Imaging modalities in focal therapy

Muller, Bart; Bos, Willemien van den; Pinto, Peter A.; Rosette, Jean J. de la

doi:10.1097/mou.0000000000000041

Cited by 36 publications

(15 citation statements)

References 44 publications

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“…In CETRUS recordings, the entire prostate is represented by groups of data points; moreover, current studies often focus on the PZ hyperperfusion region rather than the whole prostate and do not conduct tissue analysis of other normal tissue181920. Here, we show that incorporating normal tissue TICs could significantly improve the diagnostic accuracy of nodule TICs for PCa detection (Fig.…”

Section: Discussionmentioning

confidence: 78%

Contrast-enhanced transrectal ultrasound for prediction of prostate cancer aggressiveness: The role of normal peripheral zone time-intensity curves

Huang

Zhu

Zhou

et al. 2016

Sci Rep

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To assess the role of time-intensity curves (TICs) of the normal peripheral zone (PZ) in the identification of biopsy-proven prostate nodules using contrast-enhanced transrectal ultrasound (CETRUS). This study included 132 patients with 134 prostate PZ nodules. Arrival time (AT), peak intensity (PI), mean transit time (MTT), area under the curve (AUC), time from peak to one half (TPH), wash in slope (WIS) and time to peak (TTP) were analyzed using multivariate linear logistic regression and receiver operating characteristic (ROC) curves to assess whether combining nodule TICs with normal PZ TICs improved the prediction of prostate cancer (PCa) aggressiveness. The PI, AUC (p < 0.001 for both), MTT and TPH (p = 0.011 and 0.040 respectively) values of the malignant nodules were significantly higher than those of the benign nodules. Incorporating the PI and AUC values (both, p < 0.001) of the normal PZ TIC, but not the MTT and TPH values (p = 0.076 and 0.159 respectively), significantly improved the AUC for prediction of malignancy (PI: 0.784–0.923; AUC: 0.758–0.891) and assessment of cancer aggressiveness (p < 0.001). Thus, all these findings indicate that incorporating normal PZ TICs with nodule TICs in CETRUS readings can improve the diagnostic accuracy for PCa and cancer aggressiveness assessment.

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Section: Discussionmentioning

confidence: 78%

Contrast-enhanced transrectal ultrasound for prediction of prostate cancer aggressiveness: The role of normal peripheral zone time-intensity curves

Huang

Zhu

Zhou

et al. 2016

Sci Rep

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“…(PSA is not helpful for monitoring FT outcome 42 ). Histologic post FT assessment depends on either random transrectal or transperineal approach 16,43 . Transrectal option is prone to substantial sampling error and a high rate of false negative results.…”

Section: Discussionmentioning

confidence: 99%

“…Transperineal mapping option requires repeat general anesthesia 44 . mpMRI offers the promise to guide post-FT biopsy and overcome these limitations 42,43,45,46 . However there are obvious concerns related to tissue displacement 47 .…”

Section: Discussionmentioning

confidence: 99%

3D Registration of mpMRI for Assessment of Prostate Cancer Focal Therapy

et al. 2017

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Purpose To assess a novel method of 3D co-registration of prostate MRI exams performed before and after prostate cancer focal therapy. Material and method We developed a software platform for automatic 3D deformable coregistration of prostate MRI at different time points and applied this method to ten patients who underwent focal ablative therapy. MRI exams were performed preoperatively, as well as one week and six months posttreatment. Rigid registration served as reference for assessing coregistration accuracy and precision. Results Segmentation of preoperative and postoperative prostate revealed a significant post-operative volume decrease of the gland that averaged 6.49 cc (p=0.017). Applying deformable transformation based upon Mutual Information (MI) from 120 pairs of MRI slices, we refined by 2.9 mm (max 6.25mm) the alignment of the ablation zone (AZ), segmented from contrastenhanced images on the one-week post-operative exam, to the 6-month postoperative T2-weighted images. This represented a 500% improvement over the rigid approach (p=0.001), corrected by volume. The dissimilarity by Dice index of the mapped AZ using deformable transformation vs. rigid control was significantly (p=0.04) higher at the ablation site compared to the whole gland. Conclusion Our findings illustrate our method's ability to correct for deformation at the ablation site. The preliminary analysis suggests that deformable transformation computed from MI of preoperative and follow-up MRI is accurate in co-registration of MRI exams performed before and after focal therapy. The ability to localize the previously ablated tissue in 3D space may improve targeting for image-guided follow-up biopsy within focal therapy protocols.

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“…Furthermore, it can detect SVI and ECE as well as pelvic LNI at satisfactory levels in the follow-up of patients who are deemed as clinically insignificant. Its sensitivity is reported as >80% and specificity is reported as >90% in the latest series (27)(28)(29)(30). However, the results of mp-MRI are not yet included within the scope of active surveillance criteria or decision algorithm.…”

Section: Discussionmentioning

confidence: 99%

Oncologic Outcomes after Radical Retropubic Prostatectomy in Patients Meeting the Epstein Criteria

Özden¹,

Aktaş²,

Baykam³

et al. 2015

JAREM

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Objective: The Epstein criteria are used for the prediction of clinically insignificant prostate cancer and the determination of the patients who are suitable for avoiding or delaying active treatments that have many potential serious side-effects. In the present study, we aimed to retrospectively evaluate and interpret the oncologic outcomes of the patients who underwent radical retropubic prostatectomy (RRP) but were potentially eligible for active surveillance based on the Epstein criteria. Methods:Records of 305 patients who underwent RRP in our clinic between the years 2000 and 2014 for clinically localized prostate cancer were analyzed. Of these patients, 18 who met all the conditions of the Epstein criteria [clinical T1c, biopsy Gleason score (GS) <7, the number of cancer positive biopsy cores <3, cancer involvement in any core <50%, and prostate specific antigen (PSA) density <0.15 ng/mL 2 ] were included. The patients with an increased surgical specimen GS compared with that of biopsy or those with non-organ-confined disease were considered to have clinically significant disease.Results: The mean age, serum PSA level, and prostate volume of all the 305 patients were 62.8±6.1 years, 10.8±6.9 ng/mL, and 46.2±22.1 mL, respectively. Eighty-six patients (28.2%) were with extracapsular extension (ECE), 58 (19.0%) with positive surgical margin (PSM), 39 (12.8%) with seminal vesicle invasion (SVI), and 16 (5.2%) with lymph node involvement (LNI). Biochemical recurrence was detected in 55 of the 305 patients (20.9%) during the mean follow-up period of 71.2±37.3 months after RRP. Of the 305 patients who underwent RRP, 18 (5%) met the Epstein criteria. The mean age, serum PSA level, and prostate volume of these patients were 61.6±6.01 years, 5.51±1.1 ng/mL, and 45.2±10.13 mL, respectively. Five patients (27.8%) were with extracapsular extension (ECE), 4 (22.5%) with an increased GS, and 1 (5.5%) with both ECE and increased GS. A total of eight patients (44.4%) were detected to have clinically significant disease. None of the patients was with SVI or LNI. Biochemical recurrence was not detected in any of the patients during the mean follow-up period of 48.7±31.2 months after RRP. Conclusion:Our results showed that the Epstein criteria may misguide us for the prediction of clinically insignificant prostate cancers. A notable proportion of our patients potentially eligible for active surveillance based on the Epstein criteria were postoperatively revealed to have clinically significant disease. If those patients had not undergone surgery, they may have lost their chance to undergo active treatment for their cancer. (JAREM 2015; 5: 6-9)

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Imaging modalities in focal therapy

Cited by 36 publications

References 44 publications

Contrast-enhanced transrectal ultrasound for prediction of prostate cancer aggressiveness: The role of normal peripheral zone time-intensity curves

Contrast-enhanced transrectal ultrasound for prediction of prostate cancer aggressiveness: The role of normal peripheral zone time-intensity curves

3D Registration of mpMRI for Assessment of Prostate Cancer Focal Therapy

Oncologic Outcomes after Radical Retropubic Prostatectomy in Patients Meeting the Epstein Criteria

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