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Tamada T, Kido A, Ueda Y, Takeuchi M, Kanki A, Neelavalli J, Yamamoto A. Comparison of single-shot EPI and multi-shot EPI in prostate DWI at 3.0 T. Sci Rep 2022; 12:16070. [PMID: 36168032 PMCID: PMC9515065 DOI: 10.1038/s41598-022-20518-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 09/14/2022] [Indexed: 12/02/2022] Open
Abstract
In prostate MRI, single-shot EPI (ssEPI) DWI still suffers from distortion and blurring. Multi-shot EPI (msEPI) overcomes the drawbacks of ssEPI DWI. The aim of this article was to compare the image quality and diagnostic performance for clinically significant prostate cancer (csPC) between ssEPI DWI and msEPI DWI. This retrospective study included 134 patients with suspected PC who underwent 3.0 T MRI and subsequent MRI-guided biopsy. Three radiologists independently assessed anatomical distortion, prostate edge clarity, and lesion conspicuity score for pathologically confirmed csPC. Lesion apparent diffusion coefficient (ADC) and benign ADC were also calculated. In 17 PC patients who underwent prostatectomy, three radiologists independently assessed eight prostate regions by DWI score in PI-RADS v 2.1. Anatomical distortion and prostate edge clarity were significantly higher in msEPI DWI than in ssEPI DWI in the three readers. Lesion conspicuity score was significantly higher in msEPI DWI than in ssEPI DWI in reader 1 and reader 3. Regarding discrimination ability between PC with GS ≤ 3 + 4 and PC with GS ≥ 4 + 3 using lesion ADC, AUC was comparable between ssEPI DWI and msEPI DWI. For diagnostic performance of csPC using DWI score, AUC was comparable between msEPI DWI and ssEPI DWI in all readers. Compared with ssEPI DWI, msEPI DWI had improved image quality and similar or higher diagnostic performance.
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Affiliation(s)
- Tsutomu Tamada
- Department of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.
| | - Ayumu Kido
- Department of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | | | | | - Akihiko Kanki
- Department of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | | | - Akira Yamamoto
- Department of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
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2
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Diffusion-weighted imaging in prostate cancer. MAGMA (NEW YORK, N.Y.) 2021; 35:533-547. [PMID: 34491467 DOI: 10.1007/s10334-021-00957-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/11/2021] [Accepted: 08/29/2021] [Indexed: 12/21/2022]
Abstract
Diffusion-weighted imaging (DWI), a key component in multiparametric MRI (mpMRI), is useful for tumor detection and localization in clinically significant prostate cancer (csPCa). The Prostate Imaging Reporting and Data System versions 2 and 2.1 (PI-RADS v2 and PI-RADS v2.1) emphasize the role of DWI in determining PIRADS Assessment Category in each of the transition and peripheral zones. In addition, several recent studies have demonstrated comparable performance of abbreviated biparametric MRI (bpMRI), which incorporates only T2-weighted imaging and DWI, compared with mpMRI with dynamic contrast-enhanced MRI. Therefore, further optimization of DWI is essential to achieve clinical application of bpMRI for efficient detection of csPC in patients with elevated PSA levels. Although DWI acquisition is routinely performed using single-shot echo-planar imaging, this method suffers from such as susceptibility artifact and anatomic distortion, which remain to be solved. In this review article, we will outline existing problems in standard DWI using the single-shot echo-planar imaging sequence; discuss solutions that employ newly developed imaging techniques, state-of-the-art technologies, and sequences in DWI; and evaluate the current status of quantitative DWI for assessment of tumor aggressiveness in PC.
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3
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Comparison between MRI and choline-PET trans-perineal target biopsies and saturation biopsies for detection and topography of intra-prostatic recurrence after primary radiation therapy for prostate cancer. Prog Urol 2021; 31:683-691. [PMID: 34154955 DOI: 10.1016/j.purol.2021.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 04/07/2021] [Accepted: 04/30/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Biochemical recurrence of prostate cancer after radiation therapy occurs in 5 to 50% of cases depending on the radiation technique used. The diagnosis of recurrence of prostate adenocarcinoma must be made accurately. The aim of this study was to compare transperineal saturation and target biopsies to index lesion (IL) as defined on MRI and 18FCholine PET-CT (PETc) for detection of intra-prostatic recurrence after primary radiation therapy for prostate cancer. MATERIALS AND METHODS Thirty-eight patients with an history of prostate radiation for prostate cancer and biochemical recurrence were retrospectively included between March 2013 and June 2017. All patients had PETc and multiparametric MRI (MRI) defining IL. All patients had transperineal saturation biopsies and target biopsies the IL. RESULTS Among 38 patients with biochemical recurrence, 33 (87%) had biopsy proven recurrence in the prostate. The sensitivity and specificity of MRI were 32% (SD:19%) and 91% respectively (SD:7%). The sensitivity and specificity of PETc were 33% (SD:22%) and 78% respectively (SD:12%). Saturation trans-perineal and target biopsies allowed detection of disease recurrence in 79% and 84% of patients, respectively. CONCLUSION In case of positive imaging, both trans-perineal prostate saturation and target biopsies offer good performance to confirm intraprostatic recurrence. However, MRI and PETc low sensitivity to detect all sites of local recurrence of prostate cancer after radiation still justify the completion of systematic saturation biopsies. LEVEL OF EVIDENCE 3.
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Wang YF, Tadimalla S, Hayden AJ, Holloway L, Haworth A. Artificial intelligence and imaging biomarkers for prostate radiation therapy during and after treatment. J Med Imaging Radiat Oncol 2021; 65:612-626. [PMID: 34060219 DOI: 10.1111/1754-9485.13242] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/18/2021] [Accepted: 05/02/2021] [Indexed: 12/15/2022]
Abstract
Magnetic resonance imaging (MRI) is increasingly used in the management of prostate cancer (PCa). Quantitative MRI (qMRI) parameters, derived from multi-parametric MRI, provide indirect measures of tumour characteristics such as cellularity, angiogenesis and hypoxia. Using Artificial Intelligence (AI), relevant information and patterns can be efficiently identified in these complex data to develop quantitative imaging biomarkers (QIBs) of tumour function and biology. Such QIBs have already demonstrated potential in the diagnosis and staging of PCa. In this review, we explore the role of these QIBs in monitoring treatment response during and after PCa radiotherapy (RT). Recurrence of PCa after RT is not uncommon, and early detection prior to development of metastases provides an opportunity for salvage treatments with curative intent. However, the current method of monitoring treatment response using prostate-specific antigen levels lacks specificity. QIBs, derived from qMRI and developed using AI techniques, can be used to monitor biological changes post-RT providing the potential for accurate and early diagnosis of recurrent disease.
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Affiliation(s)
- Yu-Feng Wang
- Institute of Medical Physics, School of Physics, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Sirisha Tadimalla
- Institute of Medical Physics, School of Physics, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Amy J Hayden
- Sydney West Radiation Oncology, Westmead Hospital, Wentworthville, New South Wales, Australia
- Faculty of Medicine, Western Sydney University, Sydney, New South Wales, Australia
- Faculty of Medicine, Health & Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Lois Holloway
- Institute of Medical Physics, School of Physics, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- Liverpool and Macarthur Cancer Therapy Centre, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Annette Haworth
- Institute of Medical Physics, School of Physics, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
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Panebianco V, Villeirs G, Weinreb JC, Turkbey BI, Margolis DJ, Richenberg J, Schoots IG, Moore CM, Futterer J, Macura KJ, Oto A, Bittencourt LK, Haider MA, Salomon G, Tempany CM, Padhani AR, Barentsz JO. Prostate Magnetic Resonance Imaging for Local Recurrence Reporting (PI-RR): International Consensus -based Guidelines on Multiparametric Magnetic Resonance Imaging for Prostate Cancer Recurrence after Radiation Therapy and Radical Prostatectomy. Eur Urol Oncol 2021; 4:868-876. [PMID: 33582104 DOI: 10.1016/j.euo.2021.01.003] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 01/16/2021] [Accepted: 01/22/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND Imaging techniques are used to identify local recurrence of prostate cancer (PCa) for salvage therapy and to exclude metastases that should be addressed with systemic therapy. For magnetic resonance imaging (MRI), a reduction in the variability of acquisition, interpretation, and reporting is required to detect local PCa recurrence in men with biochemical relapse after local treatment with curative intent. OBJECTIVE To propose a standardised method for image acquisition and assessment of PCa local recurrence using MRI after radiation therapy (RP) and radical prostatectomy (RT). EVIDENCE ACQUISITION Prostate Imaging for Recurrence Reporting (PI-RR) was formulated using the existing literature. An international panel of experts conducted a nonsystematic review of the literature. The PI-RR system was created via consensus through a combination of face-to-face and online discussions. EVIDENCE SYNTHESIS Similar to with PI-RADS, based on the best available evidence and expert opinion, the minimum acceptable MRI parameters for detection of recurrence after radiation therapy and radical prostatectomy are set. Also, a simplified and standardised terminology and content of the reports that use five assessment categories to summarise the suspicion of local recurrence (PI-RR) are designed. PI-RR scores of 1 and 2 are assigned to lesions with a very low and low likelihood of recurrence, respectively. PI-RR 3 is assigned if the presence of recurrence is uncertain. PI-RR 4 and 5 are assigned for a high and very high likelihood of recurrence, respectively. PI-RR is intended to be used in routine clinical practice and to facilitate data collection and outcome monitoring for research. CONCLUSIONS This paper provides a structured reporting system (PI-RR) for MRI evaluation of local recurrence of PCa after RT and RP. PATIENT SUMMARY A new method called PI-RR was developed to promote standardisation and reduce variations in the acquisition, interpretation, and reporting of magnetic resonance imaging for evaluating local recurrence of prostate cancer and guiding therapy.
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Affiliation(s)
- Valeria Panebianco
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University/Policlinico Umberto I, Rome, Italy.
| | - Geert Villeirs
- Department of Radiology and Nuclear Medicine, Ghent University Hospital, Ghent, Belgium
| | - Jeffrey C Weinreb
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Baris I Turkbey
- National Cancer Institute, Center for Cancer Research, Bethesda, MD, USA
| | | | - Jonathan Richenberg
- Department of Imaging, Brighton and Sussex University Hospitals NHS Trust and Brighton and Sussex Medical School, Brighton, UK
| | - Ivo G Schoots
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Radiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Jurgen Futterer
- Department of Radiology and Nuclear Medicine, Radboudumc, Nijmegen, The Netherlands
| | - Katarzyna J Macura
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Aytekin Oto
- Department of Radiology, University of Chicago, Chicago, IL, USA
| | | | - Masoom A Haider
- Department of Medical Imaging, University of Toronto, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Canada
| | - Georg Salomon
- Martini-Clinic Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Clare M Tempany
- Department of Radiology, Brigham &Women's Hospital, Boston, MA, USA
| | - Anwar R Padhani
- Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, UK
| | - Jelle O Barentsz
- Department of Radiology and Nuclear Medicine, Radboudumc, Nijmegen, The Netherlands
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6
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Noureldin M, Eldred-Evans D, Khoo CC, Winkler M, Sokhi H, Tam H, Ahmed HU. Review article: MRI-targeted biopsies for prostate cancer diagnosis and management. World J Urol 2020; 39:57-63. [PMID: 32253585 DOI: 10.1007/s00345-020-03182-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 03/25/2020] [Indexed: 12/22/2022] Open
Abstract
PURPOSE Transrectal ultrasound (TRUS)-guided biopsy has been the traditional biopsy route in the detection of prostate cancer. However, due to concern regarding overdetection of low-risk cancer and missed clinically significant cancers as well as risk of sepsis, alternative approaches have been explored. Transperineal template biopsy-sampling the gland every 5 m to 10 mm-reduces error by sampling the whole prostate but increases risk of detecting clinically insignificant cancers as well as conferring risks of side effects such as urinary retention and bleeding. METHODS There are various targeted biopsy techniques, each with different cancer detection rates, costs and learning curves. Current research focuses on refining biopsy methodology to maximize detection of significant cancers, whilst minimising invasiveness and complications. In this article, the up-to-date research data about MRI-targeted prostate biopsy were reviewed to show its utilization in prostate cancer management and diagnosis. RESULTS AND CONCLUSION Prostate multiparametric MRI has become an effective tool in the detection of significant cancers and an essential component of the prostate cancer diagnostic pathway incorporating MRI-guided biopsy decisions.
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Affiliation(s)
- M Noureldin
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Charing Cross Campus, Fulham Palace Road, London, W6 8RF, UK. .,Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK. .,Urology Department, Ain Shams University Hospitals, Cairo, Egypt.
| | - D Eldred-Evans
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Charing Cross Campus, Fulham Palace Road, London, W6 8RF, UK.,Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - C C Khoo
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Charing Cross Campus, Fulham Palace Road, London, W6 8RF, UK.,Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - M Winkler
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Charing Cross Campus, Fulham Palace Road, London, W6 8RF, UK.,Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - H Sokhi
- Department of Radiology, Hillingdon Hospitals NHS Foundation Trust, London, UK.,Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood, UK
| | - H Tam
- Department of Radiology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - H U Ahmed
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Charing Cross Campus, Fulham Palace Road, London, W6 8RF, UK.,Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
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7
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Baty M, Créhange G, Pasquier D, Palard X, Deleuze A, Gnep K, Key S, Beuzit L, Castelli J, de Crevoisier R. Salvage reirradiation for local prostate cancer recurrence after radiation therapy. For who? When? How? Cancer Radiother 2019; 23:541-558. [PMID: 31421999 DOI: 10.1016/j.canrad.2019.07.125] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 07/03/2019] [Indexed: 12/22/2022]
Abstract
PURPOSE Literature review reporting results of salvage brachytherapy and stereotactic body radiotherapy for prostate recurrence only after radiotherapy for prostate cancer. MATERIALS AND METHODS A total of 38 studies (including at least 15 patients per study) were analysed: 19 using low-dose-rate brachytherapy, nine high-dose-rate brachytherapy and ten stereotactic body radiotherapy. Only five studies were prospective. The median numbers of patients were 30 for low-dose-rate brachytherapy, 34 for high-dose-rate brachytherapy, and 30 for stereotactic body radiotherapy. The median follow-up were 47months for low-dose-rate brachytherapy, 36months for high-dose-rate brachytherapy and 21months for stereotactic body radiotherapy. RESULTS Late genitourinary toxicity rates ranged, for grade 2: from 4 to 42% for low-dose-rate brachytherapy, from 7 to 54% for high-dose-rate brachytherapy and from 3 to 20% for stereotactic body radiotherapy, and for grade 3 or above: from 0 to 24% for low-dose-rate brachytherapy, from 0 to 13% for high-dose-rate brachytherapy and from 0 to 3% for grade 3 or above (except 12% in one study) for stereotactic body radiotherapy. Late gastrointestinal toxicity rates ranged, for grade 2: from 0 to 6% for low-dose-rate brachytherapy, from 0 to 14% for high-dose-rate brachytherapy and from 0 to 11% for stereotactic body radiotherapy, and for grade 3 or above: from 0 to 6% for low-dose-rate brachytherapy, and from 0 to 1% for high-dose-rate brachytherapy and stereotactic body radiotherapy. The 5-year biochemical disease-free survival rates ranged from 20 to 77% for low-dose-rate brachytherapy and from 51 to 68% for high-dose-rate brachytherapy. The 2- and 3-year disease-free survival rates ranged from 40 to 82% for stereotactic body radiotherapy. Prognostic factors of biochemical recurrence have been identified. CONCLUSION Despite a lack of prospective data, salvage reirradiation for prostate cancer recurrence can be proposed to highly selected patients and tumours. Prospective comparative studies are needed.
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Affiliation(s)
- M Baty
- Department of radiotherapy, centre Eugène-Marquis, 3, avenue de la Bataille-Flandres-Dunkerque, 35000 Rennes, France
| | - G Créhange
- Department of radiotherapy, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, 21000 Dijon, France
| | - D Pasquier
- Department of radiation oncology, centre Oscar-Lambret, 3, avenue Frédéric-Combemale, 59020 Lille, France
| | - X Palard
- Department of nuclear medicine, centre Eugène-Marquis, 3, avenue de la Bataille-Flandres-Dunkerque, 35000 Rennes, France
| | - A Deleuze
- Department of oncology, centre Eugène-Marquis, 3, avenue de la Bataille-Flandres-Dunkerque, 35000 Rennes, France
| | - K Gnep
- Department of radiotherapy, centre Eugène-Marquis, 3, avenue de la Bataille-Flandres-Dunkerque, 35000 Rennes, France
| | - S Key
- Department of radiotherapy, centre Eugène-Marquis, 3, avenue de la Bataille-Flandres-Dunkerque, 35000 Rennes, France
| | - L Beuzit
- Department of radiology, CHU de Rennes, 35000 Rennes, France
| | - J Castelli
- Department of radiotherapy, centre Eugène-Marquis, 3, avenue de la Bataille-Flandres-Dunkerque, 35000 Rennes, France; LTSI, Inserm U1099, 35042 Rennes, France; Université Rennes 1, 35042 Rennes, France
| | - R de Crevoisier
- Department of radiotherapy, centre Eugène-Marquis, 3, avenue de la Bataille-Flandres-Dunkerque, 35000 Rennes, France; LTSI, Inserm U1099, 35042 Rennes, France; Université Rennes 1, 35042 Rennes, France.
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8
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Tulipan AJ, Hole KH, Vlatkovic L, Revheim ME, Reijnen JS, Willoch F, Seierstad T, Lilleby W. Localization of radio-recurrence within the prostate: anti-3-18F-FACBC PET/CT compared with multiparametric MRI using histopathology as reference standard. Acta Radiol 2019; 60:1028-1038. [PMID: 30379559 DOI: 10.1177/0284185118810977] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Focal treatment of prostate cancer recurrence is emerging and increases the demand for precision in imaging; pure detection is no longer enough and accurate localization is needed. Purpose To investigate the ability of anti-1-amino-3-[18F]fluorocyclobutane-1-carboxylic acid (FACBC) PET/CT to localize radio-recurrences within the prostate, compared to multiparametric magnetic resonance imaging (mpMRI) and with histopathology as the reference standard. Material and Methods This prospective salvage focal brachytherapy protocol included 20 patients (mean age = 66 years; age range = 57–72 years) with biochemical recurrence after primary radiotherapy. All patients underwent mpMRI, FACBC PET/CT, prostate biopsies, and bone marrow aspiration. The mean time between mpMRI and FACBC PET/CT was 68 days (range = 5–147 days). Two radiologists and two nuclear medicine physicians independently interpreted MRI and PET. Based on schematic drawings, the quadrant (right, left, anterior, posterior) and the level (apex, mid, base) of tumor recurrence were compared and correlated to histopathology. Written informed consent was obtained from all patients. Results PET correctly localized the recurrence in 15 of 20 patients and MRI correctly localized 19 of 20 patients. MRI and PET were concordant for 14 of these 20 patients. There was perfect agreement between the MRI radiologists. Except for one case in which the lesion was only detected by one of the readers, there was also agreement between the nuclear medicine physicians. Conclusions FACBC PET/CT detected fewer histological verified radio-recurrences within the prostate than mpMRI. In accordance with previous studies, we found that the limitations of FACBC PET were small tumor amounts and uptake in hyperplastic benign tissue.
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Affiliation(s)
- Andreas Julius Tulipan
- Division for Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Knut Håkon Hole
- Division for Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | | | - Mona-Elisabeth Revheim
- Division for Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Frode Willoch
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Therese Seierstad
- Division for Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
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Lieng H, Hayden AJ, Christie DRH, Davis BJ, Eade TN, Emmett L, Holt T, Hruby G, Pryor D, Shakespeare TP, Sidhom M, Skala M, Wiltshire K, Yaxley J, Kneebone A. Radiotherapy for recurrent prostate cancer: 2018 Recommendations of the Australian and New Zealand Radiation Oncology Genito-Urinary group. Radiother Oncol 2018; 129:377-386. [PMID: 30037499 DOI: 10.1016/j.radonc.2018.06.027] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 06/18/2018] [Accepted: 06/19/2018] [Indexed: 12/14/2022]
Abstract
The management of patients with biochemical, local, nodal, or oligometastatic relapsed prostate cancer has become more challenging and controversial. Novel imaging modalities designed to detect recurrence are increasingly used, particularly PSMA-PET scans in Australia, New Zealand and some European countries. Imaging techniques such as MRI and PET scans using other prostate cancer-specific tracers are also being utilised across the world. The optimal timing for commencing salvage treatment, and the role of local and/or systemic therapies remains controversial. Through surveys of the membership, the Australian and New Zealand Faculty of Radiation Oncology Genito-Urinary Group (FROGG) identified wide variation in the management of recurrent prostate cancer. Following a workshop conducted in April 2017, the FROGG management committee reviewed the literature and developed a set of recommendations based on available evidence and expert opinion, for the appropriate investigation and management of recurrent prostate cancer. These recommendations cover the role and timing of post-prostatectomy radiotherapy, the management of regional nodal metastases and oligometastases, as well as the management of local prostate recurrence after definitive radiotherapy.
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Affiliation(s)
- Hester Lieng
- Central Coast Cancer Centre, Gosford Hospital, Australia.
| | - Amy J Hayden
- Sydney West Radiation Oncology, Westmead Hospital, Australia
| | - David R H Christie
- Genesis Cancer Care, Australia; Department of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Brian J Davis
- Department of Radiation Oncology, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Thomas N Eade
- Central Coast Cancer Centre, Gosford Hospital, Australia; Genesis Cancer Care, Australia; Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, Australia; University of Sydney, Australia
| | - Louise Emmett
- Department of Nuclear Medicine, St Vincent's Hospital, Sydney, Australia
| | - Tanya Holt
- University of Queensland, Australia; Department of Radiation Oncology, Princess Alexandra Hospital, Brisbane, Australia
| | - George Hruby
- Genesis Cancer Care, Australia; Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, Australia; University of Sydney, Australia
| | - David Pryor
- Department of Radiation Oncology, Princess Alexandra Hospital, Brisbane, Australia
| | - Thomas P Shakespeare
- North Coast Cancer Institute, Coffs Harbour, Australia; University of New South Wales Rural Clinical School, Australia
| | - Mark Sidhom
- Liverpool Hospital Cancer Therapy Centre, Sydney, Australia; University of New South Wales, Australia
| | | | | | - John Yaxley
- University of Queensland, Australia; Royal Brisbane and Women's Hospital, Australia; Wesley Urology Clinic, Brisbane, Australia
| | - Andrew Kneebone
- Central Coast Cancer Centre, Gosford Hospital, Australia; Genesis Cancer Care, Australia; Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, Australia; University of Sydney, Australia
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10
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Luzurier A, Jouve De Guibert PH, Allera A, Feldman SF, Conort P, Simon JM, Mozer P, Compérat E, Boudghene F, Servois V, Lucidarme O, Granger B, Renard-Penna R. Dynamic contrast-enhanced imaging in localizing local recurrence of prostate cancer after radiotherapy: Limited added value for readers of varying level of experience. J Magn Reson Imaging 2018. [DOI: 10.1002/jmri.25991] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Affiliation(s)
- Anna Luzurier
- Academic Department of Radiology, Hopital Pitié-Salpétrière, AP-HP; Sorbonne University Paris; France
| | | | - Alexandre Allera
- Academic Department of Radiology, Hopital Pitié-Salpétrière, AP-HP; Sorbonne University Paris; France
| | - Sarah F. Feldman
- Academic Departement of Statistic, Hopital Pitié-Salpétrière, AP-HP; Sorbonne University; France
| | - Pierre Conort
- Academic Department of Urology, Hopital Pitié-Salpétrière; AP-HP Sorbonne University; France
| | - Jean Marc Simon
- Academic Department of Radiotherapy, Hopital Pitié-Salpétrière, AP-HP; Sorbonne University; France
| | - Pierre Mozer
- Academic Department of Urology, Hopital Pitié-Salpétrière; AP-HP Sorbonne University; France
| | - Eva Compérat
- Academic Department of Pathology, Hopital Pitié-Salpétrière, AP-HP; Sorbonne University; France
| | - Franck Boudghene
- Academic Department of Radiology, Hopital Tenon, AP-HP; Sorbonne University; France
| | - Vincent Servois
- Academic department of Radiology; Curie Institute, Descartes Univ Paris 05; Paris France
| | - Olivier Lucidarme
- Academic Department of Radiology, Hopital Pitié-Salpétrière, AP-HP; Sorbonne University Paris; France
| | - Benjamin Granger
- Academic Departement of Statistic, Hopital Pitié-Salpétrière, AP-HP; Sorbonne University; France
| | - Raphaele Renard-Penna
- Academic Department of Radiology, Hopital Pitié-Salpétrière, AP-HP; Sorbonne University Paris; France
- Academic Department of Radiology, Hopital Tenon, AP-HP; Sorbonne University; France
- GRC-UPMC Oncotype-URO; Sorbonne University; Paris France
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11
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Editorial Comment. J Urol 2018; 199:138. [DOI: 10.1016/j.juro.2017.06.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Moldovan P, Udrescu C, Ravier E, Souchon R, Rabilloud M, Bratan F, Sanzalone T, Cros F, Crouzet S, Gelet A, Chapet O, Rouvière O. Accuracy of Elastic Fusion of Prostate Magnetic Resonance and Transrectal Ultrasound Images under Routine Conditions: A Prospective Multi-Operator Study. PLoS One 2016; 11:e0169120. [PMID: 28033423 PMCID: PMC5199076 DOI: 10.1371/journal.pone.0169120] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 12/12/2016] [Indexed: 12/27/2022] Open
Abstract
Purpose To evaluate in unselected patients imaged under routine conditions the co-registration accuracy of elastic fusion between magnetic resonance (MR) and ultrasound (US) images obtained by the Koelis Urostation™. Materials and Methods We prospectively included 15 consecutive patients referred for placement of intraprostatic fiducials before radiotherapy and who gave written informed consent by signing the Institutional Review Board-approved forms. Three fiducials were placed in the prostate under US guidance in standardized positions (right apex, left mid-gland, right base) using the Koelis Urostation™. Patients then underwent prostate MR imaging. Four operators outlined the prostate on MR and US images and an elastic fusion was retrospectively performed. Fiducials were used to measure the overall target registration error (TRE3D), the error along the antero-posterior (TREAP), right-left (TRERL) and head-feet (TREHF) directions, and within the plane orthogonal to the virtual biopsy track (TRE2D). Results Median TRE3D and TRE2D were 3.8–5.6 mm, and 2.5–3.6 mm, respectively. TRE3D was significantly influenced by the operator (p = 0.013), fiducial location (p = 0.001) and 3D axis orientation (p<0.0001). The worst results were obtained by the least experienced operator. TRE3D was smaller in mid-gland and base than in apex (average difference: -1.21 mm (95% confidence interval (95%CI): -2.03; -0.4) and -1.56 mm (95%CI: -2.44; -0.69) respectively). TREAP and TREHF were larger than TRERL (average difference: +1.29 mm (95%CI: +0.87; +1.71) and +0.59 mm (95%CI: +0.1; +0.95) respectively). Conclusions Registration error values were reasonable for clinical practice. The co-registration accuracy was significantly influenced by the operator’s experience, and significantly poorer in the antero-posterior direction and at the apex.
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Affiliation(s)
- Paul Moldovan
- Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, Lyon, France
| | - Corina Udrescu
- Hospices Civils de Lyon, Department of Radiation Oncology, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France
| | - Emmanuel Ravier
- Hospices Civils de Lyon, Department of Urology, Hôpital Edouard Herriot, Lyon, France
| | | | - Muriel Rabilloud
- Hospices Civils de Lyon, Service de Biostatistique et Bioinformatique, Lyon, France
- Université de Lyon, Lyon, France
- CNRS, UMR5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Villeurbanne, France
| | - Flavie Bratan
- Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, Lyon, France
| | - Thomas Sanzalone
- Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, Lyon, France
| | - Fanny Cros
- Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, Lyon, France
| | - Sébastien Crouzet
- Hospices Civils de Lyon, Department of Urology, Hôpital Edouard Herriot, Lyon, France
- Inserm, U1032, LabTau, Lyon, France
- Université de Lyon, Lyon, France
| | - Albert Gelet
- Hospices Civils de Lyon, Department of Urology, Hôpital Edouard Herriot, Lyon, France
- Inserm, U1032, LabTau, Lyon, France
- Université de Lyon, Lyon, France
| | - Olivier Chapet
- Hospices Civils de Lyon, Department of Radiation Oncology, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France
| | - Olivier Rouvière
- Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, Lyon, France
- Inserm, U1032, LabTau, Lyon, France
- Université de Lyon, Lyon, France
- * E-mail:
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Kanthabalan A, Abd-Alazeez M, Arya M, Allen C, Freeman A, Jameson C, Kirkham A, Mitra A, Payne H, Punwani S, Ramachandran N, Walkden M, Emberton M, Ahmed H. Transperineal Magnetic Resonance Imaging-targeted Biopsy versus Transperineal Template Prostate Mapping Biopsy in the Detection of Localised Radio-recurrent Prostate Cancer. Clin Oncol (R Coll Radiol) 2016; 28:568-76. [DOI: 10.1016/j.clon.2016.04.038] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 01/19/2016] [Accepted: 03/08/2016] [Indexed: 12/14/2022]
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Single fraction multimodal image guided focal salvage high-dose-rate brachytherapy for recurrent prostate cancer. J Contemp Brachytherapy 2016; 8:241-8. [PMID: 27504134 PMCID: PMC4965505 DOI: 10.5114/jcb.2016.61067] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 06/11/2016] [Indexed: 02/08/2023] Open
Abstract
PURPOSE We present a novel method for treatment of locally recurrent prostate cancer (PCa) following radiation therapy: focal, multimodal image guided high-dose-rate (HDR) brachytherapy. MATERIAL AND METHODS We treated two patients with recurrent PCa after primary (#1) or adjuvant (#2) external beam radiation therapy. Multiparametric magnetic resonance imaging (mpMRI), choline, positron emission tomography combined with computed tomography (PET/CT), or prostate-specific membrane antigen (PSMA)-PET combined with CT identified a single intraprostatic lesion. Positron emission tomography or magnetic resonance imaging - transrectal ultrasound (MRI-TRUS) fusion guided transperineal biopsy confirmed PCa within each target lesion. We defined a PET and mpMRI based gross tumor volume (GTV). A 5 mm isotropic margin was applied additionally to each lesion to generate a planning target volume (PTV), which accounts for technical fusion inaccuracies. A D90 of 18 Gy was intended in one fraction to each PTV using ultrasound guided HDR brachytherapy. RESULTS Six month follow-up showed adequate prostate specific antygen (PSA) decline in both patients (ΔPSA 83% in patient 1 and ΔPSA 59.3% in patient 2). Follow-up 3-tesla MRI revealed regressive disease in both patients and PSMA-PET/CT showed no evidence of active disease in patient #1. No acute or late toxicities occurred. CONCLUSIONS Single fraction, focal, multimodal image guided salvage HDR brachytherapy for recurrent prostate cancer is a feasible therapy for selected patients with single lesions. This approach has to be evaluated in larger clinical trials.
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15
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Detection of locally radio-recurrent prostate cancer at multiparametric MRI: Can dynamic contrast-enhanced imaging be omitted? Diagn Interv Imaging 2016; 97:433-41. [PMID: 26928245 DOI: 10.1016/j.diii.2016.01.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Revised: 01/17/2016] [Accepted: 01/26/2016] [Indexed: 11/21/2022]
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16
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Jalloh M, Leapman MS, Cowan JE, Shinohara K, Greene KL, Roach M, Chang AJ, Chan JM, Simko JP, Carroll PR. Patterns of Local Failure following Radiation Therapy for Prostate Cancer. J Urol 2015; 194:977-82. [DOI: 10.1016/j.juro.2015.04.111] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2015] [Indexed: 02/04/2023]
Affiliation(s)
- Mohamed Jalloh
- Department of Urology, University of California-San Francisco, San Francisco, California
- Service d'Urologie-Andrologie, Hopital General de Grand Yoff, Dakar, Senegal
| | - Michael S. Leapman
- Department of Urology, University of California-San Francisco, San Francisco, California
- University of California-San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, California
| | - Janet E. Cowan
- Department of Urology, University of California-San Francisco, San Francisco, California
| | - Katsuto Shinohara
- Department of Urology, University of California-San Francisco, San Francisco, California
- University of California-San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, California
| | - Kirsten L. Greene
- Department of Urology, University of California-San Francisco, San Francisco, California
- University of California-San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, California
| | - Mack Roach
- Department of Radiation Oncology, University of California-San Francisco, San Francisco, California
- University of California-San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, California
| | - Albert J. Chang
- Department of Radiation Oncology, University of California-San Francisco, San Francisco, California
- University of California-San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, California
| | - June M. Chan
- Department of Urology, University of California-San Francisco, San Francisco, California
- Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, California
| | - Jeffry P. Simko
- Department of Urology, University of California-San Francisco, San Francisco, California
- University of California-San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, California
| | - Peter R. Carroll
- Department of Urology, University of California-San Francisco, San Francisco, California
- University of California-San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, California
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17
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Abd-Alazeez M, Ramachandran N, Dikaios N, Ahmed HU, Emberton M, Kirkham A, Arya M, Taylor S, Halligan S, Punwani S. Multiparametric MRI for detection of radiorecurrent prostate cancer: added value of apparent diffusion coefficient maps and dynamic contrast-enhanced images. Prostate Cancer Prostatic Dis 2015; 18:128-36. [PMID: 25644248 DOI: 10.1038/pcan.2014.55] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 11/16/2014] [Accepted: 12/10/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND Multiparametric magnetic resonance imaging (mp-MRI) is increasingly advocated for prostate cancer detection. There are limited reports of its use in the setting of radiorecurrent disease. Our aim was to assess mp-MRI for detection of radiorecurrent prostate cancer and examine the added value of its functional sequences. METHODS Thirty-seven men with mean age of 69.7 (interquartile range, 66-74) with biochemical failure after external beam radiotherapy underwent mp-MRI (T2-weighted, high b-value, multi-b-value apparent diffusion coefficient (ADC) and dynamic contrast-enhanced (DCE) imaging); then transperineal systematic template prostate mapping (TPM) biopsy. Using a locked sequential read paradigm (with the sequence order above), two experienced radiologists independently reported mp-MRI studies using score 1-5. Radiologist scores were matched with TPM histopathology at the hemigland level (n=74). Accuracy statistics were derived for each reader. Interobserver agreement was evaluated using kappa statistics. RESULTS Receiver-operator characteristic area under curve (AUC) for readers 1 and 2 increased from 0.67 (95% confidence interval (CI), 0.55-0.80) to 0.80 (95% CI, 0.69-0.91) and from 0.67 (95% CI, 0.55-0.80) to 0.84 (95% CI, 0.76-0.93), respectively, between T2-weighted imaging alone and full mp-MRI reads. Addition of ADC maps and DCE imaging to the examination did not significantly improve AUC for either reader (P=0.08 and 0.47 after adding ADC, P=0.90 and 0.27 after adding DCE imaging) compared with T2+high b-value review. Inter-reader agreement increased from k=0.39 to k=0.65 between T2 and full mp-MRI review. CONCLUSIONS mp-MRI can detect radiorecurrent prostate cancer. The optimal examination included T2-weighted imaging and high b-value DWI; adding ADC maps and DCE imaging did not significantly improve the diagnostic accuracy.
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Affiliation(s)
- M Abd-Alazeez
- 1] Department of Urology, University College Hospital NHS Foundation Trust, London, UK [2] Department of Urology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - N Ramachandran
- Department of Radiology, University College London Hospital, London, UK
| | - N Dikaios
- 1] Department of Radiology, University College London Hospital, London, UK [2] Centre for Medical Imaging, University College London, London, UK
| | - H U Ahmed
- 1] Department of Urology, University College Hospital NHS Foundation Trust, London, UK [2] Division of Surgery and Interventional Science, University College London, London, UK
| | - M Emberton
- 1] Department of Urology, University College Hospital NHS Foundation Trust, London, UK [2] Division of Surgery and Interventional Science, University College London, London, UK
| | - A Kirkham
- Department of Radiology, University College London Hospital, London, UK
| | - M Arya
- 1] Department of Urology, University College Hospital NHS Foundation Trust, London, UK [2] Barts Cancer Institute, Queen Mary University of London, London, UK
| | - S Taylor
- 1] Department of Radiology, University College London Hospital, London, UK [2] Centre for Medical Imaging, University College London, London, UK
| | - S Halligan
- 1] Department of Radiology, University College London Hospital, London, UK [2] Centre for Medical Imaging, University College London, London, UK
| | - S Punwani
- 1] Department of Radiology, University College London Hospital, London, UK [2] Centre for Medical Imaging, University College London, London, UK
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Kim CK. Magnetic resonance imaging-guided prostate biopsy: present and future. Korean J Radiol 2015; 16:90-8. [PMID: 25598677 PMCID: PMC4296281 DOI: 10.3348/kjr.2015.16.1.90] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 08/04/2014] [Indexed: 12/18/2022] Open
Abstract
Systemic transrectal ultrasound-guided biopsy (TRUSBx) is the standard procedure for diagnosing prostate cancer (PCa), but reveals a limited accuracy for the detection of cancer. Currently, multiparametric MR imaging (mp-MRI) is increasingly regarded as a promising method to detect PCa with an excellent positive predictive value. The use of mp-MRI during a MRI-guided biopsy (MRGB) procedure improves the quality of a targeted biopsy. The aim of this article is to provide an overview about the MRGB technique for PCa detection, to review the accuracy and clinical indications of MRGB and discuss its current issues and further directions. A MRGB seems accurate and efficient for the detection of clinically significant PCa in men with previous negative TRUSBx. Moreover, it may decrease the detection of clinically insignificant cancers with fewer biopsy cores.
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Affiliation(s)
- Chan Kyo Kim
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea
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George AK, Pinto PA, Rais-Bahrami S. Multiparametric MRI in the PSA screening era. BIOMED RESEARCH INTERNATIONAL 2014; 2014:465816. [PMID: 25250323 PMCID: PMC4163437 DOI: 10.1155/2014/465816] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2014] [Accepted: 07/18/2014] [Indexed: 01/03/2023]
Abstract
Prostate cancer remains significant public health concern amid growing controversies regarding prostate specific antigen (PSA) based screening. The utility of PSA has been brought into question, and alternative measures are investigated to remedy the overdetection of indolent disease and safeguard patients from the potential harms resulting from an elevated PSA. Multiparametric MRI of the prostate has shown promise in identifying patients at risk for clinically significant disease but its role within the current diagnostic and treatment paradigm remains in question. The current review focuses on recent applications of MRI in this pathway.
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Affiliation(s)
- Arvin K. George
- National Cancer Institute, Urologic Oncology Branch, National Institutes of Health, 10 Center Drive, 2950-W, Building 10, CRC Room 2W-5940, Bethesda, MD 20892-1210, USA
| | - Peter A. Pinto
- National Cancer Institute, Urologic Oncology Branch, National Institutes of Health, 10 Center Drive, 2950-W, Building 10, CRC Room 2W-5940, Bethesda, MD 20892-1210, USA
| | - Soroush Rais-Bahrami
- National Cancer Institute, Urologic Oncology Branch, National Institutes of Health, 10 Center Drive, 2950-W, Building 10, CRC Room 2W-5940, Bethesda, MD 20892-1210, USA
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