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Goh V. Genitourinary Imaging in 2040. Radiology 2023; 307:e230223. [PMID: 37249430 PMCID: PMC10315527 DOI: 10.1148/radiol.230223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 05/31/2023]
Affiliation(s)
- Vicky Goh
- From the Department of Cancer Imaging, School of Biomedical
Engineering and Imaging Sciences, King’s College London, SE1 7EH,
United Kingdom; and Department of Radiology, Guy’s & St
Thomas’ NHS Foundation Trust, Level 1, Lambeth Wing, St Thomas’
Hospital, Westminster Bridge Rd, London, United Kingdom
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van der Beek JN, Fitski M, de Krijger RR, Wijnen MHWA, van den Heuvel-Eibrink MM, Vermeulen MA, van der Steeg AFW, Littooij AS. Direct correlation of MRI with histopathology in pediatric renal tumors through the use of a patient-specific 3-D-printed cutting guide: a feasibility study. Pediatr Radiol 2023; 53:235-243. [PMID: 36040524 PMCID: PMC9892092 DOI: 10.1007/s00247-022-05476-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/16/2022] [Accepted: 07/31/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Pediatric renal tumors are often heterogeneous lesions with variable regions of distinct histopathology. Direct comparison between in vivo imaging and ex vivo histopathology might be useful for identification of discriminating imaging features. OBJECTIVE This feasibility study explored the use of a patient-specific three-dimensional (3D)-printed cutting guide to ensure correct alignment (orientation and slice thickness) between magnetic resonance imaging (MRI) and histopathology. MATERIALS AND METHODS Before total nephrectomy, a patient-specific cutting guide based on each patient's preoperative renal MRI was generated and 3-D printed, to enable consistent transverse orientation of the histological specimen slices with MRI slices. This was expected to result in macroscopic slices of 5 mm each. The feasibility of the technique was determined qualitatively, through questionnaires administered to involved experts, and quantitatively, based on structured measurements including overlap calculation using the dice similarity coefficient. RESULTS The cutting guide was used in eight Wilms tumor patients receiving a total nephrectomy, after preoperative chemotherapy. The median age at diagnosis was 50 months (range: 4-100 months). The positioning and slicing of the specimens were rated overall as easy and the median macroscopic slice thickness of each specimen ranged from 5 to 6 mm. Tumor consistency strongly influenced the practical application of the cutting guide. Digital correlation of a total of 32 slices resulted in a median dice similarity coefficient of 0.912 (range: 0.530-0.960). CONCLUSION We report the feasibility of a patient-specific 3-D-printed MRI-based cutting guide for pediatric renal tumors, allowing improvement of the correlation of MRI and histopathology in future studies.
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Affiliation(s)
- Justine N. van der Beek
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands ,Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Matthijs Fitski
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Ronald R. de Krijger
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands ,Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | | | | | | | - Annemieke S. Littooij
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands ,Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
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Asuncion A, Walker PM, Bertaut A, Blanc J, Labarre M, Martin E, Bardet F, Cassin J, Cormier L, Crehange G, Loffroy R, Cochet A. Prediction of prostate cancer recurrence after radiation therapy using multiparametric magnetic resonance imaging and spectroscopy: assessment of prognostic factors on pretreatment imaging. Quant Imaging Med Surg 2022; 12:5309-5325. [PMID: 36465820 PMCID: PMC9703104 DOI: 10.21037/qims-22-184] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 08/22/2022] [Indexed: 10/15/2023]
Abstract
BACKGROUND To assess whether data from pre-therapeutic multiparametric magnetic resonance imaging (mpMRI) combined with three-dimensional magnetic resonance spectroscopy (3D MRS) provide prognostic factors of biochemical relapse in patients with localized prostate cancer treated by external radiotherapy or brachytherapy. METHODS In our single institution observational retrospective study we included a cohort of 230 patients treated by external radiotherapy or brachytherapy who had an initial mpMRI with 3D MRS from January 2008 to December 2015 for newly diagnosed localized prostatic cancer, proven histologically. Three trained radiologists recorded tumor characteristics, MRI T-stage and metabolic abnormalities from 3D MRS data. Univariate and multivariate Cox analyzes explored the relationship between clinical and imaging variables to highlight prognostic factors for recurrence, using biochemical relapse as the primary endpoint. RESULTS mpMRI data analysis allowed to reclassify 21.7% of the patients in a MRI National Comprehensive Cancer Network (NCCN) group higher than their initial clinical T-stage, but also to detect a lesion in 78% of the patients considered as clinically T1c. After a median of follow-up of 8.7 years (IQR, 6.6-10.1) following cancer diagnosis, 36 (16%) patients developed a biochemical relapse. The multivariate Cox analysis demonstrated the existence of 3 independent factors for prediction of biochemical recurrence: extracapsular extension (ECE) (HR =3.33; 95% CI: 1.93-5.73; P<0.01), choline/citrate ratio in healthy tissue in the transition zone (TZ) (HR =2.96; 95% CI: 1.06-8.28; P=0.04) and the NCCN Magnetic Resonance Imaging classification (intermediate versus low-risk, HR =3.06; 95% CI: 1.13-8.30; P<0.01). CONCLUSIONS Combination of mpMRI and 3DMRS could aid in the prognostic stratification of localized prostate cancer treated by radiotherapy or brachytherapy, by combining accurate evaluation of tumor extension, and quantification of prostate metabolism.
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Affiliation(s)
- Audrey Asuncion
- Department of Diagnostic & Interventional Radiology, University Hospital Dijon, Dijon, France
| | - Paul Michael Walker
- Department of Spectroscopy and Nuclear Magnetic Resonance, University Hospital Dijon, Dijon, France
- Laboratory of Imaging and Artificial Vision (ImVIA), IFTIM Team, EA 7535, University of Burgundy, Dijon, France
| | - Aurélie Bertaut
- Department of Methodology and biostatistics, Centre Georges-François-Leclerc, Dijon, France
| | - Julie Blanc
- Department of Methodology and biostatistics, Centre Georges-François-Leclerc, Dijon, France
| | - Maxime Labarre
- Department of Radiology, Centre Georges-François-Leclerc, Dijon, France
| | - Etienne Martin
- Department of Radiotherapy, Centre Georges-François-Leclerc, Dijon, France
| | - Florian Bardet
- Department of Urology, University Hospital Dijon, Dijon, France
| | - Jeremy Cassin
- Department of Diagnostic & Interventional Radiology, University Hospital Dijon, Dijon, France
| | - Luc Cormier
- Department of Urology, University Hospital Dijon, Dijon, France
| | | | - Romaric Loffroy
- Department of Diagnostic & Interventional Radiology, University Hospital Dijon, Dijon, France
- Laboratory of Imaging and Artificial Vision (ImVIA), IFTIM Team, EA 7535, University of Burgundy, Dijon, France
| | - Alexandre Cochet
- Department of Spectroscopy and Nuclear Magnetic Resonance, University Hospital Dijon, Dijon, France
- Laboratory of Imaging and Artificial Vision (ImVIA), IFTIM Team, EA 7535, University of Burgundy, Dijon, France
- Department of Nuclear Medicine, Centre Georges-François-Leclerc, Dijon, France
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Joy A, Nagarajan R, Saucedo A, Iqbal Z, Sarma MK, Wilson N, Felker E, Reiter RE, Raman SS, Thomas MA. Dictionary learning compressed sensing reconstruction: pilot validation of accelerated echo planar J-resolved spectroscopic imaging in prostate cancer. MAGNETIC RESONANCE MATERIALS IN PHYSICS, BIOLOGY AND MEDICINE 2022; 35:667-682. [PMID: 35869359 PMCID: PMC9363346 DOI: 10.1007/s10334-022-01029-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 07/01/2022] [Accepted: 07/03/2022] [Indexed: 11/28/2022]
Abstract
Objectives This study aimed at developing dictionary learning (DL) based compressed sensing (CS) reconstruction for randomly undersampled five-dimensional (5D) MR Spectroscopic Imaging (3D spatial + 2D spectral) data acquired in prostate cancer patients and healthy controls, and test its feasibility at 8x and 12x undersampling factors. Materials and methods Prospectively undersampled 5D echo-planar J-resolved spectroscopic imaging (EP-JRESI) data were acquired in nine prostate cancer (PCa) patients and three healthy males. The 5D EP-JRESI data were reconstructed using DL and compared with gradient sparsity-based Total Variation (TV) and Perona-Malik (PM) methods. A hybrid reconstruction technique, Dictionary Learning-Total Variation (DLTV), was also designed to further improve the quality of reconstructed spectra. Results The CS reconstruction of prospectively undersampled (8x and 12x) 5D EP-JRESI data acquired in prostate cancer and healthy subjects were performed using DL, DLTV, TV and PM. It is evident that the hybrid DLTV method can unambiguously resolve 2D J-resolved peaks including myo-inositol, citrate, creatine, spermine and choline. Conclusion Improved reconstruction of the accelerated 5D EP-JRESI data was observed using the hybrid DLTV. Accelerated acquisition of in vivo 5D data with as low as 8.33% samples (12x) corresponds to a total scan time of 14 min as opposed to a fully sampled scan that needs a total duration of 2.4 h (TR = 1.2 s, 32 \documentclass[12pt]{minimal}
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\begin{document}$${t}_{1}$$\end{document}t1). Supplementary Information The online version contains supplementary material available at 10.1007/s10334-022-01029-z.
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Wheeler TT, Cao P, Ghouri MD, Ji T, Nie G, Zhao Y. Nanotechnological strategies for prostate cancer imaging and diagnosis. Sci China Chem 2022. [DOI: 10.1007/s11426-022-1271-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Abstract
Prostate cancer is the fifth leading cause of death worldwide. A variety of treatment options is available for localized prostate cancer and may range from active surveillance to focal therapy or whole gland treatment, that is, surgery or radiotherapy. Serum prostate-specific antigen levels are an important tool to monitor treatment success after whole gland treatment, unfortunately prostate-specific antigen is unreliable after focal therapy. Multiparametric magnetic resonance imaging of the prostate is rapidly gaining field in the management of prostate cancer and may play a crucial role in the evaluation of recurrent prostate cancer. This article will focus on postprocedural magnetic resonance imaging after different forms of local therapy in patients with prostate cancer.
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Gholizadeh N, Pundavela J, Nagarajan R, Dona A, Quadrelli S, Biswas T, Greer PB, Ramadan S. Nuclear magnetic resonance spectroscopy of human body fluids and in vivo magnetic resonance spectroscopy: Potential role in the diagnosis and management of prostate cancer. Urol Oncol 2020; 38:150-173. [PMID: 31937423 DOI: 10.1016/j.urolonc.2019.10.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 09/22/2019] [Accepted: 10/31/2019] [Indexed: 01/17/2023]
Abstract
Prostate cancer is the most common solid organ cancer in men, and the second most common cause of male cancer-related mortality. It has few effective therapies, and is difficult to diagnose accurately. Prostate-specific antigen (PSA), which is currently the most effective diagnostic tool available, cannot reliably discriminate between different pathologies, and in fact only around 30% of patients found to have elevated levels of PSA are subsequently confirmed to actually have prostate cancer. As such, there is a desperate need for more reliable diagnostic tools that will allow the early detection of prostate cancer so that the appropriate interventions can be applied. Nuclear magnetic resonance (NMR) spectroscopy and magnetic resonance spectroscopy (MRS) are 2 high throughput, noninvasive analytical procedures that have the potential to enable differentiation of prostate cancer from other pathologies using metabolomics, by focusing specifically on certain metabolites which are associated with the development of prostate cancer cells and its progression. The value that this type of approach has for the early detection, diagnosis, prognosis, and personalized treatment of prostate cancer is becoming increasingly apparent. Recent years have seen many promising developments in the fields of NMR spectroscopy and MRS, with improvements having been made to hardware as well as to techniques associated with the acquisition, processing, and analysis of related data. This review focuses firstly on proton NMR spectroscopy of blood serum, urine, and expressed prostatic secretions in vitro, and then on 1- and 2-dimensional proton MRS of the prostate in vivo. Major advances in these fields and methodological principles of data collection, acquisition, processing, and analysis are described along with some discussion of related challenges, before prospects that proton MRS has for future improvements to the clinical management of prostate cancer are considered.
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Affiliation(s)
- Neda Gholizadeh
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Jay Pundavela
- Experimental Hematology and Cancer Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Rajakumar Nagarajan
- Human Magnetic Resonance Center, Institute for Applied Life Sciences, University of Massachusetts Amherst, MA, USA
| | - Anthony Dona
- Kolling Institute of Medical Research, Royal North Shore Hospital, University of Sydney, St Leonards, NSW, Australia
| | - Scott Quadrelli
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia; Radiology Department, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Tapan Biswas
- Department of Instrumentation and Electronics Engineering, Jadavpur University, Kolkata, India
| | - Peter B Greer
- School of Mathematical and Physical Sciences, University of Newcastle, Newcastle, NSW, Australia; Radiation Oncology, Calvary Mater Newcastle, Newcastle, NSW, Australia
| | - Saadallah Ramadan
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia; Imaging Centre, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
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Alexander EJ, Murray JR, Morgan VA, Giles SL, Riches SF, Hazell S, Thomas K, Sohaib SA, Thompson A, Gao A, Dearnaley DP, DeSouza NM. Validation of T2- and diffusion-weighted magnetic resonance imaging for mapping intra-prostatic tumour prior to focal boost dose-escalation using intensity-modulated radiotherapy (IMRT). Radiother Oncol 2019; 141:181-187. [PMID: 31493904 PMCID: PMC6908966 DOI: 10.1016/j.radonc.2019.07.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 07/22/2019] [Accepted: 07/25/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND PURPOSE To assess the diagnostic accuracy and inter-observer agreement of T2-weighted (T2W) and diffusion-weighted (DW) magnetic resonance imaging (MRI) for mapping intra-prostatic tumour lesions (IPLs) for the purpose of focal dose-escalation in prostate cancer radiotherapy. MATERIALS AND METHODS Twenty-six men selected for radical treatment with radiotherapy were recruited prospectively and underwent pre-treatment T2W+DW-MRI and 5 mm spaced transperineal template-guided mapping prostate biopsies (TTMPB). A 'traffic-light' system was used to score both data sets. Radiologically suspicious lesions measuring ≥0.5 cm3 were classified as red; suspicious lesions 0.2-0.5 cm3 or larger lesions equivocal for tumour were classified as amber. The histopathology assessment combined pathological grade and tumour length on biopsy (red = ≥4 mm primary Gleason grade 4/5 or ≥6 mm primary Gleason grade 3). Two radiologists assessed the MRI data and inter-observer agreement was measured with Cohens' Kappa co-efficient. RESULTS Twenty-five of 26 men had red image-defined IPLs by both readers, 24 had red pathology-defined lesions. There was a good correlation between lesions ≥0.5 cm3 classified "red" on imaging and "red" histopathology in biopsies (Reader 1: r = 0.61, p < 0.0001, Reader 2: r = 0.44, p = 0.03). Diagnostic accuracy for both readers for red image-defined lesions was sensitivity 85-86%, specificity 93-98%, positive predictive value (PPV) 79-92% and negative predictive value (NPV) 96%. Inter-observer agreement was good (Cohen's Kappa 0.61). CONCLUSIONS MRI is accurate for mapping clinically significant prostate cancer; diffusion-restricted lesions ≥0.5 cm3 can be confidently identified for radiation dose boosting.
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Affiliation(s)
- E J Alexander
- The Royal Marsden NHS Foundation Trust, Sutton, UK; The Institute of Cancer Research, Sutton, UK.
| | - J R Murray
- The Royal Marsden NHS Foundation Trust, Sutton, UK; The Institute of Cancer Research, Sutton, UK.
| | - V A Morgan
- The Institute of Cancer Research, Sutton, UK.
| | - S L Giles
- The Institute of Cancer Research, Sutton, UK.
| | - S F Riches
- The Institute of Cancer Research, Sutton, UK.
| | - S Hazell
- The Royal Marsden NHS Foundation Trust, Sutton, UK.
| | - K Thomas
- The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - S A Sohaib
- The Royal Marsden NHS Foundation Trust, Sutton, UK.
| | - A Thompson
- The Royal Marsden NHS Foundation Trust, Sutton, UK.
| | - A Gao
- The Royal Marsden NHS Foundation Trust, Sutton, UK; The Institute of Cancer Research, Sutton, UK.
| | - D P Dearnaley
- The Royal Marsden NHS Foundation Trust, Sutton, UK; The Institute of Cancer Research, Sutton, UK.
| | - N M DeSouza
- The Royal Marsden NHS Foundation Trust, Sutton, UK; The Institute of Cancer Research, Sutton, UK.
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Majumdar S, Lupo J, Vigneron D, Ronen S, Kurhanewicz J, Hess C. In memoriam: Sarah J. Nelson, January 26, 1954–April 3, 2019. Magn Reson Med 2019. [DOI: 10.1002/mrm.27814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Sharmila Majumdar
- Department of Radiology and Biomedical Imaging University of California San Francisco San Francisco California
| | - Janine Lupo
- Department of Radiology and Biomedical Imaging University of California San Francisco San Francisco California
| | - Dan Vigneron
- Department of Radiology and Biomedical Imaging University of California San Francisco San Francisco California
| | - Sabrina Ronen
- Department of Radiology and Biomedical Imaging University of California San Francisco San Francisco California
| | - John Kurhanewicz
- Department of Radiology and Biomedical Imaging University of California San Francisco San Francisco California
| | - Christopher Hess
- Department of Radiology and Biomedical Imaging University of California San Francisco San Francisco California
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Behr SC, Aggarwal R, VanBrocklin HF, Flavell RR, Gao K, Small EJ, Blecha J, Jivan S, Hope TA, Simko JP, Kurhanewicz J, Noworolski SM, Korn NJ, De Los Santos R, Cooperberg MR, Carroll PR, Nguyen HG, Greene KL, Langton-Webster B, Berkman CE, Seo Y. Phase I Study of CTT1057, an 18F-Labeled Imaging Agent with Phosphoramidate Core Targeting Prostate-Specific Membrane Antigen in Prostate Cancer. J Nucl Med 2019; 60:910-916. [PMID: 30464040 PMCID: PMC6604687 DOI: 10.2967/jnumed.118.220715] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 11/13/2018] [Indexed: 11/16/2022] Open
Abstract
Agents targeting prostate-specific membrane antigen (PSMA) comprise a rapidly emerging class of radiopharmaceuticals for diagnostic imaging of prostate cancer. Unlike most other PSMA agents with a urea backbone, CTT1057 is based on a phosphoramidate scaffold that irreversibly binds to PSMA. We conducted a first-in-humans phase I study of CTT1057 in patients with localized and metastatic prostate cancer. Methods: Two patient cohorts were recruited. Cohort A patients had biopsy-proven localized prostate cancer preceding radical prostatectomy, and cohort B patients had metastatic castration-resistant prostate cancer. Cohort A patients were imaged at multiple time points after intravenous injection with 362 ± 8 MBq of CTT1057 to evaluate the kinetics of CTT1057 and estimate radiation dose profiles. Mean organ-absorbed doses and effective doses were calculated. CTT1057 uptake in the prostate gland and regional lymph nodes was correlated with pathology, PSMA staining, and the results of conventional imaging. In cohort B, patients were imaged 60-120 min after injection of CTT1057. PET images were assessed for overall image quality, and areas of abnormal uptake were contrasted with conventional imaging. Results: In cohort A (n = 5), the average total effective dose was 0.023 mSv/MBq. The kidneys exhibited the highest absorbed dose, 0.067 mGy/MBq. The absorbed dose of the salivary glands was 0.015 mGy/MBq. For cohort B (n = 15), CTT1057 PET detected 97 metastatic lesions, and 44 of 56 bone metastases detected on CTT1057 PET (78.5%) were also detectable on bone scanning. Eight of 32 lymph nodes positive on CTT1057 PET (25%) were enlarged by size criteria on CT. Conclusion: CTT1057 is a promising novel phosphoramidate PSMA-targeting 18F-labeled PET radiopharmaceutical that demonstrates similar biodistribution to urea-based PSMA-targeted agents, with lower exposure to the kidneys and salivary glands. Metastatic lesions are detected with higher sensitivity on CTT1057 imaging than on conventional imaging. Further prospective studies with CTT1057 are warranted to elucidate its role in cancer imaging.
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Affiliation(s)
- Spencer C Behr
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California
| | - Rahul Aggarwal
- Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Henry F VanBrocklin
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California
| | - Robert R Flavell
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California
| | - Kenneth Gao
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California
| | - Eric J Small
- Department of Medicine, University of California, San Francisco, San Francisco, California
- Department of Urology, University of California, San Francisco, San Francisco, California
| | - Joseph Blecha
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California
| | - Salma Jivan
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California
| | - Thomas A Hope
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California
| | - Jeffry P Simko
- Department of Pathology, University of California, San Francisco, San Francisco, California; and
| | - John Kurhanewicz
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California
| | - Susan M Noworolski
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California
| | - Natalie J Korn
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California
| | - Romelyn De Los Santos
- Department of Pathology, University of California, San Francisco, San Francisco, California; and
| | - Matthew R Cooperberg
- Department of Urology, University of California, San Francisco, San Francisco, California
| | - Peter R Carroll
- Department of Urology, University of California, San Francisco, San Francisco, California
| | - Hao G Nguyen
- Department of Urology, University of California, San Francisco, San Francisco, California
| | - Kirsten L Greene
- Department of Urology, University of California, San Francisco, San Francisco, California
| | | | | | - Youngho Seo
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California
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Lin L, Považan M, Berrington A, Chen Z, Barker PB. Water removal in MR spectroscopic imaging with L2 regularization. Magn Reson Med 2019; 82:1278-1287. [PMID: 31148254 DOI: 10.1002/mrm.27824] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 04/03/2019] [Accepted: 05/01/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE An L2-regularization based postprocessing method is proposed and tested for removal of residual or unsuppressed water signals in proton MR spectroscopic imaging (MRSI) data recorded from the human brain at 3T. METHODS Water signals are removed by implementation of the L2 regularization using a synthesized water-basis matrix that is orthogonal to metabolite signals of interest in the spectral dimension. Simulated spectra with variable water amplitude and in vivo brain MRSI datasets were used to demonstrate the proposed method. Results were compared with two commonly-used postprocessing methods for removing water signals. RESULTS The L2 method yielded metabolite signals that were close to true values for the simulated spectra. Residual/unsuppressed water signals in human brain short- and long-echo time MRSI datasets were efficiently removed by the proposed method allowing good quality metabolite maps to be reconstructed with minimized contamination from water signals. Significant differences of the creatine signal were observed between brain long-echo time MRSI without and with water saturation, attributable to the previously described magnetization transfer effect. CONCLUSIONS With usage of a synthesized water matrix generated based on reasonable prior knowledge about water and metabolite resonances, the L2 method is shown to be an effective way to remove water signals from MRSI of the human brain.
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Affiliation(s)
- Liangjie Lin
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Electronic Science, Xiamen University, Xiamen, China
| | - Michal Považan
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Adam Berrington
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Zhong Chen
- Department of Electronic Science, Xiamen University, Xiamen, China
| | - Peter B Barker
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland
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MR Imaging-Histology Correlation by Tailored 3D-Printed Slicer in Oncological Assessment. CONTRAST MEDIA & MOLECULAR IMAGING 2019; 2019:1071453. [PMID: 31275082 PMCID: PMC6560325 DOI: 10.1155/2019/1071453] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 05/12/2019] [Indexed: 12/14/2022]
Abstract
3D printing and reverse engineering are innovative technologies that are revolutionizing scientific research in the health sciences and related clinical practice. Such technologies are able to improve the development of various custom-made medical devices while also lowering design and production costs. Recent advances allow the printing of particularly complex prototypes whose geometry is drawn from precise computer models designed on in vivo imaging data. This review summarizes a new method for histological sample processing (applicable to e.g., the brain, prostate, liver, and renal mass) which employs a personalized mold developed from diagnostic images through computer-aided design software and 3D printing. Through positioning the custom mold in a coherent manner with respect to the organ of interest (as delineated by in vivo imaging data), the cutting instrument can be precisely guided in order to obtain blocks of tissue which correspond with high accuracy to the slices imaged. This approach appeared crucial for validation of new quantitative imaging tools, for an accurate imaging-histopathological correlation and for the assessment of radiogenomic features extracted from oncological lesions. The aim of this review is to define and describe 3D printing technologies which are applicable to oncological assessment and slicer design, highlighting the radiological and pathological perspective as well as recent applications of this approach for the histological validation of and correlation with MR images.
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Mahdawy SA, Shekarchi B, Zaman M. The Role of Magnetic Resonance Spectroscopy in Evaluating the Rate of Brain Metabolic Variations in Chemical Veterans with Respiratory Problem In Comparison To Control Group. Open Access Maced J Med Sci 2018; 6:2348-2353. [PMID: 30607189 PMCID: PMC6311469 DOI: 10.3889/oamjms.2018.442] [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: 10/13/2018] [Revised: 11/19/2018] [Accepted: 11/20/2018] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND During the eight years of the imposed war, Iraq used various chemical agents such as sulfur mustard and nerve agents (mainly tabun and sometimes soman) on Iran's soldiers. Using information obtained from specialist sequences and analysing information obtained from magnetic resonance imaging (MRI) in a susceptibility weighted imaging (SWI) sequence and magnetic resonance spectroscopy (MRS) provides valuable information on continuation of treatment and identifying functional disorders. AIM The objective of this research was to evaluate the rate of metabolic variations in chemically injured veterans based on chemical neuromarkers using the chemical sequence MRS, which would help patients and physicians in terms of time, economics, and selection of appropriate therapeutic methods, so if the can physician can get complete information about the metabolic properties of the brain through paraclinical (especially MRI) tools before treatment, he might change his treatment program to reduce the complications caused by it. METHODOLOGY In this research, 40 chemically injured veterans with brain dysfunction admitted to the screening centre for MRI with specialized MRS sequence participated. Accordingly, we examined the rate of brain metabolic variations about the level of neuromarkers and evaluated the relationship between the level of neuromarkers and brain damages. RESULTS The results of this research revealed that while the demographic characteristics such as age of the two groups of chemically injured veterans and control was similar, only the median of the NAA/Cr (N-acetylaspartate to creatine ratio) ratio in PONS of chemically injured patients was significantly lower than that of the control group, and this ratio was similar in other parts of the brain in two groups. The results also showed that the ratio of NAA to total choline and Cr was similar in all parts of the brain in two groups. CONCLUSION Based on the research results, using the MR (Magnetic Resonance) spectroscopy device and determination of the value and ratio of markers such as creatinine and N-acetylaspartate and choline, the brain injuries of chemically injured veterans can be examined. By conducting further studies and larger sample size, the brain damages in veterans can be diagnosed early, which would be a great contribution in their treatment.
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Affiliation(s)
| | - Babak Shekarchi
- Department of Radiology, Aja University of Medical Sciences, Tehran, Iran
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Tayari N, Obels J, Kobus T, Scheenen TWJ, Heerschap A. Simple and broadly applicable automatic quality control for 3D 1 H MR spectroscopic imaging data of the prostate. Magn Reson Med 2018; 81:2887-2895. [PMID: 30506721 DOI: 10.1002/mrm.27616] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 10/13/2018] [Accepted: 10/31/2018] [Indexed: 12/17/2022]
Abstract
PURPOSE Quality control (QC) is a prerequisite for clinical MR spectroscopic imaging (MRSI) to avoid that bad spectra hamper data interpretation. The aim of this work was to present a simple automatic QC for prostate 1 H MRSI that can handle data obtained with different commonly used pulse sequences, echo times, field strengths, and MR platforms. METHODS A QC method was developed with a ratio (Qratio) where the numerator and the denominator are functions of several signal heights, logically combined for their positive or negative contribution to spectral quality. This Qratio was tested on 4 data sets obtained at 1.5, 3, and 7T, with and without endorectal coil and different localization sequences and echo times. Spectra of 25,248 voxels in 26 prostates were labeled as acceptable or unacceptable by MRS experts as gold standard. A threshold value was determined for Qratio from a subset of voxels, labeled in consensus by 4 experts, for an optimal accuracy to separate spectra. RESULTS Applying this Qratio threshold to the remaining test voxels, an automatic separation of good and bad spectra was possible with an accuracy of 0.88, similar to manual separation between the 2 classes. Qratio values were used to generate maps representing spectral quality on a binary or continuous scale. CONCLUSION Automated QC of prostate 1 H MRSI by Qratio is fast, simple, easily transferable and more practical than supervised feature extraction methods and therefore easy to integrate into different clinical MR systems. Moreover, quality maps can be generated to read the reliability of spectra in each voxel.
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Affiliation(s)
- Nassim Tayari
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jiri Obels
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Thiele Kobus
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Tom W J Scheenen
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Arend Heerschap
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
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Mazaheri Y, Shukla-Dave A, Goldman DA, Moskowitz CS, Takeda T, Reuter VE, Akin O, Hricak H. Characterization of prostate cancer with MR spectroscopic imaging and diffusion-weighted imaging at 3 Tesla. Magn Reson Imaging 2018; 55:93-102. [PMID: 30176373 DOI: 10.1016/j.mri.2018.08.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 08/29/2018] [Accepted: 08/30/2018] [Indexed: 12/12/2022]
Abstract
PURPOSE To retrospectively measure metabolic ratios and apparent diffusion coefficient (ADC) values from 3-Tesla MR spectroscopic imaging (MRSI) and diffusion-weighted imaging (DWI) in benign and malignant peripheral zone (PZ) prostate tissue, assess the parameters' associations with malignancy, and develop and test rules for classifying benign and malignant PZ tissue using whole-mount step-section pathology as the reference standard. METHODS This HIPAA-compliant, IRB-approved study included 67 men (median age, 61 years; range, 41-74 years) with biopsy-proven prostate cancer who underwent preoperative 3 T endorectal multiparametric MRI and had ≥1 PZ lesion >0.1 cm3 at whole-mount histopathology. In benign and malignant PZ regions identified from pathology, voxel-based choline/citrate, polyamines/choline, polyamines/creatine, and (choline + polyamines + creatine)/citrate ratios were averaged, as were ADC values. Patients were randomly split into training and test sets; rules for separating benign from malignant regions were generated with classification and regression tree (CART) analysis and assessed on the test set for sensitivity and specificity. Odds ratios (OR) were evaluated using generalized estimating equations. RESULTS CART analysis of all parameters identified only ADC and (choline + polyamines + creatine)/citrate as significant predictors of cancer. Sensitivity and specificity, respectively, were 0.81 and 0.82 with MRSI-derived, 0.98 and 0.51 with DWI-derived, and 0.79 and 0.90 with MRSI + DWI-derived classification rules. Areas under the curves (AUC) in the test set were 0.93 (0.87-0.97) with ADC, 0.82 (0.72-0.91) with MRSI, and 0.96 (0.92-0.99) with MRSI + ADC. CONCLUSION We developed statistically-based rules for identifying PZ cancer using 3-Tesla MRSI, DWI, and MRSI + DWI and demonstrated the potential value of MRSI + DWI.
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Affiliation(s)
- Yousef Mazaheri
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - Amita Shukla-Dave
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Debra A Goldman
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Chaya S Moskowitz
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Toshikazu Takeda
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Victor E Reuter
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Oguz Akin
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Hedvig Hricak
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Dregely I, Prezzi D, Kelly‐Morland C, Roccia E, Neji R, Goh V. Imaging biomarkers in oncology: Basics and application to MRI. J Magn Reson Imaging 2018; 48:13-26. [PMID: 29969192 PMCID: PMC6587121 DOI: 10.1002/jmri.26058] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 03/26/2018] [Indexed: 12/12/2022] Open
Abstract
Cancer remains a global killer alongside cardiovascular disease. A better understanding of cancer biology has transformed its management with an increasing emphasis on a personalized approach, so-called "precision cancer medicine." Imaging has a key role to play in the management of cancer patients. Imaging biomarkers that objectively inform on tumor biology, the tumor environment, and tumor changes in response to an intervention complement genomic and molecular diagnostics. In this review we describe the key principles for imaging biomarker development and discuss the current status with respect to magnetic resonance imaging (MRI). LEVEL OF EVIDENCE 5 TECHNICAL EFFICACY: Stage 5 J. Magn. Reson. Imaging 2018;48:13-26.
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Affiliation(s)
- Isabel Dregely
- Biomedical Engineering, School of Biomedical Engineering & Imaging SciencesKing's Health Partners, St Thomas' HospitalLondon, UK
| | - Davide Prezzi
- Cancer Imaging, School of Biomedical Engineering & Imaging Sciences King's College London, King's Health Partners, St Thomas' Hospital, LondonUK
- RadiologyGuy's & St Thomas' NHS Foundation TrustLondonUK
| | - Christian Kelly‐Morland
- Cancer Imaging, School of Biomedical Engineering & Imaging Sciences King's College London, King's Health Partners, St Thomas' Hospital, LondonUK
- RadiologyGuy's & St Thomas' NHS Foundation TrustLondonUK
| | - Elisa Roccia
- Biomedical Engineering, School of Biomedical Engineering & Imaging SciencesKing's Health Partners, St Thomas' HospitalLondon, UK
| | - Radhouene Neji
- Biomedical Engineering, School of Biomedical Engineering & Imaging SciencesKing's Health Partners, St Thomas' HospitalLondon, UK
- MR Research CollaborationsSiemens HealthcareFrimleyUK
| | - Vicky Goh
- Cancer Imaging, School of Biomedical Engineering & Imaging Sciences King's College London, King's Health Partners, St Thomas' Hospital, LondonUK
- RadiologyGuy's & St Thomas' NHS Foundation TrustLondonUK
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Kasson M, Ortman M, Gaitonde K, Verma S, Sidana A. Imaging Prostate Cancer Using Multiparametric Magnetic Resonance Imaging: Past, Present, and Future. Semin Roentgenol 2018; 53:200-205. [DOI: 10.1053/j.ro.2018.04.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Phase I study of dose escalation to dominant intraprostatic lesions using high-dose-rate brachytherapy. J Contemp Brachytherapy 2018; 10:193-201. [PMID: 30038638 PMCID: PMC6052382 DOI: 10.5114/jcb.2018.76881] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 05/18/2018] [Indexed: 01/02/2023] Open
Abstract
Purpose Radiation dose escalation for prostate cancer improves biochemical control but is limited by toxicity. Magnetic resonance spectroscopic imaging (MRSI) can define dominant intraprostatic lesions (DIL). This phase I study evaluated dose escalation to MRSI-defined DIL using high-dose-rate (HDR) brachytherapy. Material and methods Enrollment was closed early due to low accrual. Ten patients with prostate cancer (T2a-3b, Gleason 6-9, PSA < 20) underwent pre-treatment MRSI, and eight patients had one to three DIL identified. The eight enrolled patients received external beam radiation therapy to 45 Gy and HDR brachytherapy boost to the prostate of 19 Gy in 2 fractions. MRSI images were registered to planning CT images and DIL dose-escalated up to 150% of prescription dose while maintaining normal tissue constraints. The primary endpoint was genitourinary (GU) toxicity. Results The median total DIL volume was 1.31 ml (range, 0.67-6.33 ml). Median DIL boost was 130% of prescription dose (range, 110-150%). Median urethra V120 was 0.15 ml (range, 0-0.4 ml) and median rectum V75 was 0.74 ml (range, 0.1-1.0 ml). Three patients had acute grade 2 GU toxicity, and two patients had late grade 2 GU toxicity. No patients had grade 2 or higher gastrointestinal toxicity, and no grade 3 or higher toxicities were noted. There were no biochemical failures with median follow-up of 4.9 years (range, 2-8.5 years). Conclusions Dose escalation to MRSI-defined DIL is feasible. Toxicity was low but incompletely assessed due to limited patients’ enrollment.
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Kumar V, Bora GS, Kumar R, Jagannathan NR. Multiparametric (mp) MRI of prostate cancer. PROGRESS IN NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY 2018; 105:23-40. [PMID: 29548365 DOI: 10.1016/j.pnmrs.2018.01.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 01/17/2018] [Accepted: 01/28/2018] [Indexed: 06/08/2023]
Abstract
Prostate cancer (PCa) is one of the most prevalent cancers in men. A large number of men are detected with PCa; however, the clinical behavior ranges from low-grade indolent tumors that never develop into a clinically significant disease to aggressive, invasive tumors that may rapidly progress to metastatic disease. The challenges in clinical management of PCa are at levels of screening, diagnosis, treatment, and follow-up after treatment. Magnetic resonance imaging (MRI) methods have shown a potential role in detection, localization, staging, assessment of aggressiveness, targeting biopsies, etc. in PCa patients. Multiparametric MRI (mpMRI) is emerging as a better option compared to the individual imaging methods used in the evaluation of PCa. There are attempts to improve the reproducibility and reliability of mpMRI by using an objective scoring system proposed in the prostate imaging reporting and data system (PIRADS) for standardized reporting. Prebiopsy mpMRI may be used to detect PCa in men with elevated prostate-specific antigen or abnormal digital rectal examination and to enable targeted biopsies. mpMRI can also be used to decide on clinical management of patients, for example active surveillance, and may help in detecting only the pathology that requires detection. It can potentially not only guide patient selection for initial and repeat biopsy but also reduce false-negative biopsies. This review presents a description of the MR methods most commonly applied for investigations of prostate. The anatomical, functional and metabolic parameters obtained from these MR methods are discussed with regard to their physical basis and their contribution to mpMRI investigations of PCa.
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Affiliation(s)
- Virendra Kumar
- Department of NMR & MRI Facility, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
| | - Girdhar S Bora
- Department of Urology, Post-Graduate Institute of Medical Sciences, Chandigarh 160012, India
| | - Rajeev Kumar
- Department of Urology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Naranamangalam R Jagannathan
- Department of NMR & MRI Facility, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
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Lahoti AM, Dhok AP, Rantnaparkhi CR, Rawat JS, Chandak NU, Tawari HS. Role of Magnetic Resonance Imaging, Magnetic Resonance Spectroscopy and Transrectal Ultrasound in Evaluation of Prostatic Pathologies with Focus on Prostate Cancer. Pol J Radiol 2017; 82:827-836. [PMID: 29657651 PMCID: PMC5894040 DOI: 10.12659/pjr.903958] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 03/28/2017] [Indexed: 12/31/2022] Open
Abstract
Background Prostate cancer (PC) is an important medical and socio-economical problem due to its increasing incidence. The development of the prostate specific antigen (PSA) test, and a continuing decrease in the rates of other common neoplasms, such as lung and stomach since mid-1980s, prostate cancer has become one of the most common cancers among men. Prostate cancer (PC) is the second most common cancer in men, preceded only by lung cancer, and its early diagnosis is crucial for a successful treatment, that will prolong survival and improve quality of life.The main objective of our study was to evaluate the role of magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS) and transrectal ultrasound (TRUS) in detecting prostatic pathologies and staging of prostate cancer by correlating these methods with histopathological results. Material/Methods The study is a cross-sectional diagnostic study performed in 66 patients with a high degree of clinical suspicion of prostatic pathology. All patients underwent TRUS, T1W, T2W, DWI, and 3D PRESSMRS sequences, and we also calculated ADC values and Cho Cr/Cit MRS ratios for all patients. Results Combination of MRI and MRS showed the highest diagnostic accuracy among the imaging modalities in detecting of prostatic neoplasm, followed by MRI, and then by TRUS. MRS plays a complementary role to MRI, by increasing its diagnostic accuracy. Due to a high cost, limited availability and increased scanning time, combination of MRI and MRS is currently not recommended as a first line investigation for detecting prostate neoplasms, hence USG (TRUS) remains the first line investigation due to its low cost, easy availability, time effectiveness and comparable efficacy. Conclusions MRI MRS has more diagnostic accuracy than MRI alone for detection of prostate pathologies. MRS, plays significant complementary role and should be included in the routine MR imaging protocols. MRI helps in diagnosis, localization, better tissue characterization and staging of prostate cancer. TRUS is easily available, cost effective and has comparable efficacy.
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Affiliation(s)
- Amol Madanlal Lahoti
- Department of Radiodiagnosis, NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Nagpur, Maharashtra India
| | - Avinash Parshuram Dhok
- Department of Radiodiagnosis, NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Nagpur, Maharashtra India
| | - Chetana Ramesh Rantnaparkhi
- Department of Radiodiagnosis, NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Nagpur, Maharashtra India
| | - Jitesh Subhash Rawat
- Department of Radiodiagnosis, NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Nagpur, Maharashtra India
| | - Nihar Umakant Chandak
- Department of Surgery, NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Nagpur, Maharashtra India
| | - Hitesh Sharad Tawari
- Department of Pathology, NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Nagpur, Maharashtra India
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Tavukçu HH, Aytaç Ö, Balcı NC, Kulaksızoğlu H, Atuğ F. The efficacy and utilisation of preoperative multiparametric magnetic resonance imaging in robot-assisted radical prostatectomy: does it change the surgical dissection plan? Turk J Urol 2017; 43:470-475. [PMID: 29201510 DOI: 10.5152/tud.2017.35589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 08/18/2017] [Indexed: 12/21/2022]
Abstract
Objective We investigated the effect of the use of multiparametric prostate magnetic resonance imaging (mp-MRI) on the dissection plan of the neurovascular bundle and the oncological results of our patients who underwent robot-assisted radical prostatectomy. Material and methods We prospectively evaluated 60 consecutive patients, including 30 patients who had (Group 1), and 30 patients who had not (Group 2) mp-MRI before robot-assisted radical prostatectomy. Based on the findings of mp-MRI, the dissection plan was changed as intrafascial, interfascial, and extrafascial in the mp-MRI group. Two groups were compared in terms of age, prostate-specific antigen (PSA), Gleason sum scores and surgical margin positivity. Results There was no statistically significant difference between the two groups in terms of age, PSA, biopsy Gleason score, final pathological Gleason score and surgical margin positivity. mp-MRI changed the initial surgical plan in 18 of 30 patients (60%) in Group 1. In seventeen of these patients (56%) surgical plan was changed from non-nerve sparing to interfascial nerve sparing plan. In one patient dissection plan was changed to non-nerve sparing technique which had extraprostatic extension on final pathology. Surgical margin positivity was similar in Groups 1, and 2 (16% and 13%, respectively) although, Group 1 had higher number of high- risk patients. mp-MRI confirmed the primary tumour localisation in the final pathology in 27 of of 30 patients (90%). Conclusion Preoperative mp-MRI effected the decision to perform a nerve-sparing technique in 56% of the patients in our study; moreover, changing the dissection plan from non-nerve-sparing technique to a nerve sparing technique did not increase the rate of surgical margin positivity.
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Affiliation(s)
- Hasan Hüseyin Tavukçu
- Department of Urology, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Ömer Aytaç
- Department of Urology, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Numan Cem Balcı
- Department of Radiology, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Haluk Kulaksızoğlu
- Department of Urology, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Fatih Atuğ
- Department of Urology, İstanbul Bilim University School of Medicine, İstanbul, Turkey
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Patel DN, Nguyen C, Sirohi D, Falahatian V, Saouaf R, Luthringer D, Li D, Kim HL. Use of cylindrical coordinates to localize prostate cancers on MRI and prostatectomy pathology. Urol Oncol 2017; 35:673.e15-673.e20. [DOI: 10.1016/j.urolonc.2017.08.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 08/02/2017] [Accepted: 08/14/2017] [Indexed: 10/18/2022]
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Shah TT, To WKL, Ahmed HU. Magnetic resonance imaging in the early detection of prostate cancer and review of the literature on magnetic resonance imaging-stratified clinical pathways. Expert Rev Anticancer Ther 2017; 17:1159-1168. [PMID: 28933973 DOI: 10.1080/14737140.2017.1383899] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION With level 1 evidence now available on the diagnostic accuracy of multiparametric magnetic resonance imaging (MRI) we must now utilise this data in developing an MRI-stratified diagnostic pathway for the early detection of prostate cancer. Areas covered: A literature review was conducted and identified seven randomised control trials (RCT's) assessing the diagnostic accuracy of such a pathway against the previously accepted systematic/random trans-rectal ultrasound guided (TRUS) biopsy pathway. The studies were heterogeneous in their design. Five studies assessed the addition of MRI-targeted biopsies to a standard care systematic TRUS biopsy pathway. Three of these studies showed either an increase in their diagnostic accuracy or the potential to remove systematic biopsies. Two studies looked specifically at a targeted biopsy only pathway and although the results were again mixed, there was no decrease in the diagnostic rate and overall significantly fewer biopsy cores were taken in the MRI group. Expert commentary: Results from these RCT's together with multiple retrospective and prospective studies point towards either an improved diagnostic rate for clinically significant cancer and/or a reduction in the need for systematic biopsies with a MRI-stratified pathway. The challenge for the urological community will be to implement pre-biopsy MRI into a routine clinical pathway with likely independent monitoring of standards.
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Affiliation(s)
- Taimur Tariq Shah
- a Division of Surgery, Department of Surgery and Cancer , Imperial College London , London , UK.,b Imperial Urology, Charing Cross Hospital , Imperial College Healthcare NHS Trust , London , UK.,c Division of Surgery and Interventional Sciences , University College London , London , UK.,d Department of Urology , Whittington Hospitals NHS Trust , London , UK
| | - Wilson King Lim To
- c Division of Surgery and Interventional Sciences , University College London , London , UK
| | - Hashim Uddin Ahmed
- a Division of Surgery, Department of Surgery and Cancer , Imperial College London , London , UK.,b Imperial Urology, Charing Cross Hospital , Imperial College Healthcare NHS Trust , London , UK
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Abstract
Background Several advances in the imaging of prostate cancer have been made in recent years. Diagnostic staging has become increasingly complex and confusing as newer technologies have developed more rapidly than research has been able to confirm or refute the accuracy of these technologies. By the time research has been performed, the technology used for a study has often become outdated and newer and more sophisticated imaging has become available. Methods We reviewed the literature on local and nodal staging of prostate cancer, as well as the role of magnetic resonance imaging (MRI), magnetic resonance spectroscopic imaging (MRSI), dynamic contrast-enhanced MRI, positron emission tomography (PET), endorectal power Doppler, lymphotropic MRI contrast agents, and future possibilities such as diffusion MRI. This review is not systematic, but rather focused on these imaging modalities. Results Advances in MRI, ultrasound, and lymphotropic contrast agents have improved our ability to differentiate between T2 and T3 prostate tumors. PET imaging has proven less successful at staging prostate cancer. A literature review suggests patients with moderate risk of extracapsular extension benefit most from endorectal MRI evaluation. Spectroscopy, dynamic imaging, and lymphotropic contrast agents are expected to continue to improve sensitivity and specificity of staging of prostate cancer. Power Doppler evaluation with endorectal ultrasound has proved useful for evaluation during endorectal biopsy for identifying hypervascular tumors for directed biopsy. Diffusion-weighted MRI remains untested clinically and represents a future direction for research. Conclusions Future studies using these new techniques are needed to demonstrate changes in outcomes in large patient populations.
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Affiliation(s)
- Marla R Hersh
- Department of Radiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA.
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Ultrasound Elastography of the Prostate Using an Unconstrained Modulus Reconstruction Technique: A Pilot Clinical Study. Transl Oncol 2017; 10:744-751. [PMID: 28735201 PMCID: PMC5522957 DOI: 10.1016/j.tranon.2017.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/15/2017] [Accepted: 06/15/2017] [Indexed: 12/04/2022] Open
Abstract
A novel full-inversion-based technique for quantitative ultrasound elastography was investigated in a pilot clinical study on five patients for non-invasive detection and localization of prostate cancer and quantification of its extent. Conventional-frequency ultrasound images and radiofrequency (RF) data (~5 MHz) were collected during mechanical stimulation of the prostate using a transrectal ultrasound probe. Pre and post-compression RF data were used to construct the strain images. The Young's modulus (YM) images were subsequently reconstructed using the derived strain images and the stress distribution estimated iteratively using finite element (FE) analysis. Tumor regions determined based on the reconstructed YM images were compared to whole-mount histopathology images of radical prostatectomy specimens. Results indicated that tumors were significantly stiffer than the surrounding tissue, demonstrating a relative YM of 2.5 ± 0.8 compared to normal prostate tissue. The YM images had a good agreement with the histopathology images in terms of tumor location within the prostate. On average, 76% ± 28% of tumor regions detected based on the proposed method were inside respective tumor areas identified in the histopathology images. Results of a linear regression analysis demonstrated a good correlation between the disease extents estimated using the reconstructed YM images and those determined from whole-mount histopathology images (r2 = 0.71). This pilot study demonstrates that the proposed method has a good potential for detection, localization and quantification of prostate cancer. The method can potentially be used for prostate needle biopsy guidance with the aim of decreasing the number of needle biopsies. The proposed technique utilizes conventional ultrasound imaging system only while no additional hardware attachment is required for mechanical stimulation or data acquisition. Therefore, the technique may be regarded as a non-invasive, low cost and potentially widely-available clinical tool for prostate cancer diagnosis.
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Tayari N, Heerschap A, Scheenen TW, Kobus T. In vivo MR spectroscopic imaging of the prostate, from application to interpretation. Anal Biochem 2017; 529:158-170. [DOI: 10.1016/j.ab.2017.02.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Revised: 12/23/2016] [Accepted: 02/01/2017] [Indexed: 12/15/2022]
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Trigui R, Mitéran J, Walker P, Sellami L, Ben Hamida A. Automatic classification and localization of prostate cancer using multi-parametric MRI/MRS. Biomed Signal Process Control 2017. [DOI: 10.1016/j.bspc.2016.07.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Testa C, Pultrone C, Manners DN, Schiavina R, Lodi R. Metabolic Imaging in Prostate Cancer: Where We Are. Front Oncol 2016; 6:225. [PMID: 27882307 PMCID: PMC5101200 DOI: 10.3389/fonc.2016.00225] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 10/10/2016] [Indexed: 11/25/2022] Open
Abstract
In recent years, the development of diagnostic methods based on metabolic imaging has been aimed at improving diagnosis of prostate cancer (PCa) and perhaps at improving therapy. Molecular imaging methods can detect specific biological processes that are different when detected within cancer cells relative to those taking place in surrounding normal tissues. Many methods are sensitive to tissue metabolism; among them, positron emission tomography (PET) and magnetic resonance spectroscopic imaging (MRSI) are widely used in clinical practice and clinical research. There is a rich literature that establishes the role of these metabolic imaging techniques as valid tools for the diagnosis, staging, and monitoring of PCa. Until recently, European guidelines for PCa detection still considered both MRSI/MRI and PET/CT to be under evaluation, even though they had demonstrated their value in the staging of high risk PCa, and in the restaging of patients presenting elevated prostatic-specific antigen levels following radical treatment of PCa, respectively. Very recently, advanced methods for metabolic imaging have been proposed in the literature: multiparametric MRI (mpMRI), hyperpolarized MRSI, PET/CT with the use of new tracers and finally PET/MRI. Their detection capabilities are currently under evaluation, as is the feasibility of using such techniques in clinical studies.
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Affiliation(s)
- Claudia Testa
- Functional MR Unit, Department of Biomedical and Neuromotor Sciences, S. Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
| | - Cristian Pultrone
- Urologic Unit, Experimental, Diagnostic and Specialty Medicine, Department of Urology, S. Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
| | - David Neil Manners
- Functional MR Unit, Department of Biomedical and Neuromotor Sciences, S. Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
| | - Riccardo Schiavina
- Urologic Unit, Experimental, Diagnostic and Specialty Medicine, Department of Urology, S. Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
| | - Raffaele Lodi
- Functional MR Unit, Department of Biomedical and Neuromotor Sciences, S. Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
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Pathmanathan AU, Alexander EJ, Huddart RA, Tree AC. The delineation of intraprostatic boost regions for radiotherapy using multimodality imaging. Future Oncol 2016; 12:2495-2511. [PMID: 27322113 DOI: 10.2217/fon-2016-0129] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Dose escalation to the prostate improves tumor control but at the expense of increased rectal toxicity. Modern imaging can be used to detect the most common site of recurrence, the intraprostatic lesion (IPL), which has led to the concept of focusing dose escalation to the IPL in order to improve the therapeutic ratio. Imaging must be able to detect lesions with adequate sensitivity and specificity to accurately delineate the IPL. This information must be carefully integrated into the radiotherapy planning process to ensure the dose is targeted to the IPL. This review will consider the role and challenges of multiparametric MRI and PET computed tomography in delineating a tumor boost to be delivered by external beam radiotherapy.
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Affiliation(s)
| | - Emma J Alexander
- The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT, UK
| | - Robert A Huddart
- The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK
| | - Alison C Tree
- The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT, UK
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Tajudeen BA, Taylor ZD, Garritano J, Cheng H, Pearigen A, Sherman AJ, Palma-Diaz F, Mishra P, Bhargava S, Pesce J, Kim I, Sebastian C, Razfar A, Papour A, Stafsudd O, Grundfest W, St. John M. Dynamic optical contrast imaging as a novel modality for rapidly distinguishing head and neck squamous cell carcinoma from surrounding normal tissue. Cancer 2016; 123:879-886. [DOI: 10.1002/cncr.30338] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 06/01/2016] [Accepted: 06/02/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Bobby A. Tajudeen
- Department of Head and Neck Surgery, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
- Head and Neck Cancer Program, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
| | - Zachary D. Taylor
- Head and Neck Cancer Program, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Sciences; University of California Los Angeles; Los Angeles California
- Department of Surgery, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
| | - James Garritano
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Sciences; University of California Los Angeles; Los Angeles California
| | - Harrison Cheng
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Sciences; University of California Los Angeles; Los Angeles California
| | - Aidan Pearigen
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Sciences; University of California Los Angeles; Los Angeles California
| | - Adria J. Sherman
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Sciences; University of California Los Angeles; Los Angeles California
| | - Fernando Palma-Diaz
- Department of Pathology, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
| | - Pratik Mishra
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Sciences; University of California Los Angeles; Los Angeles California
| | - Siddharth Bhargava
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Sciences; University of California Los Angeles; Los Angeles California
| | - Julianna Pesce
- Department of Head and Neck Surgery, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
- Head and Neck Cancer Program, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
| | - Irene Kim
- Department of Head and Neck Surgery, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
- Head and Neck Cancer Program, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
| | - Christine Sebastian
- Department of Head and Neck Surgery, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
- Head and Neck Cancer Program, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
| | - Ali Razfar
- Department of Head and Neck Surgery, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
- Head and Neck Cancer Program, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
| | - Asael Papour
- Department of Electrical Engineering, Henry Samueli School of Engineering and Applied Sciences; University of California Los Angeles; Los Angeles California
| | - Oscar Stafsudd
- Department of Electrical Engineering, Henry Samueli School of Engineering and Applied Sciences; University of California Los Angeles; Los Angeles California
| | - Warren Grundfest
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Sciences; University of California Los Angeles; Los Angeles California
- Department of Surgery, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
- Department of Electrical Engineering, Henry Samueli School of Engineering and Applied Sciences; University of California Los Angeles; Los Angeles California
| | - Maie St. John
- Department of Head and Neck Surgery, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
- Head and Neck Cancer Program, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
- Jonsson Comprehensive Cancer Center, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
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Hwang VJ, Weiss RH. Metabolomic profiling for early cancer detection: current status and future prospects. Expert Opin Drug Metab Toxicol 2016; 12:1263-1265. [PMID: 27642860 DOI: 10.1080/17425255.2016.1238460] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Vicki J Hwang
- a Division of Nephrology, Department of Internal Medicine , University of California , Davis , CA , USA
| | - Robert H Weiss
- a Division of Nephrology, Department of Internal Medicine , University of California , Davis , CA , USA.,b Cancer Center , University of California , Davis , CA , USA.,c Medical Service , VA Northern California Health Care System , Sacramento , CA , USA
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Vigneault E, Mbodji K, Racine LG, Chevrette E, Lavallee MC, Martin AG, Despres P, Beaulieu L. Image-Guided High-Dose-Rate (HDR) Boost Localization Using MRI/MR Spectroscopy: A Correlation Study with Biopsy. Cureus 2016; 8:e795. [PMID: 27790388 PMCID: PMC5081253 DOI: 10.7759/cureus.795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
PURPOSE The purpose of this study is to compare the blind interpretations of magnetic resonance imaging (MRI) sequences, diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC), mapping, and magnetic resonance spectroscopy (MRS) of the prostate, in comparison to prostate biopsy to identify a valid dominant intraprostatic lesion (DIL) for dose escalation using high-dose rate brachytherapy. METHODS MRI/MRS were performed on 20 patients with intermediate risk adenocarcinoma of the prostate. T1W, T2W, DWI-ADC, and MRS sequences were performed at 1.5 T with pelvic and endorectal coils. An experienced radiologist rated the presence of cancer in each sextant by using a dichotomic approach, first on MR standard acquisitions (T1W and T2W), then on DWI-ADC mapping, and later on MRS images. Areas under the receiver's operating characteristic curve were calculated using a sextant as the unit of analysis. The transrectal ultrasonography-guided biopsy results were used as the reference standard. A table summarizing the MRI/MRS findings was made and compared to the corresponding area in the prostate biopsy report. A perfect match was defined to be the presence of cancer in the same sextant of the MRI/MRS exam and the prostate biopsy. RESULTS The interpretation of the MRI/MRS exams per sextant was compared to the diagnostic biopsy report. MRI readings were compared with the biopsy as a surrogate for the complete pathology specimen of the prostate. A sensitivity (Sn) of 98.6% (95% confidence interval, 92.2% - 99.9%) and specificity (Sp) of 60.8% (46.1% - 74.2%) were found. The positive and negative predictive values (PPV, NPV) were 77.3% (67.1% - 85.5%) and 96.9% (83.8% - 99.9%), respectively. When MRS readings were compared with biopsy, we found a Sn of 96.4% (87.7% - 99.6%) and Sp of 54.8% (38.7% - 70.2%). The PPV and NPV were 74% (62.4% - 83.6%) and 92% (74% - 99%), respectively. DWI-ADC mapping results were also compared with biopsy. We found a Sn and Sp of 93.7% (84.5% - 98.2%) and 82.1% (66.5% - 92.5%), respectively, and a PPV and NPV of 89.4% (79.4% - 95.6%) and 88.9% (73.9% - 96.9%), respectively. Finally, after combining MRI, MRS, and DWI-ADC mapping, compared with biopsy, we obtained a Sn, Sp, PPV, and NPV of 100% (94.8% - 100%), 49% (34.8% - 63.4%), 72.6% (62.5% - 81.3%), and 100% (86.3% - 100%), respectively. CONCLUSIONS The combination of MRI/MRS is a sensitive tool for both the structural and metabolic evaluation of prostate cancer location. MRI/MRS exams are useful to delineate a DIL for high-dose-rate (HDR) intraprostatic boost.
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Affiliation(s)
| | - Khaly Mbodji
- Centre de recherche du CHU de Québec, CHU de Québec - Université Laval
| | - Louis G Racine
- Département d'imagerie médicale, CHU de Québec - Université Laval
| | - Eric Chevrette
- Département d'imagerie médicale, CHU de Québec - Université Laval
| | - Marie C Lavallee
- Département de radio-oncologie, CHU de Québec - Université Laval
| | - André-Guy Martin
- Département de radio-oncologie, CHU de Québec - Université Laval
| | - Philippe Despres
- Département de radio-oncologie, Département de physique, de génie physique et d'optique, CHU de Québec - Université Laval
| | - Luc Beaulieu
- Département de radio-oncologie, Département de physique, de génie physique et d'optique, CHU de Québec - Université Laval
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Abstract
Magnetic resonance spectroscopy (MRS) is a noninvasive functional technique to evaluate the biochemical behavior of human tissues. This property has been widely used in assessment and therapy monitoring of brain tumors. MRS studies can be implemented outside the brain, with successful and promising results in the evaluation of prostate and breast cancer, although still with limited reproducibility. As a result of technical improvements, malignancies of the musculoskeletal system and abdominopelvic organs can benefit from the molecular information that MRS provides. The technical challenges and main applications in oncology of (1)H MRS in a clinical setting are the focus of this review.
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Weis J, von Below C, Tolf A, Ortiz-Nieto F, Wassberg C, Häggman M, Ladjevardi S, Ahlström H. Quantification of metabolite concentrations in benign and malignant prostate tissues using 3D proton MR spectroscopic imaging. J Magn Reson Imaging 2016; 45:1232-1240. [PMID: 27556571 DOI: 10.1002/jmri.25443] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 08/09/2016] [Accepted: 08/09/2016] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To estimate concentrations of choline (Cho), spermine (Spm), and citrate (Cit) in prostate tissue using 3D proton magnetic resonance spectroscopic imaging (MRSI) with water as an internal concentration reference as well as to assess the relationships between the measured metabolites and also between the metabolites and apparent diffusion coefficient (ADC). MATERIALS AND METHODS Forty-six prostate cancer patients were scanned at 3T. Spectra were acquired with the point-resolved spectroscopy (PRESS) localization technique. Single-voxel spectra of four healthy volunteers were used to estimate T1 relaxation time of Spm. Spm, Cho concentrations, and ADC values of benign prostate tissues were correlated with Cit content. RESULTS The T1 value, 708 ± 132 msec, was estimated for Spm. Mean concentrations in the benign peripheral zone (PZ) were Cho, 4.5 ± 1 mM, Spm, 13.0 ± 4.4 mM, Cit, 64.4 ± 16.1 mM. Corresponding values in the benign central gland (CG) were Cho, 3.6 ± 1 mM, Spm, 13.3 ± 4.5 mM, Cit, 34.3 ± 12.9 mM. Concentrations of Cit and Spm were positively correlated in the benign PZ zone (r = 0.730) and CG (r = 0.664). Positive correlation was found between Cit and Cho in the benign CG (r = 0.705). Whereas Cit and ADC were positively correlated in the benign PZ (r = 0.673), only low correlation was found in CG (r = 0.265). CONCLUSION We have shown that it is possible to perform water-referenced quantitative 3D MRSI of the prostate at the cost of a relatively short prolongation of the acquisition time. The individual metabolite concentrations provide additional information compared to the previously used metabolite-to-citrate ratios. LEVEL OF EVIDENCE 1 J. Magn. Reson. Imaging 2017;45:1232-1240.
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Affiliation(s)
- Jan Weis
- Department of Radiology, Uppsala University Hospital, Uppsala, Sweden
| | - Catrin von Below
- Department of Radiology, Uppsala University Hospital, Uppsala, Sweden
| | - Anna Tolf
- Department of Pathology, Uppsala University Hospital, Uppsala, Sweden
| | | | - Cecilia Wassberg
- Department of Radiology, Uppsala University Hospital, Uppsala, Sweden
| | | | - Sam Ladjevardi
- Department of Urology, University Hospital, Uppsala, Sweden
| | - Håkan Ahlström
- Department of Radiology, Uppsala University Hospital, Uppsala, Sweden
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Hoffner MKM, Huebner F, Scholtz JE, Zangos S, Schulz B, Luboldt W, Vogl TJ, Bodelle B. Impact of an endorectal coil for 1H-magnetic resonance spectroscopy of the prostate at 3.0T in comparison to 1.5T: Do we need an endorectal coil? Eur J Radiol 2016; 85:1432-8. [PMID: 27423684 DOI: 10.1016/j.ejrad.2016.05.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 05/25/2016] [Accepted: 05/31/2016] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To evaluate the influence of endorectal coil (ERC) regarding spectral quality and diagnostic suitability and diagnostic performance in 3.0T 1H-magnetic resonance spectroscopy imaging (MRSI) compared to 1.5T MRSI. MATERIALS AND METHODS The study was approved by the Institutional Review Board. MRSI of the prostate was performed on 19 patients at 1.5T with ERC (protocol 1), at 3.0T with a disabled ERC (protocol 2) and at 3.0T with ERC (protocol 3). Age, weight, body size, body-mass-index, prostate volume, time between measurements, diagnostic suitability of spectra, histopathological results after biopsy of cancer suspect lesions (CSL), sensitivity and specificity were evaluated. Signal-to-noise ratio (SNR) was calculated and compared using semiparametrical multiple Conover-comparisons. Correlations between SNR and prostate volume and BMI were indicated using Pearson correlation coefficient. Distribution of SNR was evaluated for prostate quadrants. RESULTS Diagnostic suitable spectra were achieved in 76 % (protocol 1, 100% in CSL), 32 % (protocol 2, 59% in CSL) and 50 % (protocol 3, 80% in CSL) of the voxels. SNR was significantly higher in protocol 3 compared to protocol 2 and 1 (93,729 vs. 27,836 vs. 32,897, p<0.0001) with significant difference between protocol 2 and 1 (p<0.023). Highest SNR was achieved in the dorsal prostate (protocols 1 and 3; p<0.0001). Sensitivity at 3.0T was higher with use of ERC. Specificity was highest at 1.5T with ERC. CONCLUSION The ERC improves the diagnostic suitability and the SNR in MRSI at 3.0T. Less voxels at 3.0T with disabled ERC are suitable for diagnosis compared to 1.5T with ERC. MRSI at 3.0T with ERC shows the highest SNR. SNR in dorsal quadrants of the prostate was higher using ERC.
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Affiliation(s)
- Maximilian K M Hoffner
- Department of Diagnostic and Interventional Radiology, Goethe University of Frankfurt, Theodor-Stern-Kai 7, Haus 23c, 60590 Frankfurt am Main, Hesse, Germany.
| | - Frank Huebner
- Department of Diagnostic and Interventional Radiology, Goethe University of Frankfurt, Theodor-Stern-Kai 7, Haus 23c, 60590 Frankfurt am Main, Hesse, Germany.
| | - Jan Erik Scholtz
- Department of Diagnostic and Interventional Radiology, Goethe University of Frankfurt, Theodor-Stern-Kai 7, Haus 23c, 60590 Frankfurt am Main, Hesse, Germany.
| | - Stephan Zangos
- Department of Diagnostic and Interventional Radiology, Goethe University of Frankfurt, Theodor-Stern-Kai 7, Haus 23c, 60590 Frankfurt am Main, Hesse, Germany.
| | - Boris Schulz
- Department of Diagnostic and Interventional Radiology, Goethe University of Frankfurt, Theodor-Stern-Kai 7, Haus 23c, 60590 Frankfurt am Main, Hesse, Germany.
| | - Wolfgang Luboldt
- Department of Diagnostic and Interventional Radiology, Goethe University of Frankfurt, Theodor-Stern-Kai 7, Haus 23c, 60590 Frankfurt am Main, Hesse, Germany.
| | - Thomas J Vogl
- Department of Diagnostic and Interventional Radiology, Goethe University of Frankfurt, Theodor-Stern-Kai 7, Haus 23c, 60590 Frankfurt am Main, Hesse, Germany.
| | - Boris Bodelle
- Department of Diagnostic and Interventional Radiology, Goethe University of Frankfurt, Theodor-Stern-Kai 7, Haus 23c, 60590 Frankfurt am Main, Hesse, Germany.
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King MT, Nasser NJ, Mathur N, Cohen GN, Kollmeier MA, Yuen J, Vargas HA, Pei X, Yamada Y, Zakian KL, Zaider M, Zelefsky MJ. Long-term outcome of magnetic resonance spectroscopic image-directed dose escalation for prostate brachytherapy. Brachytherapy 2016; 15:266-273. [PMID: 27009848 DOI: 10.1016/j.brachy.2016.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 02/02/2016] [Accepted: 02/05/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE To report the long-term control and toxicity outcomes of patients with clinically localized prostate cancer, who underwent low-dose-rate prostate brachytherapy with magnetic resonance spectroscopic image (MRSI)-directed dose escalation to intraprostatic regions. METHODS AND MATERIALS Forty-seven consecutive patients between May 2000 and December 2003 were analyzed retrospectively. Each patient underwent a preprocedural MRSI, and MRS-positive voxels suspicious for malignancy were identified. Intraoperative planning was used to determine the optimal seed distribution to deliver a standard prescription dose to the entire prostate, while escalating the dose to MRS-positive voxels to 150% of prescription. Each patient underwent transperineal implantation of radioactive seeds followed by same-day CT for postimplant dosimetry. RESULTS The median prostate D90 (minimum dose received by 90% of the prostate) was 125.7% (interquartile range [IQR], 110.3-136.5%) of prescription. The median value for the MRS-positive mean dose was 229.9% (IQR, 200.0-251.9%). Median urethra D30 and rectal D30 values were 142.2% (137.5-168.2%) and 56.1% (40.1-63.4%), respectively. Median followup was 86.4 months (IQR, 49.8-117.6). The 10-year actuarial prostate-specific antigen relapse-free survival was 98% (95% confidence interval, 93-100%). Five patients (11%) experienced late Grade 3 urinary toxicity (e.g., urethral stricture), which improved after operative intervention. Four of these patients had dose-escalated voxels less than 1.0 cm from the urethra. CONCLUSIONS Low-dose-rate brachytherapy with MRSI-directed dose escalation to suspicious intraprostatic regions exhibits excellent long-term biochemical control. Patients with dose-escalated voxels close to the urethra were at higher risk of late urinary stricture.
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Affiliation(s)
- Martin T King
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Nicola J Nasser
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Nitin Mathur
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Gil'ad N Cohen
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Marisa A Kollmeier
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Jasper Yuen
- Department of Radiation Oncology, The Carlo Fidani Regional Cancer Centre, Mississauga, Ontario
| | - Hebert A Vargas
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Xin Pei
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Yoshiya Yamada
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Kristen L Zakian
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Marco Zaider
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Michael J Zelefsky
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY.
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Initial Evaluation of [(18)F]DCFPyL for Prostate-Specific Membrane Antigen (PSMA)-Targeted PET Imaging of Prostate Cancer. Mol Imaging Biol 2016; 17:565-74. [PMID: 25896814 DOI: 10.1007/s11307-015-0850-8] [Citation(s) in RCA: 327] [Impact Index Per Article: 40.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Prostate-specific membrane antigen (PSMA) is a recognized target for imaging prostate cancer. Here we present initial safety, biodistribution, and radiation dosimetry results with [(18)F]DCFPyL, a second-generation fluorine-18-labeled small-molecule PSMA inhibitor, in patients with prostate cancer. PROCEDURES Biodistribution was evaluated using sequential positron-emission tomography (PET) scans in nine patients with prostate cancer. Time-activity curves from the most avid tumor foci were determined. The radiation dose to selected organs was estimated using OLINDA/EXM. RESULTS No major radiotracer-specific adverse events were observed. Physiologic accumulation was observed in known sites of PSMA expression. Accumulation in putative sites of prostate cancer was observed (SUVmax up to >100, and tumor-to-blood ratios up to >50). The effective radiation dose from [(18)F]DCFPyL was 0.0139 mGy/MBq or 5 mGy (0.5 rem) from an injected dose of 370 MBq (10 mCi). CONCLUSIONS [(18)F]DCFPyL is safe with biodistribution as expected, and its accumulation is high in presumed primary and metastatic foci. The radiation dose from [(18)F]DCFPyL is similar to that from other PET radiotracers.
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De Visschere PJL, Briganti A, Fütterer JJ, Ghadjar P, Isbarn H, Massard C, Ost P, Sooriakumaran P, Surcel CI, Valerio M, van den Bergh RCN, Ploussard G, Giannarini G, Villeirs GM. Role of multiparametric magnetic resonance imaging in early detection of prostate cancer. Insights Imaging 2016; 7:205-14. [PMID: 26847758 PMCID: PMC4805618 DOI: 10.1007/s13244-016-0466-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 01/07/2016] [Accepted: 01/20/2016] [Indexed: 11/30/2022] Open
Abstract
Abstract Most prostate cancers (PC) are currently found on the basis of an elevated PSA, although this biomarker has only moderate accuracy. Histological confirmation is traditionally obtained by random transrectal ultrasound guided biopsy, but this approach may underestimate PC. It is generally accepted that a clinically significant PC requires treatment, but in case of an non-significant PC, deferment of treatment and inclusion in an active surveillance program is a valid option. The implementation of multiparametric magnetic resonance imaging (mpMRI) into a screening program may reduce the risk of overdetection of non-significant PC and improve the early detection of clinically significant PC. A mpMRI consists of T2-weighted images supplemented with diffusion-weighted imaging, dynamic contrast enhanced imaging, and/or magnetic resonance spectroscopic imaging and is preferably performed and reported according to the uniform quality standards of the Prostate Imaging Reporting and Data System (PIRADS). International guidelines currently recommend mpMRI in patients with persistently rising PSA and previous negative biopsies, but mpMRI may also be used before first biopsy to improve the biopsy yield by targeting suspicious lesions or to assist in the selection of low-risk patients in whom consideration could be given for surveillance. Teaching Points • MpMRI may be used to detect or exclude significant prostate cancer. • MpMRI can guide targeted rebiopsy in patients with previous negative biopsies. • In patients with negative mpMRI consideration could be given for surveillance. • MpMRI may add valuable information for the optimal treatment selection.
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Affiliation(s)
| | - Alberto Briganti
- Department of Urology, Urological Research Institute, Vita-Salute University San Raffaele, Milan, Italy
| | - Jurgen J Fütterer
- Department of Radiology and Nuclear Medicine, Radboud UMC, Nijmegen, The Netherlands
| | - Pirus Ghadjar
- Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Hendrik Isbarn
- Department of Urology, Regio Clinic Wedel, Wedel, Germany.,Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Christophe Massard
- Department of Oncology, Institut Gustave Roussy, University of Paris Sud, Villejuif, France
| | - Piet Ost
- Department of Radiation Oncology and Experimental Cancer Research, Ghent University Hospital, Ghent, Belgium
| | - Prasanna Sooriakumaran
- Surgical Intervention Trials Unit, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.,Department of Molecular Medicine & Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Cristian I Surcel
- Centre of Urological Surgery, Dialysis and Renal Transplantation, Fundeni Clinical Institute, Bucharest, Romania
| | | | | | - Guillaume Ploussard
- Urology Department, Saint Jean Languedoc Hospital, Toulouse, France.,Research Unit INSERM U955, Paris Est University, Team 7, Paris, France
| | - Gianluca Giannarini
- Urology Unit, Academic Medical Centre Hospital «Santa Maria della Misericordia», Udine, Italy
| | - Geert M Villeirs
- Department of Radiology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium
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Multiparametric Prostate Magnetic Resonance Imaging at 3 T: Failure of Magnetic Resonance Spectroscopy to Provide Added Value. J Comput Assist Tomogr 2015; 39:674-80. [PMID: 25938212 DOI: 10.1097/rct.0000000000000261] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess the effect of proton magnetic resonance spectroscopy imaging (MRSI) on the accuracy of multiparametric magnetic resonance imaging (mpMRI) at 3 T for prostate cancer detection. MATERIALS AND METHODS Thirty-four patients with prostate cancer were included in this retrospective study. All patients underwent preoperative mpMRI on a 3-T scanner before radical prostatectomy. Magnetic resonance imaging evaluation was based on the prostate imaging-reporting and data system classification system. The accuracy of mpMRI with and without MRSI was determined using receiver operating characteristic analysis, with histology as the reference standard. RESULTS Multiparametric MRI including MRSI had a sensitivity of 57.0% and a specificity of 89.2% for sextant-based cancer detection. Multiparametric MRI without MRSI had a sensitivity of 58.1% and a specificity of 87.4%. There was no significant difference regarding the accuracy of mpMRI with and without MRSI (P = 0.48). CONCLUSION The addition of MRSI does not improve the accuracy of 3 T mpMRI for sextant localization of prostate cancer.
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Wibmer AG, Vargas HA, Hricak H. Role of MRI in the diagnosis and management of prostate cancer. Future Oncol 2015; 11:2757-66. [PMID: 26367323 DOI: 10.2217/fon.15.206] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Multiparametric MRI of the prostate consists of T1- and T2-weighted sequences, which provide anatomical information, and one or more 'functional' sequences, that is, diffusion-weighted imaging, dynamic contrast-enhanced sequences and magnetic resonance spectroscopy. Prostate MRI is the most accurate imaging method for local staging of prostate cancer and can also be used for the noninvasive evaluation of tumor aggressiveness. By magnetic resonance-guided prostate biopsy it is possible to target the most cancer-suspicious areas of the gland, especially in patients with a negative transrectal biopsy. In patients with biochemical recurrence after radical treatment, MRI is a valuable tool for the detection of local tumor recurrence and whole-body MRI can be used for the diagnosis of distant metastases.
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Affiliation(s)
- Andreas G Wibmer
- Memorial Sloan Kettering Cancer Center, Department of Radiology, 1275 York Avenue, New York City, NY 10065, USA
| | - Hebert Alberto Vargas
- Memorial Sloan Kettering Cancer Center, Department of Radiology, 1275 York Avenue, New York City, NY 10065, USA
| | - Hedvig Hricak
- Memorial Sloan Kettering Cancer Center, Department of Radiology, 1275 York Avenue, New York City, NY 10065, USA
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Hedgire SS, Eberhardt SC, Borczuk R, McDermott S, Harisinghani MG. Interpretation and reporting multiparametric prostate MRI: a primer for residents and novices. ACTA ACUST UNITED AC 2015; 39:1036-51. [PMID: 24566965 DOI: 10.1007/s00261-014-0097-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Multiparametric MRI has developed as a tool for prostate cancer lesion detection, characterization, staging, surveillance, and imaging of local recurrence. Given the disease frequency and the growing importance of imaging, as reliance on PSA declines, radiologists involved in prostate MRI imaging must become proficient with the fundamentals of multiparametric prostate MRI (T2WI, DWI, DCE-MRI, and MR spectroscopy). Interpretation and reporting must yield accuracy, consistency, and add value to clinical care. This review provides a primer to novices and trainees learning about multiparametric prostate MRI. MRI technique is presented along with the use of particular MRI sequences. Relevant prostate anatomy is outlined and imaging features of prostate cancer with staging are discussed. Finally structured reporting is introduced, and some limitations of prostate MRI are discussed.
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Affiliation(s)
- Sandeep S Hedgire
- Department of Abdominal Imaging and Intervention, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA,
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Basavanhally A, Viswanath S, Madabhushi A. Predicting classifier performance with limited training data: applications to computer-aided diagnosis in breast and prostate cancer. PLoS One 2015; 10:e0117900. [PMID: 25993029 PMCID: PMC4436385 DOI: 10.1371/journal.pone.0117900] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 10/28/2014] [Indexed: 11/18/2022] Open
Abstract
Clinical trials increasingly employ medical imaging data in conjunction with supervised classifiers, where the latter require large amounts of training data to accurately model the system. Yet, a classifier selected at the start of the trial based on smaller and more accessible datasets may yield inaccurate and unstable classification performance. In this paper, we aim to address two common concerns in classifier selection for clinical trials: (1) predicting expected classifier performance for large datasets based on error rates calculated from smaller datasets and (2) the selection of appropriate classifiers based on expected performance for larger datasets. We present a framework for comparative evaluation of classifiers using only limited amounts of training data by using random repeated sampling (RRS) in conjunction with a cross-validation sampling strategy. Extrapolated error rates are subsequently validated via comparison with leave-one-out cross-validation performed on a larger dataset. The ability to predict error rates as dataset size increases is demonstrated on both synthetic data as well as three different computational imaging tasks: detecting cancerous image regions in prostate histopathology, differentiating high and low grade cancer in breast histopathology, and detecting cancerous metavoxels in prostate magnetic resonance spectroscopy. For each task, the relationships between 3 distinct classifiers (k-nearest neighbor, naive Bayes, Support Vector Machine) are explored. Further quantitative evaluation in terms of interquartile range (IQR) suggests that our approach consistently yields error rates with lower variability (mean IQRs of 0.0070, 0.0127, and 0.0140) than a traditional RRS approach (mean IQRs of 0.0297, 0.0779, and 0.305) that does not employ cross-validation sampling for all three datasets.
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Affiliation(s)
- Ajay Basavanhally
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Satish Viswanath
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Anant Madabhushi
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
- * E-mail:
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43
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Hricak H. MR imaging of the prostate. Cancer Imaging 2015; 2. [PMCID: PMC4554687 DOI: 10.1102/1470-7330.2002.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
There is no set protocol for imaging prostate cancer, and a selection of a particular modality (TRUS, CT or MRI) often depends on the equipment and local expertise available. None of the imaging modality is perfect and a judicious combination provides the best results. MR imaging and MR spectroscopic imaging are powerful new tools for the local anatomic and metabolic evaluation of prostate cancer. MRI/MRSI offers new insights into the assessment of tumor location, volume, and aggressiveness and improve staging. The techniques are novel; indications and effectiveness continue to be defined; examination is expensive and the potential role of these studies still evolving. However, with increasing patient demand for minimally invasive and patient specific treatment, it is likely that the prostate MRI and MRSI will become the recognized modality of choice for loco-regional imaging evaluation of prostate cancer.
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Affiliation(s)
- Hedvig Hricak
- />Department of Radiology, Carroll and Milton Petrie Chair, Memorial Sloan-Kettering Cancer Center, New York, USA , />Cornell University, 1275 York Avenue, C278, New York, 10021 USA
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Improved dosimetry in prostate brachytherapy using high resolution contrast enhanced magnetic resonance imaging: a feasibility study. J Contemp Brachytherapy 2015; 6:337-43. [PMID: 25834576 PMCID: PMC4300354 DOI: 10.5114/jcb.2014.46555] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 05/04/2014] [Accepted: 09/14/2014] [Indexed: 12/04/2022] Open
Abstract
Purpose To assess detailed dosimetry data for prostate and clinical relevant intra- and peri-prostatic structures including neurovascular bundles (NVB), urethra, and penile bulb (PB) from postbrachytherapy computed tomography (CT) versus high resolution contrast enhanced magnetic resonance imaging (HR-CEMRI). Material and methods Eleven postbrachytherapy prostate cancer patients underwent HR-CEMRI and CT imaging. Computed tomography and HR-CEMRI images were randomized and 2 independent expert readers created contours of prostate, intra- and peri-prostatic structures on each CT and HR-CEMRI scan for all 11 patients. Dosimetry data including V100, D90, and D100 was calculated from these contours. Results Mean V100 values from CT and HR-CEMRI contours were as follows: prostate (98.5% and 96.2%, p = 0.003), urethra (81.0% and 88.7%, p = 0.027), anterior rectal wall (ARW) (8.9% and 2.8%, p < 0.001), left NVB (77.9% and 51.5%, p = 0.002), right NVB (69.2% and 43.1%, p = 0.001), and PB (0.09% and 11.4%, p = 0.005). Mean D90 (Gy) derived from CT and HR-CEMRI contours were: prostate (167.6 and 150.3, p = 0.012), urethra (81.6 and 109.4, p = 0.041), ARW (2.5 and 0.11, p = 0.003), left NVB (98.2 and 58.6, p = 0.001), right NVB (87.5 and 55.5, p = 0.001), and PB (11.2 and 12.4, p = 0.554). Conclusions Findings of this study suggest that HR-CEMRI facilitates accurate and meaningful dosimetric assessment of prostate and clinically relevant structures, which is not possible with CT. Significant differences were seen between CT and HR-CEMRI, with volume overestimation of CT derived contours compared to HR-CEMRI.
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Iacobazzi V, Infantino V. Citrate--new functions for an old metabolite. Biol Chem 2015; 395:387-99. [PMID: 24445237 DOI: 10.1515/hsz-2013-0271] [Citation(s) in RCA: 185] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 01/16/2014] [Indexed: 01/22/2023]
Abstract
Citrate is an important substrate in cellular energy metabolism. It is produced in the mitochondria and used in the Krebs cycle or released into cytoplasm through a specific mitochondrial carrier, CIC. In the cytosol, citrate and its derivatives, acetyl-CoA and oxaloacetate, are used in normal and pathological processes. Beyond the classical role as metabolic regulator, recent studies have highlighted that citrate is involved in inflammation, cancer, insulin secretion, histone acetylation, neurological disorders, and non-alcoholic fatty liver disease. Monitoring changes in the citrate levels could therefore potentially be used as diagnostic tool. This review highlights these new aspects of citrate functions.
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Lemaître G, Martí R, Freixenet J, Vilanova JC, Walker PM, Meriaudeau F. Computer-Aided Detection and diagnosis for prostate cancer based on mono and multi-parametric MRI: a review. Comput Biol Med 2015; 60:8-31. [PMID: 25747341 DOI: 10.1016/j.compbiomed.2015.02.009] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 02/11/2015] [Accepted: 02/12/2015] [Indexed: 12/30/2022]
Abstract
Prostate cancer is the second most diagnosed cancer of men all over the world. In the last few decades, new imaging techniques based on Magnetic Resonance Imaging (MRI) have been developed to improve diagnosis. In practise, diagnosis can be affected by multiple factors such as observer variability and visibility and complexity of the lesions. In this regard, computer-aided detection and computer-aided diagnosis systems have been designed to help radiologists in their clinical practice. Research on computer-aided systems specifically focused for prostate cancer is a young technology and has been part of a dynamic field of research for the last 10 years. This survey aims to provide a comprehensive review of the state-of-the-art in this lapse of time, focusing on the different stages composing the work-flow of a computer-aided system. We also provide a comparison between studies and a discussion about the potential avenues for future research. In addition, this paper presents a new public online dataset which is made available to the research community with the aim of providing a common evaluation framework to overcome some of the current limitations identified in this survey.
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Affiliation(s)
- Guillaume Lemaître
- LE2I-UMR CNRS 6306, Université de Bourgogne, 12 rue de la Fonderie, 71200 Le Creusot, France; ViCOROB, Universitat de Girona, Campus Montilivi, Edifici P4, 17071 Girona, Spain.
| | - Robert Martí
- ViCOROB, Universitat de Girona, Campus Montilivi, Edifici P4, 17071 Girona, Spain.
| | - Jordi Freixenet
- ViCOROB, Universitat de Girona, Campus Montilivi, Edifici P4, 17071 Girona, Spain.
| | - Joan C Vilanova
- Department of Magnetic Resonance, Clínica Girona, Lorenzana 36, 17002 Girona, Spain
| | - Paul M Walker
- LE2I-UMR CNRS 6306, Université de Bourgogne, Avenue Alain Savary, 21000 Dijon, France.
| | - Fabrice Meriaudeau
- LE2I-UMR CNRS 6306, Université de Bourgogne, 12 rue de la Fonderie, 71200 Le Creusot, France.
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Adams SB, Nettles DL, Jones LC, Miller SD, Guyton GP, Schon LC. Inflammatory cytokines and cellular metabolites as synovial fluid biomarkers of posttraumatic ankle arthritis. Foot Ankle Int 2014; 35:1241-9. [PMID: 25201328 DOI: 10.1177/1071100714550652] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND There is a paucity of research on posttraumatic ankle arthritis (PTAA). We aimed to identify synovial fluid PTAA biomarkers using cytokine analysis and metabolic profiling. METHODS Ankle joint synovial fluid was obtained from 20 patients with PTAA and 20 patients with no ankle pain and no radiographic evidence of ankle arthritis (control group). Synovial fluid samples were analyzed for IFN-γ, TNF-α, MIP-1β, MCP-1, IL-1β, IL-1Ra, IL-4, IL-6, IL-8, IL-10, IL-13, and IL-15 using ELISA and for more than 3000 metabolites using liquid and gas chromatography with mass spectroscopy. To compare presence of cytokines and metabolites between groups, t tests were used. Random forest analysis was performed on metabolites to determine whether control and PTAA samples could be differentiated based on metabolic profile. RESULTS IL-1Ra, IL-6, IL-8, IL-10, IL-15, and MCP-1 were significantly elevated in the PTAA group. In addition, 107 metabolites in the PTAA group were significantly altered, including derangement in amino acid, carbohydrate, lipid, and energy metabolism, extracellular matrix turnover, and collagen degradation. Random forest analysis yielded a predictive accuracy of 90% when using the metabolic profiles to distinguish between control and PTAA samples. CONCLUSION This study identified inflammatory cytokines and metabolites present in the synovial fluid of PTAA. CLINICAL RELEVANCE Several of these entities have previously been implicated in rheumatoid arthritis and osteoarthritis of the knee, but many could potentially be used as novel biomarkers of PTAA. Most importantly, the findings suggest that metabolites could be used to distinguish synovial fluid from patients with PTAA.
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Affiliation(s)
- Samuel B Adams
- Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA
| | - Dana L Nettles
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Lynne C Jones
- Department of Orthopaedic Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Stuart D Miller
- Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA
| | - Gregory P Guyton
- Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA
| | - Lew C Schon
- Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA
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Multiparametric MRI for localized prostate cancer: lesion detection and staging. BIOMED RESEARCH INTERNATIONAL 2014; 2014:684127. [PMID: 25525600 PMCID: PMC4266765 DOI: 10.1155/2014/684127] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 09/28/2014] [Accepted: 10/03/2014] [Indexed: 11/18/2022]
Abstract
Multiparametric MRI of the prostate combines high-resolution anatomic imaging with functional imaging of alterations in normal tissue caused by neoplastic transformation for the identification and characterization of in situ prostate cancer. Lesion detection relies on a systematic approach to the analysis of both anatomic and functional imaging using established criteria for the delineation of suspicious areas. Staging includes visual and functional analysis of the prostate "capsule" to determine if in situ disease is, in fact, organ-confined, as well as the evaluation of pelvic structures including lymph nodes and bones for the detection of metastasis. Although intertwined, the protocol can be optimized depending on whether lesion detection or staging is of the highest priority.
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Wang AS, Lodi A, Rivera LB, Izquierdo-Garcia JL, Firpo MA, Mulvihill SJ, Tempero MA, Bergers G, Ronen SM. HR-MAS MRS of the pancreas reveals reduced lipid and elevated lactate and taurine associated with early pancreatic cancer. NMR IN BIOMEDICINE 2014; 27:1361-70. [PMID: 25199993 PMCID: PMC5554431 DOI: 10.1002/nbm.3198] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 08/08/2014] [Accepted: 08/11/2014] [Indexed: 05/07/2023]
Abstract
The prognosis for patients with pancreatic cancer is extremely poor, as evidenced by the disease's five-year survival rate of ~5%. New approaches are therefore urgently needed to improve detection, treatment, and monitoring of pancreatic cancer. MRS-detectable metabolic changes provide useful biomarkers for tumor detection and response-monitoring in other cancers. The goal of this study was to identify MRS-detectable biomarkers of pancreatic cancer that could enhance currently available imaging approaches. We used (1) H high-resolution magic angle spinning MRS to probe metabolite levels in pancreatic tissue samples from mouse models and patients. In mice, the levels of lipids dropped significantly in pancreata with lipopolysaccharide-induced inflammation, in pancreata with pre-cancerous metaplasia (4 week old p48-Cre;LSL-Kras(G12D) mice), and in pancreata with pancreatic intraepithelial neoplasia, which precedes invasive pancreatic cancer (8 week old p48-Cre LSL-Kras(G12D) mice), to 26 ± 19% (p = 0.03), 19 ± 16% (p = 0.04), and 26 ± 10% (p = 0.05) of controls, respectively. Lactate and taurine remained unchanged in inflammation and in pre-cancerous metaplasia but increased significantly in pancreatic intraepithelial neoplasia to 266 ± 61% (p = 0.0001) and 999 ± 174% (p < 0.00001) of controls, respectively. Importantly, analysis of patient biopsies was consistent with the mouse findings. Lipids dropped in pancreatitis and in invasive cancer biopsies to 29 ± 15% (p = 0.01) and 26 ± 38% (p = 0.02) of normal tissue. In addition, lactate and taurine levels remained unchanged in inflammation but rose in tumor samples to 244 ± 155% (p = 0.02) and 188 ± 67% (p = 0.02), respectively, compared with normal tissue. Based on these findings, we propose that a drop in lipid levels could serve to inform on pancreatitis and cancer-associated inflammation, whereas elevated lactate and taurine could serve to identify the presence of pancreatic intraepithelial neoplasia and invasive tumor. Our findings may help enhance current imaging methods to improve early pancreatic cancer detection and monitoring.
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Affiliation(s)
- Alan S. Wang
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Alessia Lodi
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Lee B. Rivera
- Department of Neurological Surgery, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Jose L. Izquierdo-Garcia
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Matthew A. Firpo
- Department of Surgery, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Sean J. Mulvihill
- Department of Surgery, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Margaret A. Tempero
- Department of Medicine, Division of Hematology and Oncology, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Gabriele Bergers
- Department of Neurological Surgery, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Sabrina M. Ronen
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
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Adamczyk P, Tworkiewicz J, Drewa T. Radical prostatectomy specimens - a voice against focal therapy. Cent European J Urol 2014; 67:235-41. [PMID: 25247079 PMCID: PMC4165678 DOI: 10.5173/ceju.2014.03.art5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 04/22/2014] [Accepted: 06/17/2014] [Indexed: 11/28/2022] Open
Abstract
Introduction The main treatment methods of prostate carcinoma are surgery and radiation therapy, both having serious side effects. Because of these side effects, the idea of organ preserving therapy emerged. Rationale to perform focal therapy is to preserve the prostate gland, along with potency and continence, offering good cancer control with appropriate treatment. The idea of gland sparing therapy is quite controversial. Presently, EAU Guidelines propose focal therapy as experimental in the treatment of prostate carcinoma. Material and methods The aim of the study was to asses how many patients could be qualified for focal therapy, according to post prostatectomy pathological findings. 720 patients suspected of prostate cancer were biopsied. In 324 patients, prostate carcinoma was revealed, of which 81 were subjected to radical prostatectomy. Pre and post–operative pathological results were analyzed, according to possible qualification for focal treatment. Results According to the clinical evaluation of all the patients referred to the treatment, 25% could be assumed to have unifocal disease and could be qualified to the focal treatment. Post–operative evaluation revealed pT2b cancer in 5%, pT2c disease in 65%, and pT3a–pT4a disease in 20% of these patients. Cancer was unilateral (pT2a–b) in only 15% of cases, and was suitable for focal treatment (small disease not extending to whole lobe– pT2a disease) in only 10%. Conclusions It seems that with the use of current methods, proper T–staging of the disease and amount of neoplasmatic tissue inside the gland can not be reached with great certainty. In our opinion, focal therapy should not be used in patients with ≤pT2b and high risk disease. For them, radical treatment (surgery or radiation therapy) should be recommended. For the rest of the patients, with low risk disease, keeping in mind the large scale of possible overtreatment, active surveillance is a valid treatment option. Focal therapy can be an interesting therapeutic proposition for a small group of patients with pT2a cancer, but it is not possible to select them with big certainty with current methods of imaging medicine.
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Affiliation(s)
- Przemysław Adamczyk
- Nicolaus Copernicus Hospital in Toruń, Department of General and Oncologic Urology, Toruń, Poland
| | - Jakub Tworkiewicz
- Nicolaus Copernicus Hospital in Toruń, Department of General and Oncologic Urology, Toruń, Poland
| | - Tomasz Drewa
- Nicolaus Copernicus Hospital in Toruń, Department of General and Oncologic Urology, Toruń, Poland ; Regenerative Medicine Engineering Department, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
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