Three-dimensional MRI evaluation of the effect of bladder volume on prostate translocation and distortion

Snoj, Žiga; Gill, Andrew B.; Rundo, Leonardo; Sushentsev, Nikita; Barrett, Tristan

doi:10.2478/raon-2020-0001

Cited by 6 publications

(7 citation statements)

References 36 publications

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“…17 There are several studies which have investigated the influence of consistent bladder filling between RT planning and treatment on the inter-fraction prostate position. [17][18][19] It is suggested that a more than twofold difference in bladder volume between RT planning and treatment could cause moderate prostate translocations and distortions especially in the anterior/posterior direction and between the prostatic base and the apex. 19 This may result in a higher chance of geometrical miss leading to poorer tumour control.…”

Section: Discussionmentioning

confidence: 99%

“…[17][18][19] It is suggested that a more than twofold difference in bladder volume between RT planning and treatment could cause moderate prostate translocations and distortions especially in the anterior/posterior direction and between the prostatic base and the apex. 19 This may result in a higher chance of geometrical miss leading to poorer tumour control. The use of daily IGRT in this study will have ensured accurate RT delivery to both bladder filling groups which is supported by the similar population systematic and random errors.…”

Section: Discussionmentioning

confidence: 99%

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The implementation of an empty bladder filling protocol for localised prostate volumetric modulated arctherapy (VMAT): early results of a single institution service evaluation

Chetiyawardana

Hoskin

Tsang

2020

The British Journal of Radiology

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Objective: To examine the impact of an empty bladder filling protocol on patients receiving radical RT for localised prostate cancer on post RT toxicity and biochemical progression free survival (bPFS). Methods and materials: Records of patients receiving radical external beam RT (EBRT) for localised prostate cancer with a full or empty bladder were reviewed. These included the bladder size on planning CT, daily online image guided RT (IGRT) setup data, treatment time and post treatment follow up data.These included bPFS, gastrointestinal(GI) and genitourinary(GU) toxicity scoring post RT using the CTCAE v4.0 scoring system. All patients included in the study were planned and treated under the same departmental clinical protocol with VMAT and daily online IGRT corrections. Results: 90 patients were treated with 60 Gy in 20 fractions with a median follow up of 48 months. At 4 years bPFS in the empty bladder group was 100 and 98% in the full bladder group (p = 0.27). There were no statistically significant differences in cumulative ≥Grade 2GU (p = 0.10) and GI (p = 0.27) toxicity rates between the two bladder filling protocols. No statistically significant differences in the IGRT setup between the two groups of patients. Although the median treatment times per fraction were not statistically different between the two groups (p = 0.47), patients in the full bladder filling group were required to spend a longer time in the RT department per treatment session for bladder filling. Conclusion: An empty bladder filling protocol has non-inferior bPFS, GI and GU toxicities at 4 years in patients with localised prostate cancer using advanced RT techniques in comparison to a full bladder filling protocol. A longer follow up with a larger sample size is required to validate this approach. Advances in knowledge: This study suggests that an empty bladder filling protocol can be used in external beam EBRT for localised prostate cancer with non-inferior treatment outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The implementation of an empty bladder filling protocol for localised prostate volumetric modulated arctherapy (VMAT): early results of a single institution service evaluation

Chetiyawardana

Hoskin

Tsang

2020

The British Journal of Radiology

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“…15,16 Motion artefact is an important issue for MR imaging, although the low pelvic position of the prostate limits the effects of respiratory motion and small bowel peristalsis, the longer acquisition of T2-FRFSE sequences makes them prone to artefact from bulk patient movement or rectal wall and/or bladder spasm. 17-20 Motion artefact due to rectal spasm is typically visualised as “jumping” between slices, due to the time delay in acquisition of interleaved slices, and the different position of prostate if the rectal wall has moved within the time-interval. 21 Rectal preparation with a micro-enema has shown only questionable benefit in reducing such motion, 22-24 however, rectal spasm can be reduced by administration of antispasmodics, provided these are routinely available and not clinically contraindicated.…”

Section: Discussionmentioning

confidence: 99%

T2-PROPELLER Compared to T2-FRFSE for Image Quality and Lesion Detection at Prostate MRI

et al. 2021

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Purpose: The primary objective was to compare T2-FRFSE and T2-PROPELLER sequences for image quality. The secondary objective was to compare the ability to detect prostate lesions at MRI in the presence and absence of motion artefact using the 2 sequences. Methods: 99 patients underwent 3 T MRI examination of the prostate, including T2-FRFSE and T2-PROPELLER sequences. All patients underwent prostate biopsy. Two independent readers rated overall image quality, presence of motion artefact, and blurring for both sequences using a 5-point Likert scale. Scores were compared for the whole group and for subgroups with and without significant motion artefact. Outcome for lesion detection at an MRI threshold of PI-RADS score ≥3 was compared between T2-FRFSE and T2-PROPELLER. Results: The overall image quality was not significantly different between T2-FRFSE and T2-PROPELLER sequences (3.74 vs. 3.93, p = 0.275). T2-PROPELLER recorded a lesser degree of motion artefact (score 4.53 vs. 3.78, p <0.0001), but demonstrated greater image blurring (score 3.29 vs. 3.73, p <0.001). However, in a subgroup of patients with significant motion artefact on T2-FRFSE, the T2-PROPELLER sequence demonstrated significantly higher image quality (3.46 vs. 2.49, p <0.001). T2-FRFSE and T2-PROPELLER showed comparable positive predictive values for lesion detection at 93.2% and 97.7%, respectively. Conclusions: T2-PROPELLER provides higher quality imaging in the presence of motion artefact, but T2-FRFSE is preferred in the absence of motion. T2-PROPELLER is therefore recommended as a secondary T2 sequence when imaging requires repeat acquisition due to motion artefact.

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“…First, PSAD may be subject to errors in the measurement of prostate size, as most radiologists estimate prostate volume with formula-based means. 18 19 20 Second, as PSAD is inherently a small number, stratification into groups would rely on differences at two or more decimal places, increasing the likelihood of errors. If a PSAD of 0.15 ng ml −2 was employed as a single cutoff 21 22 in PI-RADS score 3 lesion patients, there would be more heterogeneity than using the four PHI categories in this study.…”

Section: Discussionmentioning

confidence: 99%

Prostate health index can stratify patients with Prostate Imaging Reporting and Data System score 3 lesions on magnetic resonance imaging to reduce prostate biopsies

Leung,

Ma,

et al. 2023

Asian Journal of Andrology

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We aim to evaluate prostate health index as an additional risk-stratification tool in patients with Prostate Imaging Reporting and Data System score 3 lesions on multiparametric magnetic resonance imaging. Men with biochemical or clinical suspicion of having prostate cancer who underwent multiparametric magnetic resonance imaging in two tertiary centers (Queen Mary Hospital and Princess Margaret Hospital, Hong Kong, China) between January 2017 and June 2022 were included. Ultrasound-magnetic resonance imaging fusion biopsies were performed after prostate health index testing. Those who only had Prostate Imaging Reporting and Data System score 3 lesions were further stratified into four prostate health index risk groups and the cancer detection rates were analyzed. Out of the 747 patients, 47.3% had Prostate Imaging Reporting and Data System score 3 lesions only. The detection rate of clinically significant prostate cancer in this group was 15.0%. The cancer detection rates of clinically significant prostate cancer had statistically significant differences: 5.3% in prostate health index <25.0, 7.4% in prostate health index 25.0–34.9, 17.9% in prostate health index 35.0–54.9, and 52.6% in prostate health index ≥55.0 (P < 0.01). Among the patients, 26.9% could have avoided a biopsy with a prostate health index <25.0, at the expense of a 5.3% risk of missing clinically significant prostate cancer. Prostate health index could be used as an additional risk stratification tool for patients with Prostate Imaging Reporting and Data System score 3 lesions. Biopsies could be avoided in patients with low prostate health index, with a small risk of missing clinically significant prostate cancer.

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Three-dimensional MRI evaluation of the effect of bladder volume on prostate translocation and distortion

Cited by 6 publications

References 36 publications

The implementation of an empty bladder filling protocol for localised prostate volumetric modulated arctherapy (VMAT): early results of a single institution service evaluation

The implementation of an empty bladder filling protocol for localised prostate volumetric modulated arctherapy (VMAT): early results of a single institution service evaluation

T2-PROPELLER Compared to T2-FRFSE for Image Quality and Lesion Detection at Prostate MRI

Prostate health index can stratify patients with Prostate Imaging Reporting and Data System score 3 lesions on magnetic resonance imaging to reduce prostate biopsies

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