Salvage radiotherapy (SR) in patients (pts) with prostate cancer (PC) and rising prostate specific antigen (PSA) after radical prostatectomy (RP): Results from a single-center study

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14556-14556
Author(s):  
T. Wiegel ◽  
G. Lohm ◽  
S. Hoecht ◽  
D. Bottke ◽  
K. Neumann ◽  
...  
Keyword(s):  
Specific Antigen ◽  
Three Dimensional ◽  
Area Under The Curve ◽  
Surgical Margin ◽  
Conformal Radiotherapy ◽  
Roc Curves ◽  
Tumor Stage ◽  
Published Data ◽  
Therapeutic Success ◽  
The Impact

14556 Background: In pts with PC and biochemical relapse after RP SR is well established. However, the significance of pre-radiotherapeutic variables for guidance of treatment decisions is less clear. We analyzed prognostic factors in a large cohort of pts treated with SR after RP. Methods: 163 pts with PC and persisting PSA-levels (n = 60) or PSA-elevation following undetectable PSA-levels (n = 103) after RP received three-dimensional conformal radiotherapy (RT). None received androgen depriving therapy between prostatectomy and start of RT. We evaluated the impact of age, stage, surgical margin status (SMS), Gleason score and PSA-kinetics by survival and regression analysis. Biochemical progression (BP) was defined as PSA-increases at 3 consecutive time points after the post RT nadir. To detect thresholds for significant prognostic variables, we calculated receiver operating characteristic (ROC) curves. Results: Medians for pre-RT variables were: 11.97 ng/ml for pre-prostatectomy PSA (Pre-OP PSA), 5.4 months for PSA doubling time (PSADT) and 0.339 ng/ml for pre-radiotherapy PSA (Pre-RT PSA). Probability for a projected 4-year PFS was 50% (median follow-up: 33.5 months). Logistic regression revealed a significant impact on the probability of BP for Pre-OP PSA (p = 0.036), PSADT (p = 0.024) and tumor-stage (p = 0.043), whereas Pre-RT PSA and SMS had a significant impact on achievement of undetectable post-RT PSA (p = 0.009 and p = 0.028 respectively). Analysis of ROC-curves for Pre-OP PSA, Pre-RT PSA, PSADT revealed an area under the curve not exceeding 0.704 for any of these parameters. Conclusions: By analyzing ROC-curves we could not detect clear thresholds for PSA kinetic variables. In accordance with recently published data we found similar independent significant variables predicting a therapeutic success. However, we observed a lower median Pre-RT PSA and a higher probability of PFS in our patient cohort. This suggests, that early radiotherapeutic intervention improves PFS. No significant financial relationships to disclose.

scholarly journals Strategies to evaluate the impact of rectal volume on prostate motion during three-dimensional conformal radiotherapy for prostate cancer

2016 ◽  
Vol 49 (1) ◽  
pp. 17-20 ◽  
Author(s):  
Ana Paula Diniz Fortuna Poli ◽  
Rodrigo Souza Dias ◽  
Adelmo José Giordani ◽  
Helena Regina Comodo Segreto ◽  
Roberto Araujo Segreto
Keyword(s):  
Prostate Cancer ◽  
Three Dimensional ◽  
Conformal Radiotherapy ◽  
Prostate Motion ◽  
Rectal Volume ◽  
Three Dimensional Conformal Radiotherapy ◽  
Interfraction Motion ◽  
The Impact ◽  
Anterior Posterior ◽  
3D Crt

Abstract Objective: To evaluate the rectal volume influence on prostate motion during three-dimensional conformal radiotherapy (3D-CRT) for prostate cancer. Materials and Methods: Fifty-one patients with prostate cancer underwent a series of three computed tomography scans including an initial planning scan and two subsequent scans during 3D-CRT. The organs of interest were outlined. The prostate contour was compared with the initial CT images considering the anterior, posterior, superior, inferior and lateral edges of the organ. Variations in the anterior limits and volume of the rectum were assessed and correlated with prostate motion in the anteroposterior direction. Results: The maximum range of prostate motion was observed in the superoinferior direction, followed by the anteroposterior direction. A significant correlation was observed between prostate motion and rectal volume variation ( p = 0.037). A baseline rectal volume superior to 70 cm3 had a significant influence on the prostate motion in the anteroposterior direction ( p = 0.045). Conclusion: The present study showed a significant interfraction motion of the prostate during 3D-CRT with greatest variations in the superoinferior and anteroposterior directions, and that a large rectal volume influences the prostate motion with a cutoff value of 70 cm3. Therefore, the treatment of patients with a rectal volume > 70 cm3 should be re-planned with appropriate rectal preparation.

scholarly journals Convolutional Neural Network for Breast and Thyroid Nodules Diagnosis in Ultrasound Imaging

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Xiaowen Liang ◽  
Jinsui Yu ◽  
Jianyi Liao ◽  
Zhiyi Chen
Keyword(s):  
Predictive Value ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Diagnostic Efficiency ◽  
Clinical Value ◽  
Data Set ◽  
Multiple Organs ◽  
Significant Difference ◽  
Segmented Images ◽  
The Impact

Objective. The incidence of superficial organ diseases has increased rapidly in recent years. New methods such as computer-aided diagnosis (CAD) are widely used to improve diagnostic efficiency. Convolutional neural networks (CNNs) are one of the most popular methods, and further improvements of CNNs should be considered. This paper aims to develop a multiorgan CAD system based on CNNs for classifying both thyroid and breast nodules and investigate the impact of this system on the diagnostic efficiency of different preprocessing approaches. Methods. The training and validation sets comprised randomly selected thyroid and breast nodule images. The data were subgrouped into 4 models according to the different preprocessing methods (depending on segmentation and the classification method). A prospective data set was selected to verify the clinical value of the CNN model by comparison with ultrasound guidelines. Diagnostic efficiency was assessed based on receiver operating characteristic (ROC) curves. Results. Among the 4 models, the CNN model using segmented images for classification achieved the best result. For the validation set, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and area under the curve (AUC) of our CNN model were 84.9%, 69.0%, 62.5%, 88.2%, 75.0%, and 0.769, respectively. There was no statistically significant difference between the CNN model and the ultrasound guidelines. The combination of the two methods achieved superior diagnostic efficiency compared with their use individually. Conclusions. The study demonstrates the probability, feasibility, and clinical value of CAD in the ultrasound diagnosis of multiple organs. The use of segmented images and classification by the nature of the disease are the main factors responsible for the improvement of the CNN model. Moreover, the combination of the CNN model and ultrasound guidelines results in better diagnostic performance, which will contribute to the improved diagnostic efficiency of CAD systems.

The impact of image-guided radiotherapy (IGRT) for prostate cancer (PC) on radiotherapy (RT)-related acute toxicities and prostate-specific antigen (PSA) kinetics.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15110-e15110 ◽  
Author(s):  
Darren M. C. Poon ◽  
CM Leung ◽  
CM Chu ◽  
WY Lee ◽  
Louis Lee ◽  
...  
Keyword(s):  
Image Guidance ◽  
Prostate Gland ◽  
Specific Antigen ◽  
Three Dimensional ◽  
Intensity Modulated Radiotherapy ◽  
Image Guided Radiotherapy ◽  
Psa Kinetics ◽  
Significant Difference ◽  
Pre Treatment ◽  
The Impact

e15110 Background: IGRT for PC could potentially improve the therapeutic ratio by enhancing accuracy of delivery of radiation to the prostate gland. Our aim is to compare the treatment outcomes in terms of RT-related acute toxicities and PSA kinetics of PC patients (pts) undergoing radical intensity-modulated radiotherapy (IMRT) with or without image-guidance. Methods: A cohort of 21 consecutive pts treated by IGRT (I) from January 2010, when the IGRT system was introduced in our institution, was compared with an immediately precedent cohort of 21 pts receiving IMRT without image-guidance (Non-I). The prescription dose (76Gy in 38 fractions) and the treatment margins were the same between the 2 groups (gps). In the I gp, daily online verification and correction of treatment position was performed with reference to image registration of the daily pre-treatment on-board imaging with the corresponding digitally reconstructed radiographs, based on three-dimensional matching of three intra-prostatic fiducial markers. Androgen deprivation therapy was not used in both gps. Acute toxicities were scored weekly during the course of RT according to the Common Terminology Criteria for Adverse Events Version 4.02. The pre- and the post-RT PSA within 6 months after completion of RT were obtained. The PSA halving time (PSAHT) was calculated by first order kinetics. Results: There was no statistically significant difference regarding the baseline clinical characteristics (age, PSA at diagnosis, Gleason score, T staging) between the gps. No grade 3 or 4 acute genitourinary (GU) or gastrointestinal (GI) toxicities was encountered in either gps. Acute grade 1 or 2 GI toxicities were significantly less frequent in the I gp (23.8% vs 81.0%, p=0.001), and their median duration of such toxicity were also significantly shorter (0.33 week vs 1.38 week, p=0.004).The frequencies of acute grade 1 or 2 GU toxicities were comparable between both gps (66.6% vs 81.0%, p=0.45).The I gp had a shorter median PSAHT than the non-I gp (3.36 week vs 5.49 week, p=0.09). Conclusions: IGRT is effective in reducing acute GI toxicities in treatment of PC, and may have more favorable PSA kinetics.

scholarly journals Advanced Imaging for the Early Diagnosis of Local Recurrence Prostate Cancer after Radical Prostatectomy

2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Valeria Panebianco ◽  
Flavio Barchetti ◽  
Daniela Musio ◽  
Francesca De Felice ◽  
Camilla Proietti ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Local Recurrence ◽  
Locoregional Recurrence ◽  
Specific Antigen ◽  
Cochrane Library ◽  
Published Data ◽  
Advanced Imaging ◽  
Pet Ct ◽  
The Impact

Currently the diagnosis of local recurrence of prostate cancer (PCa) after radical prostatectomy (RT) is based on the onset of biochemical failure which is defined by two consecutive values of prostate-specific antigen (PSA) higher than 0.2 ng/mL. The aim of this paper was to review the current roles of advanced imaging in the detection of locoregional recurrence. A nonsystematic literature search using the Medline and Cochrane Library databases was performed up to November 2013. Bibliographies of retrieved and review articles were also examined. Only those articles reporting complete data with clinical relevance for the present review were selected. This review article is divided into two major parts: the first one considers the role of PET/CT in the restaging of PCa after RP; the second part is intended to provide the impact of multiparametric-MRI (mp-MRI) in the depiction of locoregional recurrence. Published data indicate an emerging role for mp-MRI in the depiction of locoregional recurrence, while the performance of PET/CT still remains unclear. Moreover Mp-MRI, thanks to functional techniques, allows to distinguish between residual glandular healthy tissue, scar/fibrotic tissue, granulation tissue, and tumour recurrence and it may also be able to assess the aggressiveness of nodule recurrence.

scholarly journals The Impact of Pathologic Upgrading of Gleason Score 7 Prostate Cancer on the Risk of the Biochemical Recurrence after Radical Prostatectomy

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Juhyun Park ◽  
Sangjun Yoo ◽  
Min Chul Cho ◽  
Min Hyun Cho ◽  
Chang Wook Jeong ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Biochemical Recurrence ◽  
Specific Antigen ◽  
Surgical Margin ◽  
Rank Test ◽  
Kaplan Meier ◽  
Significant Difference ◽  
The Mean ◽  
The Impact

Objective. To investigate the impact of pathologic upgrading of Gleason score (GS) 7 prostate cancer on the risk of the biochemical recurrence. Materials and Methods. A total of 1678 patients with postoperative GS 7 prostate cancer without lymph node metastasis were reviewed retrospectively. The patients were categorized into four groups depending on pathologic upgrading: upgraded GS 3+4, nonupgraded GS 3+4, upgraded GS 4+3, and nonupgraded GS 4+3. Kaplan-Meier multivariate model was created. Results. The mean age was significantly higher in the nonupgraded GS 4+3 group than in other groups, whereas the mean prostate-specific antigen (PSA) level was lower in the upgraded GS 3+4 group. Pathologic findings, such as extracapsular extension, seminal vesical invasion, and the surgical margin rate, were different from each other. Five-year biochemical recurrence-free survival rate was 85%, 73%, 69%, and 60% in upgraded GS 3+4, nonupgraded GS 3+4, upgraded GS 4+3, and nonupgraded GS 4+3 group, respectively. There was significant difference between the nonupgraded 4+3 and upgraded 4+3 group, as well as between upgraded 3+4 and nonupgraded 3+4 group. However, the two middle patient groups, that is, the nonupgraded GS 3+4 group and the upgraded GS 4+3 group, did not show the statistical difference (Log-rank test, p value = 0.259). Conclusion. The information on pathologic upgrading in the biopsy reports of patients could help to provide more detailed analysis for the biochemical recurrence of GS 7 prostate cancer.

scholarly journals Random and systematic set-up errors in three-dimensional conformal radiotherapy – impact on planning target volume margins: the experience of the Radiation Oncology Centre of Sassari

2013 ◽  
Vol 13 (2) ◽  
pp. 166-179
Author(s):  
Matteo Tamponi ◽  
Angela Poggiu ◽  
Maria F. Dedola ◽  
Rossella Madeddu ◽  
Antonella Carnevale ◽  
...  
Keyword(s):  
Planning Target Volume ◽  
Three Dimensional ◽  
Conformal Radiotherapy ◽  
Target Volume ◽  
Patient Specific ◽  
Geometric Uncertainties ◽  
Three Dimensional Conformal Radiotherapy ◽  
Set Up ◽  
Oncology Centre ◽  
The Impact

AbstractPurposeGeometric uncertainties limit the accuracy of three-dimensional conformal radiotherapy treatments. This study aims to evaluate typical random and systematic set-up errors and analyse the impact of no action level (NAL) correction protocol on systematic set-up errors and clinical target volume (CTV)–planning target volume (PTV) margins.Materials and methodsA total 668 pairs of orthogonal electronic portal images were compared with digitally reconstructed radiographs from computed tomography planning scans for 100 patients consecutively treated during 2011. Patients were divided into groups depending on the treated anatomical region. Patient-specific and population random and systematic set-up errors were calculated. Impact of application of NAL correction protocol on systematic set-up errors and CTV–PTV expansions were evaluated.ResultsPopulation set-up errors resulted from about 1 mm in head and neck to 2–3 mm in prostate, rectum, lung, breast and gynaecological districts. Patient-specific systematic set-up errors were higher for breast and gynaecological districts and application of NAL correction protocol gave significant reductions, even higher than 30%. Calculated CTV–PTV margins ranged from 10 mm on left–right direction for prostate to 20 mm on superior–inferior direction for lung.ConclusionsSet-up errors resulted reasonably controlled and application of NAL correction protocol could further improve the level of accuracy. However, the NAL application alone did not seem to add any substantial benefit on CTV–PTV total margins without the adoption of corrective strategies to reduce other important uncertainties limiting accuracy of three-dimensional conformal radiotherapy.

Comparison of the 5-Year Outcome and Morbidity of Three-Dimensional Conformal Radiotherapy Versus Transperineal Permanent Iodine-125 Implantation for Early-Stage Prostatic Cancer

1999 ◽  
Vol 17 (2) ◽  
pp. 517-517 ◽  
Author(s):  
Michael J. Zelefsky ◽  
Kent E. Wallner ◽  
C. Clifton Ling ◽  
Adam Raben ◽  
Timothy Hollister ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Early Stage ◽  
Specific Antigen ◽  
Three Dimensional ◽  
Conformal Radiotherapy ◽  
Urinary Symptoms ◽  
Psa Relapse ◽  
Iodine 125 ◽  
Grade 3 ◽  
3D Crt

PURPOSE: To compare the prostate-specific antigen (PSA) relapse-free survival outcome and incidence of late toxicity for patients with early-stage prostate cancer treated at a single institution with either three-dimensional conformal radiotherapy (3D-CRT) or transperineal permanent implantation (TPI) with iodine-125 seeds. MATERIALS AND METHODS: Patients with favorable-risk prostate cancer, defined as a pretreatment PSA of less than or equal to 10.0 ng/mL, Gleason score of 6 or lower, and stage less than or equal to T2b, were selected for this analysis. Between 1989 and 1996, 137 such patients were treated with 3D-CRT and 145 with TPI. The median ages of the 3D-CRT and TPI groups were 68 years and 64 years, respectively. The median dose of 3D-CRT was 70.2 Gy, and the median implant dose was 150 Gy. Prostate-specific antigen relapse was defined according to the American Society of Therapeutic Radiation Oncology Consensus Statement, and toxicity was graded according to the Radiation Therapy Oncology Group morbidity scoring scale. The median follow-up times for the 3D-CRT and TPI groups were 36 and 24 months, respectively. RESULTS: Eleven patients (8%) in the 3D-CRT group and 12 patients (8%) in the TPI group developed a biochemical relapse. The 5-year PSA relapse-free survival rates for the 3D-CRT and the TPI groups were 88% and 82%, respectively (P = .09). Protracted grade 2 urinary symptoms were more prevalent among patients treated with TPI compared with 3D-CRT. Grade 2 urinary toxicity, which was manifest after the implant and persisted for more than 1 year after this procedure, was observed in 45 patients (31%) in the TPI group. In these 45 patients, the median duration of grade 2 urinary symptoms was 23 months (range, 12 to 70 months). On the other hand, acute grade 2 urinary symptoms resolved within 4 to 6 weeks after completion of 3D-CRT, and the 5-year actuarial likelihood of late grade 2 urinary toxicity for the 3D-CRT group was only 8%. The 5-year actuarial likelihood of developing a urethral stricture (grade 3 urinary toxicity) for the 3D-CRT and TPI groups was 2% and 12%, respectively (P < .0002). Of 45 patients who developed grade 2 or higher urinary toxicity after TPI, the likelihood of resolution or significant improvement of these symptoms at 36 months from onset was 59%. The 5-year likelihood of grade 2 late rectal toxicity for the 3D-CRT and TPI patients was similar (6% and 11%, respectively; P = .97). No patient in either group developed grade 3 or higher late rectal toxicity. The 5-year likelihood of posttreatment erectile dysfunction among patients who were initially potent before therapy was 43% for the 3D-CRT group and 53% for the TPI group (P = .52). CONCLUSION: Both 3D-CRT and TPI are associated with an excellent PSA outcome for patients with early-stage prostate cancer. Urinary toxicities are more prevalent for the TPI group and subsequently resolve or improve in most patients. In addition to evaluating long-term follow-up, future comparisons will require detailed quality-of-life assessments to further determine the impact of these toxicities on the overall well-being and quality of life of the individual patient.

Automated Detection and Classification of Pavement Distresses using 3D Pavement Surface Images and Deep Learning

2021 ◽  
pp. 036119812110074
Author(s):  
Rohit Ghosh ◽  
Omar Smadi
Keyword(s):  
Deep Learning ◽  
Data Augmentation ◽  
Three Dimensional ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Validation Dataset ◽  
Accurate Identification ◽  
Pavement Distresses ◽  
High Level

Pavement distresses lead to pavement deterioration and failure. Accurate identification and classification of distresses helps agencies evaluate the condition of their pavement infrastructure and assists in decision-making processes on pavement maintenance and rehabilitation. The state of the art is automated pavement distress detection using vision-based methods. This study implements two deep learning techniques, Faster Region-based Convolutional Neural Networks (R-CNN) and You Only Look Once (YOLO) v3, for automated distress detection and classification of high resolution (1,800 × 1,200) three-dimensional (3D) asphalt and concrete pavement images. The training and validation dataset contained 625 images that included distresses manually annotated with bounding boxes representing the location and types of distresses and 798 no-distress images. Data augmentation was performed to enable more balanced representation of class labels and prevent overfitting. YOLO and Faster R-CNN achieved 89.8% and 89.6% accuracy respectively. Precision-recall curves were used to determine the average precision (AP), which is the area under the precision-recall curve. The AP values for YOLO and Faster R-CNN were 90.2% and 89.2% respectively, indicating strong performance for both models. Receiver operating characteristic (ROC) curves were also developed to determine the area under the curve, and the resulting area under the curve values of 0.96 for YOLO and 0.95 for Faster R-CNN also indicate robust performance. Finally, the models were evaluated by developing confusion matrices comparing our proposed model with manual quality assurance and quality control (QA/QC) results performed on automated pavement data. A very high level of match to manual QA/QC, namely 97.6% for YOLO and 96.9% for Faster R-CNN, suggest the proposed methodology has potential as a replacement for manual QA/QC.

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