1
|
Payen T, Crouzet S, Guillen N, Chen Y, Chapelon JY, Lafon C, Catheline S. Passive Elastography for Clinical HIFU Lesion Detection. IEEE TRANSACTIONS ON MEDICAL IMAGING 2024; 43:1594-1604. [PMID: 38109239 DOI: 10.1109/tmi.2023.3344182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
High-intensity Focused Ultrasound (HIFU) is a promising treatment modality for a wide range of pathologies including prostate cancer. However, the lack of a reliable ultrasound-based monitoring technique limits its clinical use. Ultrasound currently provides real-time HIFU planning, but its use for monitoring is usually limited to detecting the backscatter increase resulting from chaotic bubble appearance. HIFU has been shown to generate stiffening in various tissues, so elastography is an interesting lead for ablation monitoring. However, the standard techniques usually require the generation of a controlled push which can be problematic in deeper organs. Passive elastography offers a potential alternative as it uses the physiological wave field to estimate the elasticity in tissues and not an external perturbation. This technique was adapted to process B-mode images acquired with a clinical system. It was first shown to faithfully assess elasticity in calibrated phantoms. The technique was then implemented on the Focal One® clinical system to evaluate its capacity to detect HIFU lesions in vitro (CNR = 9.2 dB) showing its independence regarding the bubbles resulting from HIFU and in vivo where the physiological wave field was successfully used to detect and delineate lesions of different sizes in porcine liver. Finally, the technique was performed for the very first time in four prostate cancer patients showing strong variation in elasticity before and after HIFU treatment (average variation of 33.0 ± 16.0 % ). Passive elastography has shown evidence of its potential to monitor HIFU treatment and thus help spread its use.
Collapse
|
2
|
Odéen H, Hofstetter LW, Payne AH, Guiraud L, Dumont E, Parker DL. Simultaneous proton resonance frequency T 1 - MR shear wave elastography for MR-guided focused ultrasound multiparametric treatment monitoring. Magn Reson Med 2023; 89:2171-2185. [PMID: 36656135 PMCID: PMC10940047 DOI: 10.1002/mrm.29587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 12/21/2022] [Accepted: 12/30/2022] [Indexed: 01/20/2023]
Abstract
PURPOSE To develop an efficient MRI pulse sequence to simultaneously measure multiple parameters that have been shown to correlate with tissue nonviability following thermal therapies. METHODS A 3D segmented EPI pulse sequence was used to simultaneously measure proton resonance frequency shift (PRFS) MR thermometry (MRT), T1 relaxation time, and shear wave velocity induced by focused ultrasound (FUS) push pulses. Experiments were performed in tissue mimicking gelatin phantoms and ex vivo bovine liver. Using a carefully designed FUS triggering scheme, a heating duty cycle of approximately 65% was achieved by interleaving FUS ablation pulses with FUS push pulses to induce shear waves in the tissue. RESULTS In phantom studies, temperature increases measured with PRFS MRT and increases in T1 correlated with decreased shear wave velocity, consistent with material softening with increasing temperature. During ablation in ex vivo liver, temperature increase measured with PRFS MRT initially correlated with increasing T1 and decreasing shear wave velocity, and after tissue coagulation with decreasing T1 and increasing shear wave velocity. This is consistent with a previously described hysteresis in T1 versus PRFS curves and increased tissue stiffness with tissue coagulation. CONCLUSION An efficient approach for simultaneous and dynamic measurements of PRSF, T1 , and shear wave velocity during treatment is presented. This approach holds promise for providing co-registered dynamic measures of multiple parameters, which correlates to tissue nonviability during and following thermal therapies, such as FUS.
Collapse
Affiliation(s)
- Henrik Odéen
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Lorne W. Hofstetter
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Allison H. Payne
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA
| | | | | | - Dennis L. Parker
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA
| |
Collapse
|
3
|
Choi YH, Lee CU, Song W, Chang Jeong B, Seo SI, Jeon SS, Lee HM, Jeon HG, Lee SJ. Combination of multiparametric magnetic resonance imaging and transperineal template-guided mapping prostate biopsy to determine potential candidates for focal therapy. Prostate Int 2022. [DOI: 10.1016/j.prnil.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
|
4
|
Zimmerman BE, Johnson S, Odeen H, Shea J, Foote MD, Winkler N, Joshi SC, Payne A. Learning Multiparametric Biomarkers for Assessing MR-Guided Focused Ultrasound Treatment of Malignant Tumors. IEEE Trans Biomed Eng 2021; 68:1737-1747. [PMID: 32946378 PMCID: PMC7969473 DOI: 10.1109/tbme.2020.3024826] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Noninvasive MR-guided focused ultrasound (MRgFUS) treatments are promising alternatives to the surgical removal of malignant tumors. A significant challenge is assessing the viability of treated tissue during and immediately after MRgFUS procedures. Current clinical assessment uses the nonperfused volume (NPV) biomarker immediately after treatment from contrast-enhanced MRI. The NPV has variable accuracy, and the use of contrast agent prevents continuing MRgFUS treatment if tumor coverage is inadequate. This work presents a novel, noncontrast, learned multiparametric MR biomarker that can be used during treatment for intratreatment assessment, validated in a VX2 rabbit tumor model. A deep convolutional neural network was trained on noncontrast multiparametric MR images using the NPV biomarker from follow-up MR imaging (3-5 days after MRgFUS treatment) as the accurate label of nonviable tissue. A novel volume-conserving registration algorithm yielded a voxel-wise correlation between treatment and follow-up NPV, providing a rigorous validation of the biomarker. The learned noncontrast multiparametric MR biomarker predicted the follow-up NPV with an average DICE coefficient of 0.71, substantially outperforming the current clinical standard (DICE coefficient = 0.53). Noncontrast multiparametric MR imaging integrated with a deep convolutional neural network provides a more accurate prediction of MRgFUS treatment outcome than current contrast-based techniques.
Collapse
|
5
|
Wang X, Geng Y, Han D, Lu M, Li R, Li Y, Zhang Q, Wan M. Viscoelastic characterization of HIFU ablation with shear wave by using K-space analysis combined with model-fitting correction method. ULTRASONICS 2020; 108:106179. [PMID: 32504988 DOI: 10.1016/j.ultras.2020.106179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 05/07/2020] [Accepted: 05/19/2020] [Indexed: 06/11/2023]
Abstract
The viscoelastic properties of tissues can reflect human physiological and pathological conditions. During and after the high-intensity focused ultrasound (HIFU) treatment, measuring the viscoelasticity of HIFU ablated tissue is important for therapy evaluation. Two-dimensional Fourier transform (2DFT) method has been reported to quantify elasticity and viscosity. However, a deviation is induced by under-sampling in practical application. This work proposes an approach based on the convolution theorem and model fitting to solve the finite spatial data problem. A model using the convolution theorem was constructed, and mean-square error (MSE) was calculated to determine the optimal fitting between the model and experimental data. For validation, HIFU therapeutic experiments were conducted in polyacrylamide-bovine serum (BAS) transparent tissue-mimicking phantoms. This approach was used to quantify the viscoelasticity of HIFU ablation and untreated phantoms. Acoustic-radiation-force (ARF) shear wave was generated by the same HIFU therapeutic transducer, and laser Doppler vibrometer (LDV) was used for the high-resolution measurement of shear wave signals. Results suggest that the shear elasticity and viscosity of untreated phantoms are generally smaller than those of HIFU ablation. Thus, the proposed method may be helpful for HIFU treatment monitoring.
Collapse
Affiliation(s)
- Xuan Wang
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi'an 710049, China
| | - Yizhe Geng
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi'an 710049, China
| | - Dan Han
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi'an 710049, China
| | - Mingzhu Lu
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi'an 710049, China.
| | - Ruixin Li
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi'an 710049, China
| | - Yujiao Li
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi'an 710049, China
| | - Quan Zhang
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi'an 710049, China
| | - Mingxi Wan
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi'an 710049, China
| |
Collapse
|
6
|
Abstract
Prostate cancer is the fifth leading cause of death worldwide. A variety of treatment options is available for localized prostate cancer and may range from active surveillance to focal therapy or whole gland treatment, that is, surgery or radiotherapy. Serum prostate-specific antigen levels are an important tool to monitor treatment success after whole gland treatment, unfortunately prostate-specific antigen is unreliable after focal therapy. Multiparametric magnetic resonance imaging of the prostate is rapidly gaining field in the management of prostate cancer and may play a crucial role in the evaluation of recurrent prostate cancer. This article will focus on postprocedural magnetic resonance imaging after different forms of local therapy in patients with prostate cancer.
Collapse
|
7
|
Wang Y, Wang Q, Luo Y, Jiang L, Zeng Z, Gan L, Chen J, Han H, Zou J. Comparative Study of Pulsed Versus Continuous High-Intensity Focused Ultrasound Ablation Using In Vitro and In Vivo Models. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:259-271. [PMID: 31339599 DOI: 10.1002/jum.15098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 06/26/2019] [Accepted: 07/01/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To compare the efficacy of pulsed high-intensity focused ultrasound (PHIFU) versus continuous high-intensity focused ultrasound (CHIFU) ablation at identical doses. METHODS Continuous and pulsed HIFU (1200 J) at duty cycles (DCs) of 60% and 20% were examined for their capacity to ablate bovine liver tissue in vitro and rabbit liver tissue in vivo. After ablation, grayscale changes and pathologic characteristics were observed or measured, and the tissue necrosis volume, energy efficiency factor, and average grayscale density were calculated. RESULTS The pulsed mode generated greater liquefaction necrosis. An inconspicuous grayscale change was observed for PHIFU at a DC of 20% in some samples, which appeared as an elliptical cavity. The energy efficiency factor of PHIFU at a DC of 60% was significantly lower than that of CHIFU, as observed both in vitro and in vivo (P < .05). The grayscale value and average grayscale density in response to CHIFU were significantly greater than those in response to PHIFU (60% or 20%; P < .05). Histopathologic analysis revealed liquefaction necrosis in all PHIFU groups. CONCLUSIONS At identical doses, compared with CHIFU, a single session of PHIFU can generate liquefaction necrosis and at a higher DC can improve ablation efficiency. This increased efficacy of PHIFU may involve enhancement of tissue destruction by cavitation effects and a reduction in the obstruction effect of endogenous microbubbles through cavitation effects or a more effective diffusion of heat.
Collapse
Affiliation(s)
- Yanhao Wang
- State Key Laboratory of Ultrasound Engineering in Medicine Co-founded by Chongqing and the Ministry of Science and Technology, Chongqing Collaborative Innovation Center for Minimally Invasive and Noninvasive Medicine, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China
- College of Stomatology, Chongqing Medical University, Chongqing, 401147, China
| | - Qi Wang
- State Key Laboratory of Ultrasound Engineering in Medicine Co-founded by Chongqing and the Ministry of Science and Technology, Chongqing Collaborative Innovation Center for Minimally Invasive and Noninvasive Medicine, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China
| | - Yong Luo
- State Key Laboratory of Ultrasound Engineering in Medicine Co-founded by Chongqing and the Ministry of Science and Technology, Chongqing Collaborative Innovation Center for Minimally Invasive and Noninvasive Medicine, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China
| | - Lu Jiang
- State Key Laboratory of Ultrasound Engineering in Medicine Co-founded by Chongqing and the Ministry of Science and Technology, Chongqing Collaborative Innovation Center for Minimally Invasive and Noninvasive Medicine, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China
| | - Zihuan Zeng
- State Key Laboratory of Ultrasound Engineering in Medicine Co-founded by Chongqing and the Ministry of Science and Technology, Chongqing Collaborative Innovation Center for Minimally Invasive and Noninvasive Medicine, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China
| | - Lidan Gan
- State Key Laboratory of Ultrasound Engineering in Medicine Co-founded by Chongqing and the Ministry of Science and Technology, Chongqing Collaborative Innovation Center for Minimally Invasive and Noninvasive Medicine, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China
| | - Jianli Chen
- State Key Laboratory of Ultrasound Engineering in Medicine Co-founded by Chongqing and the Ministry of Science and Technology, Chongqing Collaborative Innovation Center for Minimally Invasive and Noninvasive Medicine, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China
| | - Hongfei Han
- State Key Laboratory of Ultrasound Engineering in Medicine Co-founded by Chongqing and the Ministry of Science and Technology, Chongqing Collaborative Innovation Center for Minimally Invasive and Noninvasive Medicine, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China
| | - Jianzhong Zou
- State Key Laboratory of Ultrasound Engineering in Medicine Co-founded by Chongqing and the Ministry of Science and Technology, Chongqing Collaborative Innovation Center for Minimally Invasive and Noninvasive Medicine, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China
| |
Collapse
|
8
|
Liu Z, Ren F, Zhang H, Yuan Q, Jiang Z, Liu H, Sun Q, Li Z. Boosting often overlooked long wavelength emissions of rare-earth nanoparticles for NIR-II fluorescence imaging of orthotopic glioblastoma. Biomaterials 2019; 219:119364. [PMID: 31352311 DOI: 10.1016/j.biomaterials.2019.119364] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 07/13/2019] [Accepted: 07/14/2019] [Indexed: 01/06/2023]
Abstract
Rare-earth nanoparticles (RE NPs) with narrow long wavelength emissions have been recently investigated for their potential application for fluorescence imaging in the second near-infrared window (NIR-II). Previously these RE NPs have a very limited application in the diagnosis and treatment of deep-seated tumors such as brain tumors, due to their weak fluorescence in the range of 1300-1700 nm. Herein, we report a significant enhancement of more than 10 times regular emission of NaNdF4 nanoparticles at 1340 nm wavelength by coating them with an inert layer of NaLuF4, followed by sensitizing with a near-infrared dye (IR-808). We deliver these highly bright nanoparticles into the brain by using focused ultrasound to temporarily open the blood-brain barrier (BBB), and then detect the orthotopic glioblastoma by fluorescence imaging at 1340 nm. The images obtained from long wavelength fluorescence (i.e. 1340 nm) exhibited better resolution and contrast compared to the short wavelength fluorescence (i.e. 1060 nm). Our study not only provides insights for enhancing often overlooked emissions of rare-earth nanoparticles for NIR-II fluorescence imaging of deep-seated tumors, but also demonstrates great potential of focused ultrasound based technology in delivering nanotheranostic agents.
Collapse
Affiliation(s)
- Zheng Liu
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou, 215123, PR China
| | - Feng Ren
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou, 215123, PR China
| | - Hao Zhang
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou, 215123, PR China
| | - Qiang Yuan
- The Second Affiliated Hospital of Soochow University, Suzhou, 215004, PR China
| | - Zhilin Jiang
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou, 215123, PR China
| | - Hanghang Liu
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou, 215123, PR China
| | - Qiao Sun
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou, 215123, PR China
| | - Zhen Li
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou, 215123, PR China.
| |
Collapse
|
9
|
Zhang L, Armstrong T, Li X, Wu HH. A variable flip angle golden-angle-ordered 3D stack-of-radial MRI technique for simultaneous proton resonant frequency shift and T 1 -based thermometry. Magn Reson Med 2019; 82:2062-2076. [PMID: 31257639 DOI: 10.1002/mrm.27883] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/02/2019] [Accepted: 06/07/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE To develop and evaluate a variable-flip-angle golden-angle-ordered 3D stack-of-radial MRI technique for simultaneous proton resonance frequency shift (PRF) and T1 -based thermometry in aqueous and adipose tissues, respectively. METHODS The proposed technique acquires multiecho radial k-space data in segments with alternating flip angles to measure 3D temperature maps dynamically on the basis of PRF and T1 . A sliding-window k-space weighted image contrast filter is used to increase temporal resolution. PRF is measured in aqueous tissues and T1 in adipose tissues using fat/water masks. The accuracy for T1 quantification was evaluated in a reference T1 /T2 phantom. In vivo nonheating experiments were conducted in healthy subjects to evaluate the stability of PRF and T1 in the brain, prostate, and breast. The proposed technique was used to monitor high-intensity focused ultrasound (HIFU) ablation in ex vivo porcine fat/muscle tissues and compared to temperature probe readings. RESULTS The proposed technique achieved 3D coverage with 1.1-mm to 1.3-mm in-plane resolution and 2-s to 5-s temporal resolution. During 20 to 30 min of nonheating in vivo scans, the temporal coefficient of variation for T1 was <5% in the brain, prostate, and breast fatty tissues, while the standard deviation of relative PRF temperature change was within 3°C in aqueous tissues. During ex vivo HIFU ablation, the temperatures measured by PRF and T1 were consistent with temperature probe readings, with an absolute mean difference within 2°C. CONCLUSION The proposed technique achieves simultaneous PRF and T1 -based dynamic 3D MR temperature mapping in aqueous and adipose tissues. It may be used to improve MRI-guided thermal procedures.
Collapse
Affiliation(s)
- Le Zhang
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Tess Armstrong
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.,Physics in Biology and Medicine Interdepartmental Graduate Program, University of California Los Angeles, Los Angeles, California
| | - Xinzhou Li
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.,Department of Bioengineering, University of California Los Angeles, Los Angeles, California
| | - Holden H Wu
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.,Physics in Biology and Medicine Interdepartmental Graduate Program, University of California Los Angeles, Los Angeles, California.,Department of Bioengineering, University of California Los Angeles, Los Angeles, California
| |
Collapse
|
10
|
Orczyk C, Rosenkrantz AB, Mikheev A, Villers A, Bernaudin M, Taneja SS, Valable S, Rusinek H. 3D Registration of mpMRI for Assessment of Prostate Cancer Focal Therapy. Acad Radiol 2017; 24:1544-1555. [PMID: 29122471 PMCID: PMC6025844 DOI: 10.1016/j.acra.2017.06.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 05/25/2017] [Accepted: 06/09/2017] [Indexed: 01/16/2023]
Abstract
RATIONALE AND OBJECTIVES This study aimed to assess a novel method of three-dimensional (3D) co-registration of prostate magnetic resonance imaging (MRI) examinations performed before and after prostate cancer focal therapy. MATERIALS AND METHODS We developed a software platform for automatic 3D deformable co-registration of prostate MRI at different time points and applied this method to 10 patients who underwent focal ablative therapy. MRI examinations were performed preoperatively, as well as 1 week and 6 months post treatment. Rigid registration served as reference for assessing co-registration accuracy and precision. RESULTS Segmentation of preoperative and postoperative prostate revealed a significant postoperative volume decrease of the gland that averaged 6.49 cc (P = .017). Applying deformable transformation based on mutual information from 120 pairs of MRI slices, we refined by 2.9 mm (max. 6.25 mm) the alignment of the ablation zone, segmented from contrast-enhanced images on the 1-week postoperative examination, to the 6-month postoperative T2-weighted images. This represented a 500% improvement over the rigid approach (P = .001), corrected by volume. The dissimilarity by Dice index of the mapped ablation zone using deformable transformation vs rigid control was significantly (P = .04) higher at the ablation site than in the whole gland. CONCLUSIONS Our findings illustrate our method's ability to correct for deformation at the ablation site. The preliminary analysis suggests that deformable transformation computed from mutual information of preoperative and follow-up MRI is accurate in co-registration of MRI examinations performed before and after focal therapy. The ability to localize the previously ablated tissue in 3D space may improve targeting for image-guided follow-up biopsy within focal therapy protocols.
Collapse
Affiliation(s)
- Clément Orczyk
- The Prostate Unit, Department of Urology, University College London Hospitals, London, United Kingdom; Division of Urologic Oncology, Department of Urology, New York University Langone Medical Center, New York, NY; Normandie Université, UNICAEN, CEA, CNRS, ISTCT/CERVOxy Group, 14000Caen, France; Department of Urology, University Hospital of Caen, Caen, France.
| | - Andrew B Rosenkrantz
- Department of Radiology, New York University Langone Medical Center, New York, NY
| | - Artem Mikheev
- Department of Radiology, New York University Langone Medical Center, New York, NY
| | - Arnauld Villers
- Department of Urology, Université Lille Nord de France, Lille, France
| | - Myriam Bernaudin
- Normandie Université, UNICAEN, CEA, CNRS, ISTCT/CERVOxy Group, 14000Caen, France
| | - Samir S Taneja
- Division of Urologic Oncology, Department of Urology, New York University Langone Medical Center, New York, NY; Department of Radiology, New York University Langone Medical Center, New York, NY
| | - Samuel Valable
- Normandie Université, UNICAEN, CEA, CNRS, ISTCT/CERVOxy Group, 14000Caen, France
| | - Henry Rusinek
- Department of Radiology, New York University Langone Medical Center, New York, NY
| |
Collapse
|
11
|
Jadvar H. Multimodal Imaging in Focal Therapy Planning and Assessment in Primary Prostate Cancer. Clin Transl Imaging 2017; 5:199-208. [PMID: 28713796 DOI: 10.1007/s40336-017-0228-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE There is increasing interest in focal therapy (male lumpectomy) of localized low-intermediate risk prostate cancer. Focal therapy is typically associated with low morbidity and provides the possibility of retreatment. Imaging is pivotal in stratification of men with localized prostate cancer for active surveillance, focal therapy or radical intervention. This article provides a concise review of focal therapy and the evolving role of imaging in this clinical setting. METHODS We performed a narrative and critical literature review by searching PubMed/Medline database from January 1997 to January 2017 for articles in the English language and the use of search keywords "focal therapy", "prostate cancer", and "imaging". RESULTS Most imaging studies are based on multiparametric magnetic resonance imaging. Transrectal ultrasound is inadequate independently but multiparametric ultrasound may provide new prospects. Positron emission tomography with radiotracers targeted to various underlying tumor biological features may provide unprecedented new opportunities. Multimodal Imaging appears most useful in localization of intraprostatic dominant index lesions amenable to focal therapy, in early assessment of therapeutic efficacy and potential need for additional focal treatments or transition to whole-gland therapy, and in predicting short-term and long-term outcomes. CONCLUSION Multimodal imaging is anticipated to play an increasing role in the focal therapy planning and assessment of low-intermediate risk prostate cancer and thereby moving this form of treatment option forward in the clinic.
Collapse
Affiliation(s)
- Hossein Jadvar
- Division of Nuclear Medicine, Department of Radiology, University of Southern California, Los Angeles, California, USA
| |
Collapse
|
12
|
Moldovan P, Udrescu C, Ravier E, Souchon R, Rabilloud M, Bratan F, Sanzalone T, Cros F, Crouzet S, Gelet A, Chapet O, Rouvière O. Accuracy of Elastic Fusion of Prostate Magnetic Resonance and Transrectal Ultrasound Images under Routine Conditions: A Prospective Multi-Operator Study. PLoS One 2016; 11:e0169120. [PMID: 28033423 PMCID: PMC5199076 DOI: 10.1371/journal.pone.0169120] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 12/12/2016] [Indexed: 12/27/2022] Open
Abstract
Purpose To evaluate in unselected patients imaged under routine conditions the co-registration accuracy of elastic fusion between magnetic resonance (MR) and ultrasound (US) images obtained by the Koelis Urostation™. Materials and Methods We prospectively included 15 consecutive patients referred for placement of intraprostatic fiducials before radiotherapy and who gave written informed consent by signing the Institutional Review Board-approved forms. Three fiducials were placed in the prostate under US guidance in standardized positions (right apex, left mid-gland, right base) using the Koelis Urostation™. Patients then underwent prostate MR imaging. Four operators outlined the prostate on MR and US images and an elastic fusion was retrospectively performed. Fiducials were used to measure the overall target registration error (TRE3D), the error along the antero-posterior (TREAP), right-left (TRERL) and head-feet (TREHF) directions, and within the plane orthogonal to the virtual biopsy track (TRE2D). Results Median TRE3D and TRE2D were 3.8–5.6 mm, and 2.5–3.6 mm, respectively. TRE3D was significantly influenced by the operator (p = 0.013), fiducial location (p = 0.001) and 3D axis orientation (p<0.0001). The worst results were obtained by the least experienced operator. TRE3D was smaller in mid-gland and base than in apex (average difference: -1.21 mm (95% confidence interval (95%CI): -2.03; -0.4) and -1.56 mm (95%CI: -2.44; -0.69) respectively). TREAP and TREHF were larger than TRERL (average difference: +1.29 mm (95%CI: +0.87; +1.71) and +0.59 mm (95%CI: +0.1; +0.95) respectively). Conclusions Registration error values were reasonable for clinical practice. The co-registration accuracy was significantly influenced by the operator’s experience, and significantly poorer in the antero-posterior direction and at the apex.
Collapse
Affiliation(s)
- Paul Moldovan
- Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, Lyon, France
| | - Corina Udrescu
- Hospices Civils de Lyon, Department of Radiation Oncology, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France
| | - Emmanuel Ravier
- Hospices Civils de Lyon, Department of Urology, Hôpital Edouard Herriot, Lyon, France
| | | | - Muriel Rabilloud
- Hospices Civils de Lyon, Service de Biostatistique et Bioinformatique, Lyon, France
- Université de Lyon, Lyon, France
- CNRS, UMR5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Villeurbanne, France
| | - Flavie Bratan
- Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, Lyon, France
| | - Thomas Sanzalone
- Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, Lyon, France
| | - Fanny Cros
- Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, Lyon, France
| | - Sébastien Crouzet
- Hospices Civils de Lyon, Department of Urology, Hôpital Edouard Herriot, Lyon, France
- Inserm, U1032, LabTau, Lyon, France
- Université de Lyon, Lyon, France
| | - Albert Gelet
- Hospices Civils de Lyon, Department of Urology, Hôpital Edouard Herriot, Lyon, France
- Inserm, U1032, LabTau, Lyon, France
- Université de Lyon, Lyon, France
| | - Olivier Chapet
- Hospices Civils de Lyon, Department of Radiation Oncology, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France
| | - Olivier Rouvière
- Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, Lyon, France
- Inserm, U1032, LabTau, Lyon, France
- Université de Lyon, Lyon, France
- * E-mail:
| |
Collapse
|
13
|
Prostate Focused Ultrasound Therapy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 880:21-41. [PMID: 26486330 DOI: 10.1007/978-3-319-22536-4_2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
|
14
|
Jacobs I, Hectors SJCG, Schabel MC, Grüll H, Strijkers GJ, Nicolay K. Cluster analysis of DCE-MRI data identifies regional tracer-kinetic changes after tumor treatment with high intensity focused ultrasound. NMR IN BIOMEDICINE 2015; 28:1443-1454. [PMID: 26390040 DOI: 10.1002/nbm.3406] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 07/27/2015] [Accepted: 08/14/2015] [Indexed: 06/05/2023]
Abstract
Evaluation of high intensity focused ultrasound (HIFU) treatment with MRI is generally based on assessment of the non-perfused volume from contrast-enhanced T1-weighted images. However, the vascular status of tissue surrounding the non-perfused volume has not been extensively investigated with MRI. In this study, cluster analysis of the transfer constant K(trans) and extravascular extracellular volume fraction ve , derived from dynamic contrast-enhanced MRI (DCE-MRI) data, was performed in tumor tissue surrounding the non-perfused volume to identify tumor subregions with distinct contrast agent uptake kinetics. DCE-MRI was performed in CT26.WT colon carcinoma-bearing BALB/c mice before (n = 12), directly after (n = 12) and 3 days after (n = 6) partial tumor treatment with HIFU. In addition, a non-treated control group (n = 6) was included. The non-perfused volume was identified based on the level of contrast enhancement. Quantitative comparison between non-perfused tumor fractions and non-viable tumor fractions derived from NADH-diaphorase histology showed a stronger agreement between these fractions 3 days after treatment (R(2) to line of identity = 0.91) compared with directly after treatment (R(2) = 0.74). Next, k-means clustering with four clusters was applied to K(trans) and ve parameter values of all significantly enhanced pixels. The fraction of pixels within two clusters, characterized by a low K(trans) and either a low or high ve , significantly increased after HIFU. Changes in composition of these clusters were considered to be HIFU induced. Qualitative H&E histology showed that HIFU-induced alterations in these clusters may be associated with hemorrhage and structural tissue disruption. Combined microvasculature and hypoxia staining suggested that these tissue changes may affect blood vessel functionality and thereby tumor oxygenation. In conclusion, it was demonstrated that, in addition to assessment of the non-perfused tumor volume, the presented methodology gives further insight into HIFU-induced effects on tumor vascular status. This method may aid in assessment of the consequences of vascular alterations for the fate of the tissue.
Collapse
Affiliation(s)
- Igor Jacobs
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Stefanie J C G Hectors
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Matthias C Schabel
- Imaging Research Center, Oregon Health and Science University, Portland, OR, USA
- Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, UT, USA
| | - Holger Grüll
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Oncology solutions, Philips Research, Eindhoven, The Netherlands
| | - Gustav J Strijkers
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Klaas Nicolay
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| |
Collapse
|
15
|
Hectors SJCG, Jacobs I, Moonen CTW, Strijkers GJ, Nicolay K. MRI methods for the evaluation of high intensity focused ultrasound tumor treatment: Current status and future needs. Magn Reson Med 2015; 75:302-17. [PMID: 26096859 DOI: 10.1002/mrm.25758] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 03/14/2015] [Accepted: 04/10/2015] [Indexed: 01/17/2023]
Abstract
Thermal ablation with high intensity focused ultrasound (HIFU) is an emerging noninvasive technique for the treatment of solid tumors. HIFU treatment of malignant tumors requires accurate treatment planning, monitoring and evaluation, which can be facilitated by performing the procedure in an MR-guided HIFU system. The MR-based evaluation of HIFU treatment is most often restricted to contrast-enhanced T1 -weighted imaging, while it has been shown that the non-perfused volume may not reflect the extent of nonviable tumor tissue after HIFU treatment. There are multiple studies in which more advanced MRI methods were assessed for their suitability for the evaluation of HIFU treatment. While several of these methods seem promising regarding their sensitivity to HIFU-induced tissue changes, there is still ample room for improvement of MRI protocols for HIFU treatment evaluation. In this review article, we describe the major acute and delayed effects of HIFU treatment. For each effect, the MRI methods that have been-or could be-used to detect the associated tissue changes are described. In addition, the potential value of multiparametric MRI for the evaluation of HIFU treatment is discussed. The review ends with a discussion on future directions for the MRI-based evaluation of HIFU treatment.
Collapse
Affiliation(s)
- Stefanie J C G Hectors
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Department of Radiology, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Igor Jacobs
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Chrit T W Moonen
- Imaging Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gustav J Strijkers
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Klaas Nicolay
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| |
Collapse
|
16
|
Bratan F, Melodelima C, Souchon R, Hoang Dinh A, Mège-Lechevallier F, Crouzet S, Colombel M, Gelet A, Rouvière O. How accurate is multiparametric MR imaging in evaluation of prostate cancer volume? Radiology 2014; 275:144-54. [PMID: 25423145 DOI: 10.1148/radiol.14140524] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To assess the factors influencing multiparametric (MP) magnetic resonance (MR) imaging accuracy in estimating prostate cancer histologic volume (Vh). MATERIALS AND METHODS A prospective database of 202 patients who underwent MP MR imaging before radical prostatectomy was retrospectively used. Institutional review board approval and informed consent were obtained. Two independent radiologists delineated areas suspicious for cancer on images (T2-weighted, diffusion-weighted, dynamic contrast material-enhanced [DCE] pulse sequences) and scored their degree of suspicion of malignancy by using a five-level Likert score. One pathologist delineated cancers on whole-mount prostatectomy sections and calculated their volume by using digitized planimetry. Volumes of MR true-positive lesions were measured on T2-weighted images (VT2), on ADC maps (VADC), and on DCE images [VDCE]). VT2, VADC, VDCE and the greatest volume determined on images from any of the individual MR pulse sequences (Vmax) were compared with Vh (Bland-Altman analysis). Factors influencing MP MR imaging accuracy, or A, calculated as A = Vmax/Vh, were evaluated using generalized linear mixed models. RESULTS For both readers, Vh was significantly underestimated with VT2 (P < .0001, both), VADC (P < .0001, both), and VDCE (P = .02 and P = .003, readers 1 and 2, respectively), but not with Vmax (P = .13 and P = .21, readers 1 and 2, respectively). Mean, 25th percentile, and 75th percentile, respectively, for Vmax accuracy were 0.92, 0.54, and 1.85 for reader 1 and 0.95, 0.57, and 1.77 for reader 2. At generalized linear mixed (multivariate) analysis, tumor Likert score (P < .0001), Gleason score (P = .009), and Vh (P < .0001) significantly influenced Vmax accuracy (both readers). This accuracy was good in tumors with a Gleason score of 7 or higher or a Likert score of 5, with a tendency toward underestimation of Vh; accuracy was poor in small (<0.5 cc) or low-grade (Gleason score ≤6) tumors, with a tendency toward overestimation of Vh. CONCLUSION Vh can be estimated by using Vmax in aggressive tumors or in tumors with high Likert scores.
Collapse
Affiliation(s)
- Flavie Bratan
- From the Departments of Urinary and Vascular Radiology (F.B., O.R.), Pathology (F.M.), and Urology (S.C., M.C., A.G.), Hospices Civils de Lyon, Hôpital Edouard Herriot, 5 place d'Arsonval, 69437 Lyon Cedex 03, France; Université de Lyon, Lyon, France (F.B., S.C., M.C., O.R.); Université Lyon 1, Faculté de Médecine Lyon Est, Lyon, France (F.B., S.C., M.C., O.R.); Inserm, U1032, LabTau, Lyon, France (F.B., R.S., A.H.D., S.C., A.G., O.R.); Laboratoire d'Ecologie Alpine, Université Joseph Fourier, Grenoble, France (C.M.); and CNRS, UMR 5553, Grenoble, France (C.M.)
| | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Tumor boundary detection in ultrasound imagery using multi-scale generalized gradient vector flow. J Med Ultrason (2001) 2014; 42:25-38. [DOI: 10.1007/s10396-014-0559-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 06/18/2014] [Indexed: 01/29/2023]
|
18
|
Vaché T, Bratan F, Mège-Lechevallier F, Roche S, Rabilloud M, Rouvière O. Characterization of prostate lesions as benign or malignant at multiparametric MR imaging: comparison of three scoring systems in patients treated with radical prostatectomy. Radiology 2014; 272:446-55. [PMID: 24937690 DOI: 10.1148/radiol.14131584] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE To compare the subjective Likert score to the Prostate Imaging Reporting and Data System (PIRADS) and morphology-location-signal intensity (MLS) scores for categorization of prostate lesions as benign or malignant at multiparametric magnetic resonance (MR) imaging. MATERIALS AND METHODS Two hundred fifteen patients who underwent T2-weighted, diffusion-weighted, and dynamic contrast material-enhanced multiparametric MR imaging of the prostate before radical prostatectomy were included in a prospective database after they signed the institutional review board-approved forms. Senior readers 1 and 2 prospectively noted the location, shape, and signal intensity of lesions on MR images from individual pulse sequences and scored each for likelihood of malignancy by using a Likert scale (range, 1-5). A junior reader (reader 3) retrospectively reviewed the database and did the same analysis. The MLS score (range, 1-13) was computed by using the readers' descriptions of the lesions. Then, the three readers again scored the lesions they described by using the PIRADS score (range, 3-15). MLS and PIRADS scores were compared with the Likert score by using their areas under the receiver operating characteristic curves. RESULTS Areas under the receiver operating characteristic curves of the Likert, MLS, and PIRADS scores were 0.81, 0.77 (P = .03), and 0.75 (P = .01) for reader 1; 0.88, 0.74 (P < .0001), and 0.76 (P < .0001) for reader 2; and 0.81, 0.78 (P = .23), and 0.75 (P = .01) for reader 3. For diagnosing cancers with Gleason scores greater than or equal to 7, the Likert score was significantly more accurate than the others, except for the MLS score for reader 3. Weighted κ values were 0.470-0.524, 0.405-0.430, and 0.378-0.441 for the Likert, MLS, and PIRADS scores, respectively. CONCLUSION The Likert score allowed significantly more accurate categorization of prostate lesions on MR images than did the MLS and PIRADS scores.
Collapse
Affiliation(s)
- Tiphaine Vaché
- From the Departments of Urinary and Vascular Radiology (T.V., F.B., O.R.) and Pathology (F.M.L.), Hospices Civils de Lyon, Hôpital Edouard Herriot, 5 place d'Arsonval, 69437 Lyon Cedex 03-France; Université de Lyon, Lyon, France; Université Lyon 1, Faculté de Médecine Lyon Est, Lyon, France (F.B., O.R.); Inserm, U1032, LabTau, Lyon, France; Université de Lyon, Lyon, France; Université Lyon 1, France (F.B., O.R.); Department of Biostatistics, Hospices Civils de Lyon, Lyon, France; Université de Lyon, Lyon, France; Université Lyon 1; CNRS, UMR5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biotatistique-Santé, Villeurbanne, France (S.R., M.R.)
| | | | | | | | | | | |
Collapse
|
19
|
Hectors SJCG, Jacobs I, Strijkers GJ, Nicolay K. Multiparametric MRI analysis for the identification of high intensity focused ultrasound-treated tumor tissue. PLoS One 2014; 9:e99936. [PMID: 24927280 PMCID: PMC4057317 DOI: 10.1371/journal.pone.0099936] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 05/20/2014] [Indexed: 11/23/2022] Open
Abstract
Purpose In this study endogenous magnetic resonance imaging (MRI) biomarkers for accurate segmentation of High Intensity Focused Ultrasound (HIFU)-treated tumor tissue and residual or recurring non-treated tumor tissue were identified. Methods Multiparametric MRI, consisting of quantitative T1, T2, Apparent Diffusion Coefficient (ADC) and Magnetization Transfer Ratio (MTR) mapping, was performed in tumor-bearing mice before (n = 14), 1 h after (n = 14) and 72 h (n = 7) after HIFU treatment. A non-treated control group was included (n = 7). Cluster analysis using the Iterative Self Organizing Data Analysis (ISODATA) technique was performed on subsets of MRI parameters (feature vectors). The clusters resulting from the ISODATA segmentation were divided into a viable and non-viable class based on the fraction of pixels assigned to the clusters at the different experimental time points. ISODATA-derived non-viable tumor fractions were quantitatively compared to histology-derived non-viable tumor volume fractions. Results The highest agreement between the ISODATA-derived and histology-derived non-viable tumor fractions was observed for feature vector {T1, T2, ADC}. R1 (1/T1), R2 (1/T2), ADC and MTR each were significantly increased in the ISODATA-defined non-viable tumor tissue at 1 h after HIFU treatment compared to viable, non-treated tumor tissue. R1, ADC and MTR were also significantly increased at 72 h after HIFU. Conclusions This study demonstrates that non-viable, HIFU-treated tumor tissue can be distinguished from viable, non-treated tumor tissue using multiparametric MRI analysis. Clinical application of the presented methodology may allow for automated, accurate and objective evaluation of HIFU treatment.
Collapse
Affiliation(s)
- Stefanie J. C. G. Hectors
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Center for Imaging Research and Education (CIRE), Eindhoven, The Netherlands
- * E-mail:
| | - Igor Jacobs
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Center for Imaging Research and Education (CIRE), Eindhoven, The Netherlands
| | - Gustav J. Strijkers
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Center for Imaging Research and Education (CIRE), Eindhoven, The Netherlands
- Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Klaas Nicolay
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Center for Imaging Research and Education (CIRE), Eindhoven, The Netherlands
| |
Collapse
|
20
|
|
21
|
Niaf E, Lartizien C, Bratan F, Roche L, Rabilloud M, Mège-Lechevallier F, Rouvière O. Prostate focal peripheral zone lesions: characterization at multiparametric MR imaging--influence of a computer-aided diagnosis system. Radiology 2014; 271:761-9. [PMID: 24592959 DOI: 10.1148/radiol.14130448] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To assess the impact of a computer-aided diagnosis (CAD) system in the characterization of focal prostate lesions at multiparametric magnetic resonance (MR) imaging. MATERIALS AND METHODS Formal institutional review board approval was not required. Thirty consecutive 1.5-T multiparametric MR imaging studies (with T2-weighted, diffusion-weighted, and dynamic contrast material-enhanced imaging) obtained before radical prostatectomy in patients between September 2008 and February 2010 were reviewed. Twelve readers assessed the likelihood of malignancy of 88 predefined peripheral zone lesions by using a five-level (level, 0-4) subjective score (SS) in reading session 1. This was repeated 5 weeks later in reading session 2. The CAD results were then disclosed, and in reading session 3, the readers could amend the scores assigned during reading session 2. Diagnostic accuracy was assessed by using a receiver operating characteristic (ROC) regression model and was quantified with the area under the ROC curve (AUC). RESULTS Mean AUCs were significantly lower for less experienced (<1 year) readers (P < .02 for all sessions). Seven readers improved their performance between reading sessions 1 and 2, and 12 readers improved their performance between sessions 2 and 3. The mean AUCs for reading session 1 (83.0%; 95% confidence interval [CI]: 77.9%, 88.0%) and reading session 2 (84.1%; 95% CI: 78.1%, 88.7%) were not significantly different (P = .76). Although the mean AUC for reading session 3 (87.2%; 95% CI: 81.0%, 92.0%) was higher than that for session 2, the difference was not significant (P = .08). For an SS positivity threshold of 3, the specificity of reading session 2 (79.0%; 95% CI: 71.1%, 86.4%) was not significantly different from that of session 1 (78.7%; 95% CI: 70.5%, 86.8%) but was significantly lower than that of session 3 (86.2%; 95% CI: 77.1%, 93.1%; P < .03). The sensitivity of reading session 2 (68.4%; 95% CI: 57.5%, 77.7%) was significantly higher than that of session 1 (64.0%; 95% CI: 52.9%, 73.9%; P = .003) but was not significantly different from that of session 3 (71.4%; 95% CI: 58.3%, 82.7%). CONCLUSION A CAD system may improve the characterization of prostate lesions at multiparametric MR imaging by increasing reading specificity.
Collapse
Affiliation(s)
- Emilie Niaf
- From Inserm, U1032, LabTau, Lyon, F-69003, France; Université de Lyon, Lyon, F-69003, France; Université Lyon 1, Lyon, F-69003, France (E.N., F.B., O.R.); Université de Lyon, CREATIS; CNRS UMR5220; Inserm U1044; INSA-Lyon; Université Lyon 1, France (E.N., C.L.); Hospices Civils de Lyon, Department of Urinary and Vascular Radiology (F.B., O.R.) and Department of Pathology (F.M.), Hôpital Edouard Herriot, Lyon, F-69437, France; Hospices Civils de Lyon, Department of Biostatistics, F-69003, Lyon, France; Université de Lyon, F-69000, Lyon; Université Lyon 1; CNRS, UMR5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biotatistique-Santé, F-69622, Villeurbanne, France (L.R., M.R.); and Université de Lyon, Lyon, F-69003, France; Université Lyon 1, Faculté de Médecine Lyon Est, Lyon, F-69003, France (O.R.)
| | | | | | | | | | | | | |
Collapse
|
22
|
Habchi H, Bratan F, Paye A, Pagnoux G, Sanzalone T, Mège-Lechevallier F, Crouzet S, Colombel M, Rabilloud M, Rouvière O. Value of prostate multiparametric magnetic resonance imaging for predicting biopsy results in first or repeat biopsy. Clin Radiol 2014; 69:e120-8. [DOI: 10.1016/j.crad.2013.10.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 10/13/2013] [Accepted: 10/30/2013] [Indexed: 12/31/2022]
|
23
|
van den Bos W, Muller BG, Ahmed H, Bangma CH, Barret E, Crouzet S, Eggener SE, Gill IS, Joniau S, Kovacs G, Pahernik S, de la Rosette JJ, Rouvière O, Salomon G, Ward JF, Scardino PT. Focal therapy in prostate cancer: international multidisciplinary consensus on trial design. Eur Urol 2014; 65:1078-83. [PMID: 24444476 DOI: 10.1016/j.eururo.2014.01.001] [Citation(s) in RCA: 144] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 01/02/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND Focal therapy has been introduced for the treatment of localised prostate cancer (PCa). To provide the necessary data for consistent assessment, all focal therapy trials should be performed according to uniform, systematic pre- and post-treatment evaluation with well-defined end points and strict inclusion and exclusion criteria. OBJECTIVE To obtain consensus on trial design for focal therapy in PCa. DESIGN, SETTING, AND PARTICIPANTS A four-staged consensus project based on a modified Delphi process was conducted in which 48 experts in focal therapy of PCa participated. According to this formal consensus-building method, participants were asked to fill out an iterative sequence of questionnaires to collect data on trial design. Subsequently, a consensus meeting was held in which 13 panellists discussed acquired data, clarified the results, and defined the conclusions. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS A multidisciplinary board from oncologic centres worldwide reached consensus on patient selection, pretreatment assessment, evaluation of outcome, and follow-up. RESULTS AND LIMITATIONS Inclusion criteria for candidates in focal therapy trials are patients with prostate-specific antigen <15 ng/ml, clinical stage T1c-T2a, Gleason score 3+3 or 3+4, life expectancy of >10 yr, and any prostate volume. The optimal biopsy strategy includes transrectal ultrasound-guided biopsies to be taken between 6 mo and 12 mo after treatment. The primary objective should be focal ablation of clinically significant disease with negative biopsies at 12 mo after treatment as the primary end point. CONCLUSIONS This consensus report provides a standard for designing a feasible focal therapy trial. PATIENT SUMMARY A variety of ablative technologies have been introduced and applied in a focal manner for the treatment of prostate cancer (PCa). In this consensus report, an international panel of experts in the field of PCa determined pre- and post-treatment work-up for focal therapy research.
Collapse
Affiliation(s)
| | - Berrend G Muller
- Department of Urology, AMC University Hospital, Amsterdam, The Netherlands
| | - Hashim Ahmed
- Division of Surgery and Interventional Science, London, UK
| | - Chris H Bangma
- Department of Urology, Erasmus MC Rotterdam, The Netherlands
| | - Eric Barret
- Department of Urology, Institut Montsouris, Paris, France
| | - Sebastien Crouzet
- Hospices Civils de Lyon, Department of Urology, Edouard Herriot Hospital, Lyon, France
| | - Scott E Eggener
- Department of Urology, University of Chicago, Chicago, IL, USA
| | - Inderbir S Gill
- Institute of Urology, Hillard and Roclyn Herzog Center for Prostate Cancer Focal Therapy, Keck School of Medicine, Los Angeles, CA, USA
| | - Steven Joniau
- Department of Urology, University Hospitals Leuven, Belgium
| | - Gyoergy Kovacs
- Interdisciplinary Brachytherapy Unit, University of Lübeck, Lübeck, Germany
| | - Sascha Pahernik
- Department of Urology, University Clinic Heidelberg, Heidelberg, Germany
| | | | - Olivier Rouvière
- Hospices Civils de Lyon, Department of Radiology, Hôpital E. Herriot, Université de Lyon, Lyon, France
| | - Georg Salomon
- Department of Urology, University Medical Centre Hamburg, Hamburg, Germany
| | - John F Ward
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Peter T Scardino
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| |
Collapse
|
24
|
Yamamoto T. Editorial comment to contrast-enhanced transrectal ultrasonography: measurement of prostate cancer tumor size and correlation with radical prostatectomy specimens. Int J Urol 2013; 20:1091. [PMID: 23692459 DOI: 10.1111/iju.12164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Tokunori Yamamoto
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| |
Collapse
|
25
|
Mari JM, Bouchoux G, Dillenseger JL, Gimonet S, Birer A, Garnier C, Brasset L, Ke W, Guey JL, Fleury G, Chapelon JY, Blanc E. Study of a dual-mode array integrated in a multi-element transducer for imaging and therapy of prostate cancer. Ing Rech Biomed 2013. [DOI: 10.1016/j.irbm.2013.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
26
|
Influence of imaging and histological factors on prostate cancer detection and localisation on multiparametric MRI: a prospective study. Eur Radiol 2013; 23:2019-29. [PMID: 23494494 DOI: 10.1007/s00330-013-2795-0] [Citation(s) in RCA: 212] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 01/06/2013] [Accepted: 01/11/2013] [Indexed: 01/18/2023]
|