scholarly journals Multiparametric MRI - local staging of prostate cancer and beyond

2019 ◽  
Vol 53 (2) ◽  
pp. 159-170 ◽  
Author(s):  
Iztok Caglic ◽  
Viljem Kovac ◽  
Tristan Barrett
Keyword(s):  
Prostate Cancer ◽  
Imaging Modality ◽  
Imaging Techniques ◽  
Locally Advanced ◽  
Multiparametric Mri ◽  
Bone Involvement ◽  
Superior Performance ◽  
Whole Body ◽  
Clinical Prognosis ◽  
Local Staging

Abstract Background Accurate local staging is critical for treatment planning and prognosis in patients with prostate cancer (PCa). The primary aim is to differentiate between organ-confined and locally advanced disease with the latter carrying a worse clinical prognosis. Multiparametric MRI (mpMRI) is the imaging modality of choice for the local staging of PCa and has an incremental value in assessing pelvic nodal disease and bone involvement. It has shown superior performance compared to traditional staging based on clinical nomograms, and provides additional information on the site and extent of disease. MRI has a high specificity for diagnosing extracapsular extension (ECE), seminal vesicle invasion (SVI) and lymph node (LN) metastases, however, sensitivity remains poor. As a result, extended pelvic LN dissection remains the gold standard for assessing pelvic nodal involvement, and there has been recent progress in developing advanced imaging techniques for more distal staging. Conclusions T2W-weighted imaging is the cornerstone for local staging of PCa. Imaging at 3T and incorporating both diffusion weighted and dynamic contrast enhanced imaging can further increase accuracy. “Next generation” imaging including whole body MRI and PET-MRI imaging using prostate specific membrane antigen (68Ga-PSMA), has shown promising for assessment of LN and bone involvement as compared to the traditional work-up using bone scintigraphy and body CT.

scholarly journals Localising occult prostate cancer metastasis with advanced imaging techniques (LOCATE trial): a prospective cohort, observational diagnostic accuracy trial investigating whole–body magnetic resonance imaging in radio-recurrent prostate cancer

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sola Adeleke ◽  
Arash Latifoltojar ◽  
Harbir Sidhu ◽  
Myria Galazi ◽  
Taimur T. Shah ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Cost Effectiveness ◽  
Imaging Techniques ◽  
Whole Body ◽  
Conventional Imaging ◽  
Biochemical Relapse ◽  
Reference Standard ◽  
Resonance Imaging ◽  
Body Magnetic Resonance Imaging

Abstract Background Accurate whole-body staging following biochemical relapse in prostate cancer is vital in determining the optimum disease management. Current imaging guidelines recommend various imaging platforms such as computed tomography (CT), Technetium 99 m (99mTc) bone scan and 18F-choline and recently 68Ga-PSMA positron emission tomography (PET) for the evaluation of the extent of disease. Such approach requires multiple hospital attendances and can be time and resource intensive. Recently, whole-body magnetic resonance imaging (WB-MRI) has been used in a single visit scanning session for several malignancies, including prostate cancer, with promising results, providing similar accuracy compared to the combined conventional imaging techniques. The LOCATE trial aims to investigate the application of WB-MRI for re-staging of patients with biochemical relapse (BCR) following external beam radiotherapy and brachytherapy in patients with prostate cancer. Methods/design The LOCATE trial is a prospective cohort, multi-centre, non-randomised, diagnostic accuracy study comparing WB-MRI and conventional imaging. Eligible patients will undergo WB-MRI in addition to conventional imaging investigations at the time of BCR and will be asked to attend a second WB-MRI exam, 12-months following the initial scan. WB-MRI results will be compared to an enhanced reference standard comprising all the initial, follow-up imaging and non-imaging investigations. The diagnostic performance (sensitivity and specificity analysis) of WB-MRI for re-staging of BCR will be investigated against the enhanced reference standard on a per-patient basis. An economic analysis of WB-MRI compared to conventional imaging pathways will be performed to inform the cost-effectiveness of the WB-MRI imaging pathway. Additionally, an exploratory sub-study will be performed on blood samples and exosome-derived human epidermal growth factor receptor (HER) dimer measurements will be taken to investigate its significance in this cohort. Discussion The LOCATE trial will compare WB-MRI versus the conventional imaging pathway including its cost-effectiveness, therefore informing the most accurate and efficient imaging pathway. Trial registration LOCATE trial was registered on ClinicalTrial.gov on 18th of October 2016 with registration reference number NCT02935816.

Prostate cancer local staging using biparametric MRI: assessment and comparison with multiparametric MRI

2020 ◽  
Vol 132 ◽  
pp. 109350
Author(s):  
Charlotte Christophe ◽  
Sarah Montagne ◽  
Stéphanie Bourrelier ◽  
Morgan Roupret ◽  
Eric Barret ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Multiparametric Mri ◽  
Local Staging

scholarly journals MULTIPARAMETRIC MRI IN PATIENTS WITH LOCALIZED PROSTATE CANCER AFTER RADICAL EXTERNAL RADIOTHERAPY

2019 ◽  
pp. 32-41
Author(s):  
M. V. Krupina ◽  
T. N. Trofimova ◽  
M. Y. Valkov
Keyword(s):  
Prostate Cancer ◽  
Local Recurrence ◽  
Current Knowledge ◽  
External Beam Radiotherapy ◽  
Locally Advanced ◽  
Local Relapse ◽  
Multiparametric Mri ◽  
Imaging Method ◽  
External Beam ◽  
Local Progression

Prostate cancer (PC) is the one of the most common and socially significant malignancies in men. Radiotherapy is currently one of the leading conservative special treatments for a localized and locally advanced PC. The frequency of biochemical recurrence after external beam radiotherapy (EBRT) is high. One of the main problems is a differentiation between local and systemic relapse of PC. Nevertheless, a local recurrence of PC after radiotherapy can occur without increasing PSA. Magnetic resonance imaging (MRI) is a highly informative imaging method, however, currently it is used mostly for the primary diagnosis and is not included into the recommendations for detecting recurrent prostate cancer after treatment. MR-pattern of the local progression after radical EBRT can be similar to that of primary PC. It is also difficult to diagnose local relapse of prostate cancer in some cases. Multiparametric MRI (mpMRI) has the greatest prospects in the diagnosis of local tumor recurrence in prostate cancer patients after radical external beam radiotherapy. The article provides an overview of domestic and foreign literature, in which we attempted to systematize current knowledge about the possibilities of the mpMRI in diagnosing local recurrence after radical EBRT and, based on the results of published studies, identify directions for further application of this approach.

scholarly journals Local Staging of Prostate Cancer with Multiparametric MRI

2021 ◽  
Author(s):  
Nandan Keshav ◽  
Mark D. Ehrhart ◽  
Steven C. Eberhardt ◽  
Martha F. Terrazas
Keyword(s):  
Prostate Cancer ◽  
Multiparametric Mri ◽  
Local Staging

scholarly journals Erratum to ‘Prostate cancer local staging using biparametric MRI: Assessment and comparison with multiparametric MRI’ [Eur. J. Radiol. 132 (2020) 109350]

2020 ◽  
Vol 133 ◽  
pp. 109417
Author(s):  
Charlotte Christophe ◽  
Sarah Montagne ◽  
Stéphanie Bourrelier ◽  
Morgan Roupret ◽  
Eric Barret ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Multiparametric Mri ◽  
Local Staging

Sensitivity of 6-[F-18]fluoro-L-dihydroxyphenylalanine positron emission tomography for localizing tumors causing catecholamine excess

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 11064-11064
Author(s):  
H. Fiebrich ◽  
A. H. Brouwers ◽  
M. N. Kerstens ◽  
M. E. Pijl ◽  
I. P. Kema ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Imaging Modality ◽  
Imaging Techniques ◽  
Final Diagnosis ◽  
Emission Tomography ◽  
Whole Body ◽  
Mibg Scintigraphy ◽  
Metabolic Burden ◽  
Catecholamine Excess ◽  
Positron Emission

11064 Background: Positron emission tomography (PET) using the catecholamine precursor 6-[F-18]fluoro-L-dihydroxyphenylalanine (18F-DOPA) has emerged as promising technique to localize tumors with catecholamine excess. This study investigated the sensitivity of 18F-DOPA PET, compared to 123I-metaiodobenzylguanidine (123I-MIBG) scintigraphy and computer tomography (CT)/ magnetic resonance imaging (MRI) in patients with catecholamine excess. Methods: In a single center prospective study 18F-DOPA PET was compared to 123I-MIBG and CT/MRI in patients with catecholamine excess. The performance of each imaging modality was analyzed for individual patients and individual lesions. 18F-DOPA PET, 123I-MIBG, and CT/MRI were compared using a composite reference standard derived from all available imaging, clinical and histological information. Sensitivities were calculated and discordance between imaging techniques was compared. 18F-DOPA PET uptake was measured to determine whole body metabolic burden. Correlations between 18F-DOPA PET imaging and biochemical data were evaluated. Results: 48 patients were included. The tumor localization was found in 45 patients, 43 with 18F-DOPA PET, 31 with 123I-MIBG and 32 with CT/MRI, resulting with surgery in final diagnosis of pheochromocytoma in 40, adrenal hyperplasia in 2, paraganglioma in 2, ganglioneuroma in 1 and 3 unknown (as yet no lesion detected). Per patient based analysis showed sensitivities for 18F-DOPA PET, 123I-MIBG and CT/MRI of 90, 65 and 67% (P<.01 18F-DOPA PET vs 123I-MIBG, P<.01 18F-DOPA PET vs CT/MRI, P=1.0 123I-MIBG vs CT/MRI). Corresponding sensitivities in the lesion based analysis were 73, 48 and 44%, respectively (P<.001 for both 18F-DOPA PET vs 123I-MIBG and vs CT/MRI, P=.51 123I-MIBG vs CT/MRI). The 8F-DOPA PET+CT/MRI combination was superior to 123I-MIBG+CT/MRI (93 vs 76%, P<.001) Whole body metabolic burden measured with 18F-DOPA PET correlated with plasma free normetanephrine (r=.82) and 24h urinary total normetanephrine (r=.84) and metanephrine (r=.57). Conclusions: The sensitivity of 18F-DOPA PET to localize tumors with catecholamine excess is superior to either 123I-MIBG scintigraphy or CT/MRI. No significant financial relationships to disclose.

Head-to-head comparison of 68Ga-PSMA-11 PET/CT and mpMRI in the detection, intra-prostatic localization, and local extension of primary prostate cancer: A single-center imaging study with histopathology gold-standard.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 193-193
Author(s):  
Ida Sonni ◽  
Ely Felker ◽  
Andrew Thomas Lenis ◽  
Anthony E Sisk ◽  
Shadfar Bahri ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Imaging Modality ◽  
Imaging Study ◽  
Imaging Modalities ◽  
Detection Rates ◽  
Local Extension ◽  
Primary Prostate Cancer ◽  
Psma Pet ◽  
Pet Ct ◽  
Local Staging

193 Background: The local staging of prostate cancer relies on systematic or targeted biopsies and multiparametric magnetic resonance imaging (mpMRI). The role of prostate-specific membrane antigen (PSMA)-targeted PET in the evaluation of intraprostatic cancer foci and T-staging assessment is not well defined. The goal of this analysis was to compare the diagnostic performance of PSMA PET/CT, mpMRI and the combination of the two (PSMA PET/CT+mpMRI) in the detection, intra-prostatic localization and local extension of primary prostate cancer with histopathology as the gold standard.Methods: Patients with intermediate- or high-risk prostate cancer underwent a PSMA PET/CT scan and mpMRI prior to intended radical prostatectomy. Each imaging modality was interpreted by 3 blinded independent readers. A majority rule was applied (2:1). A standardized approach was used to assess presence, location and size of prostate cancer foci within the prostate. The analysis was conducted on a lesion- and segment-level. Whole mount pathology was interpreted by a Genito-Urinary pathologist using the same standardized method described above. Accuracy in determining the location, extra-capsular extension (ECE) and seminal vesicle invasion (SVI) of prostate cancer foci were assessed using receiver operating characteristic (ROC) analysis. A “raw-stringent” and “neighboring” approach were used to define imaging/pathology correlation for the detection of individual prostate cancer foci. Results: The final analysis included 74 patients. Detection rate was 75%, 79% and 82% using the “raw-stringent” approach, 86%, 83% and 87% using the “neighboring” approach for PSMA PET/CT, mpMRI and PSMA PET/CT+mpMRI, respectively. Differences in detection rates between PSMA PET/CT, mpMRI and PSMA PET/CT+mpMRI were not statistically significant. The two imaging modalities performed similarly (AUC = 0.70 vs 0.73, p = 0.09; AUC = 0.77 for the two together) in localizing prostate cancer. ΔAUC between PSMA PET/CT+mpMRI and the two imaging modalities alone was statistically significant (p < 0.001), but not between PSMA PET/CT and mpMRI (p = 0.093). mpMRI performed better than PSMA PET/CT in the T-staging assessment: ECE (AUC = 0.79 vs 0.59, p = 0.002) and SVI (AUC = 0.84 vs 0.63, p = 0.001). Conclusions: PSMA PET/CT and mpMRI have similar diagnostic accuracy in the detection and intra-prostatic localization of prostate cancer foci while mpMRI performs better in the assessment of ECE and SVI. The combination of the two imaging modalities improves performance of the two modalities alone, but this does not reach statistically significant levels on a lesion-level and might not justify changes in the current practices for local staging of prostate cancer.

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