accuracy in diagnosis and staging of prostate cancer. In addition, improvements in MR imaging hardware and software (3-T vs 1.5-T imaging) continue to improve spatial and temporal resolution and the signal-to-noise ratio of MR imaging examinations. Another recent advancement in the field is MR imaging guidance for targeted prostate biopsy, which is an alternative to the current standard of transrectal ultrasonography-guided systematic biopsy.
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Affiliation(s)
- David Bonekamp
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3140C, Baltimore, MD 21287, USA
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26
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Serkova NJ. Translational imaging endpoints to predict treatment response to novel targeted anticancer agents. Drug Resist Updat 2011; 14:224-35. [PMID: 21640633 DOI: 10.1016/j.drup.2011.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Revised: 04/20/2011] [Accepted: 04/26/2011] [Indexed: 01/22/2023]
Abstract
Response Evaluation Criteria in Solid Tumors (RECIST) and World Health Organization (WHO) Criteria have been traditionally used for the evaluation of therapeutic response to chemotherapeutic treatment regimens. They determine anatomic criteria for patients response to anti-cancer therapy based on morphological measurements of each target lesion. While this assessment is justified for cytotoxic (chemotherapeutic) drugs, it is now recognized that morphological imaging protocols are poorly suited to the evaluation of the efficacy of novel signal transduction inhibitors (STIs) which exhibit cytostatic rather than cytotoxic properties. New imaging technologies are now designed to evaluate, in a functional manner, modifications in tumor metabolic activity, cellularity, and vascularization before a reduction in tumor volume can be detected. Introduction of physiological imaging end-points, derived from dynamic contrast-enhanced (DCE) imaging protocols--including magnetic resonance imaging (MRI), computed tomography (CT) and ultrasound (US)--allow for early assessment of disruption in tumor perfusion and permeability for targeted anti-angiogenic agents. Diffusion-weighted MRI (DWI) provides another physiological imaging end-point since tumor necrosis and cellularity are seen early in response to anti-angiogenic treatment. Changes in glucose and phospholipid turnover, based on metabolic MRI and positron emission tomography (PET), provide reliable markers for therapeutic response to novel receptor-targeting agents. Finally, novel molecular imaging techniques of protein and gene expression have been developed in animal models followed by a successful human application for gene therapy-based protocols.
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Affiliation(s)
- Natalie J Serkova
- Department of Anesthesiology, University of Colorado Denver, Anschutz Medical Center, Aurora, CO 80045, USA.
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27
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SANTAMARÍA L, INGELMO I, RUIZ J, TEBA F. Study of the distribution of microvessels in normal and pathologic prostate using an information-based similarity analysis. J Microsc 2011; 243:303-14. [DOI: 10.1111/j.1365-2818.2011.03508.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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28
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29
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Li MM, Rybalov M, Haider MA, de Jong IJ. Does computed tomography or positron emission tomography/computed tomography contribute to detection of small focal cancers in the prostate? J Endourol 2010; 24:693-700. [PMID: 20367444 DOI: 10.1089/end.2009.0470] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Prostate cancer is considered to be a multifocal tumor in the majority of patients. Based on histologic data after prostatectomy, there is a growing insight that a considerable number of men who receive a diagnosis in the contemporary setting of prostate-specific antigen screening have unilateral or unifocal disease. With this, the current concept of whole-gland therapy has come into discussion. The need for improvement of intraprostatic tumor characterization is clear. Molecular imaging is one of the areas of research on this aspect. The clinical indications for positron emission tomography (PET)/CT have increased rapidly in the field of oncology and are largely based on fluorodeoxyglucose (FDG) PET. Both conventional CT and FDG PET, however, cannot detect prostate cancer foci <5 mm within the prostate. Dynamic contrast-enhanced CT involves imaging a region of interest rapidly (usually <10 seconds between images) during a bolus intravenous injection of a contrast agent. Through analysis of the contrast enhancement time curves, it is possible to distinguish tissues with different microvascular properties such as cancer. The technologic aspects of both imaging techniques and the clinical results of 11C-choline PET/CT for intraprostatic tumor characterization are discussed. Based on preliminary studies, dynamic contrast-enhanced (DCE)-CT may be a useful tool for localization of prostate tumors and, perhaps more importantly, quantification of therapeutic response in prostate cancer. Validation work is necessary, however, to define its accuracy and role in therapeutic paradigms such as focal therapies, particularly given the current accuracy of MRI. In the future, combining DCE-CT with CT or (11)C-choline PET/CT may be an alternative to MRI, offering a combination of quantitative parameters that may correlate to tumor prognosis as well as cancer localization for focal therapy.
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Affiliation(s)
- Michael M Li
- Joint Department of Medical Imaging, University Health Network and Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
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30
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Principal Component Analysis of Dynamic Contrast Enhanced MRI in Human Prostate Cancer. Invest Radiol 2010; 45:174-81. [DOI: 10.1097/rli.0b013e3181d0a02f] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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31
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Sakata N, Obenaus A, Chan NK, Hayes P, Chrisler J, Hathout E. Correlation between angiogenesis and islet graft function in diabetic mice: magnetic resonance imaging assessment. JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2010; 17:692-700. [PMID: 20703848 DOI: 10.1007/s00534-010-0269-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2009] [Accepted: 01/21/2010] [Indexed: 11/24/2022]
Abstract
BACKGROUND/PURPOSE Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) was used to evaluate neovascularization after intravenous injection of gadolinium, where contrast leaks out of new vessels and remains within the tissues. We examined the relationship between DCE-MRI and metabolic parameters such as blood glucose, serum insulin and glucose tolerance test (GTT) after intraportal islet transplantation. METHODS Streptozotocin-induced diabetic BALB/c mice (n = 15) received syngeneic intraportal islet transplantation (500 islet equivalent). Blood glucose, serum insulin and GTT were evaluated till postoperative day (POD) 14. Liver DCE-MRI was performed at POD 3, 7 and 14. Correlations between DCE-MRI and metabolic parameters were examined using regression analysis. RESULTS Eight mice achieved normoglycemia after intraportal transplantation. At POD 3 a significant but moderate correlation between DCE-MRI and blood glucose was found. No DCE-MRI or metabolic parameters correlated at POD 7. However, at POD 14 strong or moderate correlations between DCE-MRIs were found: negative correlations with blood glucose (R (2) = 0.86) and GTT (R (2) = 0.48) but a positive correlation with serum insulin (R (2) = 0.32). CONCLUSION We report that DCE-MRI can reflect the metabolic and functional condition of the transplanted islets.
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Affiliation(s)
- Naoaki Sakata
- Islet Transplant Laboratory, Department of Pediatrics, Pediatric Diabetes Center, Loma Linda University School of Medicine, 11175 Campus Street, Coleman Pavilion, A1120R, Loma Linda, CA 92354, USA
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Zee YK, O'Connor JPB, Parker GJM, Jackson A, Clamp AR, Taylor MB, Clarke NW, Jayson GC. Imaging angiogenesis of genitourinary tumors. Nat Rev Urol 2010; 7:69-82. [PMID: 20084077 DOI: 10.1038/nrurol.2009.262] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Angiogenesis is a key process in the growth and metastasis of cancer, and genitourinary tumors are no exception. The evolution of angiogenesis as an important target for novel anticancer therapeutics has brought with it new challenges for in vivo imaging. Most imaging techniques quantify physiological parameters, such as blood volume and capillary endothelial permeability. Although CT, PET and ultrasonography have shown promise, MRI is the most common method used to evaluate angiogenesis in clinical trials of genitourinary tumors. Pilot studies of MRI, CT and ultrasonography in patients with renal cancer have produced promising results; reductions in vascular permeability and blood flow have been correlated with progression-free survival. The vascular characteristics of prostate cancer have been evaluated by MRI, and this has been suggested as a means of assessing tumor response to hormone deprivation therapy. Current evidence highlights the potential of angiogenesis imaging in the diagnosis, staging and possibly response monitoring of bladder cancer. In the future, assessment of the angiogenic process at the structural, functional and molecular levels, before, during and after antiangiogenic therapy will undoubtedly be integrated into wider clinical practice.
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Affiliation(s)
- Ying-Kiat Zee
- Department of Medical Oncology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
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Candefjord S, Ramser K, Lindahl OA. Technologies for localization and diagnosis of prostate cancer. J Med Eng Technol 2010; 33:585-603. [PMID: 19848851 DOI: 10.3109/03091900903111966] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The gold standard for detecting prostate cancer (PCa), systematic biopsy, lacks sensitivity as well as grading accuracy. PSA screening leads to over-treatment of many men, and it is unclear whether screening reduces PCa mortality. This review provides an understanding of the difficulties of localizing and diagnosing PCa. It summarizes recent developments of ultrasound (including elastography) and MRI, and discusses some alternative experimental techniques, such as resonance sensor technology and vibrational spectroscopy. A comparison between the different methods is presented. It is concluded that new ultrasound techniques are promising for targeted biopsy procedures, in order to detect more clinically significant cancers while reducing the number of cores. MRI advances are very promising, but MRI remains expensive and MR-guided biopsy is complex. Resonance sensor technology and vibrational spectroscopy have shown promising results in vitro. There is a need for large prospective multicentre trials that unambiguously prove the clinical benefits of these new techniques.
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Affiliation(s)
- S Candefjord
- Department of Computer Science and Electrical Engineering, Luleå University of Technology, Luleå, Sweden.
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Abstract
There is a need for direct imaging of effects on tumor vasculature in assessment of response to antiangiogenic drugs and vascular disrupting agents. Imaging tumor vasculature depends on differences in permeability of vasculature of tumor and normal tissue, which cause changes in penetration of contrast agents. Angiogenesis imaging may be defined in terms of measurement of tumor perfusion and direct imaging of the molecules involved in angiogenesis. In addition, assessment of tumor hypoxia will give an indication of tumor vasculature. The range of imaging techniques available for these processes includes positron emission tomography (PET), dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), perfusion computed tomography (CT), and ultrasound (US).
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Affiliation(s)
- Natalie Charnley
- University of Manchester, Wolfson Molecular Imaging Centre, Manchester, UK
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35
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Somford DM, Fütterer JJ, Hambrock T, Barentsz JO. Diffusion and perfusion MR imaging of the prostate. Magn Reson Imaging Clin N Am 2008; 16:685-95, ix. [PMID: 18926431 DOI: 10.1016/j.mric.2008.07.002] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Conventional anatomic MR imaging has evolved to a superior modality in the evaluation of prostate carcinoma and is now a widely established technique in the detection and staging of this disease, aiding in clinical decision making on treatment and therapy evaluation. Recent improvements in functional MR techniques, such as diffusion-weighted MR imaging and dynamic contrast-enhanced MR imaging, have greatly increased the impact of MR imaging in prostate cancer. The combination of T2-weighted imaging, diffusion-weighted MR imaging, and dynamic contrast-enhanced MR imaging may overcome the limitations of conventional T2-weighted MR imaging of the prostate and may be able accurately to detect, localize, stage, and grade prostate carcinoma and guide biopsies.
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Affiliation(s)
- Diederik M Somford
- Department of Urology, Radboud University, Nijmegan Medical Centre, Nijmegen, The Netherlands
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Bonekamp D, Macura KJ. Dynamic contrast-enhanced magnetic resonance imaging in the evaluation of the prostate. Top Magn Reson Imaging 2008; 19:273-284. [PMID: 19512849 DOI: 10.1097/rmr.0b013e3181aacdc2] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is a novel MR technique that allows to interrogate pharmacokinetic processes in the tissues at a voxel level and to generate parametric maps that can be displayed for clinical interpretation. Dynamic contrast-enhanced MRI is an important imaging technique for the imaging of angiogenesis and vasculogenesis because it probes the microvascular networks at a microscopic level by being sensitive to the compartmentalization of tissue into the vascular and extravascular-extracellular space and to the diffusion of contrast molecules across the vascular endothelium and capillary boundaries. Dynamic contrast-enhanced MRI has already shown to improve detection and localization of prostate cancer, to improve prediction of extracapsular extension, determination of tumor volume, and after treatment follow-up. In this article, we outline the fundamental principles of DCE-MRI and describe the application of DCE methods in the imaging of the prostate.
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Affiliation(s)
- David Bonekamp
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD 21287-0750, USA
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Computed tomography imaging in patients with prostate cancer. Prostate Cancer 2008. [DOI: 10.1017/cbo9780511551994.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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An illustration of the potential for mapping MRI/MRS parameters with genetic over-expression profiles in human prostate cancer. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2008; 21:411-21. [PMID: 18752015 DOI: 10.1007/s10334-008-0133-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 01/10/2008] [Revised: 07/24/2008] [Accepted: 07/25/2008] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Magnetic resonance imaging (MRI) and MR spectroscopy can probe a variety of physiological (e.g. blood vessel permeability) and metabolic characteristics of prostate cancer. However, little is known about the changes in gene expression that underlie the spectral and imaging features observed in prostate cancer. Tumor induced changes in vascular permeability and angiogenesis are thought to contribute to patterns of dynamic contrast enhanced (DCE) MRI images of prostate cancer even though the genetic basis of tumor vasculogenesis is complex and the specific mechanisms underlying these DCEMRI features have not yet been determined. MATERIALS AND METHODS In order to identify the changes in gene expression that correspond to MRS and DCEMRI patterns in human prostate cancers, we have utilized tissue print micropeel techniques to generate "whole mount" molecular maps of radical prostatectomy specimens that correspond to pre-surgical MRI/MRS studies. These molecular maps include RNA expression profiles from both Affymetrix GeneChip microarrays and quantitative reverse transcriptase PCR (qrt-PCR) analysis, as well as immunohistochemical studies. RESULTS Using these methods on patients with prostate cancer, we found robust over-expression of choline kinase a in the majority of primary tumors. We also observed overexpression of neuropeptide Y (NPY), a newly identified angiogenic factor, in a subset of prostate cancers, visualized on DCEMRI. CONCLUSION These studies set the stage for establishing MRI/MRS parameters as validated biomarkers for human prostate cancer.
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WIN Z, ARIFF B, HARVEY CJ, RANGI P, ECKERSLEY R, HAWTIN K, BLOMLEY MJK. Comparative study of experiencedvsnon-experienced radiologists in assessing parametric CT images of the response of the prostate gland to radiotherapy. Br J Radiol 2008; 81:572-6. [DOI: 10.1259/bjr/93389975] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Huamani J, Willey C, Thotala D, Niermann KJ, Reyzer M, Leavitt L, Jones C, Fleishcher A, Caprioli R, Hallahan DE, Kim DWN. Differential efficacy of combined therapy with radiation and AEE788 in high and low EGFR-expressing androgen-independent prostate tumor models. Int J Radiat Oncol Biol Phys 2008; 71:237-46. [PMID: 18337021 DOI: 10.1016/j.ijrobp.2007.12.049] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2007] [Revised: 12/16/2007] [Accepted: 12/18/2007] [Indexed: 11/19/2022]
Abstract
PURPOSE To determine the efficacy of combining radiation (XRT) with a dual epidermal growth factor receptor (EGFR)/vascular endothelial growth factor receptor inhibitor, AEE788, in prostate cancer models with different levels of EGFR expression. METHODS AND MATERIALS Immunoblotting was performed for EGFR, phosphorylated-EGFR, and phosphorylated-AKT in prostate cancer cells. Clonogenic assays were performed on DU145, PC-3, and human umbilical vein endothelial cells treated with XRT +/- AEE788. Tumor xenografts were established for DU145 and PC-3 on hind limbs of athymic nude mice assigned to four treatment groups: (1) control, (2) AEE788, (3) XRT, and (4) AEE788 + XRT. Tumor blood flow and growth measurements were performed using immunohistochemistry and imaging. RESULTS AEE788 effectively decreased phosphorylated-EGFR and phosphorylated-AKT levels in DU145 and PC-3 cells. Clonogenic assays showed no radiosensitization for DU145 and PC-3 colonies treated with AEE788 + XRT. However, AEE788 caused decreased proliferation in DU145 cells. AEE788 showed a radiosensitization effect in human umbilical vein endothelial cells and increased apoptosis susceptibility. Concurrent AEE788 + XRT compared with either alone led to significant tumor growth delay in DU145 tumors. Conversely, PC-3 tumors derived no added benefit from combined-modality therapy. In DU145 tumors, a significant decrease in tumor blood flow with combination therapy was shown by using power Doppler sonography and tumor blood vessel destruction on immunohistochemistry. Maldi-spectrometry (MS) imaging showed that AEE788 is bioavailable and heterogeneously distributed in DU145 tumors undergoing therapy. CONCLUSIONS AEE788 + XRT showed efficacy in vitro/in vivo with DU145-based cell models, whereas PC-3-based models were adequately treated with XRT alone without added benefit from combination therapy. These findings correlated with differences in EGFR expression and showed effects on both tumor cell proliferation and vascular destruction.
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Affiliation(s)
- Jessica Huamani
- Radiation Oncology, Vanderbilt University, Nashville, TN, USA
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Hoskin PJ, Carnell DM, Taylor NJ, Smith RE, Stirling JJ, Daley FM, Saunders MI, Bentzen SM, Collins DJ, d'Arcy JA, Padhani AP. Hypoxia in prostate cancer: correlation of BOLD-MRI with pimonidazole immunohistochemistry-initial observations. Int J Radiat Oncol Biol Phys 2007; 68:1065-71. [PMID: 17637389 DOI: 10.1016/j.ijrobp.2007.01.018] [Citation(s) in RCA: 149] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2006] [Revised: 01/06/2007] [Accepted: 01/13/2007] [Indexed: 11/24/2022]
Abstract
PURPOSE To investigate the ability of blood oxygen level-dependent (BOLD) MRI to depict clinically significant prostate tumor hypoxia. METHODS AND MATERIALS Thirty-three patients with prostate carcinoma undergoing radical prostatectomy were studied preoperatively, using gradient echo sequences without and with contrast medium enhancement, to map relative tissue oxygenation according to relaxivity rates and relative blood volume (rBV). Pimonidazole was administered preoperatively, and whole-mount sections of selected tumor-bearing slices were stained for pimonidazole fixation and tumor and nontumor localization. Histologic and imaging parameters were independently mapped onto patient prostate outlines. Using 5-mm grids, 861 nontumor grid locations were compared with 237 tumor grids (with >50% tumor per location) using contingency table analysis with respect to the ability of imaging to predict pimonidazole staining. RESULTS Twenty patients completed the imaging and histologic protocols. Pimonidazole staining was found in 33% of nontumor and in 70% of tumor grids. The sensitivity of the MR relaxivity parameter R(2)* in depicting tumor hypoxia was high (88%), improving with the addition of low rBV information (95%) without changing specificity (36% and 29%, respectively). High R(2)* increased the positive predictive value for hypoxia by 6% (70% to 76%); conversely, low R(2)* decreased the likelihood of hypoxia being present by 26% (70% to 44%) and by 41% (71% to 30%) when combined with rBV information. CONCLUSION R(2)* maps from BOLD-MRI have high sensitivity but low specificity for defining intraprostatic tumor hypoxia. This together with the negative predictive value of 70% when combined with blood volume information makes BOLD-MRI a potential noninvasive technique for mapping prostatic tumor hypoxia.
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Affiliation(s)
- Peter J Hoskin
- Marie Curie Research Wing, Mount Vernon Hospital, Rickmansworth Road, Northwood, Middlesex, UK.
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Current World Literature. Curr Opin Urol 2007; 17:77-81. [PMID: 17143115 DOI: 10.1097/mou.0b013e328012cbca] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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