Whole-body MRI (WB-MRI) versus axial skeleton MRI (AS-MRI) to detect and measure bone metastases in prostate cancer (PCa)

2010 ◽  
Vol 20 (12) ◽  
pp. 2973-2982 ◽  
Author(s):  
F. E. Lecouvet ◽  
M. Simon ◽  
B. Tombal ◽  
J. Jamart ◽  
B. C. Vande Berg ◽  
...  
2018 ◽  
Vol 29 (3) ◽  
pp. 1221-1230 ◽  
Author(s):  
Eva Dyrberg ◽  
Helle W. Hendel ◽  
Tri Hien Viet Huynh ◽  
Tobias Wirenfeldt Klausen ◽  
Vibeke B. Løgager ◽  
...  

Author(s):  
Fredrik Ottosson ◽  
Eduard Baco ◽  
Peter M. Lauritzen ◽  
Erik Rud

Abstract Objective The aim of this study was to assess the prevalence and distribution of bone metastases in treatment-naïve prostate cancer patients eligible for a metastatic workup using whole-body MRI, and to evaluate the results in light of current guidelines. Methods This single-institution, retrospective study included all patients with treatment-naïve prostate cancer referred to whole-body MRI during 2016 and 2017. All were eligible for a metastatic workup according to the guidelines: PSA > 20 ng/ml and/or Gleason grade group ≥ 3 and/or cT ≥ 2c and/or bone symptoms. The definition of a metastasis was descriptive and based on the original MRI reports. The anatomical location of metastases was registered. Results We included 161 patients with newly diagnosed prostate cancer of which 36 (22%) were intermediate-risk and 125 (78%) were high-risk. The median age and PSA were 71 years (IQR 64–76) and 13 ng/ml (IQR 8–28), respectively. Bone metastases were found in 12 patients (7%, 95% CI: 4–13), and all were high-risk with Gleason grade group ≥ 4. The pelvis was affected in 4 patients, and the spine + pelvis in the remaining 8. No patients demonstrated metastases to the spine without concomitant metastases in the pelvis. Limitations are the small number of metastases and retrospective design. Conclusion This study suggests that the overall prevalence of bone metastases using the current guidelines for screening is quite low. No metastases were seen in the case of Gleason grade group ≤ 3, and further studies should investigate if it necessary to screen non-high-risk patients. Key Points • The overall prevalence of bone metastases was 7% in the case of newly diagnosed intermediate- and high-risk prostate cancer. • The prevalence in high-risk patients was 10%, and no metastases were seen in patients with Gleason grade group ≤ 3. • The pelvic skeleton is the main site, and no metastases occurred in the spine without concomitant pelvic metastases.


2018 ◽  
Vol 159 (35) ◽  
pp. 1433-1440
Author(s):  
István Farkas ◽  
Zsuzsanna Besenyi ◽  
Anikó Maráz ◽  
Zoltán Bajory ◽  
András Palkó ◽  
...  

Abstract: Introduction: The prostate-specific membrane antigen (PSMA) is a transmembrane protein, that is highly expressed on the surface of prostate cancer cells. In the last few years, several PSMA-specific ligands have been developed, that can be successfully used to detect primary prostate cancer, tumor recurrences and metastases as well. Aim: The goal of our work was to examine the clinical application of a 99mtechnetium-labeled PSMA-radiopharmaceutical as part of the routine diagnostics of prostate cancer. Method: We examined 15 male patients with verified prostate adenocarcinoma with suspicion of progression or recurrence of the disease. We performed whole-body PSMA-SPECT/CTs and multiparametric MRIs of the prostate and the pelvic regions within a week. We used 99mTc-mas3-y-nal-k(Sub-KuE) for the PSMA-SPECT scans. The images were visually evaluated by independent observers. The results were compared with the follow-up bone scintigraphies as well. Results: Twenty-two PSMA-positive lesions were found. Nine of them were localized outside, 13 were within the MRI’s field of view. From these 13 lesions, 7 matched with the SPECT/CT results and in 5 cases the MRI images showed no abnormalities. In one case, bone metastasis was suspected on the MRI scan but there was no corresponding pathological tracer uptake on the SPECT images. In two patients, none of the examinations showed signs of prostate malignancy. Four patients had PSMA-positive bone metastases. One of them had a matching PSMA/SPECT and bone scintigraphy result and in one case the PSMA examination showed metastasis in contrast to the negative bone scintigraphy. Conclusion: PSMA-SPECT/CT with 99mTc-mas3-y-nal-k(Sub-KuE) is a promising diagnostic tool. This technique is capable of visualizing bone metastases and it can detect local recurrences and visceral metastases as well. Orv Hetil. 2018; 159(35): 1433–1440.


2021 ◽  
Vol 11 ◽  
Author(s):  
Xiang Liu ◽  
Chao Han ◽  
Yingpu Cui ◽  
Tingting Xie ◽  
Xiaodong Zhang ◽  
...  

ObjectiveTo establish and evaluate the 3D U-Net model for automated segmentation and detection of pelvic bone metastases in patients with prostate cancer (PCa) using diffusion-weighted imaging (DWI) and T1 weighted imaging (T1WI) images.MethodsThe model consisted of two 3D U-Net algorithms. A total of 859 patients with clinically suspected or confirmed PCa between January 2017 and December 2020 were enrolled for the first 3D U-Net development of pelvic bony structure segmentation. Then, 334 PCa patients were selected for the model development of bone metastases segmentation. Additionally, 63 patients from January to May 2021 were recruited for the external evaluation of the network. The network was developed using DWI and T1WI images as input. Dice similarity coefficient (DSC), volumetric similarity (VS), and Hausdorff distance (HD) were used to evaluate the segmentation performance. Sensitivity, specificity, and area under the curve (AUC) were used to evaluate the detection performance at the patient level; recall, precision, and F1-score were assessed at the lesion level.ResultsThe pelvic bony structures segmentation on DWI and T1WI images had mean DSC and VS values above 0.85, and the HD values were <15 mm. In the testing set, the AUC of the metastases detection at the patient level were 0.85 and 0.80 on DWI and T1WI images. At the lesion level, the F1-score achieved 87.6% and 87.8% concerning metastases detection on DWI and T1WI images, respectively. In the external dataset, the AUC of the model for M-staging was 0.94 and 0.89 on DWI and T1WI images.ConclusionThe deep learning-based 3D U-Net network yields accurate detection and segmentation of pelvic bone metastases for PCa patients on DWI and T1WI images, which lays a foundation for the whole-body skeletal metastases assessment.


2020 ◽  
Author(s):  
Leonardino A. Digma ◽  
Christine H. Feng ◽  
Christopher C. Conlin ◽  
Ana E. Rodríguez-Soto ◽  
Kanha Batra ◽  
...  

AbstractBackgroundAccurate imaging of bone metastases is necessary for treatment planning and assessing treatment response. Diffusion-weighted magnetic resonance imaging (DWI) can detect bone metastases, but DWI acquired with echo-planar imaging is susceptible to distortions due to static magnetic field inhomogeneities.PurposeEstimate spatial displacements of bone lesions on DWI. Examine whether distortion-corrected DWI more accurately reflects underlying anatomy.Study TypeRetrospective.Subjects18 patients with prostate cancer bone metastases.Field Strength/Sequence3.0 T; DWI and T2-weighted imaging.AssessmentWe first applied the reverse polarity gradient (RPG) technique to estimate spatial displacements of bone metastasis on DWI. Next, we calculated changes in mutual information (MI) between DWI and T2-weighted images after RPG distortion correction. Further, we annotated skeletal landmarks on DWI and T2-weighted images. RPG was again used to estimate displacements of these landmarks. Lastly, we calculated changes in distance between DWI- and T2-defined landmarks (i.e., changes in error) after RPG distortion correction.Statistical TestsMean and bootstrap-derived confidence intervals were used to summarize variables that estimate bone lesion distortions. Wilcoxon signed-rank tests were used to assess change in MI between DWI and T2-weighted images after RPG.ResultsMean (95% CI) displacement of bone lesions was 5.6 mm (95% CI: 4.8-6.5); maximum displacement was 17.1 mm. Corrected diffusion images were more similar to structural MRI, as evidenced by consistent increases in MI after applying RPG (Wilcoxon signed-rank p<10−13). Like bone metastases, our annotated skeletal landmarks also underwent substantial displacement (average, 6.3 mm). Lastly, RPG led to consistent error reductions between DWI and T2 for each skeletal landmark (mean, [95% CI]): thoracic vertebrae (−3.8 mm, [-4.3,-3.3]), abdominal vertebrae (−1.0 mm, [-1.2,-0.71]), pelvic vertebrae (−0.6 mm, [-1.0,-0.17]), and femoral head (−1.2 mm, [-2.1,-0.4]).Data ConclusionsThese findings support the use of distortion correction techniques to improve localization of bone metastases on DWI.Grant SupportThis work was supported by NIH/NIBIB #K08EB026503, American Society for Radiation Oncology, and the Prostate Cancer Foundation. This work was further supported by the National Institute on Aging T35 grant AG26757 (PI: Dilip V. Jeste, MD, and Alison Moore, MD, MPH), and the Stein Institute for Research on Aging and the Center for Healthy Aging at the University of California, San Diego.


Sign in / Sign up

Export Citation Format

Share Document