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Huang H, Mo J, Ding Z, Peng X, Liu R, Zhuang D, Zhang Y, Hu G, Huang B, Qiu Y. Deep Learning to Simulate Contrast-Enhanced MRI for Evaluating Suspected Prostate Cancer. Radiology 2025; 314:e240238. [PMID: 39807983 DOI: 10.1148/radiol.240238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2025]
Abstract
Background Multiparametric MRI, including contrast-enhanced sequences, is recommended for evaluating suspected prostate cancer, but concerns have been raised regarding potential contrast agent accumulation and toxicity. Purpose To evaluate the feasibility of generating simulated contrast-enhanced MRI from noncontrast MRI sequences using deep learning and to explore their potential value for assessing clinically significant prostate cancer using Prostate Imaging Reporting and Data System (PI-RADS) version 2.1. Materials and Methods Male patients with suspected prostate cancer who underwent multiparametric MRI were retrospectively included from three centers from April 2020 to April 2023. A deep learning model (pix2pix algorithm) was trained to synthesize contrast-enhanced MRI scans from four noncontrast MRI sequences (T1-weighted imaging, T2-weighted imaging, diffusion-weighted imaging, and apparent diffusion coefficient maps) and then tested on an internal and two external datasets. The reference standard for model training was the second postcontrast phase of the dynamic contrast-enhanced sequence. Similarity between simulated and acquired contrast-enhanced images was evaluated using the multiscale structural similarity index. Three radiologists independently scored T2-weighted and diffusion-weighted MRI with either simulated or acquired contrast-enhanced images using PI-RADS, version 2.1; agreement was assessed with Cohen κ. Results A total of 567 male patients (mean age, 66 years ± 11 [SD]) were divided into a training test set (n = 244), internal test set (n = 104), external test set 1 (n = 143), and external test set 2 (n = 76). Simulated and acquired contrast-enhanced images demonstrated high similarity (multiscale structural similarity index: 0.82, 0.71, and 0.69 for internal test set, external test set 1, and external test set 2, respectively) with excellent reader agreement of PI-RADS scores (Cohen κ, 0.96; 95% CI: 0.94, 0.98). When simulated contrast-enhanced imaging was added to biparametric MRI, 34 of 323 (10.5%) patients were upgraded to PI-RADS 4 from PI-RADS 3. Conclusion It was feasible to generate simulated contrast-enhanced prostate MRI using deep learning. The simulated and acquired contrast-enhanced MRI scans exhibited high similarity and demonstrated excellent agreement in assessing clinically significant prostate cancer based on PI-RADS, version 2.1. © RSNA, 2025 Supplemental material is available for this article. See also the editorial by Neji and Goh in this issue.
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Affiliation(s)
- Hongyan Huang
- From the Department of Radiology, Shenzhen Nanshan People's Hospital, Shenzhen University, Taoyuan Rd No. 89, Nanshan District, Shenzhen 518000, Guangdong, China (H.H., Z.D., Y.Q.); Medical AI Laboratory and Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen, China (J.M., R.L., B.H.); Department of Medical Imaging, People's Hospital of Longhua, Shenzhen, Guangdong, China (X.P., Y.Z.); and Department of Radiology, Shenzhen People's Hospital, Shenzhen, Guangdong, China (D.Z., G.H.)
| | - Junyang Mo
- From the Department of Radiology, Shenzhen Nanshan People's Hospital, Shenzhen University, Taoyuan Rd No. 89, Nanshan District, Shenzhen 518000, Guangdong, China (H.H., Z.D., Y.Q.); Medical AI Laboratory and Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen, China (J.M., R.L., B.H.); Department of Medical Imaging, People's Hospital of Longhua, Shenzhen, Guangdong, China (X.P., Y.Z.); and Department of Radiology, Shenzhen People's Hospital, Shenzhen, Guangdong, China (D.Z., G.H.)
| | - Zhiguang Ding
- From the Department of Radiology, Shenzhen Nanshan People's Hospital, Shenzhen University, Taoyuan Rd No. 89, Nanshan District, Shenzhen 518000, Guangdong, China (H.H., Z.D., Y.Q.); Medical AI Laboratory and Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen, China (J.M., R.L., B.H.); Department of Medical Imaging, People's Hospital of Longhua, Shenzhen, Guangdong, China (X.P., Y.Z.); and Department of Radiology, Shenzhen People's Hospital, Shenzhen, Guangdong, China (D.Z., G.H.)
| | - Xuehua Peng
- From the Department of Radiology, Shenzhen Nanshan People's Hospital, Shenzhen University, Taoyuan Rd No. 89, Nanshan District, Shenzhen 518000, Guangdong, China (H.H., Z.D., Y.Q.); Medical AI Laboratory and Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen, China (J.M., R.L., B.H.); Department of Medical Imaging, People's Hospital of Longhua, Shenzhen, Guangdong, China (X.P., Y.Z.); and Department of Radiology, Shenzhen People's Hospital, Shenzhen, Guangdong, China (D.Z., G.H.)
| | - Ruihao Liu
- From the Department of Radiology, Shenzhen Nanshan People's Hospital, Shenzhen University, Taoyuan Rd No. 89, Nanshan District, Shenzhen 518000, Guangdong, China (H.H., Z.D., Y.Q.); Medical AI Laboratory and Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen, China (J.M., R.L., B.H.); Department of Medical Imaging, People's Hospital of Longhua, Shenzhen, Guangdong, China (X.P., Y.Z.); and Department of Radiology, Shenzhen People's Hospital, Shenzhen, Guangdong, China (D.Z., G.H.)
| | - Danping Zhuang
- From the Department of Radiology, Shenzhen Nanshan People's Hospital, Shenzhen University, Taoyuan Rd No. 89, Nanshan District, Shenzhen 518000, Guangdong, China (H.H., Z.D., Y.Q.); Medical AI Laboratory and Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen, China (J.M., R.L., B.H.); Department of Medical Imaging, People's Hospital of Longhua, Shenzhen, Guangdong, China (X.P., Y.Z.); and Department of Radiology, Shenzhen People's Hospital, Shenzhen, Guangdong, China (D.Z., G.H.)
| | - Yuzhong Zhang
- From the Department of Radiology, Shenzhen Nanshan People's Hospital, Shenzhen University, Taoyuan Rd No. 89, Nanshan District, Shenzhen 518000, Guangdong, China (H.H., Z.D., Y.Q.); Medical AI Laboratory and Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen, China (J.M., R.L., B.H.); Department of Medical Imaging, People's Hospital of Longhua, Shenzhen, Guangdong, China (X.P., Y.Z.); and Department of Radiology, Shenzhen People's Hospital, Shenzhen, Guangdong, China (D.Z., G.H.)
| | - Genwen Hu
- From the Department of Radiology, Shenzhen Nanshan People's Hospital, Shenzhen University, Taoyuan Rd No. 89, Nanshan District, Shenzhen 518000, Guangdong, China (H.H., Z.D., Y.Q.); Medical AI Laboratory and Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen, China (J.M., R.L., B.H.); Department of Medical Imaging, People's Hospital of Longhua, Shenzhen, Guangdong, China (X.P., Y.Z.); and Department of Radiology, Shenzhen People's Hospital, Shenzhen, Guangdong, China (D.Z., G.H.)
| | - Bingsheng Huang
- From the Department of Radiology, Shenzhen Nanshan People's Hospital, Shenzhen University, Taoyuan Rd No. 89, Nanshan District, Shenzhen 518000, Guangdong, China (H.H., Z.D., Y.Q.); Medical AI Laboratory and Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen, China (J.M., R.L., B.H.); Department of Medical Imaging, People's Hospital of Longhua, Shenzhen, Guangdong, China (X.P., Y.Z.); and Department of Radiology, Shenzhen People's Hospital, Shenzhen, Guangdong, China (D.Z., G.H.)
| | - Yingwei Qiu
- From the Department of Radiology, Shenzhen Nanshan People's Hospital, Shenzhen University, Taoyuan Rd No. 89, Nanshan District, Shenzhen 518000, Guangdong, China (H.H., Z.D., Y.Q.); Medical AI Laboratory and Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen, China (J.M., R.L., B.H.); Department of Medical Imaging, People's Hospital of Longhua, Shenzhen, Guangdong, China (X.P., Y.Z.); and Department of Radiology, Shenzhen People's Hospital, Shenzhen, Guangdong, China (D.Z., G.H.)
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Li T, Nalavenkata S, Fainberg J. Imaging in Diagnosis and Active Surveillance for Prostate Cancer: A Review. JAMA Surg 2025; 160:93-99. [PMID: 39535781 DOI: 10.1001/jamasurg.2024.4811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2024]
Abstract
Importance Active surveillance (AS) has become an increasingly important option for managing low-risk and select intermediate-risk prostate cancer. Although imaging, particularly multiparametric magnetic resonance imaging (mpMRI), has emerged in the prebiopsy pathway for the diagnosis of prostate cancer, the role of mpMRI in patient selection for AS and the necessity of prostate biopsies during AS remain poorly defined. Despite well-founded biopsy schedules, there has been substantial investigation into whether imaging may supplant the need for prostate biopsies during AS. This review aimed to summarize the contemporary role of imaging in the diagnosis and surveillance of prostate cancer. Observations Multiparametric MRI is the most established form of imaging in prostate cancer, with routine prebiopsy use being shown to help urologists distinguish between clinically significant and clinically insignificant disease. The visibility of these lesions on mpMRI closely correlates with their behavior, with visible disease portending a worse prognosis. Combined with other clinical data, risk calculators may better delineate patients with higher-risk disease and exclude them from undergoing AS. While current evidence suggests that mpMRI cannot replace the need for prostate biopsy during AS due to the possibility of missing higher-risk disease, the addition of prostate biomarkers may help to reduce the frequency of these biopsies. The role of prostate-specific antigen positron emission tomography/computed tomography is still emerging but has shown promising early results as an adjunct to mpMRI in initial diagnosis. Conclusions and Relevance Imaging in prostate cancer helps to better select patients appropriate for AS, and future studies may strengthen the predictive capabilities of risk calculators. Multiparametric MRI has been shown to be imperative to rationalizing biopsies for patients enrolled in AS. However, heterogeneity in the evidence of mpMRI during AS has suggested that further prospective studies and randomized clinical trials, particularly in homogenizing reporting standards, may reveal a more defined role in monitoring disease progression.
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Affiliation(s)
- Thomas Li
- University of Sydney, Sydney, New South Wales, Australia
| | - Sunny Nalavenkata
- Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jonathan Fainberg
- Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, New York
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Zhang H, Yang J, Wu K, Hou Z, Du J, Yan J, Zhao Y. Comparison of tracer kinetic models in differentiating malignant from normal prostate tissue using dynamic contrast-enhanced MRI. Front Oncol 2024; 14:1450388. [PMID: 39711955 PMCID: PMC11659129 DOI: 10.3389/fonc.2024.1450388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Accepted: 11/15/2024] [Indexed: 12/24/2024] Open
Abstract
Purpose The aim of this study was to evaluate the diagnostic value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) derived kinetic parameters with high spatiotemporal resolution in discriminating malignant from normal prostate tissues. Methods Fifty patients with suspicious of malignant diseases in prostate were included in this study. Regions of interest (ROI) were manually delineated by experienced radiologists. Voxel-wise kinetic parameters were produced with the following tracer kinetic models (TKMs): Tofts model, extended Tofts model (ETM), Brix's conventional two-compartment model (Brix), adiabatic tissue homogeneity model (ATH), and distributed parameter model (DP). The initial area under the signal-time curve (IAUC) with an uptake integral approach was also included. Mann-Whitney U test and receiver operating characteristic (ROC) curves were used to evaluate the capability of distinguishing tumor lesions from normal tissues. A p-value of 0.05 or less is considered statistically significant. ROI based parameters correlation analysis between DP and ETM were performed. Results 624 lesions and 269 normal tissue ROIs were obtained. Thirty parameters were derived from the six kinetic models. Except for PS from Brix, statistically significant differences between lesions and normal tissues (P<0.05) were observed in other parameters.Ve from DP, ATH and Brix and PS from ATH have AUC values less than 0.6 in the ROC analysis. MTT, Vp and PS from DP, Ktrans from ETM and Tofts, E and PS from ATH, IAUC parameters and F from Brix have AUC values larger than 0.8. Ve and Vp from DP and ETM are correlated (r> 0.65). The correlation coefficient between Ktrans from ETM and PS from DP is 0.751. Conclusion MTT, Vp and PS from DP, Ktrans from ETM and Tofts, E and PS from ATH, F from Brix and IAUC parameters can be used to differentiate malignant lesions from normal tissues in the prostate.
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Affiliation(s)
- Hongjiang Zhang
- Department of Magnetic Resonance Imaging (MRI), The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Jing Yang
- Department of Magnetic Resonance Imaging (MRI), The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Kunhua Wu
- Department of Magnetic Resonance Imaging (MRI), The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Zujun Hou
- Department of Radiology, FISCA Laboratory for Advanced Imaging, Nanjing, China
| | - Ji Du
- Department of Magnetic Resonance Imaging (MRI), The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Jianhua Yan
- Department of Nuclear Medicine, The First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui, China
| | - Ying Zhao
- Department of Magnetic Resonance Imaging (MRI), The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
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Nilsson E, Sandgren K, Grefve J, Jonsson J, Axelsson J, Lindberg AK, Söderkvist K, Karlsson CT, Widmark A, Blomqvist L, Strandberg S, Riklund K, Bergh A, Nyholm T. The grade of individual prostate cancer lesions predicted by magnetic resonance imaging and positron emission tomography. COMMUNICATIONS MEDICINE 2023; 3:164. [PMID: 37945817 PMCID: PMC10636013 DOI: 10.1038/s43856-023-00394-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 10/26/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Multiparametric magnetic resonance imaging (mpMRI) and positron emission tomography (PET) are widely used for the management of prostate cancer (PCa). However, how these modalities complement each other in PCa risk stratification is still largely unknown. We aim to provide insights into the potential of mpMRI and PET for PCa risk stratification. METHODS We analyzed data from 55 consecutive patients with elevated prostate-specific antigen and biopsy-proven PCa enrolled in a prospective study between December 2016 and December 2019. [68Ga]PSMA-11 PET (PSMA-PET), [11C]Acetate PET (Acetate-PET) and mpMRI were co-registered with whole-mount histopathology. Lower- and higher-grade lesions were defined by International Society of Urological Pathology (ISUP) grade groups (IGG). We used PET and mpMRI data to differentiate between grades in two cases: IGG 3 vs. IGG 2 (case 1) and IGG ≥ 3 vs. IGG ≤ 2 (case 2). The performance was evaluated by receiver operating characteristic (ROC) analysis. RESULTS We find that the maximum standardized uptake value (SUVmax) for PSMA-PET achieves the highest area under the ROC curve (AUC), with AUCs of 0.72 (case 1) and 0.79 (case 2). Combining the volume transfer constant, apparent diffusion coefficient and T2-weighted images (each normalized to non-malignant prostatic tissue) results in AUCs of 0.70 (case 1) and 0.70 (case 2). Adding PSMA-SUVmax increases the AUCs by 0.09 (p < 0.01) and 0.12 (p < 0.01), respectively. CONCLUSIONS By co-registering whole-mount histopathology and in-vivo imaging we show that mpMRI and PET can distinguish between lower- and higher-grade prostate cancer, using partially discriminative cut-off values.
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Affiliation(s)
- Erik Nilsson
- Department of Radiation Sciences, Radiation Physics, Umeå University, Umeå, Sweden.
| | - Kristina Sandgren
- Department of Radiation Sciences, Radiation Physics, Umeå University, Umeå, Sweden
| | - Josefine Grefve
- Department of Radiation Sciences, Radiation Physics, Umeå University, Umeå, Sweden
| | - Joakim Jonsson
- Department of Radiation Sciences, Radiation Physics, Umeå University, Umeå, Sweden
| | - Jan Axelsson
- Department of Radiation Sciences, Radiation Physics, Umeå University, Umeå, Sweden
| | | | - Karin Söderkvist
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | | | - Anders Widmark
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Lennart Blomqvist
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden
| | - Sara Strandberg
- Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå, Sweden
| | - Katrine Riklund
- Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå, Sweden
| | - Anders Bergh
- Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden
| | - Tufve Nyholm
- Department of Radiation Sciences, Radiation Physics, Umeå University, Umeå, Sweden
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Volpe F, Nappi C, Piscopo L, Zampella E, Mainolfi CG, Ponsiglione A, Imbriaco M, Cuocolo A, Klain M. Emerging Role of Nuclear Medicine in Prostate Cancer: Current State and Future Perspectives. Cancers (Basel) 2023; 15:4746. [PMID: 37835440 PMCID: PMC10571937 DOI: 10.3390/cancers15194746] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
Prostate cancer is the most frequent epithelial neoplasia after skin cancer in men starting from 50 years and prostate-specific antigen (PSA) dosage can be used as an early screening tool. Prostate cancer imaging includes several radiological modalities, ranging from ultrasonography, computed tomography (CT), and magnetic resonance to nuclear medicine hybrid techniques such as single-photon emission computed tomography (SPECT)/CT and positron emission tomography (PET)/CT. Innovation in radiopharmaceutical compounds has introduced specific tracers with diagnostic and therapeutic indications, opening the horizons to targeted and very effective clinical care for patients with prostate cancer. The aim of the present review is to illustrate the current knowledge and future perspectives of nuclear medicine, including stand-alone diagnostic techniques and theragnostic approaches, in the clinical management of patients with prostate cancer from initial staging to advanced disease.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Michele Klain
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80138 Naples, Italy; (F.V.); (C.N.); (L.P.); (E.Z.); (C.G.M.); (A.P.); (M.I.); (A.C.)
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Park H, Kim SH, Kim JY. Dynamic contrast-enhanced magnetic resonance imaging for risk stratification in patients with prostate cancer. Quant Imaging Med Surg 2022; 12:742-751. [PMID: 34993115 DOI: 10.21037/qims-21-455] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/27/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND To investigate the usefulness of perfusion parameters derived from dynamic contrast-enhanced (DCE)-magnetic resonance imaging (MRI) of patients diagnosed as prostate cancer (PCa) in differentiating clinically significant cancer [CSC, Gleason score (GS) ≥7] from non-CSC (GS 6). METHODS A total of 94 patients diagnosed between August 2018 and September 2020 as PCa by radical prostatectomy were included in this retrospective study (mean age: 68.7 years, range, 47-83 years). All of the patients had undergone DCE-MRI on a single 3T-MR scanner. Whole-tumor volume was measured by reviewing a pathologic topographic map as a reference standard. The quantitative DCE perfusion parameters, including volume transfer constant (Ktrans), rate constant (kep), extracellular extravascular space (EES) volume fraction (ve), plasma volume fraction (vp) and area of region of interest (ROI) were calculated under an extended Tofts model. A receiver operating characteristic (ROC) curve analysis by pair-wise comparison was performed to compare the diagnostic performances of the perfusion parameters. RESULTS The study population comprised GS 6 (n=17), GS 7 (n=57), GS 8 (n=9) and GS 9 (n=11) cases. Among the perfusion parameters, ve differed significantly between CSC (0.238±0.095) and non-CSC (0.300±0.126) (P=0.0308). Area under the curve (AUC) was 0.643 (95% CI, 0.538-0.739), and a maximum accuracy of 64%, a sensitivity of 66%, and a specificity of 53% were estimated. Area of ROI also differed significantly between CSC (201.89±163.87 mm2) and non-CSC (84.99±85.82 mm2) (P=0.0054). AUC was 0.807 (95% CI, 0.713-0.881), and maximum accuracy, sensitivity, and specificity were 81%, 82%, and 76%, respectively. CONCLUSIONS Size of the tumor and interstitial space volume fraction are significant parameters in differentiating aggressiveness in PCa.
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Affiliation(s)
- Hyungin Park
- Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital, Haeundae-gu, Busan, Korea
| | - Seung Ho Kim
- Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital, Haeundae-gu, Busan, Korea
| | - Joo Yeon Kim
- Department of Pathology, Inje University College of Medicine, Haeundae Paik Hospital, Haeundae-gu, Busan, Korea
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Pharmacokinetic modeling of dynamic contrast-enhanced (DCE)-MRI in PI-RADS category 3 peripheral zone lesions: preliminary study evaluating DCE-MRI as an imaging biomarker for detection of clinically significant prostate cancers. Abdom Radiol (NY) 2021; 46:4370-4380. [PMID: 33818626 DOI: 10.1007/s00261-021-03035-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 02/25/2021] [Accepted: 03/03/2021] [Indexed: 01/21/2023]
Abstract
PURPOSE To determine if pharmacokinetic modeling of DCE-MRI can diagnose CS-PCa in PI-RADS category 3 PZ lesions with subjective negative DCE-MRI. MATERIALS AND METHODS In the present IRB approved, bi-institutional, retrospective, case-control study, we identified 73 men with 73 PZ PI-RADS version 2.1 category 3 lesions with MRI-directed-TRUS-guided targeted biopsy yielding: 12 PZ CS-PCa (ISUP Grade Group 2; N = 9, ISUP 3; N = 3), 27 ISUP 1 PCa and 34 benign lesions. An expert blinded radiologist segmented lesions on ADC and DCE images; segmentations were overlayed onto pharmacokinetic DCE-MRI maps. Mean values were compared between groups using univariate analysis. Diagnostic accuracy was assessed by ROC. RESULTS There were no differences in age, PSA, PSAD or clinical stage between groups (p = 0.265-0.645). Mean and 10th percentile ADC did not differ comparing CS-PCa to ISUP 1 PCa and benign lesions (p = 0.376 and 0.598) but was lower comparing ISUP ≥ 1 PCa to benign lesions (p < 0.001). Mean Ktrans (p = 0.003), Ve (p = 0.003) but not Kep (p = 0.387) were higher in CS-PCa compared to ISUP 1 PCa and benign lesions. There were no differences in DCE-MRI metrics comparing ISUP ≥ 1 PCa and benign lesions (p > 0.05). AUC for diagnosis of CS-PCa using Ktrans and Ve were: 0.69 (95% CI 0.52-0.87) and 0.69 (0.49-0.88). CONCLUSION Pharmacokinetic modeling of DCE-MRI parameters in PI-RADS category 3 lesions with subjectively negative DCE-MRI show significant differences comparing CS-PCa to ISUP 1 PCa and benign lesions, in this study outperforming ADC. Studies are required to further evaluate these parameters to determine which patients should undergo targeted biopsy for PI-RADS 3 lesions.
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Liu G, Lu Y, Dai Y, Xue K, Yi Y, Xu J, Wu D, Wu G. Comparison of mono-exponential, bi-exponential, kurtosis, and fractional-order calculus models of diffusion-weighted imaging in characterizing prostate lesions in transition zone. Abdom Radiol (NY) 2021; 46:2740-2750. [PMID: 33388809 DOI: 10.1007/s00261-020-02903-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 12/01/2020] [Accepted: 12/06/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE To compare various models of diffusion-weighted imaging including mono-exponential, bi-exponential, diffusion kurtosis (DK) and fractional-order calculus (FROC) models in diagnosing prostate cancer (PCa) in transition zone (TZ) and distinguish the high-grade PCa [Gleason score (GS) ≥ 7] lesions from the total of low-grade PCa (GS ≤ 6) lesions and benign prostatic hyperplasia (BPH) in TZ. METHODS 80 Patients with 103 lesions were included in this study. Nine metrics [including apparent diffusion coefficient (ADC) derived from mono-exponential model, slow diffusion coefficient (Ds), fast diffusion coefficient (Df),, and f (the fraction of fast diffusion) from bi-exponential model; mean diffusivity (MD) and mean kurtosis (MK) from DK model; diffusion coefficient (D), fractional-order derivative in space (β), and spatial metric (μ) from FROC model] were calculated. Comparisons between BPH and PCa lesions as well as between clinically significant PCa (CsPCa) (GS ≥ 7, n = 31) and clinically insignificant lesions (Cins) (GS ≤ 6 and BPH, n = 72) of these metrics were conducted. Mann-Whitney U-test and receiver operating characteristic (ROC) analysis were used for statistical evaluations. RESULTS The areas under the ROC curve (AUC) values of β derived from FROC model were 0.778 and 0.853 in differentiating PCa from BPH and in differentiating CS (GS ≥ 7) from Cins (GS ≤ 6 and BPH), both were the highest compared to other metrics. The AUC value of β was significantly higher than that of ADC (P = 0.009) in differentiating CS from Cins, while the differentiation between BPH and PCa did not reach the statistical significance when comparing with ADC (P = 0.089). CONCLUSION Although no significant difference was found in distinguishing PCa from BPH, the metric β derived from FROC model was superior to other diffusion metrics in differentiation between CS and Cins in TZ.
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Affiliation(s)
- Guiqin Liu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, 200127, China
| | - Yang Lu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, 200127, China
| | | | - Ke Xue
- United Imaging Healthcare, Shanghai, China
| | | | - Jianrong Xu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, 200127, China
| | - Dongmei Wu
- Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Electronics Science, East China Normal University, 3663 N. Zhongshan Road, Shanghai, 200062, China.
| | - Guangyu Wu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, 200127, China.
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Wang YF, Tadimalla S, Hayden AJ, Holloway L, Haworth A. Artificial intelligence and imaging biomarkers for prostate radiation therapy during and after treatment. J Med Imaging Radiat Oncol 2021; 65:612-626. [PMID: 34060219 DOI: 10.1111/1754-9485.13242] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/18/2021] [Accepted: 05/02/2021] [Indexed: 12/15/2022]
Abstract
Magnetic resonance imaging (MRI) is increasingly used in the management of prostate cancer (PCa). Quantitative MRI (qMRI) parameters, derived from multi-parametric MRI, provide indirect measures of tumour characteristics such as cellularity, angiogenesis and hypoxia. Using Artificial Intelligence (AI), relevant information and patterns can be efficiently identified in these complex data to develop quantitative imaging biomarkers (QIBs) of tumour function and biology. Such QIBs have already demonstrated potential in the diagnosis and staging of PCa. In this review, we explore the role of these QIBs in monitoring treatment response during and after PCa radiotherapy (RT). Recurrence of PCa after RT is not uncommon, and early detection prior to development of metastases provides an opportunity for salvage treatments with curative intent. However, the current method of monitoring treatment response using prostate-specific antigen levels lacks specificity. QIBs, derived from qMRI and developed using AI techniques, can be used to monitor biological changes post-RT providing the potential for accurate and early diagnosis of recurrent disease.
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Affiliation(s)
- Yu-Feng Wang
- Institute of Medical Physics, School of Physics, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Sirisha Tadimalla
- Institute of Medical Physics, School of Physics, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Amy J Hayden
- Sydney West Radiation Oncology, Westmead Hospital, Wentworthville, New South Wales, Australia
- Faculty of Medicine, Western Sydney University, Sydney, New South Wales, Australia
- Faculty of Medicine, Health & Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Lois Holloway
- Institute of Medical Physics, School of Physics, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- Liverpool and Macarthur Cancer Therapy Centre, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Annette Haworth
- Institute of Medical Physics, School of Physics, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
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10
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Björeland U, Nyholm T, Jonsson J, Skorpil M, Blomqvist L, Strandberg S, Riklund K, Beckman L, Thellenberg-Karlsson C. Impact of neoadjuvant androgen deprivation therapy on magnetic resonance imaging features in prostate cancer before radiotherapy. PHYSICS & IMAGING IN RADIATION ONCOLOGY 2021; 17:117-123. [PMID: 33898790 PMCID: PMC8058024 DOI: 10.1016/j.phro.2021.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 01/01/2023]
Abstract
Background and purpose In locally advanced prostate cancer (PC), androgen deprivation therapy (ADT) in combination with whole prostate radiotherapy (RT) is the standard treatment. ADT affects the prostate as well as the tumour on multiparametric magnetic resonance imaging (MRI) with decreased PC conspicuity and impaired localisation of the prostate lesion. Image texture analysis has been suggested to be of aid in separating tumour from normal tissue. The aim of the study was to investigate the impact of ADT on baseline defined MRI features in prostate cancer with the goal to investigate if it might be of use in radiotherapy planning. Materials and methods Fifty PC patients were included. Multiparametric MRI was performed before, and three months after ADT. At baseline, a tumour volume was delineated on apparent diffusion coefficient (ADC) maps with suspected tumour content and a reference volume in normal prostatic tissue. These volumes were transferred to MRIs after ADT and were analysed with first-order -and invariant Haralick -features. Results At baseline, the median value and several of the invariant Haralick features of ADC, showed a significant difference between tumour and reference volumes. After ADT, only ADC median value could significantly differentiate the two volumes. Conclusions Invariant Haralick -features could not distinguish between baseline MRI defined PC and normal tissue after ADT. First-order median value remained significantly different in tumour and reference volumes after ADT, but the difference was less pronounced than before ADT.
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Affiliation(s)
- Ulrika Björeland
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
- Corresponding author at: Department of Medical Physics, Sundsvall Hospital, 85186 Sundsvall, Sweden.
| | - Tufve Nyholm
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
| | - Joakim Jonsson
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
| | - Mikael Skorpil
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Lennart Blomqvist
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Sara Strandberg
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
| | - Katrine Riklund
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
| | - Lars Beckman
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
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11
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Schmid FA, Poyet C, Rizzi G, Gomolka RS, Donati OF, Hötker AM, Eberli D. Dynamic contrast enhancement in prostate MRI as predictor of erectile function and recovery after radical prostatectomy. Aging Male 2020; 23:1518-1526. [PMID: 33252281 DOI: 10.1080/13685538.2020.1815695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
PURPOSE To analyze routine preoperative prostate MRI to predict erectile function (EF) before and after radical prostatectomy (RP). METHODS Patients who underwent RP with an existing preoperative MRI including dynamic contrast-enhanced images and completed International Index of Erectile Function (IIEF-5) questionnaires at baseline and 12 months postoperative. They were divided into four erectile dysfunction (ED) groups according to preoperative IIEF-5 score. The perfusion quality was measured in the peripheral zone of the prostate by the ratio of signal increase 120 s after wash-in of contrast agent (Ratio120) in preoperative MRI and compared between the ED groups. RESULTS Ratio120 showed differences among the preoperative ED groups (p = .020) in 97 patients. According to IIEF-5 at 12 months postoperative, 43 patients were dichotomized into "no to mild" (≥17 points) and "moderate to severe" (≤16) ED groups. Ratio120 revealed differences among the postoperative ED groups (128.84% vs. 101.95%; p = .029) and stayed an independent predictor for ED in the multivariable regression analysis (adjusted for age, nerve-sparing and preoperative IIEF-5). ROC curves demonstrated an additional diagnostic benefit. CONCLUSIONS Preoperative MRI of the prostate may be used for the prediction of EF and postsurgical recovery after RP. This may serve as important tool in preoperative patient counseling and management of expectations.
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Affiliation(s)
- Florian A Schmid
- Department of Urology, University Hospital Zurich, Zurich, Switzerland
| | - Cédric Poyet
- Department of Urology, University Hospital Zurich, Zurich, Switzerland
| | - Gianluca Rizzi
- Department of Urology, University Hospital Zurich, Zurich, Switzerland
| | - Richard S Gomolka
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Olivio F Donati
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Andreas M Hötker
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Daniel Eberli
- Department of Urology, University Hospital Zurich, Zurich, Switzerland
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12
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Prostatitis, the Great Mimicker of Prostate Cancer: Can We Differentiate Them Quantitatively With Multiparametric MRI? AJR Am J Roentgenol 2020; 215:1104-1112. [PMID: 32901562 DOI: 10.2214/ajr.20.22843] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE. The purpose of this study was to investigate the diagnostic performance of semiquantitative and quantitative pharmacokinetic parameters and quantitative apparent diffusion coefficient (ADC) values obtained from prostate multiparametric MRI (mpMRI) to differentiate prostate cancer (PCa) and prostatitis objectively. MATERIALS AND METHODS. We conducted a retrospective review of patients with biopsy-proven PCa or prostatitis who underwent mpMRI study between January 2015 and February 2018. Mean ADC, forward volume transfer constant (Ktrans), reverse volume transfer constant (kep), plasma volume fraction (Vp), extravascular extracellular space volume fraction (Ve), and time to peak (TTP) values were calculated for both lesions and contralateral normal prostate tissue. Signal intensity-time curves were analyzed. Lesion-to-normal prostate tissue ratios of pharmacokinetic parameters were also calculated. The diagnostic accuracy and cutoff points of all parameters were analyzed to differentiate PCa from prostatitis. RESULTS. A total of 138 patients (94 with PCa and 44 with prostatitis) were included in the study. Statistically, ADC, quantitative pharmacokinetic parameters (Ktrans, kep, Ve, and Vp), their lesion-to-normal prostate tissue ratios, and TTP values successfully differentiated PCa and prostatitis. Surprisingly, we found that Ve values were significantly higher in prostatitis lesions. The combination of these parameters had 92.7% overall diagnostic accuracy. ADC, kep, and TTP made up the most successful combination for differential diagnosis. Analysis of the signal intensity-time curves showed mostly type 2 and type 3 enhancement curve patterns for patients with PCa. Type 3 curves were not seen in any prostatitis cases. CONCLUSION. Quantitative analysis of mpMRI differentiates PCa from prostatitis with high sensitivity and specificity, appears to have significant potential, and may improve diagnostic accuracy. In addition, evaluating these parameters does not cause any extra burden to the patients.
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Qazi SA, Tariq F, Ullah I, Omer H. Parallel implementation of L + S signal recovery in dynamic MRI. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2020; 34:297-307. [PMID: 32601881 DOI: 10.1007/s10334-020-00861-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 06/09/2020] [Accepted: 06/22/2020] [Indexed: 11/25/2022]
Abstract
Dynamic MRI is useful to diagnose different diseases, e.g. cardiac ailments, by monitoring the structure and function of the heart and blood flow through the valves. Faster data acquisition is highly desirable in dynamic MRI, but this may lead to aliasing artifacts due to under-sampling. Advanced image reconstruction algorithms are required to obtain aliasing-free MR images from the acquired under-sampled data. One major limitation of using the advanced reconstruction algorithms is their computationally expensive and time-consuming nature, which make them infeasible for clinical use, especially for applications like cardiac MRI. L + S decomposition model is an approach provided in literature which separates the sparse and low-rank information in dynamic MRI. However, L + S decomposition model is a computationally complex process demanding significant computation time. In this paper, a parallel framework is proposed to accelerate the image reconstruction process of L + S decomposition model using GPU. Experiments are performed on cardiac perfusion dataset ([Formula: see text]) and cardiac cine dataset ([Formula: see text]) using NVIDIA's GeForce GTX780 GPU and Core-i7 CPU. The results show that the proposed method provides up to 18 × speed-up including the memory transfer time (i.e. data transfer between the CPU and GPU) and ~ 46 × speed-up without memory transfer for the cardiac perfusion dataset in our experiments. This level of improvement in the reconstruction time will increase the usefulness of L + S reconstruction by making it feasible for clinical applications.
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Affiliation(s)
- Sohaib A Qazi
- Medical Image Processing Research Group (MIPRG), Department of Electrical and Computer Engineering, COMSATS University, Islamabad, Pakistan.
| | - Fareena Tariq
- Medical Image Processing Research Group (MIPRG), Department of Electrical and Computer Engineering, COMSATS University, Islamabad, Pakistan
| | - Irfan Ullah
- Medical Image Processing Research Group (MIPRG), Department of Electrical and Computer Engineering, COMSATS University, Islamabad, Pakistan
| | - Hammad Omer
- Medical Image Processing Research Group (MIPRG), Department of Electrical and Computer Engineering, COMSATS University, Islamabad, Pakistan
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Afshari Mirak S, Mohammadian Bajgiran A, Sung K, Asvadi NH, Markovic D, Felker ER, Lu D, Sisk A, Reiter RE, Raman SS. Dynamic contrast-enhanced (DCE) MR imaging: the role of qualitative and quantitative parameters for evaluating prostate tumors stratified by Gleason score and PI-RADS v2. Abdom Radiol (NY) 2020; 45:2225-2234. [PMID: 31549211 DOI: 10.1007/s00261-019-02234-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To investigate the role of qualitative and quantitative DCE-MRI parameters in prostate cancer (PCa) stratified by whole-mount histopathology (WMHP) Gleason score (GS) and PI-RADSv2. METHODS This retrospective study included 323 PCa tumors in 254 men, who underwent 3T MRI prior to prostatectomy, 7/2009-12/2016. Qualitative DCE curve types included type 1 (progressive), type 2 (plateau) and type 3 (washout). Quantitative DCE-MRI pharmacokinetic (PK) parameters included Ktrans (influx volume transfer coefficient), Kep (efflux reflux rate constant) and iAUC (initial area under the curve). DCE-MRI features of true positive lesions were evaluated for overall, index, transition zone (TZ) and peripheral zone (PZ), based on GS grade (low = 6, high > 6) and PI-RADSv2 score using SPSSv24. RESULTS There were 57 (17.6%) low-grade and 266 (82.4%) high-grade PCa lesions. PI-RADSv2 3, 4 and 5 included 106, 120 and 97 lesions, respectively. 251 (77.7%) and 72 (22.3%) lesions were located in PZ and TZ, respectively. High-grade lesions had significantly higher proportion of Type 3 curves compared to low-grade lesions in overall (70.3% vs. 54.4%) and TZ (73.5% vs. 43.5%). As PI-RADSv2 increased, the proportion of type 3 curve significantly increased for overall (80.4-51.9%), index (80.4-54.7%) and PZ (78.7-52.1%) lesions. Among PK parameters, Ktrans (0.43 vs 0.32) and iAUC (8.99 vs 6.9) for overall PCa, Ktrans (0.43 vs 0.31) and iAUC (9 vs 6.67) for PZ PCa, and iAUC (8.94 vs 7.42) for index PCa were significantly higher for high-grade versus low-grade lesions. Also, Ktrans (0.51-0.34), Kep (1.75-1.29) and iAUC (9.79-7.6) for overall PCa, Ktrans (0.53-0.32), Kep (1.81-1.26) and iAUC (9.83-7.34) for PZ PCa; and Kep (1.79-1.17) and iAUC (11.3-8.45) for index PCa increased significantly with a higher PI-RADSv2 score. CONCLUSIONS The results of study show the possible utility of qualitative and quantitative DCE-MRI parameters for assessment of PCa GS and PI-RADSv2 categorization.
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Zhang Y, Yue B, Zhao X, Chen H, Sun L, Zhang X, Hao D. Benign or Malignant Characterization of Soft-Tissue Tumors by Using Semiquantitative and Quantitative Parameters of Dynamic Contrast-Enhanced Magnetic Resonance Imaging. Can Assoc Radiol J 2020; 71:92-99. [PMID: 32062994 DOI: 10.1177/0846537119888409] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To evaluate the efficacy of the semiquantitative and quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in differentiating between benign and malignant soft-tissue tumors. METHODS A total of 45 patients with pathologically confirmed soft-tissue tumors (15 benign and 30 malignant tumors) underwent DCE-MRI. The semiquantitative parameters assessed were as follows: time to peak (TTP), maximum concentration (MAX Conc), area under the curve of time-concentration curve (AUC-TC), and maximum rise slope (MAX Slope). Quantitative DCE-MRI was analyzed with the extended Tofts-Kety model to assess the following quantitative parameters: volume transfer constant (Ktrans), microvascular permeability reflux constant (Kep), and distribute volume per unit tissue volume (Ve). Data were evaluated using the independent t test or Mann-Whitney U test and receiver operating characteristic (ROC) curves. RESULTS The TTP (P = .0035), MAX Conc (P = .0018), AUC-TC (P = .0018), MAX Slope (P = .0018), Ktrans (P = .0018), and Kep (P = .0035) were significantly different between the benign and malignant soft-tissue tumors. The AUC of the ROC curve demonstrated the diagnostic potential of TTP (0.778), MAX Conc (0.849), AUC-TC (0.831), MAX Slope (0.847), Ktrans (0.836), Kep (0.778), and Ve (0.638). CONCLUSIONS The use of semiquantitative and quantitative parameters of DCE-MRI enabled differentiation between benign and malignant soft-tissue tumors. The values of TTP were lower, while those of MAX Conc, AUC-TC, MAX Slope, Ktrans, and Kep were higher in malignant than in benign tumors.
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Affiliation(s)
- Yu Zhang
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Bin Yue
- Department of Orthopedics, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiaodan Zhao
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Haisong Chen
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lingling Sun
- Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | | | - Dapeng Hao
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China
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Wang N, Gaddam S, Wang L, Xie Y, Fan Z, Yang W, Tuli R, Lo S, Hendifar A, Pandol S, Christodoulou AG, Li D. Six-dimensional quantitative DCE MR Multitasking of the entire abdomen: Method and application to pancreatic ductal adenocarcinoma. Magn Reson Med 2020; 84:928-948. [PMID: 31961967 DOI: 10.1002/mrm.28167] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 11/09/2019] [Accepted: 12/18/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE To develop a quantitative DCE MRI technique enabling entire-abdomen coverage, free-breathing acquisition, 1-second temporal resolution, and T1 -based quantification of contrast agent concentration and kinetic modeling for the characterization of pancreatic ductal adenocarcinoma (PDAC). METHODS Segmented FLASH readouts following saturation-recovery preparation with randomized 3D Cartesian undersampling was used for incoherent data acquisition. MR Multitasking was used to reconstruct 6-dimensional images with 3 spatial dimensions, 1 T1 recovery dimension for dynamic T1 quantification, 1 respiratory dimension to resolve respiratory motion, and 1 DCE time dimension to capture the contrast kinetics. Sixteen healthy subjects and 14 patients with pathologically confirmed PDAC were recruited for the in vivo studies, and kinetic parameters vp , Ktrans , ve , and Kep were evaluated for each subject. Intersession repeatability of Multitasking DCE was assessed in 8 repeat healthy subjects. One-way unbalanced analysis of variance was performed between control and patient groups. RESULTS In vivo studies demonstrated that vp , Ktrans , and Kep of PDAC were significantly lower compared with nontumoral regions in the patient group (P = .002, .003, .004, respectively) and normal pancreas in the control group (P = .011, <.001, <.001, respectively), while ve was significantly higher than nontumoral regions (P < .001) and healthy pancreas (P < .001). The kinetic parameters showed good in vivo repeatability (interclass correlation coefficient: vp , 0.95; Ktrans , 0.98; ve , 0.96; Kep , 0.99). CONCLUSION The proposed Multitasking DCE is promising for the quantification of vascular properties of PDAC. Quantitative DCE parameters were repeatable in vivo and showed significant differences between normal pancreas and both tumor and nontumoral regions in patients with PDAC.
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Affiliation(s)
- Nan Wang
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California.,Department of Bioengineering, University of California, Los Angeles, California
| | - Srinivas Gaddam
- Division of Digestive and Liver Diseases, Cedars-Sinai Medical Center, Los Angeles, California
| | - Lixia Wang
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Yibin Xie
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Zhaoyang Fan
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California.,Department of Bioengineering, University of California, Los Angeles, California
| | - Wensha Yang
- Department of Clinical Radiation Oncology, University of Southern California, Los Angeles, California
| | - Richard Tuli
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Simon Lo
- Division of Digestive and Liver Diseases, Cedars-Sinai Medical Center, Los Angeles, California
| | - Andrew Hendifar
- Department of Gastrointestinal Malignancies, Cedars-Sinai Medical Center, Los Angeles, California
| | - Stephen Pandol
- Division of Digestive and Liver Diseases, Cedars-Sinai Medical Center, Los Angeles, California
| | | | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California.,Department of Bioengineering, University of California, Los Angeles, California
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Cosma I, Tennstedt-Schenk C, Winzler S, Psychogios MN, Pfeil A, Teichgraeber U, Malich A, Papageorgiou I. The role of gadolinium in magnetic resonance imaging for early prostate cancer diagnosis: A diagnostic accuracy study. PLoS One 2019; 14:e0227031. [PMID: 31869380 PMCID: PMC6927639 DOI: 10.1371/journal.pone.0227031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 12/10/2019] [Indexed: 01/01/2023] Open
Abstract
Objective Prostate lesions detected with multiparametric magnetic resonance imaging (mpMRI) are classified for their malignant potential according to the Prostate Imaging-Reporting And Data System (PI-RADS™2). In this study, we evaluate the diagnostic accuracy of the mpMRI with and without gadolinium, with emphasis on the added diagnostic value of the dynamic contrast enhancement (DCE). Materials and methods The study was retrospective for 286 prostate lesions / 213 eligible patients, n = 116/170, and 49/59% malignant for the peripheral (Pz) and transitional zone (Tz), respectively. A stereotactic MRI-guided prostate biopsy served as the histological ground truth. All patients received a mpMRI with DCE. The influence of DCE in the prediction of malignancy was analyzed by blinded assessment of the imaging protocol without DCE and the DCE separately. Results Significant (CSPca) and insignificant (IPca) prostate cancers were evaluated separately to enhance the potential effects of the DCE in the detection of CSPca. The Receiver Operating Characteristics Area Under Curve (ROC-AUC), sensitivity (Se) and specificity (Spe) of PIRADS-without-DCE in the Pz was 0.70/0.47/0.86 for all cancers (IPca and CSPca merged) and 0.73/0.54/0.82 for CSPca. PIRADS-with-DCE for the same patients showed ROC-AUC/Se/Spe of 0.70/0.49/0.86 for all Pz cancers and 0.69/0.54/0.81 for CSPca in the Pz, respectively, p>0.05 chi-squared test. Similar results for the Tz, AUC/Se/Spe for PIRADS-without-DCE was 0.75/0.61/0.79 all cancers and 0.67/0.54/0.71 for CSPca, not influenced by DCE (0.66/0.47/0.81 for all Tz cancers and 0.61/0.39/0.75 for CSPca in Tz). The added Se and Spe of DCE for the detection of CSPca was 88/34% and 78/33% in the Pz and Tz, respectively. Conclusion DCE showed no significant added diagnostic value and lower specificity for the prediction of CSPca compared to the non-enhanced sequences. Our results support that gadolinium might be omitted without mitigating the diagnostic accuracy of the mpMRI for prostate cancer.
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Affiliation(s)
- Ilinca Cosma
- Institute of Diagnostic and Interventional Radiology, University Hospital Jena, Jena, Germany
- Institute of Radiology, Suedharz Hospital Nordhausen, Nordhausen, Germany
| | | | - Sven Winzler
- Institute of Radiology, Suedharz Hospital Nordhausen, Nordhausen, Germany
| | - Marios Nikos Psychogios
- Department of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Alexander Pfeil
- Department of Internal Medicine, University Hospital Jena, Jena, Germany
| | - Ulf Teichgraeber
- Institute of Diagnostic and Interventional Radiology, University Hospital Jena, Jena, Germany
| | - Ansgar Malich
- Institute of Radiology, Suedharz Hospital Nordhausen, Nordhausen, Germany
| | - Ismini Papageorgiou
- Institute of Diagnostic and Interventional Radiology, University Hospital Jena, Jena, Germany
- Institute of Radiology, Suedharz Hospital Nordhausen, Nordhausen, Germany
- * E-mail:
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18
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Willmitzer F, Del Chicca F, Kircher PR, Wang-Leandro A, Kronen PW, Verdino D, Rüfenacht D, Porcellini B, Richter H. Diffusion-weighted and perfusion-weighted magnetic resonance imaging of the prostate gland of healthy adult dogs. Am J Vet Res 2019; 80:832-839. [PMID: 31449441 DOI: 10.2460/ajvr.80.9.832] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe diffusion and perfusion characteristics of the prostate gland of healthy sexually intact adult dogs as determined by use of diffusion-weighted and perfusion-weighted MRI. ANIMALS 12 healthy sexually intact adult Beagles. PROCEDURES Ultrasonography of the prostate gland was performed. Subsequently, each dog was anesthetized, and morphological, diffusion-weighted, and perfusion-weighted MRI of the caudal aspect of the abdomen was performed. The apparent diffusion coefficient was calculated for the prostate gland parenchyma in diffusion-weighted MRI images in the central ventral and peripheral dorsal areas. Perfusion variables were examined in multiple regions of interest (ROIs) in the ventral and dorsal areas of the prostate gland and in the gluteal musculature. Signal intensity was determined, and a time-intensity curve was generated for each ROI. RESULTS Results of ultrasonographic examination of the prostate gland revealed no abnormalities for any dog. Median apparent diffusion coefficient of the prostate gland was 1.51 × 10-3 mm2/s (range, 1.04 × 10-3 mm2/s to 1.86 × 10-3 mm2/s). Perfusion-weighted MRI variables for the ROIs differed between the prostate gland parenchyma and gluteal musculature. CONCLUSIONS AND CLINICAL RELEVANCE Results provided baseline information about diffusion and perfusion characteristics of the prostate gland in healthy sexually intact adult dogs. Additional studies with dogs of various ages and breeds, with and without abnormalities of the prostate gland, will be necessary to validate these findings and investigate clinical applications.
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19
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Brown E, Brunker J, Bohndiek SE. Photoacoustic imaging as a tool to probe the tumour microenvironment. Dis Model Mech 2019; 12:dmm039636. [PMID: 31337635 PMCID: PMC6679374 DOI: 10.1242/dmm.039636] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The tumour microenvironment (TME) is a complex cellular ecosystem subjected to chemical and physical signals that play a role in shaping tumour heterogeneity, invasion and metastasis. Studying the roles of the TME in cancer progression would strongly benefit from non-invasive visualisation of the tumour as a whole organ in vivo, both preclinically in mouse models of the disease, as well as in patient tumours. Although imaging techniques exist that can probe different facets of the TME, they face several limitations, including limited spatial resolution, extended scan times and poor specificity from confounding signals. Photoacoustic imaging (PAI) is an emerging modality, currently in clinical trials, that has the potential to overcome these limitations. Here, we review the biological properties of the TME and potential of existing imaging methods that have been developed to analyse these properties non-invasively. We then introduce PAI and explore the preclinical and clinical evidence that support its use in probing multiple features of the TME simultaneously, including blood vessel architecture, blood oxygenation, acidity, extracellular matrix deposition, lipid concentration and immune cell infiltration. Finally, we highlight the future prospects and outstanding challenges in the application of PAI as a tool in cancer research and as part of a clinical oncologist's arsenal.
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Affiliation(s)
- Emma Brown
- Department of Physics, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
| | - Joanna Brunker
- Department of Physics, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
| | - Sarah E Bohndiek
- Department of Physics, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
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20
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Photoacoustic imaging of clofazimine hydrochloride nanoparticle accumulation in cancerous vs normal prostates. PLoS One 2019; 14:e0219655. [PMID: 31306463 PMCID: PMC6629155 DOI: 10.1371/journal.pone.0219655] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 06/28/2019] [Indexed: 11/19/2022] Open
Abstract
Prostate cancer was the most common form and had the second highest death rate of male cancer in the United States in 2015. Current diagnosis techniques, such as prostate-specific antigen tests, transrectal ultrasound scans, and biopsies, are often inconclusive, and in the latter case, invasive. Here, we explore the use of clofazimine hydrochloride nanoparticles (CFZ-HCl NPs), a repurposed formulation from an FDA-approved antimycobacterial agent, as a photoacoustic contrast agent for the evaluation of prostate cancer due to its macrophage-targeting capabilities and high optical absorbance at 495 nm. Using a transgenic adenocarcinoma of the mouse prostate (TRAMP) mouse model, our results indicate a preferential accumulation of intravenously injected CFZ-HCl NPs in cancerous prostates over normal prostates. Differences in accumulation of CFZ-HCl NPs between cancerous and normal prostates were determined using a two-wavelength unmixing technique via ex vivo photoacoustic imaging. Thus, intravenous injection of CFZ-HCl NPs leads to differences in the interactions of the particles with cancerous vs normal prostates, while allowing for photoacoustic detection and analysis of prostate cancer. These findings could lead to the development of a new noninvasive technique for the detection and monitoring of prostate cancer progression in an animal model that can potentially be translated to human patients.
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21
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Wang S, Fan X, Zhang Y, Medved M, He D, Yousuf A, Jamison E, Oto A, Karczmar GS. Use of Indicator Dilution Principle to Evaluate Accuracy of Arterial Input Function Measured With Low-Dose Ultrafast Prostate Dynamic Contrast-Enhanced MRI. ACTA ACUST UNITED AC 2019; 5:260-265. [PMID: 31245547 PMCID: PMC6588202 DOI: 10.18383/j.tom.2019.00004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Accurately measuring arterial input function (AIF) is essential for quantitative analysis of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI). We used the indicator dilution principle to evaluate the accuracy of AIF measured directly from an artery following a low-dose contrast media ultrafast DCE-MRI. In total, 15 patients with biopsy-confirmed localized prostate cancers were recruited. Cardiac MRI (CMRI) and ultrafast DCE-MRI were acquired on a Philips 3 T Ingenia scanner. The AIF was measured at iliac arties following injection of a low-dose (0.015 mmol/kg) gadolinium (Gd) contrast media. The cardiac output (CO) from CMRI (COCMRI) was calculated from the difference in ventricular volume at diastole and systole measured on the short axis of heart. The CO from DCE-MRI (CODCE) was also calculated from the AIF and dose of the contrast media used. A correlation test and Bland–Altman plot were used to compare COCMRI and CODCE. The average (±standard deviation [SD]) area under the curve measured directly from local AIF was 0.219 ± 0.07 mM·min. The average (±SD) COCMRI and CODCE were 6.52 ± 1.47 L/min and 6.88 ± 1.64 L/min, respectively. There was a strong positive correlation (r = 0.82, P < .01) and good agreement between COCMRI and CODCE. The CODCE is consistent with the reference standard COCMRI. This indicates that the AIF can be measured accurately from an artery with ultrafast DCE-MRI following injection of a low-dose contrast media.
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Affiliation(s)
- Shiyang Wang
- Department of Radiology, University of Chicago, Chicago, IL and
| | - Xiaobing Fan
- Department of Radiology, University of Chicago, Chicago, IL and
| | - Yue Zhang
- Department of Radiology, University of Chicago, Chicago, IL and
| | - Milica Medved
- Department of Radiology, University of Chicago, Chicago, IL and
| | - Dianning He
- Department of Radiology, University of Chicago, Chicago, IL and.,Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang, China
| | - Ambereen Yousuf
- Department of Radiology, University of Chicago, Chicago, IL and
| | - Ernest Jamison
- Department of Radiology, University of Chicago, Chicago, IL and
| | - Aytekin Oto
- Department of Radiology, University of Chicago, Chicago, IL and
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22
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Ai M, Youn JI, Salcudean SE, Rohling R, Abolmaesumi P, Tang S. Photoacoustic tomography for imaging the prostate: a transurethral illumination probe design and application. BIOMEDICAL OPTICS EXPRESS 2019; 10:2588-2605. [PMID: 31143504 PMCID: PMC6524588 DOI: 10.1364/boe.10.002588] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 04/09/2019] [Accepted: 04/10/2019] [Indexed: 05/05/2023]
Abstract
In vivo imaging of prostate cancer with photoacoustic tomography is currently limited by the lack of sufficient local fluence for deep tissue penetration and the risk of over-irradiation near the laser-tissue contact surface. We propose the design of a transurethral illumination probe that addresses those limitations. A high energy of 50 mJ/pulse is coupled into a 1000-µm-core diameter multimode fiber. A 2 cm diffusing end is fabricated, which delivers light in radial illumination. The radial illumination is then reflected and reshaped by a parabolic cylindrical mirror to obtain nearly parallel side illumination with a doubled fluence. The fiber assembly is housed in a 25 Fr cystoscope sheath to provide protection of the fiber and maintain a minimal laser-tissue contact distance of 5 mm. A large laser-tissue contact surface area of 4 cm2 is obtained and the fluence on the tissue surface is kept below the maximum permissible exposure. By imaging a prostate mimicking phantom, a penetration depth of 3.5 cm at 10 mJ/cm2 fluence and 700 nm wavelength is demonstrated. The results indicate that photoacoustic tomography with the proposed transurethral probe has the potential to image the entire prostate while satisfying the fluence maximum permissible exposure and delivering a high power to the tissue.
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Affiliation(s)
- Min Ai
- University of British Columbia, Faculty of Applied Science, Department of Electrical and Computer Engineering, 2332 Main Mall, Vancouver, V6T 1Z4, Canada
| | - Jong-in Youn
- Daegu Catholic University, College of Bio and Medical Sciences, Department of Biomedical Engineering, Gyeongsan-si, Gyeongbuk, 712702, South Korea
| | - Septimiu E. Salcudean
- University of British Columbia, Faculty of Applied Science, Department of Electrical and Computer Engineering, 2332 Main Mall, Vancouver, V6T 1Z4, Canada
| | - Robert Rohling
- University of British Columbia, Faculty of Applied Science, Department of Electrical and Computer Engineering, 2332 Main Mall, Vancouver, V6T 1Z4, Canada
| | - Purang Abolmaesumi
- University of British Columbia, Faculty of Applied Science, Department of Electrical and Computer Engineering, 2332 Main Mall, Vancouver, V6T 1Z4, Canada
| | - Shuo Tang
- University of British Columbia, Faculty of Applied Science, Department of Electrical and Computer Engineering, 2332 Main Mall, Vancouver, V6T 1Z4, Canada
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23
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Sun Y, Reynolds HM, Parameswaran B, Wraith D, Finnegan ME, Williams S, Haworth A. Multiparametric MRI and radiomics in prostate cancer: a review. AUSTRALASIAN PHYSICAL & ENGINEERING SCIENCES IN MEDICINE 2019; 42:3-25. [PMID: 30762223 DOI: 10.1007/s13246-019-00730-z] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 01/22/2019] [Indexed: 12/30/2022]
Abstract
Multiparametric MRI (mpMRI) is an imaging modality that combines anatomical MR imaging with one or more functional MRI sequences. It has become a versatile tool for detecting and characterising prostate cancer (PCa). The traditional role of mpMRI was confined to PCa staging, but due to the advanced imaging techniques, its role has expanded to various stages in clinical practises including tumour detection, disease monitor during active surveillance and sequential imaging for patient follow-up. Meanwhile, with the growing speed of data generation and the increasing volume of imaging data, it is highly demanded to apply computerised methods to process mpMRI data and extract useful information. Hence quantitative analysis for imaging data using radiomics has become an emerging paradigm. The application of radiomics approaches in prostate cancer has not only enabled automatic localisation of the disease but also provided a non-invasive solution to assess tumour biology (e.g. aggressiveness and the presence of hypoxia). This article reviews mpMRI and its expanding role in PCa detection, staging and patient management. Following that, an overview of prostate radiomics will be provided, with a special focus on its current applications as well as its future directions.
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Affiliation(s)
- Yu Sun
- University of Sydney, Sydney, Australia. .,Peter MacCallum Cancer Centre, Melbourne, Australia.
| | | | | | - Darren Wraith
- Queensland University of Technology, Brisbane, Australia
| | - Mary E Finnegan
- Imperial College Healthcare NHS Trust, London, UK.,Imperial College London, London, UK
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24
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Zhong X, Shakeri S, Liu D, Sayre J, Raman SS, Wu HH, Sung K. Repeatability and reproducibility of variable flip angle T
1
quantification in the prostate at 3 T. J Magn Reson Imaging 2018; 49:1730-1735. [DOI: 10.1002/jmri.26596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 11/18/2018] [Accepted: 11/20/2018] [Indexed: 11/09/2022] Open
Affiliation(s)
- Xinran Zhong
- Department of Radiological Sciences, David Geffen School of Medicine University of California California Los Angeles USA
- Physics and Biology in Medicine IDP, David Geffen School of Medicine University of California California Los Angeles USA
| | - Sepideh Shakeri
- Physics and Biology in Medicine IDP, David Geffen School of Medicine University of California California Los Angeles USA
| | - Dapeng Liu
- Department of Radiological Sciences, David Geffen School of Medicine University of California California Los Angeles USA
| | - James Sayre
- Department of Radiological Sciences, David Geffen School of Medicine University of California California Los Angeles USA
| | - Steven S. Raman
- Physics and Biology in Medicine IDP, David Geffen School of Medicine University of California California Los Angeles USA
| | - Holden H. Wu
- Department of Radiological Sciences, David Geffen School of Medicine University of California California Los Angeles USA
- Physics and Biology in Medicine IDP, David Geffen School of Medicine University of California California Los Angeles USA
| | - Kyunghyun Sung
- Department of Radiological Sciences, David Geffen School of Medicine University of California California Los Angeles USA
- Physics and Biology in Medicine IDP, David Geffen School of Medicine University of California California Los Angeles USA
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25
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Improving Diagnosis of Primary Prostate Cancer With Combined 68Ga–Prostate-Specific Membrane Antigen–HBED-CC Simultaneous PET and Multiparametric MRI and Clinical Parameters. AJR Am J Roentgenol 2018; 211:1246-1253. [DOI: 10.2214/ajr.18.19585] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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26
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Purysko AS, Rosenkrantz AB. Technique of Multiparametric MR Imaging of the Prostate. Urol Clin North Am 2018; 45:427-438. [DOI: 10.1016/j.ucl.2018.03.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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27
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Abstract
The concept of tumour hypoxia as a cause of radiation resistance has been prevalent for over 100 years. During this time, our understanding of tumour hypoxia has matured with the recognition that oxygen tension within a tumour is influenced by both diffusion and perfusion mechanisms. In parallel, clinical strategies to modify tumour hypoxia with the expectation that this will improve response to radiation have been developed and tested in clinical trials. Despite many disappointments, meta-analysis of the data on hypoxia modification confirms a significant impact on both tumour control and survival. Early trials evaluated hyperbaric oxygen followed by a generation of studies testing oxygen mimetics such as misonidazole, pimonidazole and etanidazole. One highly significant result stands out from the use of nimorazole in advanced laryngeal cancer with a significant advantage seen for locoregional control using this radiosensitiser. More recent studies have evaluated carbogen and nicotinamide targeting both diffusion related and perfusion related hypoxia. A significant survival advantage is seen in muscle invasive bladder cancer and also for locoregional control in hypopharygeal cancer associated with a low haemoglobin. New developments include the recognition that mitochondrial complex inhibitors reducing tumour oxygen consumption are potential radiosensitising agents and atovaquone is currently in clinical trials. One shortcoming of past hypoxia modifying trials is the failure to identify oxygenation status and select those patient with significant hypoxia. A range of biomarkers are now available including histological necrosis, immunohistochemical intrinsic markers such as CAIX and Glut 1 and hypoxia gene signatures which have been shown to predict outcome and will inform the next generation of hypoxia modifying clinical trials.
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Affiliation(s)
- Hannah Tharmalingham
- Mount Vernon Cancer Centre, Northwood, UK.,University of Manchester, Manchester, UK.,Christie Hospital, Manchester, UK
| | - Peter Hoskin
- Mount Vernon Cancer Centre, Northwood, UK.,University of Manchester, Manchester, UK.,Christie Hospital, Manchester, UK.,Manchester Cancer Research Centre, Manchester, UK
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28
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Zhong X, Martin T, Wu HH, Nayak KS, Sung K. Prostate DCE-MRI with <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow><mml:msubsup><mml:mi>B</mml:mi> <mml:mn>1</mml:mn> <mml:mo>+</mml:mo></mml:msubsup> </mml:mrow> </mml:math> correction using an approximated analytical approach. Magn Reson Med 2018; 80:2525-2537. [PMID: 29770495 DOI: 10.1002/mrm.27232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 03/03/2018] [Accepted: 04/02/2018] [Indexed: 11/11/2022]
Abstract
PURPOSE To develop and evaluate a practical <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow><mml:msubsup><mml:mi>B</mml:mi> <mml:mn>1</mml:mn> <mml:mo>+</mml:mo></mml:msubsup> </mml:mrow> </mml:math> correction method for prostate dynamic contrast-enhanced (DCE) MRI analysis. THEORY We proposed a simple analytical <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow><mml:msubsup><mml:mi>B</mml:mi> <mml:mn>1</mml:mn> <mml:mo>+</mml:mo></mml:msubsup> </mml:mrow> </mml:math> correction method using a Taylor series approximation to the steady-state spoiled gradient echo signal equation. This approach only requires <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow><mml:msubsup><mml:mi>B</mml:mi> <mml:mn>1</mml:mn> <mml:mo>+</mml:mo></mml:msubsup> </mml:mrow> </mml:math> maps and uncorrected pharmacokinetic (PK) parameters as input to estimate the corrected PK parameters. METHODS The proposed method was evaluated using a prostate digital reference object (DRO), and 82 in vivo prostate DCE-MRI cases. The approximated analytical correction was compared with the ground truth PK parameters in simulation, and compared with the reference numerical correction in in vivo experiments, using percentage error as the metric. RESULTS The prostate DRO results showed that our approximated analytical approach provided residual error less than 0.4% for both Ktrans and ve , compared to the ground truth. This noise-free residual error was smaller than the noise-induced error using the reference numerical correction, which had a minimum error of 2.1+4.3% with baseline signal-to-noise ratio of 234.5. For the 82 in vivo cases, Ktrans and ve percentage error compared to the reference numerical correction method had a mean of 0.1% (95% central range of [0.0%, 0.2%]) across the prostate volume. CONCLUSION The approximated analytical <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow><mml:msubsup><mml:mi>B</mml:mi> <mml:mn>1</mml:mn> <mml:mo>+</mml:mo></mml:msubsup> </mml:mrow> </mml:math> correction method provides comparable results with less than 0.2% error within 95% central range, compared to reference numerical <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow><mml:msubsup><mml:mi>B</mml:mi> <mml:mn>1</mml:mn> <mml:mo>+</mml:mo></mml:msubsup> </mml:mrow> </mml:math> correction. The proposed method is a practical solution for <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow><mml:msubsup><mml:mi>B</mml:mi> <mml:mn>1</mml:mn> <mml:mo>+</mml:mo></mml:msubsup> </mml:mrow> </mml:math> correction in prostate DCE-MRI because of its simple implementation.
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Affiliation(s)
- Xinran Zhong
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California.,Physics and Biology in Medicine Graduate Program, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Thomas Martin
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California.,Physics and Biology in Medicine Graduate Program, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Holden H Wu
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California.,Physics and Biology in Medicine Graduate Program, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Krishna S Nayak
- Ming Hsieh Department of Electrical Engineering, University of Southern California, Los Angeles, California
| | - Kyunghyun Sung
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California.,Physics and Biology in Medicine Graduate Program, David Geffen School of Medicine, University of California, Los Angeles, California
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29
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Kumar V, Bora GS, Kumar R, Jagannathan NR. Multiparametric (mp) MRI of prostate cancer. PROGRESS IN NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY 2018; 105:23-40. [PMID: 29548365 DOI: 10.1016/j.pnmrs.2018.01.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 01/17/2018] [Accepted: 01/28/2018] [Indexed: 06/08/2023]
Abstract
Prostate cancer (PCa) is one of the most prevalent cancers in men. A large number of men are detected with PCa; however, the clinical behavior ranges from low-grade indolent tumors that never develop into a clinically significant disease to aggressive, invasive tumors that may rapidly progress to metastatic disease. The challenges in clinical management of PCa are at levels of screening, diagnosis, treatment, and follow-up after treatment. Magnetic resonance imaging (MRI) methods have shown a potential role in detection, localization, staging, assessment of aggressiveness, targeting biopsies, etc. in PCa patients. Multiparametric MRI (mpMRI) is emerging as a better option compared to the individual imaging methods used in the evaluation of PCa. There are attempts to improve the reproducibility and reliability of mpMRI by using an objective scoring system proposed in the prostate imaging reporting and data system (PIRADS) for standardized reporting. Prebiopsy mpMRI may be used to detect PCa in men with elevated prostate-specific antigen or abnormal digital rectal examination and to enable targeted biopsies. mpMRI can also be used to decide on clinical management of patients, for example active surveillance, and may help in detecting only the pathology that requires detection. It can potentially not only guide patient selection for initial and repeat biopsy but also reduce false-negative biopsies. This review presents a description of the MR methods most commonly applied for investigations of prostate. The anatomical, functional and metabolic parameters obtained from these MR methods are discussed with regard to their physical basis and their contribution to mpMRI investigations of PCa.
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Affiliation(s)
- Virendra Kumar
- Department of NMR & MRI Facility, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
| | - Girdhar S Bora
- Department of Urology, Post-Graduate Institute of Medical Sciences, Chandigarh 160012, India
| | - Rajeev Kumar
- Department of Urology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Naranamangalam R Jagannathan
- Department of NMR & MRI Facility, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
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30
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A simulation study comparing nine mathematical models of arterial input function for dynamic contrast enhanced MRI to the Parker model. AUSTRALASIAN PHYSICAL & ENGINEERING SCIENCES IN MEDICINE 2018; 41:507-518. [DOI: 10.1007/s13246-018-0632-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 03/20/2018] [Indexed: 02/06/2023]
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31
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Automatic Prostate Cancer Segmentation Using Kinetic Analysis in Dynamic Contrast-Enhanced MRI. J Biomed Phys Eng 2018; 8:107-116. [PMID: 29732345 PMCID: PMC5928300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 08/27/2016] [Indexed: 10/27/2022]
Abstract
BACKGROUND Dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) provides functional information on the microcirculation in tissues by analyzing the enhancement kinetics which can be used as biomarkers for prostate lesions detection and characterization. OBJECTIVE The purpose of this study is to investigate spatiotemporal patterns of tumors by extracting semi-quantitative as well as wavelet-based features, both extracted from pixel-based time-signal intensity curves to segment prostate lesions on prostate DCE-MRI. METHODS Quantitative dynamic contrast-enhanced MRI data were acquired on 22 patients. Optimal features selected by forward selection are used for the segmentation of prostate lesions by applying fuzzy c-means (FCM) clustering. The images were reviewed by an expert radiologist and manual segmentation performed as the ground truth. RESULTS Empirical results indicate that fuzzy c-mean classifier can achieve better results in terms of sensitivity, specificity when semi-quantitative features were considered versus wavelet kinetic features for lesion segmentation (Sensitivity of 87.58% and 75.62%, respectively) and (Specificity of 89.85% and 68.89 %, respectively). CONCLUSION The proposed segmentation algorithm in this work can potentially be implemented for automatic prostate lesion detection in a computer aided diagnosis scheme and combined with morphologic features to increase diagnostic credibility.
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32
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Mazaheri Y, Akin O, Hricak H. Dynamic contrast-enhanced magnetic resonance imaging of prostate cancer: A review of current methods and applications. World J Radiol 2017; 9:416-425. [PMID: 29354207 PMCID: PMC5746645 DOI: 10.4329/wjr.v9.i12.416] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 08/03/2017] [Accepted: 10/17/2017] [Indexed: 02/06/2023] Open
Abstract
In many areas of oncology, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has proven to be a clinically useful, non-invasive functional imaging technique to quantify tumor vasculature and tumor perfusion characteristics. Tumor angiogenesis is an essential process for tumor growth, proliferation, and metastasis. Malignant lesions demonstrate rapid extravasation of contrast from the intravascular space to the capillary bed due to leaky capillaries associated with tumor neovascularity. DCE-MRI has the potential to provide information regarding blood flow, areas of hypoperfusion, and variations in endothelial permeability and microvessel density to aid treatment selection, enable frequent monitoring during treatment and assess response to targeted therapy following treatment. This review will discuss the current status of DCE-MRI in cancer imaging, with a focus on its use in imaging prostate malignancies as well as weaknesses that limit its widespread clinical use. The latest techniques for quantification of DCE-MRI parameters will be reviewed and compared.
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Affiliation(s)
- Yousef Mazaheri
- Department of Medical Physics and Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
| | - Oguz Akin
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
| | - Hedvig Hricak
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
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33
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Kargar S, Borisch EA, Froemming AT, Kawashima A, Mynderse LA, Stinson EG, Trzasko JD, Riederer SJ. Robust and efficient pharmacokinetic parameter non-linear least squares estimation for dynamic contrast enhanced MRI of the prostate. Magn Reson Imaging 2017; 48:50-61. [PMID: 29278764 DOI: 10.1016/j.mri.2017.12.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Revised: 12/09/2017] [Accepted: 12/21/2017] [Indexed: 12/15/2022]
Abstract
PURPOSE To describe an efficient numerical optimization technique using non-linear least squares to estimate perfusion parameters for the Tofts and extended Tofts models from dynamic contrast enhanced (DCE) MRI data and apply the technique to prostate cancer. METHODS Parameters were estimated by fitting the two Tofts-based perfusion models to the acquired data via non-linear least squares. We apply Variable Projection (VP) to convert the fitting problem from a multi-dimensional to a one-dimensional line search to improve computational efficiency and robustness. Using simulation and DCE-MRI studies in twenty patients with suspected prostate cancer, the VP-based solver was compared against the traditional Levenberg-Marquardt (LM) strategy for accuracy, noise amplification, robustness to converge, and computation time. RESULTS The simulation demonstrated that VP and LM were both accurate in that the medians closely matched assumed values across typical signal to noise ratio (SNR) levels for both Tofts models. VP and LM showed similar noise sensitivity. Studies using the patient data showed that the VP method reliably converged and matched results from LM with approximate 3× and 2× reductions in computation time for the standard (two-parameter) and extended (three-parameter) Tofts models. While LM failed to converge in 14% of the patient data, VP converged in the ideal 100%. CONCLUSION The VP-based method for non-linear least squares estimation of perfusion parameters for prostate MRI is equivalent in accuracy and robustness to noise, while being more reliably (100%) convergent and computationally about 3× (TM) and 2× (ETM) faster than the LM-based method.
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Affiliation(s)
- Soudabeh Kargar
- Biomedical Engineering and Physiology Program, Mayo Graduate School, Rochester, MN, United States; Department of Radiology, Mayo Clinic, Rochester, MN, United States
| | - Eric A Borisch
- Department of Radiology, Mayo Clinic, Rochester, MN, United States
| | - Adam T Froemming
- Department of Radiology, Mayo Clinic, Rochester, MN, United States
| | - Akira Kawashima
- Department of Radiology, Mayo Clinic, Scottsdale, AZ, United States
| | - Lance A Mynderse
- Department of Urology, Mayo Clinic, Rochester, MN, United States
| | - Eric G Stinson
- Department of Radiology, Mayo Clinic, Rochester, MN, United States
| | - Joshua D Trzasko
- Department of Radiology, Mayo Clinic, Rochester, MN, United States
| | - Stephen J Riederer
- Biomedical Engineering and Physiology Program, Mayo Graduate School, Rochester, MN, United States; Department of Radiology, Mayo Clinic, Rochester, MN, United States.
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34
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PI-RADS v2 in Prostate Cancer and Correlation with T Staging, PSA Levels and ADC Values. IRANIAN JOURNAL OF RADIOLOGY 2017. [DOI: 10.5812/iranjradiol.14038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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35
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Purysko AS, Rosenkrantz AB. Technique of Multiparametric MR Imaging of the Prostate. Radiol Clin North Am 2017; 56:211-222. [PMID: 29420977 DOI: 10.1016/j.rcl.2017.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Multiparametric MR imaging provides detailed anatomic assessment of the prostate as well as information that allows the detection and characterization of prostate cancer. To obtain high-quality MR imaging of the prostate, radiologists must understand sequence optimization to overcome commonly encountered technical challenges. This review discusses the techniques that are used in state-of-the-art MR imaging of the prostate, including imaging protocols, hardware considerations, and important aspects of patient preparation, with an emphasis on the recommendations provided in the prostate imaging-reporting and data system version 2 guidelines.
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Affiliation(s)
- Andrei S Purysko
- Section of Abdominal Imaging, Imaging Institute, Cleveland Clinic, 9500 Euclid Avenue, Mail Code JB-3, Cleveland, OH 44195, USA.
| | - Andrew B Rosenkrantz
- Department of Radiology, New York University Langone Medical Center, 660 First Avenue, New York, NY 10016, USA
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Chen Z, Zheng Y, Ji G, Liu X, Li P, Cai L, Guo Y, Yang J. Accuracy of dynamic contrast-enhanced magnetic resonance imaging in the diagnosis of prostate cancer: systematic review and meta-analysis. Oncotarget 2017; 8:77975-77989. [PMID: 29100440 PMCID: PMC5652829 DOI: 10.18632/oncotarget.20316] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 08/04/2017] [Indexed: 01/23/2023] Open
Abstract
The goals of this meta-analysis were to assess the effectiveness of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in patients with prostate carcinoma (PCa) and to explore the risk profiles with the highest benefit. Systematic electronic searched were conducted in database. We used patient-based and biopsy-based pooled weighted estimates of the sensitivity, specificity, and a summary receiver operating characteristic (SROC) curve for assessing the diagnostic performance of DCE. We performed direct and indirect comparisons of DCE and other methods of imaging. A total of 26 articles met the inclusion criteria for the analysis. DCE-MRI pooled sensitivity was 0.53 (95% CI 0.39 to 0.67), with a specificity of 0.88 (95% CI 0.83 to 0.92) on whole gland. The peripheral zone pooled sensitivity was 0.70 (95% CI 0.46 to 0.86), with a specificity of 0.88 (95% CI 0.76 to 0.94). Compared with T2-weighted imaging (T2WI), DCE was statistically superior to T2. In conclusion, DCE had relatively high specificity in detecting PCa but relatively low sensitivity as a complementary functional method. DCE-MRI might help clinicians exclude cases of normal tissue and serve as an adjunct to conventional imaging when seeking to identify tumor foci in patients with PCa.
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Affiliation(s)
- Zhiqiang Chen
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
- Radiology Department of The General Hospital, Ningxia Medical University, Yinchuan 750004, Ningxia, China
| | - Yi Zheng
- Radiology Department of The General Hospital, Ningxia Medical University, Yinchuan 750004, Ningxia, China
| | - Guanghai Ji
- Radiology Department of The General Hospital, Ningxia Medical University, Yinchuan 750004, Ningxia, China
| | - Xinxin Liu
- Department of Diagnostic Imaging, Honghui Hospital, Health Science Center of Xi'an Jiaotong University, Xi'an 750004, Shaanxi, China
| | - Peng Li
- Radiology Department of The General Hospital, Ningxia Medical University, Yinchuan 750004, Ningxia, China
| | - Lei Cai
- Radiology Department of The General Hospital, Ningxia Medical University, Yinchuan 750004, Ningxia, China
| | - Yulin Guo
- Radiology Department of The General Hospital, Ningxia Medical University, Yinchuan 750004, Ningxia, China
| | - Jian Yang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
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Troost EGC, Koi L, Yaromina A, Krause M. Therapeutic options to overcome tumor hypoxia in radiation oncology. Clin Transl Imaging 2017. [DOI: 10.1007/s40336-017-0247-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Role of MRI-US Fusion Biopsy in Diagnosing Prostatic Cancer. Indian J Surg Oncol 2017; 8:357-360. [DOI: 10.1007/s13193-016-0612-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 11/10/2016] [Indexed: 10/20/2022] Open
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Zhang Y, Liu H, Xiao W, Zhu L, Wang N, He X, Jiang Z, Guan B. Quantitative dynamic contrast-enhanced magnetic resonance imaging in a VX2 rabbit liver tumour model using different gadolinium-based contrast agents: comparison of DCE-MRI quantitative results between Magnevist and Eovist. BJR Case Rep 2017; 3:20160099. [PMID: 30363268 PMCID: PMC6159198 DOI: 10.1259/bjrcr.20160099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 02/24/2017] [Accepted: 03/06/2017] [Indexed: 11/18/2022] Open
Abstract
Quantitative dynamic contrast enhanced MRI (DCE-MRI) can offer information related to tumour perfusion and permeability (Ktrans), rate constant (Kep), extravascular extracellular volume fraction (Ve) and distribution volume (Vd). Different types of gadolinium-based contrast agents (GBCAs) may traverse the vascular wall with different velocities owing to their physicochemical characteristics. The purpose of this article was to compare the DCE-MRI quantitative results (Ktrans, Kep, Ve and Vd) between Magnevist and Eovist in a VX2 rabbit liver tumour model. Sixteen rabbits (body weight, 3 Kg; random gender) containing implanted hepatic VX2 carcinomas were randomly divided into two groups based on the regimen of MRI contrast agent administered, eight rabbits in each group. All rabbits underwent a liver DCE-MRscan before tumour transplantation. Fourteen days after tumour transplantation, the eight rabbits in Group A (Magnevist group) underwent a liver DCE-MR scan in a 3.0 T Magnetom Verio MR scanner (Siemens Healthcare, AD, Germany) after the administration of Magnevist at the flow rate of 1 ml s–1. The Group B rabbits underwent the same scan except for the administration of Eovist at the same flow rate. Twenty-four hours after the initial DCE-MRI, repeat DCE-MRI was performed with the cross-over GBCA at the same flow rate in each group. Every rabbit received 0.6 ml GBCA (0.2 ml Kg–1) during each DCE-MRI. Ktrans, Kep, Ve and Vd were measured in the tumour lesion and compared with normal liver tissue in the same slice. A pathologic examination was also performed. Hepatocellular carcinoma was diagnosed in all 16 rabbits by pathologic examination. There were no significant differences in Ktrans, Ve, Kep and Vd between the two groups of rabbits (p > 0.05). The Ktrans, Ve, Kep and Vd of the VX2 rabbit liver tumour model were significantly higher than the normal liver parenchyma (0.742 ± 0.086 vs 0.027 ± 0.002, 7.345 ± 0.043 vs 6.721 ± 0.035, 0.101 ± 0.005 vs 0.101 ± 0.005, 0.419 ± 0.083 vs 0.037 ± 0.005, respectively; p < 0.01). The Ktrans, Ve and Vd of Eovist group were significantly higher compared with the values in the Magnevist group (0.116 ± 0.016 vs 0.010 ± 0.002, respectively, p < 0.01; 0.101 ± 0.005 vs 0.004 ± 0.0009, respectively, p < 0.01; 0.419 ± 0.083 vs 0.037 ± 0.005, respectively, p < 0.001). There was no significant difference in Kep between the Eovist and Magnevist groups (7.345 ± 0.043 vs 6.721 ± 0.035, respectively; p > 0.05). In the VX2 rabbit liver tumour model, DCE-MRI performed with different types of GBCA can develop different quantitative results with respect to Ktrans, Ve and Vd. The liver-specific GBCA, Eovist, is more sensitive than the general GBCA, Magnevist, in detecting tumour perfusion and permeability.
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Affiliation(s)
- Yule Zhang
- Ultrasound, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Hongsheng Liu
- MR, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Weiqiang Xiao
- MR, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Liling Zhu
- Ultrasound, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Na Wang
- Ultrasound, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xuehua He
- Ultrasound, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | | | - Buyun Guan
- Ultrasound, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
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Pesapane F, Patella F, Fumarola EM, Panella S, Ierardi AM, Pompili GG, Franceschelli G, Angileri SA, Magenta Biasina A, Carrafiello G. Intravoxel Incoherent Motion (IVIM) Diffusion Weighted Imaging (DWI) in the Periferic Prostate Cancer Detection and Stratification. Med Oncol 2017; 34:35. [PMID: 28144814 DOI: 10.1007/s12032-017-0892-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 01/16/2017] [Indexed: 12/18/2022]
Abstract
The aim of this study was to compare the Intravoxel Incoherent Motion (IVIM) parameters between healthy Peripheral Zone (PZ), Benign Prostatic Hyperplasia (BPH) and Prostate Cancer (PCa) and compare them to assess whether there was correlation with Gleason Score (GS) grading system. Thirty-one patients with suspect of PCa underwent 1.5T Multi-Parametric Magnetic Resonance Imaging (MP-MRI) with endorectal coil with a protocol including T2WI, DWI using 10 b values (0, 10, 20, 30, 50, 80, 100, 200, 400, 1000 s/mm2) and DCE. Monoexponential and IVIM model fits were used to calculate both apparent diffusion coefficient (ADC) and the following IVIM parameters: molecular diffusion coefficient (D), perfusion-related diffusion coefficient (D*) and perfusion fraction (f). The ADC and D values were significantly lower in the PCa (0.70 ± 0.16 × 10-3 mm2/s and 0.88 ± 0.31 × 10-3 mm2/s) compared to those found in the PZ (1.22 ± 0.20 × 10-3 mm2/s and 1.78 ± 0.34 × 10-3 mm2/s) and in the BPH (1.53 ± 0.23 × 10-3 mm2/s and 1.11 ± 0.28 × 10-3 mm2/s). The D* parameter was significantly increased in the PCa (5.35 ± 5.12 × 10-3 mm2/s) compare to the healthy PZ (3.02 ± 2.86 × 10-3 mm2/s), instead there was not significantly difference in the PCa compare to the BPH (5.61 ± 6.77 × 10-3 mm2/s). The f was statistically lower in the PCa (9.01 ± 5.20%) compared to PZ (10.57 ± 9.30%), but not significantly different between PCa and BPH (9.29 ± 7.29%). The specificity, sensitivity and accuracy of T2WI associated with DWI and IVIM were higher (100, 98 and 99%, respectively) than for T2WI/DWI and IVIM alone (89, 92 and 90%, respectively). Only for ADC was found a statistical difference between low- and intermediate-/high-grade tumors. Adding IVIM to the MP-MRI could increase the diagnostic performance to detect clinically relevant PCa. ADC values have been found to have a rule to discriminate PCa reliably from normal areas and differed significantly in low- and intermediate-/high-grade PCa. In contrast, IVIM parameters were unable to distinguish between the different GS.
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Affiliation(s)
- Filippo Pesapane
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy.
| | - Francesca Patella
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy
| | - Enrico Maria Fumarola
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy
| | - Silvia Panella
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy
| | - Anna Maria Ierardi
- Department of Radiology, Interventional Radiology, Insubria University, Varese, Italy
| | - Giovanni Guido Pompili
- Department of Health Sciences, Diagnostic and Interventional Radiology, San Paolo Hospital, Università degli Studi di Milano, Via A di Rudinì 8, 20142, Milan, Italy
| | - Giuseppe Franceschelli
- Department of Health Sciences, Diagnostic and Interventional Radiology, San Paolo Hospital, Università degli Studi di Milano, Via A di Rudinì 8, 20142, Milan, Italy
| | - Salvatore Alessio Angileri
- Department of Health Sciences, Diagnostic and Interventional Radiology, San Paolo Hospital, Università degli Studi di Milano, Via A di Rudinì 8, 20142, Milan, Italy
| | - Alberto Magenta Biasina
- Department of Health Sciences, Diagnostic and Interventional Radiology, San Paolo Hospital, Università degli Studi di Milano, Via A di Rudinì 8, 20142, Milan, Italy
| | - Gianpaolo Carrafiello
- Department of Health Sciences, Diagnostic and Interventional Radiology, San Paolo Hospital, Università degli Studi di Milano, Via A di Rudinì 8, 20142, Milan, Italy
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Gao P, Shi C, Zhao L, Zhou Q, Luo L. Differential diagnosis of prostate cancer and noncancerous tissue in the peripheral zone and central gland using the quantitative parameters of DCE-MRI: A meta-analysis. Medicine (Baltimore) 2016; 95:e5715. [PMID: 28033274 PMCID: PMC5207570 DOI: 10.1097/md.0000000000005715] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The objective of this meta-analysis was to evaluate the clinical usefulness of K, Kep, and Ve values in the differential diagnosis of prostate cancer (PCa) and noncancerous tissue in the peripheral zone (PZ) and central gland (CG). METHODS A search was conducted of the PubMed, MEDLINE, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases from January 2000 to October 2015 using the search terms "prostate cancer," " dynamic contrast-enhanced (DCE)," "magnetic resonance imaging," "K," "Kep," and "Ve." Studies were selected and included according to strict eligibility criteria. Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were used to compare K, Kep, and Ve values between PCa and noncancerous tissue. RESULTS Fourteen studies representing 484 patients highly suspicious for prostate adenocarcinoma were selected for the meta-analysis. We found that K values measured by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) were significantly higher in PCa tissue than in noncancerous tissue in the PZ (SMD 1.57, 95% CI 0.98-2.16; z = 5.21, P <0.00001) and CG (SMD 1.19, 95% CI 0.46-1.91; z = 3.21, P = 0.001). Kep values measured by DCE-MRI were significantly higher in PCa than in noncancerous tissue in the PZ (SMD 1.41, 95% CI 0.92-1.91; z = 5.59, P < 0.00001) and CG (SMD 1.57, 95% CI 0.69-2.46; z = 3.49, P = 0.0005). Ve values generated by DCE-MRI were slightly higher in PCa than in noncancerous tissue in the PZ (SMD 0.72, 95% CI 0.17-1.27; z = 2.58, P = 0.010), but sensitivity analysis found that the Ve value was unstable for differentiation between PCa and noncancerous PZ tissue. However, there was no significant difference in the Ve value between PCa and noncancerous CG tissue (SMD -0.29, 95% CI -1.18, 0.59; z = 0.65, P = 0.51). CONCLUSION Our meta-analysis shows that K and Kep were the most reliable parameters for differentiating PCa from noncancerous tissue and were critical for evaluation of the internal structure of cancer. The Ve value was not helpful for distinguishing PCa from noncancerous CG tissue; its ability to distinguish between PCa and noncancerous PZ tissue remains uncertain.
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Affiliation(s)
- Peng Gao
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou
| | - Changzheng Shi
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou
| | - Lianping Zhao
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou
- Department of Radiology, Gansu Provincial Hospital, Gansu, China
| | - Quan Zhou
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou
| | - Liangping Luo
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou
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Borofsky S, Haji-Momenian S, Shah S, Taffel M. Multiparametric MRI of the prostate gland: technical aspects. Future Oncol 2016; 12:2445-2462. [DOI: 10.2217/fon-2016-0218] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
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El-Samei HAEKA, Amin MF, Hassan EE. Assessment of the accuracy of multi-parametric MRI with PI-RADS 2.0 scoring system in the discrimination of suspicious prostatic focal lesions. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2016. [DOI: 10.1016/j.ejrnm.2016.04.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Kalmuk J, Folaron M, Buchinger J, Pili R, Seshadri M. Multimodal imaging guided preclinical trials of vascular targeting in prostate cancer. Oncotarget 2016. [PMID: 26203773 PMCID: PMC4695192 DOI: 10.18632/oncotarget.4463] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The high mortality rate associated with castration-resistant prostate cancer (CRPC) underscores the need for improving therapeutic options for this patient population. The purpose of this study was to examine the potential of vascular targeting in prostate cancer. Experimental studies were carried out in subcutaneous and orthotopic Myc-CaP prostate tumors implanted into male FVB mice to examine the efficacy of a novel microtubule targeted vascular disrupting agent (VDA), EPC2407 (Crolibulin™). A non-invasive multimodality imaging approach based on magnetic resonance imaging (MRI), bioluminescence imaging (BLI), and ultrasound (US) was utilized to guide preclinical trial design and monitor tumor response to therapy. Imaging results were correlated with histopathologic assessment, tumor growth and survival analysis. Contrast-enhanced MRI revealed potent antivascular activity of EPC2407 against subcutaneous and orthotopic Myc-CaP tumors. Longitudinal BLI of Myc-CaP tumors expressing luciferase under the androgen response element (Myc-CaP/ARE-luc) revealed changes in AR signaling and reduction in intratumoral delivery of luciferin substrate following castration suggestive of reduced blood flow. This reduction in blood flow was validated by US and MRI. Combination treatment resulted in sustained vascular suppression, inhibition of tumor regrowth and conferred a survival benefit in both models. These results demonstrate the therapeutic potential of vascular targeting in combination with androgen deprivation against prostate cancer.
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Affiliation(s)
- James Kalmuk
- Department of Pharmacology and Therapeutics, Roswell Park Cancer Institute, Buffalo, NY, USA.,Current address: SUNY Upstate Medical University, Syracuse, NY, USA
| | - Margaret Folaron
- Department of Pharmacology and Therapeutics, Roswell Park Cancer Institute, Buffalo, NY, USA.,Department of Molecular and Cellular Biophysics and Biochemistry, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Julian Buchinger
- Department of Pharmacology and Therapeutics, Roswell Park Cancer Institute, Buffalo, NY, USA.,Current address: University at Buffalo - School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Roberto Pili
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Mukund Seshadri
- Department of Pharmacology and Therapeutics, Roswell Park Cancer Institute, Buffalo, NY, USA.,Department of Molecular and Cellular Biophysics and Biochemistry, Roswell Park Cancer Institute, Buffalo, NY, USA
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Dynamic contrast enhanced MR imaging for evaluation of angiogenesis of hepatocellular nodules in liver cirrhosis in N-nitrosodiethylamine induced rat model. Eur Radiol 2016; 27:2086-2094. [PMID: 27488851 DOI: 10.1007/s00330-016-4505-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 04/12/2016] [Accepted: 07/06/2016] [Indexed: 02/07/2023]
Abstract
PURPOSE To investigate whether dynamic contrast -enhanced MRI (DCE-MRI) can distinguish the type of liver nodules in a rat model with N-nitrosodiethylamine- induced cirrhosis. METHODS Liver nodules in cirrhosis were induced in 60 male Wistar rats via 0.01 % N-nitrosodiethylamine in the drinking water for 35-100 days. The nodules were divided into three groups: regenerative nodule (RN), dysplastic nodule (DN), and hepatocellular carcinoma (HCC). DCE-MRI was performed, and parameters including transfer constant (Ktrans), rate constant (Kep), extravascular extracellular space volume fraction (Ve), and initial area under the contrast concentration versus time curve (iAUC) were measured and compared. RESULTS The highest Ktrans and iAUC values were seen in HCC, followed by DN and RN (all P < 0.05). The area under the receiver operating characteristic curve (AUROC) for DN and HCC were 0.738 and 0.728 for Ktrans and iAUC, respectively. The AUROC for HCC were 0.850 and 0.840 for Ktrans and iAUC, respectively. Ordinal logistic regression analysis showed that Ktrans had a high goodness of fit (0.970, 95 % confidence interval, 13.751-24.958). CONCLUSION DCE-MRI is a promising method to differentiate of liver nodules. Elevated Ktrans suggested that the nodules may be transformed into HCC. KEY POINTS • DCE-MRI is promising for differentiating among RN, DN, and HCC • K trans and iAUC positively correlated with malignancy degree of liver nodules • Elevated K trans suggests that the nodules may be transformed into HCC.
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Sahu M, Wijesekera N, Donohue JF. Anterior prostate cancer: Current perspectives and diagnostic dilemmas. JOURNAL OF CLINICAL UROLOGY 2016. [DOI: 10.1177/2051415816655724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Anterior zone (transition zone and anterior horn of peripheral zone) tumours represent 20–30% of all prostate cancers. Traditional transrectal prostate biopsies fail to sample this area of the prostate gland adequately, thereby underestimating the true extent of anterior zone cancers. This article outlines the behaviour and significance of this entity and discusses investigations that are currently available which may aid in their detection. The implementation of transperineal template-guided prostate biopsies will allow optimal sampling of the anterior zone whilst advances in the field of magnetic resonance imaging allow the use of multiple sequences (T2-weighted, spectroscopy, diffusion weighted and dynamic contrast enhancement) to identify these tumours accurately. Such investigations will result in more accurate risk stratification compared with the current diagnostic pathway, and could lead to improved management in this subset of men.
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Affiliation(s)
- Mahua Sahu
- Department of Urology, Maidstone and Tunbridge Wells Hospital, UK
| | - Nevin Wijesekera
- Department of Radiology, Kingston Hospital NHS Foundation Trust, UK
| | - John F Donohue
- Department of Urology, Maidstone and Tunbridge Wells Hospital, UK
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Ginsburg SB, Taimen P, Merisaari H, Vainio P, Boström PJ, Aronen HJ, Jambor I, Madabhushi A. Patient-specific pharmacokinetic parameter estimation on dynamic contrast-enhanced MRI of prostate: Preliminary evaluation of a novel AIF-free estimation method. J Magn Reson Imaging 2016; 44:1405-1414. [PMID: 27285161 DOI: 10.1002/jmri.25330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 05/20/2016] [Indexed: 01/05/2023] Open
Abstract
PURPOSE To develop and evaluate a prostate-based method (PBM) for estimating pharmacokinetic parameters on dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) by leveraging inherent differences in pharmacokinetic characteristics between the peripheral zone (PZ) and transition zone (TZ). MATERIALS AND METHODS This retrospective study, approved by the Institutional Review Board, included 40 patients who underwent a multiparametric 3T MRI examination and subsequent radical prostatectomy. A two-step PBM for estimating pharmacokinetic parameters exploited the inherent differences in pharmacokinetic characteristics associated with the TZ and PZ. First, the reference region model was implemented to estimate ratios of Ktrans between normal TZ and PZ. Subsequently, the reference region model was leveraged again to estimate values for Ktrans and ve for every prostate voxel. The parameters of PBM were compared with those estimated using an arterial input function (AIF) derived from the femoral arteries. The ability of the parameters to differentiate prostate cancer (PCa) from benign tissue was evaluated on a voxel and lesion level. Additionally, the effect of temporal downsampling of the DCE MRI data was assessed. RESULTS Significant differences (P < 0.05) in PBM Ktrans between PCa lesions and benign tissue were found in 26/27 patients with TZ lesions and in 33/38 patients with PZ lesions; significant differences in AIF-based Ktrans occurred in 26/27 and 30/38 patients, respectively. The 75th and 100th percentiles of Ktrans and ve estimated using PBM positively correlated with lesion size (P < 0.05). CONCLUSION Pharmacokinetic parameters estimated via PBM outperformed AIF-based parameters in PCa detection. J. Magn. Reson. Imaging 2016;44:1405-1414.
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Affiliation(s)
- Shoshana B Ginsburg
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| | - Pekka Taimen
- Department of Pathology, University of Turku and Turku University Hospital, Turku, Finland
| | - Harri Merisaari
- Department of Diagnostic Radiology, University of Turku, Turku, Finland
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Information Technology, University of Turku, Turku, Finland
| | - Paula Vainio
- Department of Pathology, University of Turku and Turku University Hospital, Turku, Finland
| | - Peter J Boström
- Department of Urology, Turku University Hospital, Turku, Finland
| | - Hannu J Aronen
- Department of Diagnostic Radiology, University of Turku, Turku, Finland
- Medical Imaging Centre of Southwest Finland, Turku University Hospital, Turku, Finland
| | - Ivan Jambor
- Department of Diagnostic Radiology, University of Turku, Turku, Finland
- Turku PET Centre, University of Turku, Turku, Finland
- Medical Imaging Centre of Southwest Finland, Turku University Hospital, Turku, Finland
| | - Anant Madabhushi
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
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Schalk SG, Demi L, Bouhouch N, Kuenen MPJ, Postema AW, de la Rosette JJMCH, Wijkstra H, Tjalkens TJ, Mischi M. Contrast-Enhanced Ultrasound Angiogenesis Imaging by Mutual Information Analysis for Prostate Cancer Localization. IEEE Trans Biomed Eng 2016; 64:661-670. [PMID: 28113214 DOI: 10.1109/tbme.2016.2571624] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The role of angiogenesis in cancer growth has stimulated research aimed at noninvasive cancer detection by blood perfusion imaging. Recently, contrast ultrasound dispersion imaging was proposed as an alternative method for angiogenesis imaging. After the intravenous injection of an ultrasound-contrast-agent bolus, dispersion can be indirectly estimated from the local similarity between neighboring time-intensity curves (TICs) measured by ultrasound imaging. Up until now, only linear similarity measures have been investigated. Motivated by the promising results of this approach in prostate cancer (PCa), we developed a novel dispersion estimation method based on mutual information, thus including nonlinear similarity, to further improve its ability to localize PCa. METHODS First, a simulation study was performed to establish the theoretical link between dispersion and mutual information. Next, the method's ability to localize PCa was validated in vivo in 23 patients (58 datasets) referred for radical prostatectomy by comparison with histology. RESULTS A monotonic relationship between dispersion and mutual information was demonstrated. The in vivo study resulted in a receiver operating characteristic (ROC) curve area equal to 0.77, which was superior (p = 0.21-0.24) to that obtained by linear similarity measures (0.74-0.75) and (p <; 0.05) to that by conventional perfusion parameters (≤0.70). CONCLUSION Mutual information between neighboring time-intensity curves can be used to indirectly estimate contrast dispersion and can lead to more accurate PCa localization. SIGNIFICANCE An improved PCa localization method can possibly lead to better grading and staging of tumors, and support focal-treatment guidance. Moreover, future employment of the method in other types of angiogenic cancer can be considered.
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A role for dynamic contrast-enhanced magnetic resonance imaging in predicting tumour radiation response. Br J Cancer 2016; 114:1206-11. [PMID: 27140315 PMCID: PMC4891499 DOI: 10.1038/bjc.2016.110] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/25/2016] [Accepted: 03/22/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Dynamic contrast-enhanced (DCE) MRI may provide prognostic insights into tumour radiation response. This study examined quantitative DCE MRI parameters in rat tumours, as potential biomarkers of tumour growth delay following single high-dose irradiation. METHODS Dunning R3327-AT1 prostate tumours were evaluated by DCE MRI following intravenous injection of Gd-DTPA. The next day tumours were irradiated (single dose of 30 Gy), while animals breathed air (n=4) or oxygen (n=4); two animals were non-irradiated controls. Growth was followed and tumour volume-quadrupling time (T4) was compared with pre-irradiation DCE assessments. RESULTS Irradiation caused significant tumour growth delay (T4 ranged from 28 to 48 days for air-breathing rats, and 40 to 75 days for oxygen-breathing rats) compared with the controls (T4=7 to 9 days). A strong correlation was observed between T4 and extravascular-extracellular volume fraction (ve) irrespective of the gas inhaled during irradiation. There was also a correlation between T4 and volume transfer constant (K(trans)) for the air-breathing group alone. CONCLUSIONS The data provide rationale for expanded studies of other tumour sites, types and progressively patients, and are potentially significant, as many patients undergo contrast-enhanced MRI as part of treatment planning.
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Multiparametric MRI of the anterior prostate gland: clinical–radiological–histopathological correlation. Clin Radiol 2016; 71:405-17. [DOI: 10.1016/j.crad.2016.01.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 08/19/2015] [Accepted: 01/04/2016] [Indexed: 11/19/2022]
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