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Bloemberg J, Hoppener B, Coolen B, Sakes A, Breedveld P. Design and evaluation of a pneumatic actuation unit for a wasp-inspired self-propelled needle. PLoS One 2024; 19:e0306411. [PMID: 38954720 DOI: 10.1371/journal.pone.0306411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 06/17/2024] [Indexed: 07/04/2024] Open
Abstract
Transperineal laser ablation is a minimally invasive thermo-ablative treatment for prostate cancer that requires the insertion of a needle for accurate optical fiber positioning. Needle insertion in soft tissues may cause tissue motion and deformation, resulting in tissue damage and needle positioning errors. In this study, we present a wasp-inspired self-propelled needle that uses pneumatic actuation to move forward with zero external push force, thus avoiding large tissue motion and deformation. The needle consists of six parallel 0.25-mm diameter Nitinol rods driven by a pneumatic actuation system. The pneumatic actuation system consists of Magnetic Resonance (MR) safe 3D-printed parts and off-the-shelf plastic screws. A self-propelled motion is achieved by advancing the needle segments one by one, followed by retracting them simultaneously. The advancing needle segment has to overcome a cutting and friction force, while the stationary needle segments experience a friction force in the opposite direction. The needle self-propels through the tissue when the friction force of the five stationary needle segments overcomes the sum of the friction and cutting forces of the advancing needle segment. We evaluated the prototype's performance in 10-wt% gelatin phantoms and ex vivo porcine liver tissue inside a preclinical Magnetic Resonance Imaging (MRI) scanner in terms of the slip ratio of the needle with respect to the phantom or liver tissue. Our results demonstrated that the needle was able to self-propel through the phantom and liver tissue with slip ratios of 0.912-0.955 and 0.88, respectively. The prototype is a promising step toward the development of self-propelled needles for MRI-guided transperineal laser ablation as a method to treat prostate cancer.
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Affiliation(s)
- Jette Bloemberg
- Faculty of Mechanical Engineering, Department of BioMechanical Engineering, Bio-Inspired Technology (BITE) Group, Delft University of Technology, Delft, The Netherlands
| | - Bruce Hoppener
- Faculty of Mechanical Engineering, Department of BioMechanical Engineering, Bio-Inspired Technology (BITE) Group, Delft University of Technology, Delft, The Netherlands
| | - Bram Coolen
- Department of Biomedical Engineering & Physics, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Aimée Sakes
- Faculty of Mechanical Engineering, Department of BioMechanical Engineering, Bio-Inspired Technology (BITE) Group, Delft University of Technology, Delft, The Netherlands
| | - Paul Breedveld
- Faculty of Mechanical Engineering, Department of BioMechanical Engineering, Bio-Inspired Technology (BITE) Group, Delft University of Technology, Delft, The Netherlands
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Ma J, Yang Q, Ye X, Xu W, Chang Y, Chen R, Wang Y, Luo M, Lou Y, Yang X, Li D, Xu Y, He W, Cai M, Cao W, Ju G, Yin L, Wang J, Ren J, Ma Z, Zuo C, Ren S. Head-to-head comparison of prostate-specific membrane antigen PET and multiparametric MRI in the diagnosis of pretreatment patients with prostate cancer: a meta-analysis. Eur Radiol 2024; 34:4017-4037. [PMID: 37981590 DOI: 10.1007/s00330-023-10436-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 09/05/2023] [Accepted: 09/19/2023] [Indexed: 11/21/2023]
Abstract
OBJECTIVES To compare prostate-specific membrane antigen (PSMA) PET with multiparametric MRI (mpMRI) in the diagnosis of pretreatment prostate cancer (PCa). METHODS Pubmed, Embase, Medline, Web of Science, and Cochrane Library were searched for eligible studies published before June 22, 2022. We assessed risk of bias and applicability by using QUADAS-2 tool. Data synthesis was performed with Stata 17.0 software, using the "midas" and "meqrlogit" packages. RESULTS We included 29 articles focusing on primary cancer detection, 18 articles about primary staging, and two articles containing them both. For PSMA PET versus mpMRI in primary PCa detection, sensitivities and specificities in the per-patient analysis were 0.90 and 0.84 (p<0.0001), and 0.66 and 0.60 (p <0.0001), and in the per-lesion analysis they were 0.79 and 0.78 (p <0.0001), and 0.84 and 0.82 (p <0.0001). For the per-patient analysis of PSMA PET versus mpMRI in primary staging, sensitivities and specificities in extracapsular extension detection were 0.59 and 0.66 (p =0.005), and 0.79 and 0.76 (p =0.0074), and in seminal vesicle infiltration (SVI) detection they were 0.51 and 0.60 (p =0.0008), and 0.93 and 0.96 (p =0.0092). For PSMA PET versus mpMRI in lymph node metastasis (LNM) detection, sensitivities and specificities in the per-patient analysis were 0.68 and 0.46 (p <0.0001), and 0.91 and 0.90 (p =0.81), and in the per-lesion analysis they were 0.67 and 0.36 (p <0.0001), and 0.99 and 0.99 (p =0.18). CONCLUSION PSMA PET has higher diagnostic value than mpMRI in the detection of primary PCa. Regarding the primary staging, mpMRI has potential advantages in SVI detection, while PSMA PET has relative advantages in LNM detection. CLINICAL RELEVANCE STATEMENT The integration of prostate-specific membrane antigen (PSMA) PET into the diagnostic pathway may be helpful for improving the accuracy of prostate cancer detection. However, further studies are needed to address the cost implications and evaluate its utility in specific patient populations or clinical scenarios. Moreover, we recommend the combination of PSMA PET and mpMRI for cancer staging. KEY POINTS • Prostate-specific membrane antigen PET has higher sensitivity and specificity for primary tumor detection in prostate cancer compared to multiparametric MRI. • Prostate-specific membrane antigen PET also has significantly better sensitivity and specificity for lymph node metastases of prostate cancer compared to multiparametric MRI. • Multiparametric MRI has better accuracy for extracapsular extension and seminal vesicle infiltration compared to ate-specific membrane antigen PET.
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Affiliation(s)
- Jianglei Ma
- Department of Urology, Changzheng Hospital, Naval Medical University, Shanghai, 200003, China
| | - Qinqin Yang
- Department of Nuclear Medicine, Changhai Hospital, Naval Medical University, Shanghai, 200433, China
| | - Xiaofei Ye
- Department of Health Statistics, Naval Medical University, Shanghai, 200433, China
| | - Weidong Xu
- Department of Urology, Changzheng Hospital, Naval Medical University, Shanghai, 200003, China
| | - Yifan Chang
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, 200433, China
| | - Rui Chen
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, 200433, China
| | - Ye Wang
- Department of Urology, Changzheng Hospital, Naval Medical University, Shanghai, 200003, China
| | - Mengting Luo
- College of Basic Medical Sciences, Naval Medical University, Shanghai, 200433, China
| | - Yihaoyun Lou
- Department of Urology, Changzheng Hospital, Naval Medical University, Shanghai, 200003, China
| | - Xuming Yang
- Department of Urology, Hengyang Central Hospital, Hengyang, 421001, Hu'nan, China
| | - Duocai Li
- Department of Urology, Changzheng Hospital, Naval Medical University, Shanghai, 200003, China
| | - Yusi Xu
- Department of Urology, Changzheng Hospital, Naval Medical University, Shanghai, 200003, China
| | - Wei He
- Department of Urology, Changzheng Hospital, Naval Medical University, Shanghai, 200003, China
| | - Minglei Cai
- Department of Urology, Changzheng Hospital, Naval Medical University, Shanghai, 200003, China
| | - Wanli Cao
- Department of Urology, Changzheng Hospital, Naval Medical University, Shanghai, 200003, China
| | - Guanqun Ju
- Department of Urology, Changzheng Hospital, Naval Medical University, Shanghai, 200003, China
| | - Lei Yin
- Department of Urology, Changzheng Hospital, Naval Medical University, Shanghai, 200003, China
| | - Junkai Wang
- Department of Urology, Changzheng Hospital, Naval Medical University, Shanghai, 200003, China
| | - Jizhong Ren
- Department of Urology, Changzheng Hospital, Naval Medical University, Shanghai, 200003, China
| | - Zifang Ma
- Department of Urology, Hengyang Central Hospital, Hengyang, 421001, Hu'nan, China.
| | - Changjing Zuo
- Department of Nuclear Medicine, Changhai Hospital, Naval Medical University, Shanghai, 200433, China.
| | - Shancheng Ren
- Department of Urology, Changzheng Hospital, Naval Medical University, Shanghai, 200003, China.
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Sørland KI, Trimble CG, Wu CY, Bathen TF, Elschot M, Cloos MA. Reducing femoral flow artefacts in radial magnetic resonance fingerprinting of the prostate using region-optimised virtual coils. NMR IN BIOMEDICINE 2024:e5136. [PMID: 38514929 DOI: 10.1002/nbm.5136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 01/19/2024] [Accepted: 02/07/2024] [Indexed: 03/23/2024]
Abstract
High acceleration factors in radial magnetic resonance fingerprinting (MRF) of the prostate lead to strong streak-like artefacts from flow in the femoral blood vessels, possibly concealing important anatomical information. Region-optimised virtual (ROVir) coils is a beamforming-based framework to create virtual coils that maximise signal in a region of interest while minimising signal in a region of interference. In this study, the potential of removing femoral flow streak artefacts in prostate MRF using ROVir coils is demonstrated in silico and in vivo. The ROVir framework was applied to radial MRF k-space data in an automated pipeline designed to maximise prostate signal while minimising signal from the femoral vessels. The method was tested in 15 asymptomatic volunteers at 3 T. The presence of streaks was visually assessed and measurements of whole prostate T1, T2 and signal-to-noise ratio (SNR) with and without streak correction were examined. In addition, a purpose-built simulation framework in which blood flow through the femoral vessels can be turned on and off was used to quantitatively evaluate ROVir's ability to suppress streaks in radial prostate MRF. In vivo it was shown that removing selected ROVir coils visibly reduces streak-like artefacts from the femoral blood flow, without increasing the reconstruction time. On average, 80% of the prostate SNR was retained. A similar reduction of streaks was also observed in silico, while the quantitative accuracy of T1 and T2 mapping was retained. In conclusion, ROVir coils efficiently suppress streaking artefacts from blood flow in radial MRF of the prostate, thereby improving the visual clarity of the images, without significant sacrifices to acquisition time, reconstruction time and accuracy of quantitative values. This is expected to help enable T1 and T2 mapping of prostate cancer in clinically viable times, aiding differentiation between prostate cancer from noncancer and healthy prostate tissue.
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Affiliation(s)
- Kaia I Sørland
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Christopher G Trimble
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Radiology and Nuclear Medicine, St. Olavs hospital, Trondheim University Hostpital, Trondheim, Norway
| | - Chia-Yin Wu
- Centre for Advanced Imaging, The University of Queensland, St Lucia, Queensland, Australia
- ARC Training Centre for Innovation on Biomedical Imaging Technology (CIBIT), The University of Queensland, St Lucia, Queensland, Australia
- School of Electrical Engineering and Computer Science, The University of Queensland, St Lucia, Queensland, Australia
| | - Tone F Bathen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Radiology and Nuclear Medicine, St. Olavs hospital, Trondheim University Hostpital, Trondheim, Norway
| | - Mattijs Elschot
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Radiology and Nuclear Medicine, St. Olavs hospital, Trondheim University Hostpital, Trondheim, Norway
| | - Martijn A Cloos
- Centre for Advanced Imaging, The University of Queensland, St Lucia, Queensland, Australia
- ARC Training Centre for Innovation on Biomedical Imaging Technology (CIBIT), The University of Queensland, St Lucia, Queensland, Australia
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Liu X, Xiong Q, Zeng W, Yang R, Wen Y, Li X. Comparison of the Utility of PI-RADS 2.1, ADC Values, and Combined Use of Both, for the Diagnosis of Transition Zone Prostate Cancers. J Comput Assist Tomogr 2024; 48:206-211. [PMID: 38149651 DOI: 10.1097/rct.0000000000001560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
OBJECTIVE To assess the performance of apparent diffusion coefficient (ADC; values or category) alone, Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1) scoring alone, and the two in combination, to diagnose transition zone prostate cancers (PCas). METHODS This retrospective study included 222 patients who underwent multiparametric magnetic resonance imaging of the prostate between May 2020 and December 2022 and who had pathologically confirmed PCa or benign prostatic hyperplasia (BPH). Prostate Imaging Reporting and Data System version 2.1 and ADC (values or category) were used in the assessment of suspicious findings identified in the transition zone. The interobserver agreements for region-of-interest measurements were calculated by intraclass correlation coefficients. Logistic regression analyses were used to determine the performance of PI-RADS v2.1 alone and in combination with ADC (values or category) to diagnose PCa. Receiver operating characteristic curve and DeLong test were used to evaluate the diagnostic performance of the quantitative parameters. RESULTS A total of 152 patients had BPH, and 70 patients had PCa. For BPH versus PCa, the ADC values of PCa (0.64 × 10 -3 ± 0.16 × 10 -3 mm 2 /s) were significantly lower than BPH (1.06 ± 0.18 × 10 -3 mm 2 /s; P < 0.001). The PI-RADS scores for PCa (5 [interquartile range, 5-5]) were significantly higher than BPH (2 [interquartile range, 2-3]; P < 0.001). For all patients who had PI-RADS 1-5, the combined use of ADC (values or category) together with PI-RADS v2.1 did not perform significantly better than the use of PI-RADS v2.1 alone. The receiver operating characteristic of ADC category in combination with PI-RADS v2.1 score, 0.756 (95% confidence interval, 0.646-0.846), was significantly higher than that for PI-RADS 2.1 alone, 0.631 (95% confidence interval, 0.514-0.738), in PI-RADS 3-4 lesions ( P = 0.047). CONCLUSION The ADC category can help to improve the diagnostic performance of PI-RADS v2.1 category 3-4 lesions in diagnosing PCa.
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Affiliation(s)
- Xinghua Liu
- From the Department of Radiology, Chongqing University Three Gorges Hospital, Chongqing, China
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Yuan Q, Recchimuzzi DZ, Costa DN. Magnetic Resonance Perfusion Imaging of Prostate. Magn Reson Imaging Clin N Am 2024; 32:171-179. [PMID: 38007279 DOI: 10.1016/j.mric.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
Magnetic resonance (MR) perfusion imaging, both with and without exogenous contrast agents, has the potential to assess tissue perfusion and vascularity in prostate cancer. Dynamic contrast-enhanced (DCE) MRI is an important element of the clinical non-invasive multiparametric MRI, which can be used to differentiate benign from malignant lesions, to stage tumors, and to monitor response to therapy. The arterial spin labeled (ASL) and intravoxel incoherent motion (IVIM) diffusion-weighted MRI have the advantage of quantitative perfusion measurements without the concerns of gadolinium-based contrast agent safety and retention issues. The adoption of these non-contrast techniques in clinical practice needs more research and clinical evaluation.
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Affiliation(s)
- Qing Yuan
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA.
| | - Debora Z Recchimuzzi
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Daniel N Costa
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA; Department of Urology, University of Texas Southwestern Medical Center, 2201 Inwood Road, TX 75390, USA
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Tang J, Zheng X, Wang X, Mao Q, Xie L, Wang R. Computer-aided detection of prostate cancer in early stages using multi-parameter MRI: A promising approach for early diagnosis. Technol Health Care 2024; 32:125-133. [PMID: 38759043 PMCID: PMC11191472 DOI: 10.3233/thc-248011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Abstract
BACKGROUND Transrectal ultrasound-guided prostate biopsy is the gold standard diagnostic test for prostate cancer, but it is an invasive examination of non-targeted puncture and has a high false-negative rate. OBJECTIVE In this study, we aimed to develop a computer-assisted prostate cancer diagnosis method based on multiparametric MRI (mpMRI) images. METHODS We retrospectively collected 106 patients who underwent radical prostatectomy after diagnosis with prostate biopsy. mpMRI images, including T2 weighted imaging (T2WI), diffusion weighted imaging (DWI), and dynamic-contrast enhanced (DCE), and were accordingly analyzed. We extracted the region of interest (ROI) about the tumor and benign area on the three sequential MRI axial images at the same level. The ROI data of 433 mpMRI images were obtained, of which 202 were benign and 231 were malignant. Of those, 50 benign and 50 malignant images were used for training, and the 333 images were used for verification. Five main feature groups, including histogram, GLCM, GLGCM, wavelet-based multi-fractional Brownian motion features and Minkowski function features, were extracted from the mpMRI images. The selected characteristic parameters were analyzed by MATLAB software, and three analysis methods with higher accuracy were selected. RESULTS Through prostate cancer identification based on mpMRI images, we found that the system uses 58 texture features and 3 classification algorithms, including Support Vector Machine (SVM), K-nearest Neighbor (KNN), and Ensemble Learning (EL), performed well. In the T2WI-based classification results, the SVM achieved the optimal accuracy and AUC values of 64.3% and 0.67. In the DCE-based classification results, the SVM achieved the optimal accuracy and AUC values of 72.2% and 0.77. In the DWI-based classification results, the ensemble learning achieved optimal accuracy as well as AUC values of 75.1% and 0.82. In the classification results based on all data combinations, the SVM achieved the optimal accuracy and AUC values of 66.4% and 0.73. CONCLUSION The proposed computer-aided diagnosis system provides a good assessment of the diagnosis of the prostate cancer, which may reduce the burden of radiologists and improve the early diagnosis of prostate cancer.
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Affiliation(s)
- Jianer Tang
- Department of Urology, First Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, Zhejiang, China
- Department of Urology, First Affiliated Hospital of Huzhou Teachers College, Huzhou, Zhejiang, China
| | - Xiangyi Zheng
- Department of Urology, First Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiao Wang
- Department of Urology, First Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, Zhejiang, China
| | - Qiqi Mao
- Department of Urology, First Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, Zhejiang, China
| | - Liping Xie
- Department of Urology, First Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, Zhejiang, China
| | - Rongjiang Wang
- Department of Urology, First Affiliated Hospital of Huzhou Teachers College, Huzhou, Zhejiang, China
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Switlyk MD, Hopland A, Reitan E, Sivanesan S, Brennhovd B, Axcrona U, Hole KH. Multiparametric Magnetic Resonance Imaging of Penile Cancer: A Pictorial Review. Cancers (Basel) 2023; 15:5324. [PMID: 38001583 PMCID: PMC10670261 DOI: 10.3390/cancers15225324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
The role of multiparametric magnetic resonance imaging (mpMRI) in assessing penile cancer is not well defined. However, this modality may be successfully applied for preoperative staging and patient selection; postoperative local and regional surveillance; and assessments of treatment response after oncological therapies. Previous studies have been mostly limited to a few small series evaluating the accuracy of MRI for the preoperative staging of penile cancer. This review discusses the principles of non-erectile mpMRI, including functional techniques and their applications in evaluating the male genital region, along with clinical protocols and technical considerations. The latest clinical classifications and guidelines are reviewed, focusing on imaging recommendations and discussing potential gaps and disadvantages. The development of functional MRI techniques and the extraction of quantitative parameters from these sequences enables the noninvasive assessment of phenotypic and genotypic tumor characteristics. The applications of advanced techniques in penile MRI are yet to be defined. There is a need for prospective trials and feasible multicenter trials due to the rarity of the disease, highlighting the importance of minimum technical requirements for MRI protocols, particularly image resolution, and finally determining the role of mpMRI in the assessment of penile cancer.
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Affiliation(s)
- Marta D. Switlyk
- Department of Radiology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway; (E.R.); (K.H.H.)
| | - Andreas Hopland
- Department of Urology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway; (A.H.); (S.S.); (B.B.)
| | - Edmund Reitan
- Department of Radiology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway; (E.R.); (K.H.H.)
| | - Shivanthe Sivanesan
- Department of Urology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway; (A.H.); (S.S.); (B.B.)
- Institute of Clinical Medicine (KlinMED), Faculty of Medicine, University of Oslo, 0318 Oslo, Norway
| | - Bjørn Brennhovd
- Department of Urology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway; (A.H.); (S.S.); (B.B.)
| | - Ulrika Axcrona
- Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway;
| | - Knut H. Hole
- Department of Radiology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway; (E.R.); (K.H.H.)
- Institute of Clinical Medicine (KlinMED), Faculty of Medicine, University of Oslo, 0318 Oslo, Norway
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Lemberskiy G, Chandarana H, Bruno M, Ginocchio LA, Huang C, Tong A, Keerthivasan MB, Fieremans E, Novikov DS. Feasibility of Accelerated Prostate Diffusion-Weighted Imaging on 0.55 T MRI Enabled With Random Matrix Theory Denoising. Invest Radiol 2023; 58:720-729. [PMID: 37222526 PMCID: PMC10527232 DOI: 10.1097/rli.0000000000000979] [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] [Indexed: 05/25/2023]
Abstract
INTRODUCTION Prostate cancer diffusion weighted imaging (DWI) MRI is typically performed at high-field strength (3.0 T) in order to overcome low signal-to-noise ratio (SNR). In this study, we demonstrate the feasibility of prostate DWI at low field enabled by random matrix theory (RMT)-based denoising, relying on the MP-PCA algorithm applied during image reconstruction from multiple coils. METHODS Twenty-one volunteers and 2 prostate cancer patients were imaged with a 6-channel pelvic surface array coil and an 18-channel spine array on a prototype 0.55 T system created by ramping down a commercial magnetic resonance imaging system (1.5 T MAGNETOM Aera Siemens Healthcare) with 45 mT/m gradients and 200 T/m/s slew rate. Diffusion-weighted images were acquired with 4 non-collinear directions, for which b = 50 s/mm 2 was used with 8 averages and b = 1000 s/mm 2 with 40 averages; 2 extra b = 50 s/mm 2 were used as part of the dynamic field correction. Standard and RMT-based reconstructions were applied on DWI over different ranges of averages. Accuracy/precision was evaluated using the apparent diffusion coefficient (ADC), and image quality was evaluated over 5 separate reconstructions by 3 radiologists with a 5-point Likert scale. For the 2 patients, we compare image quality and lesion visibility of the RMT reconstruction versus the standard one on 0.55 T and on clinical 3.0 T. RESULTS The RMT-based reconstruction in this study reduces the noise floor by a factor of 5.8, thereby alleviating the bias on prostate ADC. Moreover, the precision of the ADC in prostate tissue after RMT increases over a range of 30%-130%, with the increase in both signal-to-noise ratio and precision being more prominent for a low number of averages. Raters found that the images were consistently of moderate to good overall quality (3-4 on the Likert scale). Moreover, they determined that b = 1000 s/mm 2 images from a 1:55-minute scan with the RMT-based reconstruction were on par with the corresponding images from a 14:20-minute scan with standard reconstruction. Prostate cancer was visible on ADC and calculated b = 1500 images even with the abbreviated 1:55-minute scan reconstructed with RMT. CONCLUSIONS Prostate imaging using DWI is feasible at low field and can be performed more rapidly with noninferior image quality compared with standard reconstruction.
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Affiliation(s)
- Gregory Lemberskiy
- Center for Biomedical Imaging, Department of Radiology, NYU Grossman School of Medicine
| | - Hersh Chandarana
- Center for Biomedical Imaging, Department of Radiology, NYU Grossman School of Medicine
| | - Mary Bruno
- Center for Biomedical Imaging, Department of Radiology, NYU Grossman School of Medicine
| | - Luke A. Ginocchio
- Center for Biomedical Imaging, Department of Radiology, NYU Grossman School of Medicine
| | - Chenchan Huang
- Center for Biomedical Imaging, Department of Radiology, NYU Grossman School of Medicine
| | - Angela Tong
- Center for Biomedical Imaging, Department of Radiology, NYU Grossman School of Medicine
| | | | - Els Fieremans
- Center for Biomedical Imaging, Department of Radiology, NYU Grossman School of Medicine
| | - Dmitry S. Novikov
- Center for Biomedical Imaging, Department of Radiology, NYU Grossman School of Medicine
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Paesano N, Catalá V, Tcholakian L, Trilla E, Morote J. A Systematic Review of the Current Status of Magnetic Resonance-Ultrasound Images Fusion Software Platforms for Transperineal Prostate Biopsies. Cancers (Basel) 2023; 15:3329. [PMID: 37444439 DOI: 10.3390/cancers15133329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Given this new context, our objective is to recognize the suitability of the currently available software for image fusion and the reported series using the transperineal route, as well as to generate new evidence on the complementarity of the directed and systematic biopsies, which has been established through the transrectal approach. EVIDENCE ACQUISITION This systematic review, registered in Prospero (CRD42022375619), began with a bibliographic search that was carried out in PubMed, Cochrane, and Google Scholar databases. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) criteria and the studied eligibility based on the Participants, Intervention, Comparator, and Outcomes (PICO) strategy were followed. Warp analysis of selected studies was performed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. In addition, a Google search of all currently available fusion platforms was performed. Our Google search found 11 different commercially available robots to perform transperineal image fusion biopsies, of which 10 devices have published articles supporting their diagnostic effectiveness in transperineal prostate biopsies. RESULTS A total of 30 articles were selected and the characteristics and results of the biopsies of 11,313 patients were analyzed. The pooled mean age was 66.5 years (63-69). The mean pooled PSA level was 7.8 ng/mL (5.7-10.8). The mean pooled prostate volume was 45.4 cc. (34-56). The mean pooled PSA density was 0.17 (0.12-0.27). The overall cancer detection rate for all prostate cancers was 61.4%, while for csPCa it was 47.8%. PCa detection rate was more effective than that demonstrated in the systematic transrectal biopsy. However, the detection of csPCa in the systematic biopsy was only 9.5% in the reported series. To standardize our review, we grouped prostate cancer screening results according to the population studied and the software used. When the same populations were compared between elastic and rigid software, we found that rigid biopsies had a higher csPCa detection rate than biopsies with elastic fusion systems. CONCLUSION Platforms performing prostate biopsy using transperineal image fusion have better detection rates of csPCa than systematic transrectal biopsies. Rigid fusion systems have a better csPCa detection rate than elastic ones. We found no diagnostic differences between the different types of robotic systems currently available. The complementarity of systematic biopsy has also been demonstrated in transperineal imaging fusion biopsies.
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Affiliation(s)
| | | | | | - Enric Trilla
- Department of Urology, Vall d'Hebron Hospital, 08035 Barcelona, Spain
- Department of Surgery, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Juan Morote
- Department of Urology, Vall d'Hebron Hospital, 08035 Barcelona, Spain
- Department of Surgery, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
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Gibbons M, Simko JP, Carroll PR, Noworolski SM. Prostate cancer lesion detection, volume quantification and high-grade cancer differentiation using cancer risk maps derived from multiparametric MRI with histopathology as the reference standard. Magn Reson Imaging 2023; 99:48-57. [PMID: 36641104 DOI: 10.1016/j.mri.2023.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/08/2023] [Indexed: 01/13/2023]
Abstract
Multi-parametric MRI (mpMRI) has proven itself a clinically useful tool to assess prostate cancer (PCa). Our objective was to generate PCa risk maps to quantify the volume and location of both all PCa and high grade (Gleason grade group ≥ 3) PCa. Such capabilities would aid physicians and patients in treatment decisions, targeting biopsy, and planning focal therapy. A cohort of men with biopsy proven prostate cancer and pre-prostatectomy mpMRI were studied. PCa and benign ROIs (1524) were identified on mpMRI and histopathology with histopathology serving as the reference standard. Logistic regression models were created to differentiate PCa from benign tissues. The MRI images were registered to ensure correct overlay. The cancer models were applied to each image voxel within prostates to create probability maps of cancer and of high-grade cancer. Use of an optimum probability threshold quantified PCa volume for all lesions >0.1 cc. Accuracies were calculated using area under the curve (AUC) for the receiver operating characteristic (ROC). The PCa models utilized apparent diffusion coefficient (ADC), T2 weighted (T2W), dynamic contrast-enhanced MRI (DCE MRI) enhancement slope, and DCE MRI washout as the statistically significant MRI scans. Application of the PCa maps method provided total PCa volume and individual lesion volumes. The AUCs derived from lesion analysis were 0.91 for all PCa and 0.73 for high-grade PCa. At the optimum threshold, the PCa maps detected 135 / 150 (90%) histopathological lesions >0.1 cc. This study showed the feasibility of cancer risk maps, created from pre-prostatectomy, mpMR images validated with histopathology, to detect PCa lesions >0.1 cc. The method quantified the volume of cancer within the prostate. Method improvements were identified by determining root causes for over and underestimation of cancer volumes. The maps have the potential for improved non-invasive capability in quantitative detection, localization, volume estimation, and MRI characterization of PCa.
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Affiliation(s)
- Matthew Gibbons
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, United States.
| | - Jeffry P Simko
- Department of Urology, University of California, San Francisco, CA, United States; Department of Pathology, University of California, San Francisco, CA, United States.
| | - Peter R Carroll
- Department of Urology, University of California, San Francisco, CA, United States.
| | - Susan M Noworolski
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, United States.
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11
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Koopaei S, Fathi Kazerooni A, Ghafoori M, Alviri M, Pashaei F, Saligheh Rad H. Quantification of Multi-Parametric Magnetic Resonance Imaging Based on Radiomics Analysis for Differentiation of Benign and Malignant Lesions of Prostate. J Biomed Phys Eng 2023; 13:251-260. [PMID: 37312887 PMCID: PMC10258207 DOI: 10.31661/jbpe.v0i0.2008-1158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 10/28/2020] [Indexed: 06/15/2023]
Abstract
Background The most common cancer (non-cutaneous) malignancy among men is prostate cancer. Management of prostate cancer, including staging and treatment, playing an important role in decreasing mortality rates. Among all current diagnostic tools, multiparametric MRI (mp-MRI) has shown high potential in localizing and staging prostate cancer. Quantification of mp-MRI helps to decrease the dependency of diagnosis on readers' opinions. Objective The aim of this research is to set a method based on quantification of mp-MRI images for discrimination between benign and malignant prostatic lesions with fusion-guided MR imaging/transrectal ultrasonography biopsy as a pathology validation reference. Material and Methods It is an analytical research that 27 patients underwent the mp-MRI examination, including T1- and T2- weighted and diffusion weighted imaging (DWI). Quantification was done by calculating radiomic features from mp-MRI images. Receiver-operating-characteristic curve was done for each feature to evaluate the discriminatory capacity and linear discriminant analysis (LDA) and leave-one-out cross-validation for feature filtering to estimate the sensitivity, specificity and accuracy of the benign and malignant lesion differentiation process is used. Results An accuracy, sensitivity and specificity of 92.6%, 95.2% and 83.3%, respectively, were achieved from a subset of radiomics features obtained from T2-weighted images and apparent diffusion coefficient (ADC) maps for distinguishing benign and malignant prostate lesions. Conclusion Quantification of mp-MRI (T2-weighted images and ADC-maps) based on radiomics feature has potential to distinguish benign with appropriate accuracy from malignant prostate lesions. This technique is helpful in preventing needless biopsies in patients and provides an assisted diagnosis for classifications of prostate lesions.
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Affiliation(s)
- Soheila Koopaei
- Quantitative MR Imaging and Spectroscopy Group, Research Center for Molecular and Cellular Imaging, Institute for Advanced Medical Technologies, Imam Hospital, Tehran, Iran
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Science Tehran, Iran
| | - Anahita Fathi Kazerooni
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Science Tehran, Iran
| | - Mahyar Ghafoori
- Department of Radiology, Hazrat Rasoul Akram University Hospital, Tehran, Iran
| | - Mohamadreza Alviri
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Science Tehran, Iran
| | - Fakhereh Pashaei
- Quantitative MR Imaging and Spectroscopy Group, Research Center for Molecular and Cellular Imaging, Institute for Advanced Medical Technologies, Imam Hospital, Tehran, Iran
- Radiation Sciences Research Center (RSRC), Aja University of Medical Sciences, Tehran, Iran
| | - Hamidreza Saligheh Rad
- Quantitative MR Imaging and Spectroscopy Group, Research Center for Molecular and Cellular Imaging, Institute for Advanced Medical Technologies, Imam Hospital, Tehran, Iran
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Science Tehran, Iran
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12
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Nishioka N, Fujima N, Tsuneta S, Yoneyama M, Matsumoto R, Abe T, Kimura R, Sakamoto K, Kato F, Kudo K. Clinical utility of single-shot echo-planar diffusion-weighted imaging using L1-regularized iterative sensitivity encoding in prostate MRI. Medicine (Baltimore) 2023; 102:e33639. [PMID: 37115048 PMCID: PMC10146059 DOI: 10.1097/md.0000000000033639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
We investigated the ability of echo-planar imaging with L1-regularized iterative sensitivity encoding-based diffusion-weighted imaging (DWI) to improve the image quality and reduce the scanning time in prostate magnetic resonance imaging. We retrospectively analyzed 109 cases of prostate magnetic resonance imaging. We compared variables in the quantitative and qualitative assessments among 3 imaging groups: conventional parallel imaging-based DWI (PI-DWI) with an acquisition time of 3 minutes 15 seconds; echo-planar imaging with L1-regularized iterative sensitivity encoding-based DWI (L1-DWI) with a normal acquisition time (L1-DWINEX12) of 3 minutes 15 seconds; and L1-DWI with a half acquisition time (L1-DWINEX6) of 1 minute 45 seconds. As a quantitative assessment, the signal-to-noise ratio (SNR) of DWI (SNR-DWI), the contrast-to-noise ratio (CNR) of DWI (CNR-DWI), and the CNR of apparent diffusion coefficient were measured. As a qualitative assessment, the image quality and visual detectability of prostate carcinoma were evaluated. In the quantitative analysis, L1-DWINEX12 showed significantly higher SNR-DWI than PI-DWI (P = .0058) and L1-DWINEX6 (P < .0001). In the qualitative analysis, the image quality score for L1-DWINEX12 was significantly higher than those of PI-DWI and L1-DWINEX6. A non-inferiority assessment demonstrated that L1-DWINEX6 was non-inferior to PI-DWI in terms of both quantitative CNR-DWI and qualitative grading of image quality with a <20% inferior margin. L1-DWI successfully demonstrated a reduced scanning time while maintaining good image quality.
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Affiliation(s)
- Noriko Nishioka
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Kita-Ku, Sapporo, Japan
- Department of Diagnostic Imaging, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-Ku, Sapporo, Japan
| | - Noriyuki Fujima
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Kita-Ku, Sapporo, Japan
| | - Satonori Tsuneta
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Kita-Ku, Sapporo, Japan
| | | | - Ryuji Matsumoto
- Department of Renal and Genitourinary Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-Ku, Sapporo, Japan
| | - Takashige Abe
- Department of Renal and Genitourinary Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-Ku, Sapporo, Japan
| | - Rina Kimura
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Kita-Ku, Sapporo, Japan
- Department of Diagnostic Imaging, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-Ku, Sapporo, Japan
| | - Keita Sakamoto
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Kita-Ku, Sapporo, Japan
| | - Fumi Kato
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Kita-Ku, Sapporo, Japan
| | - Kohsuke Kudo
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Kita-Ku, Sapporo, Japan
- Department of Diagnostic Imaging, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-Ku, Sapporo, Japan
- Department of Advanced Diagnostic Imaging Development, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-Ku, Sapporo, Japan
- Global Center for Biomedical Science and Engineering, Faculty of Medicine, Hokkaido University, Kita-Ku, Sapporo, Hokkaido, Japan
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13
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Lin B, Cavdar IK, Buxton M, Sellers J, Brandi L, Helo N, de Riese WTW. Association between prostate size and glandular tissue volume of the peripheral zone via novel combined MRI and histopathology: possible pathophysiological implications on prostate cancer development. Int Urol Nephrol 2023; 55:835-844. [PMID: 36739353 DOI: 10.1007/s11255-023-03483-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 01/22/2023] [Indexed: 02/06/2023]
Abstract
PURPOSE Benign prostatic hyperplasia (BPH) and prostate cancer (PCa) are the two most prevalent urologic diseases affecting elderly men. An inverse relationship between BPH/prostate size and PCa incidence is well documented in the current literature, but the precise mechanism is poorly understood. This study aims to investigate the effect of total prostate volume on total glandular tissue volume of the peripheral zone via a novel combination of magnetic resonance imaging (MRI) and histo-anatomical imaging. METHODS 42 male patients between ages 53-79 years underwent both radical prostatectomy and pre-operative MRI scans. Prostate sizes ranged from 14.8-133.3cc. Quantitative measurements of surgical capsule thickness and glandular epithelial cell density within the peripheral zone (PZ) were obtained on histo-anatomical slides using computer-based imaging software. Quantitative prostatic zonal measurements were obtained from MRI scans. Combining MRI- and histopathology-obtained parameters allowed measurement of the total glandular tissue volume of the PZ (GVPZ). Statistical analysis was performed to identify associations between total prostate volume (TPV) and GVPZ. RESULTS The Mann-Whitney U-test showed significant decreases in GVPZ in larger prostates when compared to smaller prostates. CONCLUSIONS Combined MRI and histopathology techniques provide a novel method for accurate measuring of glandular tissue content within the prostatic PZ. The findings of this pilot study support the hypothesis of PZ compression by an expanding transition zone in large BPH prostates, leading to atrophy of PZ glandular tissue. As the majority of PCa originates in the PZ, this dynamic process may explain the protective effect of large BPH prostates against PCa development.
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Affiliation(s)
- Benjamin Lin
- School of Medicine, Department of Urology, Texas Tech University Health Sciences Center, 3601-4th Street STOP 7260, Lubbock, TX, 79430-7260, USA
| | - Irina Kim Cavdar
- School of Medicine, Department of Urology, Texas Tech University Health Sciences Center, 3601-4th Street STOP 7260, Lubbock, TX, 79430-7260, USA
| | - Matthew Buxton
- School of Medicine, Department of Urology, Texas Tech University Health Sciences Center, 3601-4th Street STOP 7260, Lubbock, TX, 79430-7260, USA
| | - Jake Sellers
- School of Medicine, Department of Urology, Texas Tech University Health Sciences Center, 3601-4th Street STOP 7260, Lubbock, TX, 79430-7260, USA
| | - Luis Brandi
- Department of Radiology, University Medical Center, Lubbock, TX, 79415, USA
| | - Naseem Helo
- School of Medicine, Department of Pathology, Texas Tech University Health Sciences Center, Lubbock, TX, 79415, USA
| | - Werner T W de Riese
- School of Medicine, Department of Urology, Texas Tech University Health Sciences Center, 3601-4th Street STOP 7260, Lubbock, TX, 79430-7260, USA.
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14
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Liu K, Li P, Otikovs M, Ning X, Xia L, Wang X, Yang L, Pan F, Zhang Z, Wu G, Xie H, Bao Q, Zhou X, Liu C. Mutually communicated model based on multi-parametric MRI for automated segmentation and classification of prostate cancer. Med Phys 2023. [PMID: 36905102 DOI: 10.1002/mp.16343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Multiparametric magnetic resonance imaging (mp-MRI) is introduced and established as a noninvasive alternative for prostate cancer (PCa) detection and characterization. PURPOSE To develop and evaluate a mutually communicated deep learning segmentation and classification network (MC-DSCN) based on mp-MRI for prostate segmentation and PCa diagnosis. METHODS The proposed MC-DSCN can transfer mutual information between segmentation and classification components and facilitate each other in a bootstrapping way. For classification task, the MC-DSCN can transfer the masks produced by the coarse segmentation component to the classification component to exclude irrelevant regions and facilitate classification. For segmentation task, this model can transfer the high-quality localization information learned by the classification component to the fine segmentation component to mitigate the impact of inaccurate localization on segmentation results. Consecutive MRI exams of patients were retrospectively collected from two medical centers (referred to as center A and B). Two experienced radiologists segmented the prostate regions, and the ground truth of the classification refers to the prostate biopsy results. MC-DSCN was designed, trained, and validated using different combinations of distinct MRI sequences as input (e.g., T2-weighted and apparent diffusion coefficient) and the effect of different architectures on the network's performance was tested and discussed. Data from center A were used for training, validation, and internal testing, while another center's data were used for external testing. The statistical analysis is performed to evaluate the performance of the MC-DSCN. The DeLong test and paired t-test were used to assess the performance of classification and segmentation, respectively. RESULTS In total, 134 patients were included. The proposed MC-DSCN outperforms the networks that were designed solely for segmentation or classification. Regarding the segmentation task, the classification localization information helped to improve the IOU in center A: from 84.5% to 87.8% (p < 0.01) and in center B: from 83.8% to 87.1% (p < 0.01), while the area under curve (AUC) of PCa classification was improved in center A: from 0.946 to 0.991 (p < 0.02) and in center B: from 0.926 to 0.955 (p < 0.01) as a result of the additional information provided by the prostate segmentation. CONCLUSION The proposed architecture could effectively transfer mutual information between segmentation and classification components and facilitate each other in a bootstrapping way, thus outperforming the networks designed to perform only one task.
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Affiliation(s)
- Kewen Liu
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, Wuhan, P.R. China.,School of Information Engineering, Wuhan University of Technology, Wuhan, P.R. China
| | - Piqiang Li
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, Wuhan, P.R. China.,School of Information Engineering, Wuhan University of Technology, Wuhan, P.R. China
| | - Martins Otikovs
- Weizmann Institute of Science, Department of Chemical and Biological Physics, Rehovot, Israel
| | - Xinzhou Ning
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, Wuhan, P.R. China
| | - Liyang Xia
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, Wuhan, P.R. China.,School of Information Engineering, Wuhan University of Technology, Wuhan, P.R. China
| | - Xiangyu Wang
- First Affiliated Hospital of Shenzhen University, Shenzhen, P.R. China
| | - Lian Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Feng Pan
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Zhi Zhang
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, Wuhan, P.R. China
| | - Guangyao Wu
- Shenzhen University General Hospital, Shenzhen, P.R. China
| | - Han Xie
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, Wuhan, P.R. China
| | - Qingjia Bao
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, Wuhan, P.R. China
| | - Xin Zhou
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, Wuhan, P.R. China.,University of Chinese Academy of Sciences, Beijing, P.R. China.,Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology-Optics Valley Laboratory, Wuhan, P.R. China
| | - Chaoyang Liu
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, Wuhan, P.R. China.,University of Chinese Academy of Sciences, Beijing, P.R. China.,Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology-Optics Valley Laboratory, Wuhan, P.R. China
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15
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Ueda T, Ohno Y, Shinohara M, Yamamoto K, Ikedo M, Yui M, Yoshikawa T, Takenaka D, Ishida S, Furuta M, Matsuyama T, Nagata H, Ikeda H, Ozawa Y, Toyama H. Reverse encoding distortion correction for diffusion-weighted MRI: Efficacy for improving image quality and ADC evaluation for differentiating malignant from benign areas in suspected prostatic cancer patients. Eur J Radiol 2023; 162:110764. [PMID: 36905716 DOI: 10.1016/j.ejrad.2023.110764] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/20/2023] [Accepted: 02/28/2023] [Indexed: 03/07/2023]
Abstract
PURPOSE The purpose of this study was to determine the influenceof reverse encoding distortion correction (RDC) on ADC measurement and its efficacy for improving image quality and diagnostic performance for differentiating malignant from benign prostatic areas on prostatic DWI. METHODS Forty suspected prostatic cancer patients underwent DWI with or without RDC (i.e. RDC DWI or DWI) using a 3 T MR system as well as pathological examinations. The pathological examination results indicated 86 areas were malignant while 86 out of 394 areas were computationally selected as benign. SNR for benign areas and muscle and ADCs for malignant and benign areas were determined by ROI measurements on each DWI. Moreover, overall image quality was assessed with a 5-point visual scoring system on each DWI. Paired t-test or Wilcoxon's signed rank test was performed to compare SNR and overall image quality for DWIs. ROC analysis was then used to compare the diagnostic performance, and sensitivity (SE), specificity (SP) and accuracy (AC) of ADC were compared between two DWI by means of McNemar's test. RESULTS SNR and overall image quality of RDC DWI showed significant improvements when compared with those of DWI (p < 0.05). Areas under the curve (AUC), SP and AC of DWI RDC DWI (AUC: 0.85, SP: 72.1%, AC: 79.1%) were significantly better than those of DWI (AUC: 0.79, p = 0.008; SP: 64%, p = 0.02; AC: 74.4%, p = 0.008). CONCLUSION RDC technique has the potential to improve image quality and ability to differentiate malignant from benign prostatic areas on DWIs of suspected prostatic cancer patients.
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Affiliation(s)
- Takahiro Ueda
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Yoshiharu Ohno
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan; Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
| | | | - Kaori Yamamoto
- Canon Medical Systems Corporation, Otawara, Tochigi, Japan
| | - Masato Ikedo
- Canon Medical Systems Corporation, Otawara, Tochigi, Japan
| | - Masao Yui
- Canon Medical Systems Corporation, Otawara, Tochigi, Japan
| | - Takeshi Yoshikawa
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan; Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | - Daisuke Takenaka
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan; Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | - Sayuri Ishida
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Minami Furuta
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Takahiro Matsuyama
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Hiroyuki Nagata
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Hirotaka Ikeda
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Yoshiyuki Ozawa
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Hiroshi Toyama
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
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16
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Knull E, Park CKS, Bax J, Tessier D, Fenster A. Toward mechatronic MRI-guided focal laser ablation of the prostate: Robust registration for improved needle delivery. Med Phys 2023; 50:1259-1273. [PMID: 36583505 DOI: 10.1002/mp.16190] [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: 04/26/2022] [Revised: 12/04/2022] [Accepted: 12/11/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Multiparametric MRI (mpMRI) is an effective tool for detecting and staging prostate cancer (PCa), guiding interventional therapy, and monitoring PCa treatment outcomes. MRI-guided focal laser ablation (FLA) therapy is an alternative, minimally invasive treatment method to conventional therapies, which has been demonstrated to control low-grade, localized PCa while preserving patient quality of life. The therapeutic success of FLA depends on the accurate placement of needles for adequate delivery of ablative energy to the target lesion. We previously developed an MR-compatible mechatronic system for prostate FLA needle guidance and validated its performance in open-air and clinical 3T in-bore experiments using virtual targets. PURPOSE To develop a robust MRI-to-mechatronic system registration method and evaluate its in-bore MR-guided needle delivery accuracy in tissue-mimicking prostate phantoms. METHODS The improved registration multifiducial assembly houses thirty-six aqueous gadolinium-filled spheres distributed over a 7.3 × 7.3 × 5.2 cm volume. MRI-guided needle guidance accuracy was quantified in agar-based tissue-mimicking prostate phantoms on trajectories (N = 44) to virtual targets covering the mechatronic system's range of motion. 3T gradient-echo recalled (GRE) MRI images were acquired after needle insertions to each target, and the air-filled needle tracks were segmented. Needle guidance error was measured as the shortest Euclidean distance between the target point and the segmented needle trajectory, and angular error was measured as the angle between the targeted trajectory and the segmented needle trajectory. These measurements were made using both the previously designed four-sphere registration fiducial assembly on trajectories (N = 7) and compared with the improved multifiducial assembly using a Mann-Whitney U test. RESULTS The median needle guidance error of the system using the improved registration fiducial assembly at a depth of 10 cm was 1.02 mm with an interquartile range (IQR) of 0.42-2.94 mm. The upper limit of the one-sided 95% prediction interval of needle guidance error was 4.13 mm. The median (IQR) angular error was 0.0097 rad (0.0057-0.015 rad) with a one-sided 95% prediction interval upper limit of 0.022 rad. The median (IQR) positioning error using the previous four-sphere registration fiducial assembly was 1.87 mm (1.77-2.14 mm). This was found to be significantly different (p = 0.0012) from the median (IQR) positioning error of 0.28 mm (0.14-0.95 mm) using the new registration fiducial assembly on the same trajectories. No significant difference was detected between the medians of the angular errors (p = 0.26). CONCLUSION This is the first study presenting an improved registration method and validation in tissue-mimicking phantoms of our remotely actuated MR-compatible mechatronic system for delivery of prostate FLA needles. Accounting for the effects of needle deflection, the system was demonstrated to be capable of needle delivery with an error of 4.13 mm or less in 95% of cases under ideal conditions, which is a statistically significant improvement over the previous method. The system will next be validated in a clinical setting.
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Affiliation(s)
- Eric Knull
- Faculty of Engineering, School of Biomedical Engineering, Western University, London, Ontario, Canada
- Robarts Research Institute, Western University, London, Ontario, Canada
| | - Claire Keun Sun Park
- Robarts Research Institute, Western University, London, Ontario, Canada
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Jeffrey Bax
- Robarts Research Institute, Western University, London, Ontario, Canada
| | - David Tessier
- Robarts Research Institute, Western University, London, Ontario, Canada
| | - Aaron Fenster
- Faculty of Engineering, School of Biomedical Engineering, Western University, London, Ontario, Canada
- Robarts Research Institute, Western University, London, Ontario, Canada
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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17
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Kido A, Tamada T, Ueda Y, Takeuchi M, Kanki A, Yamamoto A. Comparison Between Amide Proton Transfer Magnetic Resonance Imaging Using 3-Dimensional Acquisition and Diffusion-Weighted Imaging for Characterization of Prostate Cancer: A Preliminary Study. J Comput Assist Tomogr 2023; 47:178-185. [PMID: 36729617 DOI: 10.1097/rct.0000000000001398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study aimed to compare diagnostic performance for tumor detection and for assessment of tumor aggressiveness in prostate cancer (PC) between amide proton transfer magnetic resonance imaging (MRI) with 3-dimensional acquisition (3DAPT) and diffusion-weighted imaging. METHODS The subjects were 23 patients with 27 pathologically proven PCs who underwent 3T multiparametric MRI. With reference to the pathology findings, 2 readers in consensus identified the location of PC on multiparametric MRI and measured APT signal intensity (APT SI [%]) and mean apparent diffusion coefficient (ADC) of the benign region and each PC lesion. RESULTS The mean ADC showed a significant difference between benign regions and PC lesions (0.74 ± 0.15 vs 1.37 ± 0.21, P < 0.001), whereas APT SI did not ( P = 0.091). Lesion APT SI was significantly higher and lesion ADC was significantly lower in PCs with Gleason group (GG) ≥3 than in PCs with GG ≤2 (3.37 ± 1.30 vs 1.78 ± 0.67, P < 0.001, and 0.71 ± 0.18 vs 0.79 ± 0.10, P = 0.038, respectively). The APT SI was significantly higher in GG3 than in GG1, in GG3 than in GG2, and in GG4 than in GG2 ( P = 0.009, P = 0.001, and P = 0.006, respectively). The area under the curve for separating tumor lesions and benign regions was 0.601 for 3DAPT and 0.983 for ADC ( P < 0.001). The area under the curve for separating tumors with GG ≤2 from tumors with GG ≥3 was 0.912 for 3DAPT and 0.734 for ADC ( P = 0.172). CONCLUSIONS In patients with PC, it might be preferable to use ADC to discriminate benign from malignant tissue and use APT SI for assessment of tumor aggressiveness.
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Affiliation(s)
- Ayumu Kido
- From the Department of Radiology, Kawasaki Medical School, Kurashiki
| | - Tsutomu Tamada
- From the Department of Radiology, Kawasaki Medical School, Kurashiki
| | | | | | - Akihiko Kanki
- From the Department of Radiology, Kawasaki Medical School, Kurashiki
| | - Akira Yamamoto
- From the Department of Radiology, Kawasaki Medical School, Kurashiki
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Jetty S, Loftus JR, Patel A, Gupta A, Puri S, Dogra V. Prostate Cancer-PET Imaging Update. Cancers (Basel) 2023; 15:cancers15030796. [PMID: 36765754 PMCID: PMC9913636 DOI: 10.3390/cancers15030796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 01/20/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
Prostate cancer is the most common non-dermatologic cancer in men, and one of the leading causes of cancer-related mortality. The incidence of prostate cancer increases precipitously after the age of 65 and demonstrates variable aggressiveness, depending on its grade and stage at diagnosis. Despite recent advancements in prostate cancer treatment, recurrence is seen in 25% of patients. Advancements in prostate cancer Positron Emission Tomography (PET) molecular imaging and recent United States Food and Drug Administration (FDA) approvals have led to several new options for evaluating prostate cancer. This manuscript will review the commonly used molecular imaging agents, with an emphasis on Fluorine-18 fluciclovine (Axumin) and PSMA-ligand agents, including their protocols, imaging interpretation, and pitfalls.
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Affiliation(s)
- Sankarsh Jetty
- Department of Imaging Sciences, University of Rochester Medical Center, New York, NY 14642, USA
| | - James Ryan Loftus
- Department of Imaging Sciences, University of Rochester Medical Center, New York, NY 14642, USA
| | - Abhinav Patel
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Akshya Gupta
- Department of Imaging Sciences, University of Rochester Medical Center, New York, NY 14642, USA
| | - Savita Puri
- Department of Imaging Sciences, University of Rochester Medical Center, New York, NY 14642, USA
| | - Vikram Dogra
- Department of Imaging Sciences, University of Rochester Medical Center, New York, NY 14642, USA
- Correspondence:
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Multi-parametric MRI without artificial erection for preoperative assessment of primary penile carcinoma: A pilot study on the correlation between imaging and histopathological findings. Eur J Radiol Open 2023; 10:100478. [PMID: 36793771 PMCID: PMC9922909 DOI: 10.1016/j.ejro.2023.100478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 01/29/2023] Open
Abstract
Purpose We aimed to evaluate the diagnostic potential of non-erectile multi-parametric magnetic resonance imaging (mpMRI) for preoperative assessment of primary penile squamous cell carcinoma (SCC). Method Twenty-five patients who underwent surgery for penile SCC were included. Preoperative mpMRI without artificial erection was performed in all patients. The preoperative MRI protocol consisted of high-resolution morphological and functional sequences (diffusion-weighted imaging and dynamic contrast-enhanced MRI perfusion) covering the penis and lower pelvis. T and N staging, according to the 8th edition of the Union for International Cancer Control TNM classification, as well as the largest diameter and thickness/infiltration depth of the primary lesions were determined in all patients. Imaging data were retrospectively collected and compared with the final histopathology reports. Results Very good agreement was observed between MRI and histopathology for the involvement of corpus spongiosum (p = 0.002) and good agreement was observed for the involvement of penile urethra and tunica albuginea/corpus cavernosum (p < 0.001 and p = 0.007, respectively). Good agreement was observed between MRI and histopathology for overall T staging and weaker, but still good agreement was observed for N staging (p < 0.001 and p = 0.002, respectively). A strong and significant correlation was observed between MRI and histopathology for the largest diameter and thickness/infiltration depth of the primary lesions (p < 0.001). Conclusions Good concordance was observed between MRI and histopathological findings. Our initial findings indicate that non-erectile mpMRI is useful in preoperative assessment of primary penile SCC.
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Tavakoli AA, Hielscher T, Badura P, Görtz M, Kuder TA, Gnirs R, Schwab C, Hohenfellner M, Schlemmer HP, Bonekamp D. Contribution of Dynamic Contrast-enhanced and Diffusion MRI to PI-RADS for Detecting Clinically Significant Prostate Cancer. Radiology 2023; 306:186-199. [PMID: 35972360 DOI: 10.1148/radiol.212692] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Prostate Imaging Reporting and Data System (PI-RADS) version 2.0 requires multiparametric MRI of the prostate, including diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) imaging sequences; however, the contribution of DCE imaging remains unclear. Purpose To assess whether DCE imaging in addition to apparent diffusion coefficient (ADC) and normalized T2 values improves PI-RADS version 2.0 for prediction of clinically significant prostate cancer (csPCa). Materials and Methods In this retrospective study, clinically reported PI-RADS lesions in consecutive men who underwent 3-T multiparametric MRI (T2-weighted, DWI, and DCE MRI) from May 2015 to September 2016 were analyzed quantitatively and compared with systematic and targeted MRI-transrectal US fusion biopsy. The normalized T2 signal (nT2), ADC measurement, mean early-phase DCE signal (mDCE), and heuristic DCE parameters were calculated. Logistic regression analysis indicated the most predictive DCE parameters for csPCa (Gleason grade group ≥2). Receiver operating characteristic parameter models were compared using the Obuchowski test. Recursive partitioning analysis determined ADC and mDCE value ranges for combined use with PI-RADS. Results Overall, 260 men (median age, 64 years [IQR, 58-69 years]) with 432 lesions (csPCa [n = 152] and no csPCa [n = 280]) were included. The mDCE parameter was predictive of csPCa when accounting for the ADC and nT2 parameter in the peripheral zone (odds ratio [OR], 1.76; 95% CI: 1.30, 2.44; P = .001) but not the transition zone (OR, 1.17; 95% CI: 0.81, 1.69; P = .41). Recursive partitioning analysis selected an ADC cutoff of 0.897 × 10-3 mm2/sec (P = .04) as a classifier for peripheral zone lesions with a PI-RADS score assessed on the ADC map (hereafter, ADC PI-RADS) of 3. The mDCE parameter did not differentiate ADC PI-RADS 3 lesions (P = .11), but classified lesions with ADC PI-RADS scores greater than 3 with low ADC values (less than 0.903 × 10-3 mm2/sec, P < .001) into groups with csPCa rates of 70% and 97% (P = .008). A lesion size cutoff of 1.5 cm and qualitative DCE parameters were not defined as classifiers according to recursive partitioning (P > .05). Conclusion Quantitative or qualitative dynamic contrast-enhanced MRI was not relevant for Prostate Imaging Reporting and Data System (PI-RADS) 3 lesion risk stratification, while quantitative apparent diffusion coefficient (ADC) values were helpful in upgrading PI-RADS 3 and PI-RADS 4 lesions. Quantitative ADC measurement may be more important for risk stratification than current methods in future versions of PI-RADS. © RSNA, 2022 Online supplemental material is available for this article See also the editorial by Goh in this issue.
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Affiliation(s)
- Anoshirwan Andrej Tavakoli
- From the Department of Radiology (E010) (A.A.T., P.B., R.G., H.P.S., D.B.), Division of Biostatistics (T.H.), and Department of Medical Physics (T.A.K.), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; and Department of Urology (M.G., M.H.) and Institute of Pathology (C.S.), University of Heidelberg Medical Center, Heidelberg, Germany
| | - Thomas Hielscher
- From the Department of Radiology (E010) (A.A.T., P.B., R.G., H.P.S., D.B.), Division of Biostatistics (T.H.), and Department of Medical Physics (T.A.K.), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; and Department of Urology (M.G., M.H.) and Institute of Pathology (C.S.), University of Heidelberg Medical Center, Heidelberg, Germany
| | - Patrick Badura
- From the Department of Radiology (E010) (A.A.T., P.B., R.G., H.P.S., D.B.), Division of Biostatistics (T.H.), and Department of Medical Physics (T.A.K.), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; and Department of Urology (M.G., M.H.) and Institute of Pathology (C.S.), University of Heidelberg Medical Center, Heidelberg, Germany
| | - Magdalena Görtz
- From the Department of Radiology (E010) (A.A.T., P.B., R.G., H.P.S., D.B.), Division of Biostatistics (T.H.), and Department of Medical Physics (T.A.K.), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; and Department of Urology (M.G., M.H.) and Institute of Pathology (C.S.), University of Heidelberg Medical Center, Heidelberg, Germany
| | - Tristan Anselm Kuder
- From the Department of Radiology (E010) (A.A.T., P.B., R.G., H.P.S., D.B.), Division of Biostatistics (T.H.), and Department of Medical Physics (T.A.K.), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; and Department of Urology (M.G., M.H.) and Institute of Pathology (C.S.), University of Heidelberg Medical Center, Heidelberg, Germany
| | - Regula Gnirs
- From the Department of Radiology (E010) (A.A.T., P.B., R.G., H.P.S., D.B.), Division of Biostatistics (T.H.), and Department of Medical Physics (T.A.K.), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; and Department of Urology (M.G., M.H.) and Institute of Pathology (C.S.), University of Heidelberg Medical Center, Heidelberg, Germany
| | - Constantin Schwab
- From the Department of Radiology (E010) (A.A.T., P.B., R.G., H.P.S., D.B.), Division of Biostatistics (T.H.), and Department of Medical Physics (T.A.K.), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; and Department of Urology (M.G., M.H.) and Institute of Pathology (C.S.), University of Heidelberg Medical Center, Heidelberg, Germany
| | - Markus Hohenfellner
- From the Department of Radiology (E010) (A.A.T., P.B., R.G., H.P.S., D.B.), Division of Biostatistics (T.H.), and Department of Medical Physics (T.A.K.), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; and Department of Urology (M.G., M.H.) and Institute of Pathology (C.S.), University of Heidelberg Medical Center, Heidelberg, Germany
| | - Heinz-Peter Schlemmer
- From the Department of Radiology (E010) (A.A.T., P.B., R.G., H.P.S., D.B.), Division of Biostatistics (T.H.), and Department of Medical Physics (T.A.K.), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; and Department of Urology (M.G., M.H.) and Institute of Pathology (C.S.), University of Heidelberg Medical Center, Heidelberg, Germany
| | - David Bonekamp
- From the Department of Radiology (E010) (A.A.T., P.B., R.G., H.P.S., D.B.), Division of Biostatistics (T.H.), and Department of Medical Physics (T.A.K.), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; and Department of Urology (M.G., M.H.) and Institute of Pathology (C.S.), University of Heidelberg Medical Center, Heidelberg, Germany
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Singla A, Deep N, Naik S, Mohakud S, Nayak P, Sable M. Correlation of multiparametric MRI with histopathological grade of peripheral zone prostate carcinoma. J Cancer Res Ther 2023; 19:S569-S576. [PMID: 38384020 DOI: 10.4103/jcrt.jcrt_280_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 07/06/2022] [Indexed: 02/23/2024]
Abstract
BACKGROUND Prostatic cancer is the second most common malignant tumor in men. Preoperative grading of prostate cancer is important for its management. Our objective is to compare individual and combined detection rates of T2-weighted imaging (T2WI), diffusion weighted imaging (DWI), dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI), and magnetic resonance spectroscopy (MRS) for prostate cancer with histopathological diagnosis as its golden standard. METHODS Forty-four patients with positive digital rectal examination (DRE) findings and elevated prostate specific antigen (PSA), underwent multiparametric MRI (Mp-MRI). T2WI, DWI, DCE-MRI and MRS were done in all the patients. Cognitive magnetic resonance-transrectal ultrasound (MR-TRUS) fusion biopsy was done in all the patients. Sensitivity and specificity of T2WI, DWI, DCE-MRI, and Prostate Imaging - Reporting and Data System PIRADS version 2 was obtained. Apparent diffusion coefficient (ADC) value and choline/citrate ratio were obtained for each lesion and correlated with histopathological grade. RESULTS The mean age of the patients was 68.7 ± 10.1 years, and the mean serum PSA level was 58.1 ± 22.4 ng/dL. Of the 38 lesions in peripheral zone, 33 (87%) had histopathologically proven prostate cancer. T2WI had a sensitivity and specificity of 75.8% and 80% and DWI had a sensitivity and specificity of 90.9% and 80%, respectively, for detection of malignant prostatic lesion. The mean ADC values for prostate cancer, prostatitis, and normal prostatic parenchyma were 0.702 ± 0.094 × 10-3 mm2/sec, 0.959 ± 0.171 × 10-3 mm2/sec, and 1.31 ± 0.223 × 10-3 mm2/sec, respectively. Type 3 curve has lower sensitivity (45.5%) but high specificity (80%) for diagnosing prostate cancer. CONCLUSION DWI can be useful to differentiate benign from malignant prostatic lesions, and low-grade from high-grade prostate carcinoma. ADC value has a positive correlation with histopathological grade of prostate cancer.
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Affiliation(s)
- Amit Singla
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Nerbadyswari Deep
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sudipta Mohakud
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Prasant Nayak
- Department of Urology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Mukund Sable
- Department of Pathology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Suguino RK, Mussi TC, Coelho FMA, Baroni RH. Prostate imaging features on magnetic resonance imaging of young patients. EINSTEIN-SAO PAULO 2022; 20:eAO0024. [PMID: 36477522 DOI: 10.31744/einstein_journal/2022ao0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 08/23/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To identify magnetic resonance imaging findings of the prostate in young adults, including symptomatic and asymptomatic patients. The aim of this study is to evaluate the main aspects of prostate imaging in young patients. METHODS A total of 102 patients under 40 years of age, who underwent prostate magnetic resonance imaging between January 2016 and January 2019, were included in this study. The patients were divided into two groups: symptomatic for prostatitis (Group 1) and asymptomatic (Group 2). Magnetic resonance imaging scans were anonymized and interpreted by a radiologist blinded for clinical information. The study evaluated peripheral zone signal in T2-weighted sequences, diffusion and apparent diffusion coefficient map; peripheral zone enhancement pattern; seminal vesicles and periprostatic fat. RESULTS All evaluated criteria did not present statistically significant differences between the two groups. The most common pattern was heterogeneous hyposignal on T2 (57.9% in Group 1 and 57.8% in Group 2; p=0.506), mild diffuse / wedge-shaped areas of hypointensity on apparent diffusion coefficient map (61.4% in Group 1 and 64.4% in Group 2; p=0.931) and early post-contrast enhancement (73.7% in Group 1 and 68.9% in Group 2, p=0719). CONCLUSION The magnetic resonance imaging aspect of young patients showed no differences between symptomatic and asymptomatic patients.
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Washino S, Ito K, Miyagawa T. Prostate-specific antigen level, biopsy grade group, and tumor-capsular contact length on magnetic resonance imaging are independently associated with an extraprostatic extension. Int J Urol 2022; 29:1455-1461. [PMID: 36001632 DOI: 10.1111/iju.15012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 07/21/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To define the clinicopathological and radiological factors independently associated with the existence of an extraprostatic extension in radical prostatectomy specimens. METHODS A total of 202 patients who underwent robotic prostatectomy following biparametric magnetic resonance imaging were assessed. We evaluated the clinicopathological and magnetic resonance imaging variables. We performed receiver-operating characteristic curve analyses to identify factors associated with extraprostatic extension. We engaged in multivariate analysis to identify factors independently associated with such extension. RESULTS Extraprostatic extensions were apparent in the final prostatectomy specimens of 62 patients (31%). The areas under the curves of the prostate-specific antigen level, the biopsy grade group, and the tumor-capsular contact length on magnetic resonance imaging were 0.76, 0.71, and 0.70, respectively, in receiver-operating characteristic analysis when used to predict extraprostatic extension; thus, higher than the areas under the curves of the other variables (0.61-0.68). The prostate-specific antigen level (odds ratio 1.090, p = 0.004), the biopsy grade group (odds ratios 2.678 and 6.358, p = 0.017 and p < 0.001 for grade group 3-4 and 5), and the tumor-capsular contact length (odds ratio 1.079, p = 0.001) were independently associated with extraprostatic extension. When the three factors were combined, the area under the receiver-operator characteristic curve increased to 0.79. CONCLUSIONS The prostate-specific antigen level, the biopsy grade group, and the tumor-capsular contact length on magnetic resonance imaging were independently associated with extracapsular extension.
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Affiliation(s)
- Satoshi Washino
- Department of Urology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Koichi Ito
- Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Tomoaki Miyagawa
- Department of Urology, Jichi Medical University Saitama Medical Center, Saitama, Japan
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Ghanghoria A, Barua SK, Rajeev TP, Bagchi PK, Sarma D, Phukan M, Sharma V. Role of diffusion-weighted MRI for prediction of regional lymph node positivity in radiologically organ-confined renal tumour: a prospective study. AFRICAN JOURNAL OF UROLOGY 2022. [DOI: 10.1186/s12301-022-00307-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Lymph node metastasis is one of the major factors that decide the prognosis of renal cell carcinoma. Presently, lymphadenectomy is only accepted as the most precise and dependable staging method to detect lymph node invasion; still, its therapeutic value for renal cell carcinoma is controversial. Diffusion-weighted magnetic resonance imaging along with its apparent diffusion coefficient value has already shown great value as a non-invasive modality to detect early microstructural changes in various human tumours. The present study is done to know the role of DWMRI in determining regional lymph node positivity in radiologically organ-confined renal cell carcinoma.
Methods
In this prospective study, we measured the ADC value of renal mass and regional lymph node in patient of RCC. ADC value < 1.25 is taken as cut-off to determine lymph node involvement. A malignant lymph node was confirmed by histopathology postoperatively. After that, we analysed the data retrospectively and studied the association between cut-off ADC value and lymph node positivity.
Results
Total 44 patients of RCC were evaluated in the study. Out of 44 patients, lymph node was found to be malignant on histopathology in 25 (56.8%) patients, and of these, 23 patients had ADC value < 1.25. This association was statistically significant (p < 0.05). The findings of DW MRI were accurate in 72.7% of patients with sensitivity of 63.1%, specificity of 80% and positive predictive value of 70.5%.
Conclusions
Lymph node with ADC value < 1.25 × 10–3 mm2/s has higher probabilities of harbouring malignant cell, so ADC value of DWMRI can be used as a sensitive and specific parameter to differentiate malignant lymph node from benign lymph node. However, our futuristic observation needs to be validated by multi-institutional large sample cohort.
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Biswas P, Dehghani H, Sikander S, Song SE. Kinematic and mechanical modelling of a novel 4-DOF robotic needle guide for MRI-guided prostate intervention. BIOMEDICAL ENGINEERING ADVANCES 2022; 4:100036. [PMID: 35968253 PMCID: PMC9365025 DOI: 10.1016/j.bea.2022.100036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Traditionally ultrasound-guided biopsy has been used to diagnose prostate cancer despite of its poor soft tissue contrast and frequent false negative results. Magnetic Resonance Imaging (MRI) has the advantage of excellent soft tissue contrast for guiding and monitoring prostate biopsy. However, its working area and access in the confined MRI bore space limit the use of interventional guide devices including robotic systems. To provide robotic precision, greater access, and compact design, we designed a novel robotic mechanism that can provide four degrees of freedom (DOF) manipulation in a compact form comparable to size of manual templates. To develop the mechanism, we established a mathematical model of inverse and forward kinematics and prototyped a proof-of-concept needle guide for MRI guided prostate biopsy. The mechanism was materialized using four discs that house small passive spherical joints that can be moved by rotating the discs consisting of grooved profile. With an initial needle insertion angle range of ±15°, we identified mathematical and kinematic parameters for the mechanism design and fabricated the first prototype that has dimension of 40 × 110 × 180 mm3. The prototype demonstrated that the unique robotic manipulation can physically be delivered and could provide precise needle guidance including angulated needle insertion with higher structural rigidity.
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Affiliation(s)
- Pradipta Biswas
- Department of Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL, United States
| | | | - Sakura Sikander
- Department of Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL, United States
| | - Sang-Eun Song
- Department of Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL, United States
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Knight AS, Sharma P, de Riese WTW. MRI determined prostate volume and the incidence of prostate cancer on MRI-fusion biopsy: a systemic review of reported data for the last 20 years. Int Urol Nephrol 2022; 54:3047-3054. [PMID: 36040649 DOI: 10.1007/s11255-022-03351-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 08/20/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE Magnetic resonance imaging (MRI) is a precise, systemic and advantageous imaging technique when compared to transrectal ultrasound (TRUS) which is very operator dependent. The negative correlation between prostate volume and the incidence of prostate cancer (PCa) obtained by TRUS biopsy has been well documented in the literature. The purpose of this systemic review is analyzing the reported MRI-fusion study results on prostate biopsies regarding any correlation between prostate volume and the incidence of PCa. METHODS After defining the inclusion and exclusion criteria an in-depth review were performed between 01.01.2000 and 02.08.2022 using the PubMed database and applying the "PRISMA" guidelines. RESULTS Twelve studies qualified, and all showed an inverse/negative relationship between prostate volume and incidence of PCa. Sample sizes ranged from 33 to 2767 patients in single and multi-institutional studies. All studies showed a statistically significant inverse relationship with a p value < 0.05. The graph summarizing all of studies and using Fisher's method revealed a highly significant combined p level of 0.00001. Additionally, not one single study was found showing the contrary (a positive correlation between prostate size and the incidence of PCa). CONCLUSION To our knowledge, this is the first systemic review of reported MRI-Fusion data on the incidence of PCa in correlation with prostate volume. This MRI review confirms previous TRUS-biopsy studies which demonstrated an inverse relationship between prostate volume and the incidence of PCa, and thus further supports the hypothesis that large prostates size may be protective against PCa when compared to smaller prostates.
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Affiliation(s)
- Andrew S Knight
- Department of Urology, School of Medicine, Texas Tech University Health Sciences Center, 3601-4th Street STOP 7260, Lubbock, TX, 79430-7260, USA
| | - Pranav Sharma
- Department of Urology, School of Medicine, Texas Tech University Health Sciences Center, 3601-4th Street STOP 7260, Lubbock, TX, 79430-7260, USA
| | - Werner T W de Riese
- Department of Urology, School of Medicine, Texas Tech University Health Sciences Center, 3601-4th Street STOP 7260, Lubbock, TX, 79430-7260, USA.
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Harder FN, Weiss K, Amiel T, Peeters JM, Tauber R, Ziegelmayer S, Burian E, Makowski MR, Sauter AP, Gschwend JE, Karampinos DC, Braren RF. Prospectively Accelerated T2-Weighted Imaging of the Prostate by Combining Compressed SENSE and Deep Learning in Patients with Histologically Proven Prostate Cancer. Cancers (Basel) 2022; 14:cancers14235741. [PMID: 36497223 PMCID: PMC9738899 DOI: 10.3390/cancers14235741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND To assess the performance of prospectively accelerated and deep learning (DL) reconstructed T2-weighted (T2w) imaging in volunteers and patients with histologically proven prostate cancer (PCa). METHODS Prospectively undersampled T2w datasets were acquired with acceleration factors of 1.7 (reference), 3.4 and 4.8 in 10 healthy volunteers and 23 patients with histologically proven PCa. Image reconstructions using compressed SENSE (C-SENSE) and a combination of C-SENSE and DL-based artificial intelligence (C-SENSE AI) were analyzed. Qualitative image comparison was performed using a 6-point Likert scale (overall image quality, noise, motion artifacts, lesion detection, diagnostic certainty); the T2 and PI-RADS scores were compared between the two reconstructions. Additionally, quantitative image parameters were assessed (apparent SNR, apparent CNR, lesion size, line profiles). RESULTS All C-SENSE AI-reconstructed images received a significantly higher qualitative rating compared to the C-SENSE standard images. Analysis of the quantitative parameters supported this finding, with significantly higher aSNR and aCNR. The line profiles demonstrated a significantly steeper signal change at the border of the prostatic lesion and the adjacent normal tissue in the C-SENSE AI-reconstructed images, whereas the T2 and PI-RADS scores as well as the lesion size did not differ. CONCLUSION In this prospective study, we demonstrated the clinical feasibility of a novel C-SENSE AI reconstruction enabling a 58% acceleration in T2w imaging of the prostate while obtaining significantly better image quality.
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Affiliation(s)
- Felix N. Harder
- Institute of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
- Correspondence:
| | - Kilian Weiss
- Philips GmbH, Röntgenstrasse 22, 22335 Hamburg, Germany
| | - Thomas Amiel
- Department of Urology, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Johannes M. Peeters
- Philips Healthcare, Veenpluis 4-6, Building QR-0.113, 5684 Best, The Netherlands
| | - Robert Tauber
- Department of Urology, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Sebastian Ziegelmayer
- Institute of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Egon Burian
- Institute of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Marcus R. Makowski
- Institute of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Andreas P. Sauter
- Institute of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Jürgen E. Gschwend
- Department of Urology, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Dimitrios C. Karampinos
- Institute of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Rickmer F. Braren
- Institute of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
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Mohsen N. Role of MRI, Ultrasound, and Computed Tomography in the Management of Prostate Cancer. PET Clin 2022; 17:565-583. [DOI: 10.1016/j.cpet.2022.07.002] [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]
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Prostate Cancer Detection with mpMRI According to PI-RADS v2 Compared with Systematic MRI/TRUS-Fusion Biopsy: A Prospective Study. Tomography 2022; 8:2020-2029. [PMID: 36006067 PMCID: PMC9416664 DOI: 10.3390/tomography8040169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/05/2022] [Accepted: 08/07/2022] [Indexed: 11/17/2022] Open
Abstract
Background: mpMRI assesses prostate lesions through their PI-RADS score. The primary goal of this prospective study was to demonstrate the correlation of PI-RADS v2 score and the volume of a lesion with the presence and clinical significance of prostate cancer (PCa). The secondary goal was to determine the extent of additionally PCa in inconspicuous areas. Methods: All 157 patients underwent a perineal MRI/TRUS-fusion prostate biopsy. Targeted biopsies as well as a systematic biopsy were performed. The presence of PCa in the probes was specified by the ISUP grading system. Results: In total, 258 lesions were biopsied. Of the PI-RADS 3 lesions, 24% were neoplastic. This was also true for 36.9% of the PI-RADS 4 lesions and for 59.5% of the PI-RADS 5 lesions. Correlation between ISUP grades and lesion volume was significant (p < 0.01). In the non-suspicious mpMRI areas carcinoma was revealed in 19.7% of the patients. Conclusions: The study shows that the PI-RADS v2 score and the lesion volume correlate with the presence and clinical significance of PCa. However, there are two major points to consider: First, there is a high number of false positive findings. Second, inconspicuous mpMRI areas revealed PCa.
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Hu C, Sun J, Xu Z, Zhang Z, Zhou Q, Xu J, Chen H, Wang C, Ouyang J. Development and external validation of a novel nomogram to predict prostate cancer in biopsy-naïve patients with PSA <10 ng/ml and PI-RADS v2.1 = 3 lesions. Cancer Med 2022; 12:2560-2571. [PMID: 35920264 PMCID: PMC9939143 DOI: 10.1002/cam4.5100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To develop and externally validate a novel nomogram in biopsy-naïve patients with prostate-specific antigen (PSA) <10 ng/ml and PI-RADS v2.1 = 3 lesions. METHODS We retrospectively collected 307 men that underwent initial biopsy from October 2015 to January 2022 in Cohort 1 (The First Affiliated Hospital of Soochow University). External cohort (Cohort 2, Kunshan Hospital) included 109 men that met our criteria from July 2016 to June 2021. By Slicer-3D Software, the volume of all lesions was divided into two subgroups (PI-RADS v2.1 = 3a and 3b). Logistic regression analysis was performed to screen for variables and construct nomogram by analyzing clinical data from Cohort 1. Receiver operating characteristics curve analysis, calibration plot and decision curve analysis (DCA) were plotted to validate the nomogram in external cohort. RESULTS A total of 70 (22.8%) patients was diagnosed with prostate cancer in Institution 1. Among them, 34 (11.1%) had clinically significant prostate cancer (csPCa). Age, prostate-specific antigen density, digital rectal examination, PI-RADS v2.1 = 3 subgroups (3a and 3b) and apparent diffusion coefficient (ADC, <750 mm2 /s) were predictive factors for prostate cancer (PCa) and csPCa. High area under the curve of the nomogram was found in Cohort 1 and Cohort 2 for PCa (0.857 vs. 0.850) and for csPCa (0.896 vs. 0.893). Calibration curves showed excellent agreement between the predicted probability and actual risk for the models in internal and external validation. The DCA demonstrated net benefit of our nomogram. CONCLUSION Until now, this is the first nomogram that predicts PCa and csPCa in biopsy-naïve patients with PSA <10 ng/ml and PI-RADS v2.1 = 3 lesions. Furthermore, PI-RADS v2.1 = 3 subgroups were considered to be an independent risk factor in our model. Our nomogram may assist urologists in biopsy decision making for these so-called "double gray zone" patients.
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Affiliation(s)
- Can Hu
- Department of UrologyThe First Affiliated Hospital of Soochow UniversitySuzhouJiangsuChina
| | - Jiale Sun
- Department of UrologyThe First Affiliated Hospital of Soochow UniversitySuzhouJiangsuChina
| | - Zhenyu Xu
- Department of UrologyThe Affiliated Hospital of Nanjing University of Traditional Chinese MedicineKunshanChina
| | - Zhiyu Zhang
- Department of UrologyThe First Affiliated Hospital of Soochow UniversitySuzhouJiangsuChina
| | - Qi Zhou
- Department of UrologyThe First Affiliated Hospital of Soochow UniversitySuzhouJiangsuChina
| | - Jiangnan Xu
- Department of UrologyThe First Affiliated Hospital of Soochow UniversitySuzhouJiangsuChina
| | - Hao Chen
- Department of UrologyThe First Affiliated Hospital of Soochow UniversitySuzhouJiangsuChina
| | - Chao Wang
- Department of UrologyThe First Affiliated Hospital of Soochow UniversitySuzhouJiangsuChina
| | - Jun Ouyang
- Department of UrologyThe First Affiliated Hospital of Soochow UniversitySuzhouJiangsuChina
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Tamada T, Ueda Y, Kido A, Yoneyama M, Takeuchi M, Sanai H, Ono K, Yamamoto A, Sone T. Clinical application of single-shot echo-planar diffusion-weighted imaging with compressed SENSE in prostate MRI at 3T: preliminary experience. MAGMA (NEW YORK, N.Y.) 2022; 35:549-556. [PMID: 35403993 DOI: 10.1007/s10334-022-01010-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/16/2022] [Accepted: 03/22/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Image quality (IQ) of diffusion-weighted imaging (DWI) with single-shot echo-planar imaging (ssEPI) suffers from low signal-to-noise ratio (SNR) in high b-value acquisitions. Compressed SENSE (C-SENSE), which combines SENSE with compressed sensing, enables SNR to be improved by reducing noise. The aim of this study was to compare IQ and prostate cancer (PC) detectability between DWI with ssEPI using SENSE (EPIS) and using C-SENSE (EPICS). MATERIALS AND METHODS Twenty-five patients with pathologically proven PC underwent multi-parametric magnetic resonance imaging at 3T. DW images acquired with EPIS and EPICS were assessed for the following: lesion conspicuity (LC), SNR, contrast-to-noise ratio (CNR), mean and standard deviation (SD) of apparent diffusion coefficient (ADC) of lesion (lADCm and lADCsd), coefficient of variation of lesion ADC (lADCcv), and mean ADC of benign prostate (bADCm). RESULTS LC were comparable between EPIS and EPICS (p > 0.050), and SNR and CNR were significantly higher in EPICS than EPIS (p = 0.001 and p < 0.001). In both EPIS and EPICS, lADCm was significantly lower than bADCm (p < 0.001). In addition, lADCcv was significantly lower in EPICS than in EPIS (p < 0.001). CONCLUSION Compared with EPIS, EPICS has improved IQ and comparable diagnostic performance in PC.
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Affiliation(s)
- Tsutomu Tamada
- Department of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki-city, Okayama, 701-0192, Japan.
| | - Yu Ueda
- Philips Japan, Konan 2-13-37, Minato-ku, Tokyo, 108-8507, Japan
| | - Ayumu Kido
- Department of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki-city, Okayama, 701-0192, Japan
| | - Masami Yoneyama
- Philips Japan, Konan 2-13-37, Minato-ku, Tokyo, 108-8507, Japan
| | - Mitsuru Takeuchi
- Department of Radiology, Radiolonet Tokai, Asaoka-cho 3-86-2, Chikusa-ku, Nagoya-city , Aichi, 464-0811, Japan
| | - Hiroyasu Sanai
- Department of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki-city, Okayama, 701-0192, Japan
| | - Kentaro Ono
- Department of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki-city, Okayama, 701-0192, Japan
| | - Akira Yamamoto
- Department of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki-city, Okayama, 701-0192, Japan
| | - Teruki Sone
- Department of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki-city, Okayama, 701-0192, Japan
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Stamatelatou A, Scheenen TWJ, Heerschap A. Developments in proton MR spectroscopic imaging of prostate cancer. MAGMA (NEW YORK, N.Y.) 2022; 35:645-665. [PMID: 35445307 PMCID: PMC9363347 DOI: 10.1007/s10334-022-01011-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/04/2022] [Accepted: 03/22/2022] [Indexed: 10/25/2022]
Abstract
In this paper, we review the developments of 1H-MR spectroscopic imaging (MRSI) methods designed to investigate prostate cancer, covering key aspects such as specific hardware, dedicated pulse sequences for data acquisition and data processing and quantification techniques. Emphasis is given to recent advancements in MRSI methodologies, as well as future developments, which can lead to overcome difficulties associated with commonly employed MRSI approaches applied in clinical routine. This includes the replacement of standard PRESS sequences for volume selection, which we identified as inadequate for clinical applications, by sLASER sequences and implementation of 1H MRSI without water signal suppression. These may enable a new evaluation of the complementary role and significance of MRSI in prostate cancer management.
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Affiliation(s)
- Angeliki Stamatelatou
- Department of Medical Imaging (766), Radboud University Medical Center Nijmegen, Geert Grooteplein 10, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Tom W J Scheenen
- Department of Medical Imaging (766), Radboud University Medical Center Nijmegen, Geert Grooteplein 10, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Arend Heerschap
- Department of Medical Imaging (766), Radboud University Medical Center Nijmegen, Geert Grooteplein 10, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
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Sunoqrot MRS, Saha A, Hosseinzadeh M, Elschot M, Huisman H. Artificial intelligence for prostate MRI: open datasets, available applications, and grand challenges. Eur Radiol Exp 2022; 6:35. [PMID: 35909214 PMCID: PMC9339427 DOI: 10.1186/s41747-022-00288-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/09/2022] [Indexed: 11/29/2022] Open
Abstract
Artificial intelligence (AI) for prostate magnetic resonance imaging (MRI) is starting to play a clinical role for prostate cancer (PCa) patients. AI-assisted reading is feasible, allowing workflow reduction. A total of 3,369 multi-vendor prostate MRI cases are available in open datasets, acquired from 2003 to 2021 in Europe or USA at 3 T (n = 3,018; 89.6%) or 1.5 T (n = 296; 8.8%), 346 cases scanned with endorectal coil (10.3%), 3,023 (89.7%) with phased-array surface coils; 412 collected for anatomical segmentation tasks, 3,096 for PCa detection/classification; for 2,240 cases lesions delineation is available and 56 cases have matching histopathologic images; for 2,620 cases the PSA level is provided; the total size of all open datasets amounts to approximately 253 GB. Of note, quality of annotations provided per dataset highly differ and attention must be paid when using these datasets (e.g., data overlap). Seven grand challenges and commercial applications from eleven vendors are here considered. Few small studies provided prospective validation. More work is needed, in particular validation on large-scale multi-institutional, well-curated public datasets to test general applicability. Moreover, AI needs to be explored for clinical stages other than detection/characterization (e.g., follow-up, prognosis, interventions, and focal treatment).
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Affiliation(s)
- Mohammed R S Sunoqrot
- Department of Circulation and Medical Imaging, NTNU-Norwegian University of Science and Technology, 7030, Trondheim, Norway. .,Department of Radiology and Nuclear Medicine, St. Olavs Hospital, Trondheim University Hospital, 7030, Trondheim, Norway.
| | - Anindo Saha
- Diagnostic Image Analysis Group, Department of Medical Imaging, Radboud University Medical Center, Nijmegen, 6525 GA, The Netherlands
| | - Matin Hosseinzadeh
- Diagnostic Image Analysis Group, Department of Medical Imaging, Radboud University Medical Center, Nijmegen, 6525 GA, The Netherlands
| | - Mattijs Elschot
- Department of Circulation and Medical Imaging, NTNU-Norwegian University of Science and Technology, 7030, Trondheim, Norway.,Department of Radiology and Nuclear Medicine, St. Olavs Hospital, Trondheim University Hospital, 7030, Trondheim, Norway
| | - Henkjan Huisman
- Department of Circulation and Medical Imaging, NTNU-Norwegian University of Science and Technology, 7030, Trondheim, Norway.,Diagnostic Image Analysis Group, Department of Medical Imaging, Radboud University Medical Center, Nijmegen, 6525 GA, The Netherlands
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Pseudo-T2 mapping for normalization of T2-weighted prostate MRI. MAGMA (NEW YORK, N.Y.) 2022; 35:573-585. [PMID: 35150363 PMCID: PMC9363383 DOI: 10.1007/s10334-022-01003-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/22/2021] [Accepted: 01/23/2022] [Indexed: 01/04/2023]
Abstract
Objective Signal intensity normalization is necessary to reduce heterogeneity in T2-weighted (T2W) magnetic resonance imaging (MRI) for quantitative analysis of multicenter data. AutoRef is an automated dual-reference tissue normalization method that normalizes transversal prostate T2W MRI by creating a pseudo-T2 map. The aim of this study was to evaluate the accuracy of pseudo-T2s and multicenter standardization performance for AutoRef with three pairs of reference tissues: fat/muscle (AutoRefF), femoral head/muscle (AutoRefFH) and pelvic bone/muscle (AutoRefPB). Materials and methods T2s measured by multi-echo spin echo (MESE) were compared to AutoRef pseudo-T2s in the whole prostate (WP) and zones (PZ and TZ/CZ/AFS) for seven asymptomatic volunteers with a paired Wilcoxon signed-rank test. AutoRef normalization was assessed on T2W images from a multicenter evaluation set of 1186 prostate cancer patients. Performance was measured by inter-patient histogram intersections of voxel intensities in the WP before and after normalization in a selected subset of 80 cases. Results AutoRefFH pseudo-T2s best approached MESE T2s in the volunteer study, with no significant difference shown (WP: p = 0.30, TZ/CZ/AFS: p = 0.22, PZ: p = 0.69). All three AutoRef versions increased inter-patient histogram intersections in the multicenter dataset, with median histogram intersections of 0.505 (original data), 0.738 (AutoRefFH), 0.739 (AutoRefF) and 0.726 (AutoRefPB). Discussion All AutoRef versions reduced variation in the multicenter data. AutoRefFH pseudo-T2s were closest to experimentally measured T2s. Supplementary Information The online version contains supplementary material available at 10.1007/s10334-022-01003-9.
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Value of 68Ga-labeled bombesin antagonist (RM2) in the detection of primary prostate cancer comparing with [ 18F]fluoromethylcholine PET-CT and multiparametric MRI-a phase I/II study. Eur Radiol 2022; 33:472-482. [PMID: 35864350 DOI: 10.1007/s00330-022-08982-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 04/12/2022] [Accepted: 06/12/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The bombesin derivative RM2 is a GRPr antagonist with strong binding affinity to prostate cancer (PCa). In this study, the impact of [68Ga]Ga-RM2 positron emission tomography-computed tomography (PET-CT) for the detection of primary PCa was compared with that of [18F]FCH PET-CT and multiparametric magnetic resonance imaging (mpMRI). METHODS This phase I/II study was conducted in 30 biopsy-positive PCa subjects. The patients were stratified into high (10 patients), intermediate (10 patients), and low risk (10 patients) for extraglandular metastases as defined by National Comprehensive Cancer Network (NCCN) criteria (NCCN Clinical Practice Guidelines in Oncology, 2016). The prostate gland was classified in 12 anatomic segments for data analysis of the imaging modalities as well as histopathologic findings. The segment with the highest radiotracer uptake was defined as the "index lesion." All cases were scheduled to undergo prostatectomy with pelvic lymph node (LN) dissection in intermediate- and high-risk patients. Intraprostatic and pelvic nodal [68Ga]Ga-RM2 and [18F]FCH PET-CT findings were correlated with mpMRI and histopathologic results. RESULTS Of the 312 analyzed regions, 120 regions (4 to 8 lesions per patient) showed abnormal findings in the prostate gland. In a region-based analysis, overall sensitivity and specificity of [68Ga]Ga-RM2 PET-CT in the detection of primary tumor were 74% and 90%, respectively, while it was 60% and 80% for [18F]FCH PET-CT and 72% and 89% for mpMRI. Although the overall sensitivity of [68Ga]Ga-RM2 PET-CT was higher compared to that of [18F]FCH PET-CT and mpMRI, the statistical analysis showed only significant difference between [68Ga]Ga-RM2 PET-CT and [18F]FCH PET-CT in the intermediate-risk group (p = 0.01) and [68Ga]Ga-RM2 PET-CT and mpMRT in the high-risk group (p = 0.03). In the lesion-based analysis, there was no significant difference between SUVmax of [68Ga]Ga-RM2 and [18F]FCH PET-CT in the intraprostatic malignant lesions ([68Ga]Ga-RM2: mean SUVmax: 5.98 ± 4.13, median: 4.75; [18F]FCH: mean SUVmax: 6.08 ± 2.74, median: 5.5; p = 0.13). CONCLUSIONS [68Ga]Ga-RM2 showed promising PET tracer for the detection of intraprostatic PCa in a cohort of patients with different risk stratifications. However, significant differences were only found between [68Ga]Ga-RM2 PET-CT and [18F]FCH PET-CT in the intermediate-risk group and [68Ga]Ga-RM2 PET-CT and mpMRT in the high-risk group. In addition, GRP-R-based imaging seems to play a complementary role to choline-based imaging for full characterization of PCa extent and biopsy guidance in low- and intermediate-metastatic-risk PCa patients and has the potential to discriminate them from those at higher risks. KEY POINTS • [68Ga]Ga-RM2 is a promising PET tracer with a high detection rate for intraprostatic PCa especially in intermediate-risk prostate cancer patients. • GRPr-based imaging seems to play a complementary role to choline-based or PSMA-based PET/CT imaging in selected low- and intermediate-risk PCa patients for better characterization and eventually biopsy guidance of prostate cancer disease.
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Sellers J, Wagstaff R, Helo N, de Riese WTW. Association Between Prostate Size and MRI Determined Quantitative Prostate Zonal Measurements. Res Rep Urol 2022; 14:265-274. [PMID: 35795724 PMCID: PMC9252583 DOI: 10.2147/rru.s362070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/22/2022] [Indexed: 11/28/2022] Open
Abstract
Purpose Benign prostatic hyperplasia (BPH) and prostate cancer (PCa) are the two most prevalent and common urologic diseases impacting elderly men. The current literature has well documented an inverse relationship between prostate/BPH-size and incidence of PCa, but the exact interaction between these two disease entities is not well understood. The purpose of this study is to analyze prostatic zonal measurements with magnetic resonance imaging (MRI) in order to investigate the dynamic changes of the transition zone (TZ) and peripheral zone (PZ) in response to prostate/BPH growth. Methods Multiparametric magnetic resonance imaging (mpMRI) scans of 430 consecutive male patients aged 18–89 years were obtained to measure the different zonal areas of the prostate. The data were statistically analyzed to identify specific associations between the different measurement parameters and total prostate volume (TPV). Results The Mann–Whitney U-test showed a significant decline of the average peripheral zone thickness (PZT) (z = −4.5665, p < 0.0001) in larger prostates when compared to smaller prostates. The Spearman correlation between TPV and PZT demonstrated a significant negative correlation (−0.20, p < 0.0001). Conclusion The data revealed that PZT was significantly smaller in the subgroup of patients with higher TPV. This supports the hypothesis of PZ compression and thinning caused by the growing and expanding TZ in BPH prostates. This dynamic growth-related process in the different prostatic zones may explain the protective effect of BPH against PCa.
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Affiliation(s)
- Jake Sellers
- Texas Tech University Health Sciences Center - School of Medicine, Department of Urology, Lubbock, TX, 79430-7260, USA
| | - Rachel Wagstaff
- Texas Tech University Health Sciences Center - School of Medicine, Department of Urology, Lubbock, TX, 79430-7260, USA
| | - Naseem Helo
- University Medical Center - Department of Radiology, Lubbock, TX, 79415, USA
| | - Werner T W de Riese
- Texas Tech University Health Sciences Center - School of Medicine, Department of Urology, Lubbock, TX, 79430-7260, USA
- Correspondence: Werner TW de Riese, Texas Tech University Health Sciences Center – Department of Urology, 3601 4 Street, Lubbock, TX, 79430-7260, USA, Tel +1 806-743-3862, Fax +1 806-743-3030, Email
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Srinivasan S, Dasgupta A, Chatterjee A, Baheti A, Engineer R, Gupta T, Murthy V. The Promise of Magnetic Resonance Imaging in Radiation Oncology Practice in the Management of Brain, Prostate, and GI Malignancies. JCO Glob Oncol 2022; 8:e2100366. [PMID: 35609219 PMCID: PMC9173575 DOI: 10.1200/go.21.00366] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Magnetic resonance imaging (MRI) has a key role to play at multiple steps of the radiotherapy (RT) treatment planning and delivery process. Development of high-precision RT techniques such as intensity-modulated RT, stereotactic ablative RT, and particle beam therapy has enabled oncologists to escalate RT dose to the target while restricting doses to organs at risk (OAR). MRI plays a critical role in target volume delineation in various disease sites, thus ensuring that these high-precision techniques can be safely implemented. Accurate identification of gross disease has also enabled selective dose escalation as a means to widen the therapeutic index. Morphological and functional MRI sequences have also facilitated an understanding of temporal changes in target volumes and OAR during a course of RT, allowing for midtreatment volumetric and biological adaptation. The latest advancement in linear accelerator technology has led to the incorporation of an MRI scanner in the treatment unit. MRI-guided RT provides the opportunity for MRI-only workflow along with online adaptation for either target or OAR or both. MRI plays a key role in post-treatment response evaluation and is an important tool for guiding decision making. In this review, we briefly discuss the RT-related applications of MRI in the management of brain, prostate, and GI malignancies.
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Affiliation(s)
- Shashank Srinivasan
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Archya Dasgupta
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Abhishek Chatterjee
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Akshay Baheti
- Department of Radiodiagnosis, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Reena Engineer
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Tejpal Gupta
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Vedang Murthy
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
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Impact of enema prep on the false-negative rate of a PI-RADS 1 MRI of the prostate for clinically significant prostate cancer. Abdom Radiol (NY) 2022; 47:2494-2499. [PMID: 35583821 DOI: 10.1007/s00261-022-03547-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE To investigate whether use of an enema prep reduces the false-negative (FN) rate of PI-RADS 1 MRI of the prostate for clinically significant prostate cancer (csPCa). MATERIALS AND METHODS 1108 consecutive patients with a PI-RADS 1 MRI performed 01/2016-09/2021 were retrospectively collected. Patient charts were examined for subsequent systematic prostate biopsy performed within 1 year if positive or anytime thereafter if negative. Patients without biopsy were excluded. Use of an enema prep 1-2 h before MRI, which was implemented in 03/2019, was recorded. FN rate of MRI for detection of csPCa, defined as Gleason score ≥ 7, using systematic biopsy was assessed per patient and compared between those with and without an enema prep. Χ2 test and logistic regression were performed. RESULTS 255 patients (median age 64, IQR 58-69) with median PSA 5.6 (IQR 4.2-8.1), PI-RADS 1 MRI, and subsequent biopsy were included in the analysis. 66 patients (26%) had an enema prep and 189 patients (74%) did not. 7 (11%) patients with and 21 (11%) patients without enema prep had a FN biopsy. There was no significant association between enema prep and FN biopsy (OR 0.95, 95% CI 0.38-2.35, p = 0.91). CONCLUSIONS Use of an enema prep prior to prostate MRI did not decrease the FN rate of PI-RADS 1 MRI of the prostate for clinically significant prostate cancer.
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Guerra A, Negrão E, Papanikolaou N, Donato H. Machine learning in predicting extracapsular extension (ECE) of prostate cancer with MRI: a protocol for a systematic literature review. BMJ Open 2022; 12:e052342. [PMID: 35523484 PMCID: PMC9083401 DOI: 10.1136/bmjopen-2021-052342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION In patients with prostate cancer (PCa), the detection of extracapsular extension (ECE) and seminal vesicle invasion is not only important for selecting the appropriate therapy but also for preoperative planning and patient prognosis. It is of paramount importance to stage PCa correctly before surgery, in order to achieve better surgical and outcome results. Over the last years, MRI has been incorporated in the classical prostate staging nomograms with clinical improvement accuracy in detecting ECE, but with variability between studies and radiologist's experience. METHODS AND ANALYSIS The research question, based on patient, index test, comparator, outcome and study design criteria, was the following: what is the diagnostic performance of artificial intelligence algorithms for predicting ECE in PCa patients, when compared with that of histopathological results after radical prostatectomy. To answer this question, we will use databases (EMBASE, PUBMED, Web of Science and CENTRAL) to search for the different studies published in the literature and we use the QUADA tool to evaluate the quality of the research selection. ETHICS AND DISSEMINATION This systematic review does not require ethical approval. The results will be disseminated through publication in a peer-review journal, as a chapter of a doctoral thesis and through presentations at national and international conferences. PROSPERO REGISTRATION NUMBER CRD42020215671.
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Affiliation(s)
| | - Eduardo Negrão
- Radiology, Centro Hospitalar Universitário de São João, Porto, Portugal
| | | | - Helena Donato
- Documentation and Information Service, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
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Comparison of Prostate Imaging and Reporting Data System V2.0 and V2.1 for Evaluation of Transition Zone Lesions: A 5-Reader 202-Patient Analysis. J Comput Assist Tomogr 2022; 46:523-529. [PMID: 35405714 DOI: 10.1097/rct.0000000000001313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The aim of the study was to compare the distribution of Prostate Imaging and Reporting Data System (PI-RADS) scores, interreader agreement, and diagnostic performance of PI-RADS v2.0 and v2.1 for transition zone (TZ) lesions. METHODS The study included 202 lesions in 202 patients who underwent 3T prostate magnetic resonance imaging showing a TZ lesion that was later biopsied with magnetic resonance imaging/ultrasound fusion. Five abdominal imaging faculty reviewed T2-weighted imaging and high b value/apparent diffusion coefficient images in 2 sessions. Cases were randomized using a crossover design whereby half in the first session were reviewed using v2.0 and the other half using v2.1, and vice versa for the 2nd session. Readers provided T2-weighted imaging and DWI scores, from which PI-RADS scores were derived. RESULTS Interreader agreement for all PI-RADS scores had κ of 0.37 (v2.0) and 0.26 (v2.1). For 4 readers, the percentage of lesions retrospectively scored PI-RADS 1 increased greater than 5% and PI-RADS 2 score decreased greater than 5% from v2.0 to v2.1. For 2 readers, the percentage scored PI-RADS 3 decreased greater than 5% and, for 2 readers, increased greater than 5%. The percentage of PI-RADS 4 and 5 lesions changed less than 5% for all readers. For the 4 readers with increased frequency of PI-RADS 1 using v2.1, 4% to 16% were Gleason score ≥3 + 4 tumor. Frequency of Gleason score ≥3 + 4 in PI-RADS 3 lesions increased for 2 readers and decreased for 1 reader. Sensitivity of PI-RADS of 3 or greater for Gleason score ≥3 + 4 ranged 76% to 90% (v2.0) and 69% to 96% (v2.1). Specificity ranged 32% to 64% (v2.0) and 25% to 72% (v2.1). Positive predictive value ranged 43% to 55% (v2.0) and 41% to 58% (v2.1). Negative predictive value ranged 82% to 87% (v2.0) and 81% to 91% (v2.1). CONCLUSIONS Poor interreader agreement and lack of improvement in diagnostic performance indicate an ongoing need to refine evaluation of TZ lesions.
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Herrmann J, Kaufmann S, Zhang C, Rausch S, Bedke J, Stenzl A, Nikolaou K, Kruck S, Seith F. [Multiparametric MRI of the prostate]. Urologe A 2022; 61:428-440. [PMID: 35389061 DOI: 10.1007/s00120-022-01806-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2022] [Indexed: 11/27/2022]
Abstract
Multiparametric magnetic resonance imaging (mpMRI) is an integral component of prostate cancer diagnostics. According to the S3 guidelines on prostate cancer, mpMRI should be used for the primary diagnostics of prostate cancer as well as in active surveillance (AS). Basically, mpMRI consists of high-resolution T2-weighted (T2w) sequences, diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) sequences, which in turn are the basis for structured reporting according to the prostate imaging reporting and data system (PI-RADS) classification.
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Affiliation(s)
- Judith Herrmann
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - Sascha Kaufmann
- Institut für Diagnostische und Interventionelle Radiologie, Siloah St. Trudpert Klinikum, Wilferdinger Str. 67, 75179, Pforzheim, Deutschland.
| | - Cecilia Zhang
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - Steffen Rausch
- Klinik für Urologie, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - Jens Bedke
- Klinik für Urologie, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - Arnulf Stenzl
- Klinik für Urologie, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - Konstantin Nikolaou
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - Stephan Kruck
- Klinik für Urologie, Siloah St. Trudpert Klinikum, Pforzheim, Deutschland
| | - Ferdinand Seith
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Tübingen, Tübingen, Deutschland
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Grimaldi AM, Salvatore M, Cavaliere C. Diagnostic and prognostic significance of extracellular vesicles in prostate cancer drug resistance: A systematic review of the literature. Prostate Cancer Prostatic Dis 2022:10.1038/s41391-022-00521-w. [PMID: 35264776 DOI: 10.1038/s41391-022-00521-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 02/04/2022] [Accepted: 02/16/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND The clinical behavior of prostate cancer is highly heterogeneous, with most patients diagnosed with localized disease that successfully responds to surgery or radiotherapy. However, a fraction of men relapse after initial treatment because they develop drug resistance. The failure of anticancer drugs leaves resistant cancer cells to survive and proliferate, negatively affecting patient survival. Thus, drug resistance remains a significant obstacle to the effective treatment of prostate cancer patients. In this scenario, the involvement of extracellular vesicles (EVs) in intrinsic and acquired resistance have been reported in several tumors, and accumulating data suggests that their differential content can be used as diagnostic or prognostic factors. Thus, we propose a systematic study of literature to provide a snapshot of the current scenario regarding EVs as diagnostic and prognostic biomarkers resource in resistant prostate cancer. METHODS We performed the current systematic review according to PRISMA guidelines and comprehensively explored PubMed, EMBASE and Google Scholar databases to achieve the article search. RESULTS Thirty-three studies were included and investigated. Among all systematically reviewed EV biomarkers, we found mainly molecules with prognostic significance (61%), molecules with diagnostic relevance (18%), and molecules that serve both purposes (21%). Moreover, among all analyzed molecules isolated from EVs, proteins, mRNAs, and miRNAs emerged to be the most investigated and proposed as potential tools to diagnose or predict resistance/sensitivity to advanced PCa treatments. DISCUSSION Our analysis provides a snapshot of the current scenario regarding EVs as potential clinical biomarkers in resistant PCa. Nevertheless, despite many efforts, the use of EV biomarkers in PCa is currently at an early stage: none of the selected EV biomarkers goes beyond preclinical studies, and their translatability is yet far from clinical settings.
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Tamada T, Kido A, Ueda Y, Takeuchi M, Fukunaga T, Sone T, Yamamoto A. Clinical impact of ultra-high b-value (3000 s/mm 2) diffusion-weighted magnetic resonance imaging in prostate cancer at 3T: comparison with b-value of 2000 s/mm 2. Br J Radiol 2022; 95:20210465. [PMID: 34558293 PMCID: PMC8978230 DOI: 10.1259/bjr.20210465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE High b-value diffusion-weighted imaging (hDWI) with a b-value of 2000 s/mm2 provides insufficient image contrast between benign and malignant tissues and an overlap of apparent diffusion coefficient (ADC) between Gleason grades (GG) in prostate cancer (PC). We compared image quality, PC detectability, and discrimination ability for PC aggressiveness between ultra-high b-value DWI (uhDWI) of 3000 s/mm2 and hDWI. METHODS The subjects were 49 patients with PC who underwent 3T multiparametric MRI. Single-shot echo-planar DWI was acquired with b-values of 0, 2000, and 3000 s/mm2. Anatomical distortion of prostate (AD), signal intensity of benign prostate (PSI), and lesion conspicuity score (LCS) were assessed using a 4-point scale; and signal-to-noise ratio, contrast-to-noise ratio, and mean ADC (×10-3 mm2/s) of lesion (lADC) and surrounding benign region (bADC) were measured. RESULTS PSI was significantly lower in uhDWI than in hDWI (p < 0.001). AD, LCS, signal-to-noise ratio, and contrast-to-noise ratio were comparable between uhDWI and hDWI (all p > 0.05). In contrast, lADC was significantly lower than bADC in both uhDWI and hDWI (both p < 0.001). In comparison of lADC between tumors of ≤GG2 and those of ≥GG3, both uhDWI and hDWI showed significant difference (p = 0.007 and p = 0.021, respectively). AUC for separating tumors of ≤GG2 from those of ≥GG3 was 0.731 in hDWI and 0.699 in uhDWI (p = 0.161). CONCLUSION uhDWI suppressed background signal better than hDWI, but did not contribute to increased diagnostic performance in PC. ADVANCES IN KNOWLEDGE Compared with hDWI, uhDWI could not contribute to increased diagnostic performance in PC.
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Affiliation(s)
- Tsutomu Tamada
- Department of Radiology, Kawasaki Medical School, Kurashiki, Japan
| | - Ayumu Kido
- Department of Radiology, Kawasaki Medical School, Kurashiki, Japan
| | - Yu Ueda
- Philips Japan, Konan 2-13-37, Minato-ku, Tokyo, Japan
| | | | - Takeshi Fukunaga
- Department of Radiology, Kawasaki Medical School, Kurashiki, Japan
| | - Teruki Sone
- Department of Radiology, Kawasaki Medical School, Kurashiki, Japan
| | - Akira Yamamoto
- Department of Radiology, Kawasaki Medical School, Kurashiki, Japan
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MR Imaging in Real Time Guiding of Therapies in Prostate Cancer. Life (Basel) 2022; 12:life12020302. [PMID: 35207589 PMCID: PMC8878909 DOI: 10.3390/life12020302] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 01/31/2022] [Accepted: 02/11/2022] [Indexed: 11/22/2022] Open
Abstract
Magnetic resonance imaging (MRI)-guided therapy for prostate cancer (PCa) aims to reduce the treatment-associated comorbidity of existing radical treatment, including radical prostatectomy and radiotherapy. Although active surveillance has been used as a conservative method to reduce overtreatment, there is a growing demand for less morbidity and personalized (focal) treatment. The development of multiparametric MRI was of real importance in improving the detection, localization and staging of PCa. Moreover, MRI has been useful for lesion targeting within the prostate, as it is used in the guidance of prostate biopsies, by means of cognitive registration, MRI-ultrasound fusion guidance or direct in-bore MRI-guidance. With regard to PCa therapies, MRI is used for precise probe placement into the lesion and to accurately monitor the treatment in real-time. Moreover, advances in MR-compatible thermal ablation allow for noninvasive real-time temperature mapping during treatment. In this review, we present an overview of the current status of MRI-guided therapies in PCa, focusing on cryoablation, focal laser ablation, high intensity focused ultrasound and transurethral ultrasound ablation. We explain the important role of MRI in the evaluation of the completeness of the ablation and during follow-up. Finally, we will discuss the challenges and future development inherent to these new technologies.
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Yuan J, Poon DMC, Lo G, Wong OL, Cheung KY, Yu SK. A narrative review of MRI acquisition for MR-guided-radiotherapy in prostate cancer. Quant Imaging Med Surg 2022; 12:1585-1607. [PMID: 35111651 PMCID: PMC8739116 DOI: 10.21037/qims-21-697] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 08/20/2021] [Indexed: 08/24/2023]
Abstract
Magnetic resonance guided radiotherapy (MRgRT), enabled by the clinical introduction of the integrated MRI and linear accelerator (MR-LINAC), is a novel technique for prostate cancer (PCa) treatment, promising to further improve clinical outcome and reduce toxicity. The role of prostate MRI has been greatly expanded from the traditional PCa diagnosis to also PCa screening, treatment and surveillance. Diagnostic prostate MRI has been relatively familiar in the community, particularly with the development of Prostate Imaging - Reporting and Data System (PI-RADS). But, on the other hand, the use of MRI in the emerging clinical practice of PCa MRgRT, which is substantially different from that in PCa diagnosis, has been so far sparsely presented in the medical literature. This review attempts to give a comprehensive overview of MRI acquisition techniques currently used in the clinical workflows of PCa MRgRT, from treatment planning to online treatment guidance, in order to promote MRI practice and research for PCa MRgRT. In particular, the major differences in the MRI acquisition of PCa MRgRT from that of diagnostic prostate MRI are demonstrated and explained. Limitations in the current MRI acquisition for PCa MRgRT are analyzed. The future developments of MRI in the PCa MRgRT are also discussed.
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Affiliation(s)
- Jing Yuan
- Medical Physics and Research Department, Hong Kong Sanatorium & Hospital, Hong Kong, China
| | - Darren M. C. Poon
- Comprehensive Oncology Centre, Hong Kong Sanatorium & Hospital, Hong Kong, China
| | - Gladys Lo
- Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium & Hospital, Hong Kong, China
| | - Oi Lei Wong
- Medical Physics and Research Department, Hong Kong Sanatorium & Hospital, Hong Kong, China
| | - Kin Yin Cheung
- Medical Physics and Research Department, Hong Kong Sanatorium & Hospital, Hong Kong, China
| | - Siu Ki Yu
- Medical Physics and Research Department, Hong Kong Sanatorium & Hospital, Hong Kong, China
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Ueda T, Ohno Y, Yamamoto K, Murayama K, Ikedo M, Yui M, Hanamatsu S, Tanaka Y, Obama Y, Ikeda H, Toyama H. Deep Learning Reconstruction of Diffusion-weighted MRI Improves Image Quality for Prostatic Imaging. Radiology 2022; 303:373-381. [PMID: 35103536 DOI: 10.1148/radiol.204097] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background Deep learning reconstruction (DLR) may improve image quality. However, its impact on diffusion-weighted imaging (DWI) of the prostate has yet to be assessed. Purpose To determine whether DLR can improve image quality of diffusion-weighted MRI at b values ranging from 1000 sec/mm2 to 5000 sec/mm2 in patients with prostate cancer. Materials and Methods In this retrospective study, images of the prostate obtained at DWI with a b value of 0 sec/mm2, DWI with a b value of 1000 sec/mm2 (DWI1000), DWI with a b value of 3000 sec/mm2 (DWI3000), and DWI with a b value of 5000 sec/mm2 (DWI5000) from consecutive patients with biopsy-proven cancer from January to June 2020 were reconstructed with and without DLR. Image quality was assessed using signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) from region-of-interest analysis and qualitatively assessed using a five-point visual scoring system (1 [very poor] to 5 [excellent]) for each high-b-value DWI sequence with and without DLR. The SNR, CNR, and visual score for DWI with and without DLR were compared with the paired t test and the Wilcoxon signed rank test with Bonferroni correction, respectively. Apparent diffusion coefficients (ADCs) from DWI with and without DLR were also compared with the paired t test with Bonferroni correction. Results A total of 60 patients (mean age, 67 years; age range, 49-79 years) were analyzed. DWI with DLR showed significantly higher SNRs and CNRs than DWI without DLR (P < .001); for example, with DWI1000 the mean SNR was 38.7 ± 0.6 versus 17.8 ± 0.6, respectively (P < .001), and the mean CNR was 18.4 ± 5.6 versus 7.4 ± 5.6, respectively (P < .001). DWI with DLR also demonstrated higher qualitative image quality than DWI without DLR (mean score: 4.8 ± 0.4 vs 4.0 ± 0.7, respectively, with DWI1000 [P = .001], 3.8 ± 0.7 vs 3.0 ± 0.8 with DWI3000 [P = .002], and 3.1 ± 0.8 vs 2.0 ± 0.9 with DWI5000 [P < .001]). ADCs derived with and without DLR did not differ substantially (P > .99). Conclusion Deep learning reconstruction improves the image quality of diffusion-weighted MRI scans of prostate cancer with no impact on apparent diffusion coefficient quantitation with a 3.0-T MRI system. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Turkbey in this issue.
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Affiliation(s)
- Takahiro Ueda
- From the Department of Radiology (T.U., Y. Ohno, S.H., Y.T., Y. Obama, H.I., H.T.) and Joint Research Laboratory of Advanced Medical Imaging (Y. Ohno, K.M.), Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan; and Canon Medical Systems Corporation, Otawara, Japan (K.Y., M.I., M.Y.)
| | - Yoshiharu Ohno
- From the Department of Radiology (T.U., Y. Ohno, S.H., Y.T., Y. Obama, H.I., H.T.) and Joint Research Laboratory of Advanced Medical Imaging (Y. Ohno, K.M.), Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan; and Canon Medical Systems Corporation, Otawara, Japan (K.Y., M.I., M.Y.)
| | - Kaori Yamamoto
- From the Department of Radiology (T.U., Y. Ohno, S.H., Y.T., Y. Obama, H.I., H.T.) and Joint Research Laboratory of Advanced Medical Imaging (Y. Ohno, K.M.), Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan; and Canon Medical Systems Corporation, Otawara, Japan (K.Y., M.I., M.Y.)
| | - Kazuhiro Murayama
- From the Department of Radiology (T.U., Y. Ohno, S.H., Y.T., Y. Obama, H.I., H.T.) and Joint Research Laboratory of Advanced Medical Imaging (Y. Ohno, K.M.), Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan; and Canon Medical Systems Corporation, Otawara, Japan (K.Y., M.I., M.Y.)
| | - Masato Ikedo
- From the Department of Radiology (T.U., Y. Ohno, S.H., Y.T., Y. Obama, H.I., H.T.) and Joint Research Laboratory of Advanced Medical Imaging (Y. Ohno, K.M.), Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan; and Canon Medical Systems Corporation, Otawara, Japan (K.Y., M.I., M.Y.)
| | - Masao Yui
- From the Department of Radiology (T.U., Y. Ohno, S.H., Y.T., Y. Obama, H.I., H.T.) and Joint Research Laboratory of Advanced Medical Imaging (Y. Ohno, K.M.), Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan; and Canon Medical Systems Corporation, Otawara, Japan (K.Y., M.I., M.Y.)
| | - Satomu Hanamatsu
- From the Department of Radiology (T.U., Y. Ohno, S.H., Y.T., Y. Obama, H.I., H.T.) and Joint Research Laboratory of Advanced Medical Imaging (Y. Ohno, K.M.), Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan; and Canon Medical Systems Corporation, Otawara, Japan (K.Y., M.I., M.Y.)
| | - Yumi Tanaka
- From the Department of Radiology (T.U., Y. Ohno, S.H., Y.T., Y. Obama, H.I., H.T.) and Joint Research Laboratory of Advanced Medical Imaging (Y. Ohno, K.M.), Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan; and Canon Medical Systems Corporation, Otawara, Japan (K.Y., M.I., M.Y.)
| | - Yuki Obama
- From the Department of Radiology (T.U., Y. Ohno, S.H., Y.T., Y. Obama, H.I., H.T.) and Joint Research Laboratory of Advanced Medical Imaging (Y. Ohno, K.M.), Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan; and Canon Medical Systems Corporation, Otawara, Japan (K.Y., M.I., M.Y.)
| | - Hirotaka Ikeda
- From the Department of Radiology (T.U., Y. Ohno, S.H., Y.T., Y. Obama, H.I., H.T.) and Joint Research Laboratory of Advanced Medical Imaging (Y. Ohno, K.M.), Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan; and Canon Medical Systems Corporation, Otawara, Japan (K.Y., M.I., M.Y.)
| | - Hiroshi Toyama
- From the Department of Radiology (T.U., Y. Ohno, S.H., Y.T., Y. Obama, H.I., H.T.) and Joint Research Laboratory of Advanced Medical Imaging (Y. Ohno, K.M.), Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan; and Canon Medical Systems Corporation, Otawara, Japan (K.Y., M.I., M.Y.)
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Gibbons M, Starobinets O, Simko JP, Kurhanewicz J, Carroll PR, Noworolski SM. Identification of prostate cancer using multiparametric MR imaging characteristics of prostate tissues referenced to whole mount histopathology. Magn Reson Imaging 2022; 85:251-261. [PMID: 34666162 PMCID: PMC9931199 DOI: 10.1016/j.mri.2021.10.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/05/2021] [Accepted: 10/12/2021] [Indexed: 12/24/2022]
Abstract
In this study, the objective was to characterize the MR signatures of the various benign prostate tissues and to differentiate them from cancer. Data was from seventy prostate cancer patients who underwent multiparametric MRI (mpMRI) and subsequent prostatectomy. The scans included T2-weighted imaging (T2W), diffusion weighted imaging, dynamic contrast-enhanced MRI (DCE MRI), and MR spectroscopic imaging. Histopathology tissue information was translated to MRI images. The mpMRI parameters were characterized separately per zone and by tissue type. The tissues were ordered according to trends in tissue parameter means. The peripheral zone tissue order was cystic atrophy, high grade prostatic intraepithelial neoplasia (HGPIN), normal, atrophy, inflammation, and cancer. Decreasing values for tissue order were exhibited by ADC (1.8 10-3 mm2/s to 1.2 10-3 mm2/s) and T2W intensity (3447 to 2576). Increasing values occurred for DCE MRI peak (143% to 157%), DCE MRI slope (101%/min to 169%/min), fractional anisotropy (FA) (0.16 to 0.19), choline (7.2 to 12.2), and choline / citrate (0.3 to 0.9). The transition zone tissue order was cystic atrophy, mixed benign prostatic hyperplasia (BPH), normal, atrophy, inflammation, stroma, anterior fibromuscular stroma, and cancer. Decreasing values occurred for ADC (1.6 10-3 mm2/s to 1.1 10-3 mm2/s) and T2W intensity (2863 to 2001). Increasing values occurred for DCE MRI peak (143% to 150%), DCE MRI slope (101%/min to 137%/min), FA (0.18 to 0.25), choline (7.9 to 11.7), and choline / citrate (0.3 to 0.7). Logistic regression was used to create parameter model fits to differentiate cancer from benign prostate tissues. The fits achieved AUCs ≥0.91. This study quantified the mpMRI characteristics of benign prostate tissues and demonstrated the capability of mpMRI to discriminate among benign as well as cancer tissues, potentially aiding future discrimination of cancer from benign confounders.
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Affiliation(s)
- Matthew Gibbons
- Deparment of Radiology and Biomedical Imaging, University of California, 185 Berry Street, San Francisco, CA, USA.
| | - Olga Starobinets
- Deparment of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry Street, San Francisco, CA, USA
| | - Jeffry P. Simko
- Department of Urology, University of California, San Francisco, 550 16th Street, San Francisco, CA, USA,Department of Pathology, University of California, San Francisco, 1825 4th Street, San Francisco, CA, USA
| | - John Kurhanewicz
- Deparment of Radiology and Biomedical Imaging, University of California, 185 Berry Street, San Francisco, CA, USA; Department of Urology, University of California, 550 16th Street, San Francisco, CA, USA.
| | - Peter R Carroll
- Department of Urology, University of California, 550 16th Street, San Francisco, CA, USA.
| | - Susan M Noworolski
- Deparment of Radiology and Biomedical Imaging, University of California, 185 Berry Street, San Francisco, CA, USA.
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Sharma P, Mahajan M, Gupta V, Gupta P, Abrol D. Evaluation of clinically significant prostate cancer using biparametric magnetic resonance imaging: An evolving concept. J Cancer Res Ther 2022; 18:1640-1645. [DOI: 10.4103/jcrt.jcrt_1313_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Deep learning-accelerated T2-weighted imaging of the prostate: Impact of further acceleration with lower spatial resolution on image quality. Eur J Radiol 2021; 145:110012. [PMID: 34753082 DOI: 10.1016/j.ejrad.2021.110012] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/19/2021] [Accepted: 10/26/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE To compare image quality in prostate MRI among standard T2-weighted imaging (T2-std), accelerated T2-weighted imaging (T2WI) with high resolution (T2-HR) and more accelerated T2WI with lower resolution (T2-LR) using both conventional reconstruction (C) and deep learning reconstruction (DL). MATERIALS AND METHODS In 46 consecutive patients, T2-std, T2-HR and T2-LR were acquired in 3:32 min, 1:06 min and 0.52 min, respectively. Both reconstruction techniques (C and DL) were applied to T2-HR and T2-LR. Five sets of images (T2-std, T2-HRC, T2-LRC, T2-HRDL, and T2-LRDL) for each patient were independently evaluated by two radiologists. Quantitative analysis including the signal-to-noise ratio (SNR) and contrast ratio (CR) and qualitative analysis with a 5-point scale for the sharpness of structures, ghosting or other artifacts, noise and overall image quality were performed. RESULTS The SNR was not different in either the peripheral zone (PZ) or transition zone (TZ) between T2-LRDL and T2-std with the median value of 21.7 versus 22.6 in PZ and 16.5 versus 17.3 in TZ, respectively. The CR between the prostate gland and muscle was significantly lower on T2-HRC and T2-LRC than on T2-std. Most of the evaluated factors showed significantly lower scores on T2-HRC and T2-LRC than on T2-std. Although noise and overall image quality on T2-HRDL and other artifacts on T2-LRDL were rated significantly lower than on T2-std (median value 4.0 versus 4.5, P < 0.001; 4.5 versus 5.0, P = 0.001; 4.5 versus 5.0, P = 0.006, respectively), other factors did not differ between T2-std and T2-HRDL or T2-LRDL. CONCLUSION DL is useful to improve image quality in accelerated T2WI of the prostate gland. Using DL, accelerated T2WI with lower spatial resolution than T2-std can be achieved with similar image quality in much shorter scan time (75.5% reduction in the acquisition time).
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Fatty Acid Metabolism Reprogramming in Advanced Prostate Cancer. Metabolites 2021; 11:metabo11110765. [PMID: 34822423 PMCID: PMC8618281 DOI: 10.3390/metabo11110765] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 11/01/2021] [Accepted: 11/03/2021] [Indexed: 12/23/2022] Open
Abstract
Prostate cancer (PCa) is a carcinoma in which fatty acids are abundant. Fatty acid metabolism is rewired during PCa development. Although PCa can be treated with hormone therapy, after prolonged treatment, castration-resistant prostate cancer can develop and can lead to increased mortality. Changes to fatty acid metabolism occur systemically and locally in prostate cancer patients, and understanding these changes may lead to individualized treatments, especially in advanced, castration-resistant prostate cancers. The fatty acid metabolic changes are not merely reflective of oncogenic activity, but in many cases, these represent a critical factor in cancer initiation and development. In this review, we analyzed the literature regarding systemic changes to fatty acid metabolism in PCa patients and how these changes relate to obesity, diet, circulating metabolites, and peri-prostatic adipose tissue. We also analyzed cellular fatty acid metabolism in prostate cancer, including fatty acid uptake, de novo lipogenesis, fatty acid elongation, and oxidation. This review broadens our view of fatty acid switches in PCa and presents potential candidates for PCa treatment and diagnosis.
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