Identifying the dominant prostate cancer focal lesion using image analysis and planning of a simultaneous integrated stereotactic boost

Feng, Yang; Welsh, Daniel; McDonald, Kim; Carruthers, Linda; Cheng, Kun; Montgomery, Dean; Lawrence, Jessica; Argyle, David; McLaughlin, Stephen; McLaren, Duncan B.; Nailon, William H.

doi:10.3109/0284186x.2015.1063782

Cited by 11 publications

(11 citation statements)

References 27 publications

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“…The imaging fusion issue and its clinical implications have already been studied in literature. 10 Other patients had to be excluded due to mp-MRI findings not matching the inclusion criteria (e.g. cT3 tumors) or to an unsatisfactory urinary flow.…”

Section: Discussionmentioning

confidence: 99%

Short-term high precision radiotherapy for early prostate cancer with concomitant boost to the dominant lesion: ad interim analysis and preliminary results of Phase II trial AIRC-IG-13218

Timon

Ciardo

Bazani

et al. 2018

BJR

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Our preliminary data about early toxicity of an extreme hypofractionated schedule with concomitant boost on the DIL are encouraging. The higher number of patients expected for the trial and a longer follow-up are needed to confirm these results. Advances in knowledge: The use of mpMRI to identify and boost the DIL is an innovative and interesting approach to PCa. Our preliminary findings suggest that dose escalation using DIL boost and extremely hypofractionated radiotherapy regimens might be a safe approach, allowing for short and effective treatment of organ-confined PCa.

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Section: Discussionmentioning

confidence: 99%

Short-term high precision radiotherapy for early prostate cancer with concomitant boost to the dominant lesion: ad interim analysis and preliminary results of Phase II trial AIRC-IG-13218

Timon

Ciardo

Bazani

et al. 2018

BJR

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“…Two out of 3 cases for V 30.8 Gy > 1 cc were also exceeding range within 2 cc. We had to point out that the other study groups used more generous OAR constraint than the present study; rectal D max ranged from 36 to 38 Gy (The present study, 35 Gy), rectal V 32.3 -36 Gy < 1 cc (The present study, V 30.8 Gy < 1 cc), and bladder D max 41.8 Gy (The present study, 38.5 Gy), V 38 Gy < 1 cc or V 37 Gy < 10 cc (The present study, V 35.7 Gy < 1 cc) [15][16][17] . Kim et al reported the dosimetric predictors of rectal tolerance observed in a phase 1-2 trial of dose-escalated SBRT with 45, 47.5, and 50 Gy in 5 fractions to the whole prostate 18 .…”

Section: Discussionmentioning

confidence: 43%

Simultaneous integrated boost with stereotactic radiotherapy for dominant intraprostatic lesion of localized prostate cancer: a dosimetric planning study

Kim

Yoon

Kim

2020

Sci Rep

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Dominant intraprostatic lesion (DIL) has been known as the most common local recurrence site of prostate cancer. We evaluated the feasibility of simultaneous integrated boost (SIB) to DIL with CyberKnife stereotactic body radiotherapy (CK-SBRT). We selected 15 patients with prostate cancer and visible DIL and compared 3 plans for each patient: 1) No boost plan of 35 Gy to prostate, 2) DIL_40 plan of SIB 40 Gy to DIL and 35 Gy to prostate, and 3) DIL_45 plan with 45 Gy to DIL and 35 Gy to the prostate in 5 fractions. All targets satisfied with the prescription coverage per protocol. However, some patients failed to meet the Dmax of the rectum in DIL_40 plans (n = 4), and DIL_45 plans (n = 6). Violations of bladder constraints occurred in four DIL_45 plans. Consequently, the DIL boost with SBRT was possible in 73% of patients with DIL_40 plans, and 60% of patients with DIL_45 plans without any violation of normal organ constraints. All patients who experienced constraint violations had DILs in posterior segments. DIL boost using CK-SBRT could be an option for localized prostate cancer patients. For patients who had DIL in posterior segments, a moderate dose escalation of 40 Gy seemed appropriate.

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“…While the majority of these efforts have been realized using intensity-modulated radiation therapy (7, 9, 11, 31–33), studies have also included dose-escalation using brachytherapy with biologically equivalent doses of around 200 Gy to the DIL (6, 34–36), and more recently with stereotactic body radiotherapy using a simultaneous integrated boost technique (14, 32, 37, 38).…”

Section: Discussionmentioning

confidence: 99%

Volumetric and Voxel-Wise Analysis of Dominant Intraprostatic Lesions on Multiparametric MRI

et al. 2019

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Introduction: Multiparametric MR imaging (mpMRI) has shown promising results in the diagnosis and localization of prostate cancer. Furthermore, mpMRI may play an important role in identifying the dominant intraprostatic lesion (DIL) for radiotherapy boost. We sought to investigate the level of correlation between dominant tumor foci contoured on various mpMRI sequences. Methods: mpMRI data from 90 patients with MR-guided biopsy-proven prostate cancer were obtained from the SPIE-AAPM-NCI Prostate MR Classification Challenge. Each case consisted of T2-weighted (T2W), apparent diffusion coefficient (ADC), and K trans images computed from dynamic contrast-enhanced sequences. All image sets were rigidly co-registered, and the dominant tumor foci were identified and contoured for each MRI sequence. Hausdorff distance (HD), mean distance to agreement (MDA), and Dice and Jaccard coefficients were calculated between the contours for each pair of MRI sequences (i.e., T2 vs. ADC, T2 vs. K trans , and ADC vs. K trans ). The voxel wise spearman correlation was also obtained between these image pairs. Results: The DILs were located in the anterior fibromuscular stroma, central zone, peripheral zone, and transition zone in 35.2, 5.6, 32.4, and 25.4% of patients, respectively. Gleason grade groups 1–5 represented 29.6, 40.8, 15.5, and 14.1% of the study population, respectively (with group grades 4 and 5 analyzed together). The mean contour volumes for the T2W images, and the ADC and K trans maps were 2.14 ± 2.1, 2.22 ± 2.2, and 1.84 ± 1.5 mL, respectively. K trans values were indistinguishable between cancerous regions and the rest of prostatic regions for 19 patients. The Dice coefficient and Jaccard index were 0.74 ± 0.13, 0.60 ± 0.15 for T2W-ADC and 0.61 ± 0.16, 0.46 ± 0.16 for T2W-K trans . The voxel-based Spearman correlations were 0.20 ± 0.20 for T2W-ADC and 0.13 ± 0.25 for T2W-K trans . Conclusions: The DIL contoured on T2W images had a high level of agreement with those contoured on ADC maps, but there was little to no quantitative correlation of these results with tumor location and Gleason grade group. Technical hurdles are yet to be solved for precision radiotherapy to target the DILs based on physiological imaging. A Boolean sum volume (BSV) incorporating all available MR sequences may be reasonable in delineating the DIL boost volume.

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Identifying the dominant prostate cancer focal lesion using image analysis and planning of a simultaneous integrated stereotactic boost

Abstract: These preliminary results demonstrate the potential of this image analysis method for reliably mapping dominant focal disease within the prostate from MR images onto planning CT images. Significant dose escalation using a simultaneous integrated SABR boost was achieved in all patients.

Cited by 11 publications

References 27 publications

Short-term high precision radiotherapy for early prostate cancer with concomitant boost to the dominant lesion: ad interim analysis and preliminary results of Phase II trial AIRC-IG-13218

Short-term high precision radiotherapy for early prostate cancer with concomitant boost to the dominant lesion: ad interim analysis and preliminary results of Phase II trial AIRC-IG-13218

Simultaneous integrated boost with stereotactic radiotherapy for dominant intraprostatic lesion of localized prostate cancer: a dosimetric planning study

Volumetric and Voxel-Wise Analysis of Dominant Intraprostatic Lesions on Multiparametric MRI

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