Zonal anatomy of the prostate using magnetic resonance imaging, morphometrics, and radiomic features: impact of age-related changes

2021 ◽  
pp. 20210156
Author(s):  
Sophie Laschkar ◽  
Sarah Montagne ◽  
Eric De Kerviler ◽  
Morgan Roupret ◽  
Olivier Lucidarme ◽  
...  
Keyword(s):  
Specific Antigen ◽  
Posterior Part ◽  
Peripheral Zone ◽  
Transitional Zone ◽  
Age Related ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Adc Map ◽  
Textural Changes ◽  
The Impact

Objective: To evaluate the impact of age on the zonal anatomy of the prostate by MRI using morphometric and textural analysis. Methods: A total of 154 men (mean age: 63 years) who underwent MRI due to a high prostate-specific antigen (PSA) level were included retrospectively. At each MRI examination the following variables were measured: overall dimensions of the prostate (whole gland (WG), transitional zone (TZ), and peripheral zone (PZ)), and thickness of the anterior fibromuscular stroma (AFMS) and the periprostatic venous plexus (PPVP) on T2 weighted images. Identical regions of interest (ROIs) were delineated on the apparent diffusion coefficient (ADC) map on the anterior (horn) and posterior part of the PZ. Textural (TexRAD®) parameter differences between TZ and PZ ROIs on T2 weighted images were analyzed by linear regression. Results were correlated with age (distributed into five decades from 22 to 89 years). Results: Age was positively correlated with PSA level and glandular volumes (WG, TZ, and TZ/WG ratio; p < 0.0001) and was negatively correlated with AFSM and PPVP thickness (p < 0.0001). There was a positive correlation between ADC values of the PZ and age (p = 0.003) and between entropy of the TZ and PZ and age (p < 0.001). Conclusion: Gradual variations in morphologic and textural features of the prostate were observed with age, mainly due to the increase in TZ volume while PZ volume tended to decrease. These modifications resulted in textural changes mainly at the expense of entropy. Advances in knowledge: Entropy could be relevant for studying the process of aging of the prostate.

scholarly journals Nonrigid Registration of Prostate Diffusion-Weighted MRI

2017 ◽  
Vol 2017 ◽  
pp. 1-12 ◽  
Author(s):  
Lei Hao ◽  
Yali Huang ◽  
Yuehua Gao ◽  
Xiaoxi Chen ◽  
Peiguang Wang
Keyword(s):  
Clinical Staging ◽  
Free Form ◽  
Nonrigid Registration ◽  
Diffusion Weighted ◽  
Image Registration Algorithm ◽  
Statistical Experiments ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Weighted Magnetic Resonance Imaging ◽  
Adc Map

Motion and deformation are common in prostate diffusion-weighted magnetic resonance imaging (DWI) during acquisition. These misalignments lead to errors in estimating an apparent diffusion coefficient (ADC) map fitted with DWI. To address this problem, we propose an image registration algorithm to align the prostate DWI and improve ADC map. First, we apply affine transformation to DWI to correct intraslice motions. Then, nonrigid registration based on free-form deformation (FFD) is used to compensate for intraimage deformations. To evaluate the influence of the proposed algorithm on ADC values, we perform statistical experiments in three schemes: no processing of the DWI, with the affine transform approach, and with FFD. The experimental results show that our proposed algorithm can correct the misalignment of prostate DWI and decrease the artifacts of ROI in the ADC maps. These ADC maps thus obtain sharper contours of lesions, which are helpful for improving the diagnosis and clinical staging of prostate cancer.

scholarly journals Changes in prostate apparent diffusion coefficient values during radiotherapy after neoadjuvant hormones

2018 ◽  
Vol 10 (12) ◽  
pp. 359-364
Author(s):  
Andrew McPartlin ◽  
Lucy Kershaw ◽  
Alan McWilliam ◽  
Marcus Ben Taylor ◽  
Clare Hodgson ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Gleason Score ◽  
Prostate Gland ◽  
Specific Antigen ◽  
Predictive Tool ◽  
Significant Difference ◽  
Apparent Diffusion ◽  
Adc Values

Background: Changes in prostate cancer apparent diffusion coefficient (ADC) derived from diffusion-weighted magnetic resonance imaging (MRI) provide a noninvasive method for assessing radiotherapy response. This may be attenuated by neoadjuvant hormone therapy (NA-HT). We investigate ADC values measured before, during and after external beam radiotherapy (EBRT) following NA-HT. Methods: Patients with ⩾T2c biopsy-proven prostate cancer receiving 3 months of NA-HT plus definitive radiotherapy were prospectively identified. All underwent ADC-MRI scans in the week before EBRT, in the third week of EBRT and 8 weeks after its completion. Imaging was performed at 1.5 T. The tumour, peripheral zone (PZ) and central zone (CZ) of the prostate gland were identified and median ADC calculated for each region and time point. Results: Between September and December 2014, 15 patients were enrolled (median age 68.3, range 57–78) with a median Gleason score of 7 (6–9) and prostate-specific antigen (PSA) at diagnosis 14 (3–197) ng/ml. Median period of NA-HT prior to first imaging was 96 days (69–115). All patients completed treatment. Median follow up was 25 months (7–34), with one patient relapsing in this time. Thirteen patients completed all imaging as intended, one withdrew after one scan and another missed the final imaging. PZ and CZ could not be identified in one patient. Median tumour ADC before, during and post radiotherapy was 1.24 × 10−3 mm2/s (interquartile range 0.16 × 10−3 mm2/s), 1.31 × 10−3 mm2/s (0.22 × 10−3 mm2/s), then 1.32 × 10−3 mm2/s (0.13 × 10−3 mm2/s) respectively ( p > 0.05). There was no significant difference between median tumour and PZ or CZ ADC at any point. Gleason score did not correlate with ADC values. Conclusions: Differences in ADC parameters of normal and malignant tissue during EBRT appear attenuated by prior NA-HT. The use of changes in ADC as a predictive tool in this group may have limited utility.

scholarly journals Comparing the accuracy and reliability of detecting intensity of spinal inflammation on STIR sequence with ADC values in axial spondyloarthritis

2019 ◽  
Author(s):  
Ho Yin Chung ◽  
Tommy Tsang Cheung ◽  
Vince Wing Hang Lau ◽  
Kam Ho Lee ◽  
Florence King Pui Chan ◽  
...  
Keyword(s):  
Axial Spondyloarthritis ◽  
Region Of Interest ◽  
Regression Analyses ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Stir Sequence ◽  
Spinal Mri ◽  
Adc Map ◽  
Potential Factors ◽  
Spinal Inflammation

Abstract Objective To compare the accuracy and reliability of detecting the intensity of spinal inflammation on short tau inversion recovery (STIR) with the apparent diffusion coefficient (ADC) values of the active MRI lesions in axial spondyloarthritis (axSpA). Materials and methods Fifty active lesions in STIR sequence of spinal MRI were identified. With reference to sites of active lesions in STIR, the corresponding region of interest (ROI) on ADC map was drawn to determine the maximum ADC (ADCmax), mean ADC (ADCmean), normalized maxium (nADCmax) and mean (nADCmean). Four independent readers scored the identified active lesions as “intense” or “non-intense” according to the SPARCC MRI index. They were compared to various ADC parameters for assessment of accuracy and reliability. Regression analyses were used to adjust potential factors that could affect ADC. Results Significant differences were found in ADCmax between “intense” and “non-intense” lesions scored by 3 of the 4 readers (1405.7±271.4 vs 1165.8±223.8, p=0.01; 1420.7±272.1 vs 1209.0±248.5, p=0.01; 1438.0±307.2 vs 1213.6±231.0, p=0.01). Only 1 reader could differentiate a difference in “intense” and “non-intense” lesions with respect to ADCmean (899.2±248.3 vs 711.0±222.6, p=0.01) and nADCmean (4.4±2.1 vs 3.4±1.4, p=0.05). Inter-reader agreements were slight to moderate (Kappa=0.07-0.45). Reliability substantially improved when only the lowest and highest 25th percentiles of ADC values were included (Kappa=0.17-0.75). Regression analyses showed the “intense” lesions were associated with higher ADC values after adjustment for confounders. Conclusion Reading of STIR MRI is limited by the lack of ability in differentiating subtle differences of spinal inflammation. ADC could be an alternative method.

scholarly journals Hepatic sclerosed hemangioma and sclerosing cavernous hemangioma: a radiological study

2021 ◽  
Author(s):  
Cuiyu Jia ◽  
Guangxue Liu ◽  
Xinxin Wang ◽  
Dawei Zhao ◽  
Ruili Li ◽  
...  
Keyword(s):  
Cavernous Hemangioma ◽  
Liver Parenchyma ◽  
Weighted Image ◽  
Mri Features ◽  
Significant Difference ◽  
Apparent Diffusion ◽  
Cavernous Hemangiomas ◽  
Adc Values ◽  
Adc Map ◽  
Dynamic Enhancement

Abstract Purpose To investigate and compare the CT and MRI features of hepatic sclerosed hemangioma (HSH) and sclerosing cavernous hemangioma (SCH). Materials and methods Twelve HSH cases and 36 SCH cases were included, the imaging findings on CT (9 HSH and 34 SCH) and MRI (8 HSH and 10 SCH) were analyzed. Qualitative image analysis included the location, size, shape, capsular retraction, density, calcification, signal intensity on T1-weighted image (T1WI) and T2-weighted image (T2WI), presence of diffusion restriction, apparent diffusion coefficient (ADC) map, transient hepatic attenuation difference around the lesion, and the dynamic enhancement patterns. Results The presence of liver cirrhosis in patients with HSH (3/12) was higher than SCH (1/36) (P = 0.043). The morphology appearance before enhancement showed no significant difference between HSH and SCH. Moreover, SCH had a stronger trend of centripetal enhancement patterns of cavernous hemangiomas (83.3%) compared to HSH (25%) (P < 0.001). Due to more frequent atypical enhancement features, containing rim-like enhancement, no enhancement, and peripheral heterogeneous enhancement, the misdiagnosis rate of HSH (75%) was significantly higher than that of SCH (16.7%) (P < 0.001). Furthermore, the ADC values of HSH and SCH were both higher than that of the surrounding liver parenchyma (P = 0.009, P = 0.002); however, there was no significant difference in ADC values between themselves (P = 0.613). Conclusion SCH showed the same trend of centripetal enhancement characteristics as typical hemangioma, while HSH exhibited atypical enhancement features due to complete sclerosis. Higher ADC values might contribute to the identification of atypical HSH and SCH from malignancies.

Effects of cediranib (VEGF signaling inhibitor) on edema in newly diagnosed glioblastoma patients during initial chemoradiation.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 2012-2012 ◽  
Author(s):  
Pavlina Polaskova ◽  
Marco C Pinho ◽  
Jayashree Kalpathy-Cramer ◽  
Alexander R Guimaraes ◽  
Patrick Y. Wen ◽  
...  
Keyword(s):  
Antiangiogenic Therapy ◽  
Control Group ◽  
Newly Diagnosed ◽  
Post Contrast ◽  
Diffusion Weighted Images ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Newly Diagnosed Glioblastoma ◽  
The Right ◽  
The Impact

2012 Background: A significant benefit of antiangiogenic therapy is control of brain edema. We evaluated the impact of adding cediranib to standard chemoradiation (CRT) on peritumoral edema in patients with newly diagnosed glioblastoma(GBM) during the initial 6 weeks of CRT. Methods: Two cohorts of patients were enrolled in two clinical trials. The control group (N=13) received radiation for 6 weeks plus temozolomide. The cediranib (CED) group received standard CRT plus daily cediranib (N=34). MRIs were performed at baseline and weekly during CRT. Volumes of interest (VOIs) were drawn outlining the enhancing tumor on T1-weighted post contrast images and the abnormal FLAIR hyperintensity. ADC (apparent diffusion coefficient) maps were calculated from diffusion-weighted images and histograms of the distribution of ADC values created for each visit using the baseline FLAIR VOI to characterize the peritumoraledema. Patients were on stable or decreasing doses of steroids. Results: In the CED group, T1 and FLAIR VOI decreased during CRT vs controls where T1 VOI did not change and FLAIR VOI increased. By the end of CRT, the mode of the ADC histogram in the CED group shifted to the left while the mode of the controls shifted to the right. The skewness, a measure of asymmetry of the distribution, increased in the CED group and decreased in controls. Conclusions: In patients with newly diagnosed GBM treated with CRT and cediranib, tumor volume decreased on T1 and FLAIR images whereas the FLAIR volume significantly increased in the control group suggesting increased edema. The shift of mode to the right and decreasing skewness in controls (indicating an increase in the proportion of very high ADC values) suggests that adding cediranibprevented the development of edema and contributed to the resolution of existing edema. Preventing the edema by adding anti-VEGF treatment may improve the tolerability of CRT for GBM patients. [Table: see text]

Impact of mandated prospectively reported apparent diffusion coefficient values on the rates of positivity for clinically significant prostate cancer by PI-RADS score

2020 ◽  
pp. 028418512091561
Author(s):  
Hiram Shaish ◽  
Randy Casals ◽  
Firas Ahmed ◽  
Jasnit Makkar ◽  
Sven Wenske
Keyword(s):  
Prostate Cancer ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Chi Square ◽  
Apparent Diffusion Coefficient Values ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Clinically Significant ◽  
Magnetic Resonance Imaging Mri ◽  
The Impact

Background Prior research has shown that retrospectively measured apparent diffusion coefficient (ADC) of prostate magnetic resonance imaging (MRI) lesions is associated with clinically significant prostate cancer (csPCa) on targeted biopsy suggesting that ADC should be measured and reported prospectively. Purpose To assess the impact of mandatory prospective measurement of ADC on the rates of positivity across PI-RADS scores for csPCa. Material and Methods Consecutive patients who underwent ultrasound (US)-MRI fusion prostate biopsy from August 2018 to July 2019 and who had prospectively reported ADC were compared to control patients who did not. Rates of positivity by PI-RADS category were computed and compared using Chi-square. Multivariable regression was performed. Results In total, 126 patients (median age 65 years) with 165 prostate lesions (19, 51, 70, and 25 PI-RADS 2, 3, 4, and 5, respectively) and prospectively reported ADC values were compared to 113 control patients (median age 66 years) with 157 prostate lesions (17, 42, 64, and 34 PI-RADS 2, 3, 4, and 5, respectively). Rates of positivity across PI-RADS scores were similar between the two cohorts; 11%, 25%, 55%, and 76% and 0%, 21%, 56%, and 62% for PI-RADS 2, 3, 4, and 5 in the test and control cohorts, respectively (Chi-square P = 0.78). Multivariate logistic regression showed no significant association between the presence of prospectively measured ADC and csPCa (odds ratio 1.1, 95% confidence interval 0.7–1.7, P = 0.82). Conclusion Prospective ADC measurement may not impact PI-RADS category assignments or positivity rates for csPCa under current guidelines. Future versions of PI-RADS may need to incorporate ADC into scoring rules to realize their potential.

scholarly journals Heritability of Prostate-Specific Antigen and Relationship with Zonal Prostate Volumes in Aging Twins*

2000 ◽  
Vol 85 (3) ◽  
pp. 1272-1276
Author(s):  
Aruna Bansal ◽  
Darrell K. Murray ◽  
James T. Wu ◽  
Robert A. Stephenson ◽  
Richard G. Middleton ◽  
...  
Keyword(s):  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Peripheral Zone ◽  
Monozygotic Twin ◽  
Total Serum ◽  
Free Psa ◽  
Two Factors ◽  
Total Psa ◽  
The Impact

Abstract Both benign prostatic hyperplasia and prostate-specific antigen (PSA) have been shown to increase with age and with prostate volume in men, but the influence of heredity on these relationships is not completely understood. This study has two aims: 1) to investigate the inter-relationships of age, PSA, and various zonal measurements in the prostate; and 2) to assess the impact of heritable influences on total PSA. Eighty-four monozygotic twin pairs and 83 dizygotic twin pairs were studied, and serum total PSA, free PSA, and PSA-∝1-antichymotrypsin were measured. Their prostate volumes [total (TV), transition zone (TZ), and peripheral zone) were quantitated using transrectal ultrasound. Total PSA is significantly correlated with all zonal prostate measurements (TZ, peripheral zone, TV, and TZ/TV) and with age. When linear regression was applied, only age and TZ were retained in the final model. The proportion of variability in total PSA explained by these two factors, however, is below 24%. In contrast, estimates of heritability show that approximately 45% of the variability in total PSA can be explained by inherited factors. Whereas age and TZ are linearly related to total PSA, their influence is much less than that of familial and genetic factors. It is uncertain whether these factors predispose also to prostate cancer or if they are independent of those, whether they confound the accuracy of using total serum PSA level as a diagnostic tool.

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