Dynamic contrast-enhanced MRI for prostate cancer localization
| Autor: | Cathy Corbishley, Martin O. Leach, Sameer Jhavar, Stefan A. Reinsberg, Michael Bailey, Cyril Fisher, Timothy J. Christmas, Elizabeth M Charles-Edwards, A. Jackson, David P. Dearnaley, S.A. Sohaib, Alan Thompson |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Gadolinium DTPA Male medicine.medical_treatment Contrast Media Adenocarcinoma Sensitivity and Specificity Prostate cancer Prostate Image Interpretation Computer-Assisted medicine Humans Radiology Nuclear Medicine and imaging skin and connective tissue diseases Aged Prostatectomy medicine.diagnostic_test Receiver operating characteristic business.industry Radiotherapy Planning Computer-Assisted Cancer Prostatic Neoplasms Magnetic resonance imaging General Medicine Middle Aged medicine.disease Magnetic Resonance Imaging Radiation therapy medicine.anatomical_structure Dynamic contrast-enhanced MRI Nuclear medicine business |
| Zdroj: | The British journal of radiology. 82(974) |
| ISSN: | 1748-880X |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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