2.50
Hdl Handle:
http://hdl.handle.net/10541/69739
Title:
Dynamic contrast-enhanced MRI for prostate cancer localization.
Authors:
Jackson, Andrew; Reinsberg, S A; Sohaib, S A; Charles-Edwards, E M; Jhavar, S; Christmas, T J; Thompson, A C; Bailey, M J; Corbishley, C M; Fisher, C; Leach, Martin O; Dearnaley, David P
Abstract:
Radiotherapy dose escalation improves tumour control in prostate cancer but with increased toxicity. Boosting focal tumour only may allow dose escalation with acceptable toxicity. Intensity-modulated radiotherapy can deliver this, but visualization of the tumour remains limiting. CT or conventional MRI techniques are poor at localizing tumour, but dynamic contrast-enhanced MRI (DCE-MRI) may be superior. 18 patients with prostate cancer had T(2) weighted (T2W) and DCE-MRI prior to prostatectomy. The prostate was sectioned meticulously so as to achieve accurate correlation between imaging and pathology. The accuracy of DCE-MRI for cancer detection was calculated by a pixel-by-pixel correlation of quantitative DCE-MRI parameter maps and pathology. In addition, a radiologist interpreted the DCE-MRI and T2W images. The location of tumour on imaging was compared with histology, and the accuracy of DCE-MRI and T2W images was then compared. Pixel-by-pixel comparison of quantitative parameter maps showed a significant difference between the benign peripheral zone and tumour for the parameters K(trans), v(e) and k(ep). Calculation of areas under the receiver operating characteristic curve showed that the pharmacokinetic parameters were only "fair" discriminators between cancer and benign gland. Interpretation of DCE-MRI and T2W images by a radiologist showed DCE-MRI to be more sensitive than T2W images for tumour localization (50% vs 21%; p = 0.006) and similarly specific (85% vs 81%; p = 0.593). The superior sensitivity of DCE-MRI compared with T2W images, together with its high specificity, is arguably sufficient for its use in guiding radiotherapy boosts in prostate cancer.
Affiliation:
Academic Department of Radiotherapy and Oncology, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, UK. Andrew.Jackson@manchester.ac.uk
Citation:
Dynamic contrast-enhanced MRI for prostate cancer localization. 2009, 82 (974):148-56 Br J Radiol
Journal:
The British Journal of Radiology
Issue Date:
Feb-2009
URI:
http://hdl.handle.net/10541/69739
DOI:
10.1259/bjr/89518905
PubMed ID:
19168692
Type:
Article
Language:
en
ISSN:
1748-880X
Appears in Collections:
All Christie Publications ; Academic Department of Radiation Oncology - ADRO

Full metadata record

DC FieldValue Language
dc.contributor.authorJackson, Andrew-
dc.contributor.authorReinsberg, S A-
dc.contributor.authorSohaib, S A-
dc.contributor.authorCharles-Edwards, E M-
dc.contributor.authorJhavar, S-
dc.contributor.authorChristmas, T J-
dc.contributor.authorThompson, A C-
dc.contributor.authorBailey, M J-
dc.contributor.authorCorbishley, C M-
dc.contributor.authorFisher, C-
dc.contributor.authorLeach, Martin O-
dc.contributor.authorDearnaley, David P-
dc.date.accessioned2009-06-04T14:38:36Z-
dc.date.available2009-06-04T14:38:36Z-
dc.date.issued2009-02-
dc.identifier.citationDynamic contrast-enhanced MRI for prostate cancer localization. 2009, 82 (974):148-56 Br J Radiolen
dc.identifier.issn1748-880X-
dc.identifier.pmid19168692-
dc.identifier.doi10.1259/bjr/89518905-
dc.identifier.urihttp://hdl.handle.net/10541/69739-
dc.description.abstractRadiotherapy dose escalation improves tumour control in prostate cancer but with increased toxicity. Boosting focal tumour only may allow dose escalation with acceptable toxicity. Intensity-modulated radiotherapy can deliver this, but visualization of the tumour remains limiting. CT or conventional MRI techniques are poor at localizing tumour, but dynamic contrast-enhanced MRI (DCE-MRI) may be superior. 18 patients with prostate cancer had T(2) weighted (T2W) and DCE-MRI prior to prostatectomy. The prostate was sectioned meticulously so as to achieve accurate correlation between imaging and pathology. The accuracy of DCE-MRI for cancer detection was calculated by a pixel-by-pixel correlation of quantitative DCE-MRI parameter maps and pathology. In addition, a radiologist interpreted the DCE-MRI and T2W images. The location of tumour on imaging was compared with histology, and the accuracy of DCE-MRI and T2W images was then compared. Pixel-by-pixel comparison of quantitative parameter maps showed a significant difference between the benign peripheral zone and tumour for the parameters K(trans), v(e) and k(ep). Calculation of areas under the receiver operating characteristic curve showed that the pharmacokinetic parameters were only "fair" discriminators between cancer and benign gland. Interpretation of DCE-MRI and T2W images by a radiologist showed DCE-MRI to be more sensitive than T2W images for tumour localization (50% vs 21%; p = 0.006) and similarly specific (85% vs 81%; p = 0.593). The superior sensitivity of DCE-MRI compared with T2W images, together with its high specificity, is arguably sufficient for its use in guiding radiotherapy boosts in prostate cancer.en
dc.language.isoenen
dc.subjectProstate Canceren
dc.subject.meshAdenocarcinoma-
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshContrast Media-
dc.subject.meshGadolinium DTPA-
dc.subject.meshHumans-
dc.subject.meshImage Interpretation, Computer-Assisted-
dc.subject.meshMagnetic Resonance Imaging-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshProstatectomy-
dc.subject.meshProstatic Neoplasms-
dc.subject.meshRadiotherapy Planning, Computer-Assisted-
dc.subject.meshSensitivity and Specificity-
dc.titleDynamic contrast-enhanced MRI for prostate cancer localization.en
dc.typeArticleen
dc.contributor.departmentAcademic Department of Radiotherapy and Oncology, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, UK. Andrew.Jackson@manchester.ac.uken
dc.identifier.journalThe British Journal of Radiologyen

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