Prostate tumor delineation using multiparametric magnetic resonance imaging: Inter-observer variability and pathology validation

Steenbergen, Peter J.; Haustermans, Karin; Lerut, Evelyne; Oyen, Raymond; Wever, Liesbeth De; Bergh, Laura Van den; Kerkmeijer, Linda G.W.; Pameijer, Frank A.; Veldhuis, Wouter B.; Zyp, Jochem R.N. van der Voort van; Pos, Floris J.; Heijmink, Stijn W. T. P. J.; Kalisvaart, Robin; Teertstra, Hendrik J.; Dinh, Cuong V.; Ghobadi, Ghazaleh; Heide, Uulke A. van der

doi:10.1016/j.radonc.2015.04.012

Cited by 110 publications

(93 citation statements)

References 26 publications

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“…It was shown by mathematical modeling that targeting the MRI-positive regions potentially could increase the tumor control probability, albeit to a small extent, without increased normal tissue toxicity compared to a conventional RT strategy. However, it is interesting to note that only a minority of the lesions was positive in all the MR image series, and considerable inter-observer variability in MRI-based tumor delineation has further been reported [25]. This substantiates the need for more robust and objective methodologies and/or guidelines for delineation.…”

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confidence: 68%

Bridging imaging and therapy: the role of medical physics in development of precision cancer care

et al. 2017

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confidence: 68%

Bridging imaging and therapy: the role of medical physics in development of precision cancer care

et al. 2017

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“…In a study by Steenbergen et al six teams of delineators contoured the intraprostatic tumour volume in 20 patients based on mpMRI information and used prostatectomy as the reference. The interobserver agreement between delineations of the teams and the pathologist was only moderate (kappa 0.45 ± 0.16) and one dominant lesion in the central zone was missed by all teams [58]. Rischke et al could prove that a DWI-MRI based GTV-delineation resulted in higher intraobserver variability compared to DCE-or T2w-based approaches [60].…”

Section: Mpmrimentioning

confidence: 99%

“…Furthermore, mpMR image interpretation for PCa diagnosis is reported to result in substantial inter-reader variability [57] which impacts intraprostatic tumour delineation [58,59]. In a study by Steenbergen et al six teams of delineators contoured the intraprostatic tumour volume in 20 patients based on mpMRI information and used prostatectomy as the reference.…”

Section: Mpmrimentioning

confidence: 99%

Multimodal imaging for radiation therapy planning in patients with primary prostate cancer

Zamboglou

Eiber

Fassbender

et al. 2018

Physics and Imaging in Radiation Oncology

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Implementation of advanced imaging techniques like multiparametric magnetic resonance imaging (mpMRI) or Positron Emission Tomography (PET) in radiation therapy (RT) planning of patients with primary prostate cancer demands several preconditions: accurate staging of the extraprostatic and intraprostatic tumor mass, robust delineation of the intraprostatic gross tumor volume (GTV) and a reproducible characterization of the prostate cancer's biological properties. In the current review we searched for the currently available imaging techniques and we discussed their ability to fulfill these preconditions. We found that current pretreatment imaging was mainly performed with mpMRI and/or Prostate-specific membrane antigen PET imaging. Both techniques offered an accurate detection of the extraprostatic and intraprostatic tumor burden and had a major impact on RT concepts. However, some studies postulated that mpMRI and PSMA PET had complementary information for intraprostatic GTV detection. Moreover, interobserver differences for intraprostatic tumor delineation based on mpMRI were observed. It is currently unclear whether PET based GTV delineation underlies also interobserver heterogeneity. Further research is warranted to answer whether multimodal imaging is able to visualize biological processes related to prostate cancer pathophysiology and radiation resistance.

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“…In particular, using these images in a multi-parametric MRI (mp-MRI) framework has demonstrated to improve tumor detection, localization and characterization, especially in the transitional zone [21], [22]. The performance of mp-MRI is, however, still limited due to the intrinsic MR image limitations in visualizing prostate tumor regions [23] and inter-observer variability of tumor delineation [24].…”

Section: Introductionmentioning

confidence: 99%

Ultrasound Elastography of the Prostate Using an Unconstrained Modulus Reconstruction Technique: A Pilot Clinical Study

Mousavi

Rivaz

Czarnota

et al. 2017

Translational Oncology

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A novel full-inversion-based technique for quantitative ultrasound elastography was investigated in a pilot clinical study on five patients for non-invasive detection and localization of prostate cancer and quantification of its extent. Conventional-frequency ultrasound images and radiofrequency (RF) data (~5 MHz) were collected during mechanical stimulation of the prostate using a transrectal ultrasound probe. Pre and post-compression RF data were used to construct the strain images. The Young's modulus (YM) images were subsequently reconstructed using the derived strain images and the stress distribution estimated iteratively using finite element (FE) analysis. Tumor regions determined based on the reconstructed YM images were compared to whole-mount histopathology images of radical prostatectomy specimens. Results indicated that tumors were significantly stiffer than the surrounding tissue, demonstrating a relative YM of 2.5 ± 0.8 compared to normal prostate tissue. The YM images had a good agreement with the histopathology images in terms of tumor location within the prostate. On average, 76% ± 28% of tumor regions detected based on the proposed method were inside respective tumor areas identified in the histopathology images. Results of a linear regression analysis demonstrated a good correlation between the disease extents estimated using the reconstructed YM images and those determined from whole-mount histopathology images (r2 = 0.71). This pilot study demonstrates that the proposed method has a good potential for detection, localization and quantification of prostate cancer. The method can potentially be used for prostate needle biopsy guidance with the aim of decreasing the number of needle biopsies. The proposed technique utilizes conventional ultrasound imaging system only while no additional hardware attachment is required for mechanical stimulation or data acquisition. Therefore, the technique may be regarded as a non-invasive, low cost and potentially widely-available clinical tool for prostate cancer diagnosis.

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Prostate tumor delineation using multiparametric magnetic resonance imaging: Inter-observer variability and pathology validation

Abstract: Since all teams identify most dominant lesions, dose escalation to the dominant lesion is feasible. Sufficient dose to the whole prostate may need to be maintained to prevent under treatment of smaller lesions and undetected parts of larger lesions.

Cited by 110 publications

References 26 publications

Bridging imaging and therapy: the role of medical physics in development of precision cancer care

Bridging imaging and therapy: the role of medical physics in development of precision cancer care

Multimodal imaging for radiation therapy planning in patients with primary prostate cancer

Ultrasound Elastography of the Prostate Using an Unconstrained Modulus Reconstruction Technique: A Pilot Clinical Study

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