Comparing PSA outcome after radical prostatectomy or magnetic resonance imaging-guided partial prostatic irradiation in select patients with clinically localized adenocarcinoma of the prostate

D’Amico, Anthony V.; Tempany, Clare M.; Schultz, Delray; Cormack, Robert A.; Hurwitz, Mark; Beard, Clair J.; Albert, Michele; Kooy, Hanne M.; Jólesz, Ferenc A.; Richie, Jerome P.

doi:10.1016/s0090-4295(03)00772-6

Cited by 52 publications

(21 citation statements)

References 18 publications

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“…The introduction of multiparametric magnetic resonance (MR) imaging of the prostate, with T2-weighted, diffusion-weighted, and dynamic contrast agent-enhanced imaging, has resulted in rapid expansion of the role of MR imaging in the detection and localization of PCa (6-10) and of MR imaging-guided or -targeted prostate interventional procedures (11,12). There are now several MR imaging-guided biopsy approaches that use multiparametric MR imaging for prebiopsy target identification and localization of the suspected lesion.…”

Section: Implication For Patient Carementioning

confidence: 99%

Transperineal In-Bore 3-T MR Imaging–guided Prostate Biopsy: A Prospective Clinical Observational Study

Penzkofer¹,

Tuncalı²,

Fedorov³

et al. 2015

Radiology

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The contents of this manuscript are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.q RSNA, 2014 Purpose:To determine the detection rate, clinical relevance, Gleason grade, and location of prostate cancer (PCa) diagnosed with and the safety of an in-bore transperineal 3-T magnetic resonance (MR) imaging-guided prostate biopsy in a clinically heterogeneous patient population. Materials and Methods:This prospective retrospectively analyzed study was HIPAA compliant and institutional review board approved, and informed consent was obtained. Eighty-seven men (mean age, 66.2 years 6 6.9) underwent multiparametric endorectal prostate MR imaging at 3 T and transperineal MR imaging-guided biopsy. Three subgroups of patients with at least one lesion suspicious for cancer were included: men with no prior PCa diagnosis, men with PCa who were undergoing active surveillance, and men with treated PCa and suspected recurrence. Exclusion criteria were prior prostatectomy and/or contraindication to 3-T MR imaging. The transperineal MR imaging-guided biopsy was performed in a 70-cm wide-bore 3-T device. Overall patient biopsy outcomes, cancer detection rates, Gleason grade, and location for each subgroup were evaluated and statistically compared by using x 2 and one-way analysis of variance followed by Tukey honestly significant difference post hoc comparisons. Results:Ninety biopsy procedures were performed with no serious adverse events, with a mean of 3.7 targets sampled per gland. Cancer was detected in 51 (56.7%) men: 48.1% (25 of 52) with no prior PCa, 61.5% (eight of 13) under active surveillance, and 72.0% (18 of 25) in whom recurrence was suspected. Gleason pattern 4 or higher was diagnosed in 78.1% (25 of 32) in the no prior PCa and active surveillance groups. Gleason scores were not assigned in the suspected recurrence group. MR targets located in the anterior prostate had the highest cancer yield (40 of 64, 62.5%) compared with those for the other parts of the prostate (P , .001). Conclusion:In-bore 3-T transperineal MR imaging-guided biopsy, with a mean of 3.7 targets per gland, allowed detection of many clinically relevant cancers, many of which were located anteriorly.q RSNA, 2014

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Section: Implication For Patient Carementioning

confidence: 99%

Transperineal In-Bore 3-T MR Imaging–guided Prostate Biopsy: A Prospective Clinical Observational Study

Penzkofer¹,

Tuncalı²,

Fedorov³

et al. 2015

Radiology

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“…Those that received brachytherapy alone as initial treatment (n=11) had all received an MRI-guided implant which attempts to reduce dose to portions of the anterior prostate where cancer is rarely found but which can cause significant urinary toxicity. While PSA control with this technique was found to be equivalent to surgery in a matched cohort (95% at 5 years), 17 it is certainly conceivable that these patients had harbored some microscopic disease in the anterior prostate, although with good patient selection, the chance of this happening is extremely small.…”

Section: Discussionmentioning

confidence: 89%

Patient-reported quality of life after salvage brachytherapy for radio-recurrent prostate cancer: A prospective Phase II study

et al. 2009

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Background Patient-reported quality of life following salvage brachytherapy for radiorecurrent prostate cancer has not been well-characterized prospectively. Methods We examined 25 men who recurred after primary radiotherapy for prostate cancer and received MRI-guided salvage brachytherpy as part of a prospective phase II study. These patients prospectively received a validated patient-reported quality of life questionnaire to fill out at baseline, as well as 3, 15, and 27 months after re-irradiation to determine the degree of sexual, bowel, and urinary dysfunction (maximum dysfunction score = 100). Results On average, sexual function continued to decline with time, and patients had significantly worse sexual function scores at 27 months than baseline (p=0.01). However, while bowel and urinary symptoms worsened acutely at 3 or 15 months, they showed on average some improvement by 27 months, and there were no significant differences between baseline and 27 month urinary or bowel scores. An interval to re-irradiation less than 4.5 years and prior brachytherapy were each significantly associated with the largest decrements in bowel function (p=0.035). Conclusion Similar to the patterns seen in the de novo setting, patients who receive salvage brachytherapy report a worsening of bowel and urinary symptoms followed by some improvement by 27 months, while sexual function steadily declines over time. Interval to re-irradiation and type of prior radiation received may be used to counsel and optimize selection of men for salvage brachytherapy with regard to quality-of-life endpoints.

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“…Given that prostate cancer is much more likely to arise in the peripheral zone, it is likely that the dose to the peripheral zone is more important than the dose to the entire gland. D'Amico et al (21) reported results with their technique in which only the peripheral zone is implanted. Their results have been as good as any reported and lend support to the notion that the dose to the peripheral zone Fig.…”

Section: Discussionmentioning

confidence: 99%

Dosimetry and cancer control after low-dose-rate prostate brachytherapy

Lee¹,

deGuzman²,

McMullen³

et al. 2005

International Journal of Radiation Oncology*Biology*Physics

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Comparing PSA outcome after radical prostatectomy or magnetic resonance imaging-guided partial prostatic irradiation in select patients with clinically localized adenocarcinoma of the prostate

Cited by 52 publications

References 18 publications

Transperineal In-Bore 3-T MR Imaging–guided Prostate Biopsy: A Prospective Clinical Observational Study

Transperineal In-Bore 3-T MR Imaging–guided Prostate Biopsy: A Prospective Clinical Observational Study

Patient-reported quality of life after salvage brachytherapy for radio-recurrent prostate cancer: A prospective Phase II study

Dosimetry and cancer control after low-dose-rate prostate brachytherapy

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