Tumor Target Volume for Focal Therapy of Prostate Cancer—Does Multiparametric Magnetic Resonance Imaging Allow for a Reliable Estimation?
| Autor: | Naïm Bouazza, Michaël Peyromaure, T. Flam, Frédéric Beuvon, François Cornud, Gaby Khoury, Nicolas Barry Delongchamps, Paul Legmann, Marc Zerbib |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Urology medicine.medical_treatment Prostate cancer Prostate Preoperative Care Medical imaging medicine Humans Effective diffusion coefficient Multiparametric Magnetic Resonance Imaging Aged Retrospective Studies Prostatectomy medicine.diagnostic_test business.industry Prostatic Neoplasms Reproducibility of Results Magnetic resonance imaging Middle Aged equipment and supplies medicine.disease Magnetic Resonance Imaging Tumor Burden medicine.anatomical_structure Radiology business Nuclear medicine human activities Volume (compression) |
| Zdroj: | Journal of Urology. 191:1272-1279 |
| ISSN: | 1527-3792 0022-5347 |
| Popis: | We determined whether endorectal multiparametric magnetic resonance imaging at 1.5 Tesla could predict tumor target volume in the perspective of focal therapy of prostate cancer.A total of 84 consecutive patients underwent multiparametric magnetic resonance imaging before radical prostatectomy. The volume of each suspicious area detected on magnetic resonance imaging and of all surgical histological foci was determined by planimetry. We first used each magnetic resonance imaging sequence (T2-weighted, diffusion weighted and dynamic contrast enhanced) and then the sequence showing the largest tumor area (multiparametric volume). Finally, the largest area of any sequence was used to calculate a target volume according to the volume of a cylinder. Agreement between magnetic resonance imaging and pathological findings was assessed by linear regression and residual analysis.Histology revealed 99 significant tumors with a volume of greater than 0.2 cc and/or a Gleason score of greater than 6. Of the tumors 16 (16.2%) were undetected by multiparametric magnetic resonance imaging. Linear regression analysis showed that tumor volume estimated by T2-weighted or diffusion weighted imaging correlated significantly with pathological volume (r(2) = 0.82 and 0.83, respectively). Residuals from diffusion weighted imaging volume estimations did not significantly differ from 0. Nevertheless, diffusion weighted imaging underestimated pathological volume in 43 of 87 cases (49%) by a mean of 0.56 cc (range 0.005 to 2.84). Multiparametric and target volumes significantly overestimated pathological volume by a mean of 16% and 44% with underestimation in 28 (32%) and 15 cases (17%), respectively. Volume underestimation was significantly higher for tumor foci less than 0.5 cc. The percent of Gleason grade 4 did not influence tumor volume estimation.Magnetic resonance imaging can detect most significant tumors. However, delineating a target volume may require further adjustment before planning magnetic resonance imaging targeted focal treatment. |
| Databáze: | OpenAIRE |
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