Interrater agreement of contouring of the neurovascular bundles and internal pudendal arteries in neurovascular-sparing magnetic resonance-guided radiotherapy for localized prostate cancer

Daily online contouring and re-planning versus translation-only correction in neurovascular-sparing magnetic resonance-guided radiotherapy for localized prostate cancer

“…This may have led to an over- or underestimation of the difference between ATP and ATS in this study. However, our previous work showed that interrater variability is substantially lower at the mid prostate to apex level [15] . This is the level where the NVB is closest to the prostate, and any contour shifts will relatively have the largest effect on NVB dose, therefore making our ATP and ATS dose estimates more reliable.…”

“…Another limitation is the inter- and intrarater variability of the contouring of the IPA and especially the NVB, which is a lower contrast soft-tissue structure with less pronounced boundaries at the level of the prostate base [15] , [16] , [17] . This may have led to an over- or underestimation of the difference between ATP and ATS in this study.…”

Erectile dysfunction following hydrogel injection and hypofractionated radiotherapy for prostate cancer: Our experience in 56 cases

“…Goy et al (17) reported in 1,503 men with intermediate risk PCa who underwent radical prostatectomy vs. external radiotherapy vs. brachytherapy a prevalence of ED at 10 years of follow up equal to 24.3%, 6.6%, 8.2%, respectively; in addition, ED was not significantly different in men submitted to standard dose radiation therapy (38.1%) vs. dose escalated radiation therapy (49.7%) (18). Recently, the introduction in clinical practice of the so-called precision medicin decreased the risk of complications; in fact, neurovascular-sparing magnetic resonance-guided adaptive radiotherapy seems to reduce the risk of ED following external radiotherapy (19). At the same time, CT-MRI image registration using dedicated software, the use of intraprostatic fiducials and hydrogel spacer could help to better focalize radiation therapy into the prostate; therefore, these devices used before radiotherapy could better preserve neurovascular bundle reducing the risk of ED.…”

MRI-guided stereotactic radiotherapy for localised prostate cancer

“…The idea for integrating a linac with a 1.5 T MRI scanner originated in Utrecht. [64][65][66] The 1.5 T MR-Linac system was developed at the University Medical Centre Utrecht (UMC Utrecht, Utrecht, The Netherlands), together with Philips (Best, The Netherlands) and Elekta AB (Stockholm, Sweden). It consists of a 1.5 T Philips MRI scanner surrounded by a 7 megavolt (MV) linac, mounted on a ringshaped gantry.…”

“…Besides targeting the DIL, MR-Linac systems can also be deployed to spare structures that are not visible with conventional computed tomography (CT) imaging, such as the neurovascular structures involved in erectile function. 61 Currently, multiple studies are ongoing that investigate neurovascular sparing radiotherapy, including the POTEN-C (NCT03525262 62 ) and ERECT trial (NCT04861194 63,64 ). In the latter study, patients are treated on a 1.5 T MR-Linac with an ATS workflow.…”