A Deep Learning-Based Automated CT Segmentation of Prostate Cancer Anatomy for Radiation Therapy Planning-A Retrospective Multicenter Study

A commercial deep learning (DL)-based automated segmentation tool (AST) for computed tomography (CT) is evaluated for accuracy and efficiency gain within prostate cancer patients. Thirty patients from six clinics were reviewed with manual- (MC), automated- (AC) and automated and edited (AEC) contouring methods. In the AEC group, created contours (prostate, seminal vesicles, bladder, rectum, femoral heads and penile bulb) were edited, whereas the MC group included empty datasets for MC. In one clinic, lymph node CTV delineations were evaluated for interobserver variability. Compared to MC, the mean time saved using the AST was 12 min for the whole data set (46%) and 12 min for the lymph node CTV (60%), respectively. The delineation consistency between MC and AEC groups according to the Dice similarity coefficient (DSC) improved from 0.78 to 0.94 for the whole data set and from 0.76 to 0.91 for the lymph nodes. The mean DSCs between MC and AC for all six clinics were 0.82 for prostate, 0.72 for seminal vesicles, 0.93 for bladder, 0.84 for rectum, 0.69 for femoral heads and 0.51 for penile bulb. This study proves that using a general DL-based AST for CT images saves time and improves consistency.

Seminal plasma interference in the kinetics and viability of cryopreserved canine sperm

Most researchers have frozen dog semen using methodologies described for other species. Consequently, these studies have shown that the thawed semen of dogs is of low quality, with conception rates lower than that of other species. Therefore, in this study, we evaluated different freezing protocols for canine semen, using three adult Bulldog Campeiro males, aged 2 to 5 years, with proven fertility. Five semen samples were collected from each animal using the penile bulb digital manipulation method. The collected samples were divided into: group 1, the samples were diluted directly in Botudog® commercial freezing medium (Botupharma Biotecnologia Animal) and group 2, the samples were centrifuged at 600 g for 10 min and the pellet was resuspended in Botudog®, totaling a concentration end of 200 x 106 sperm per ml. The samples were packaged in 0.5 mL straws at a concentration of 100 x 106 viable sperm. The samples remained for 1 h in stabilization at 4 °C and transferred to nitrogen vapor for 20 min, immersed in nitrogen, stored in a cryogenic cylinder, and thawed at 46 °C for 20 s. It was found that the total motility (MT, %), path speed (VAP, μm/s), progressive motility (PM, %), progressive linear speed (VSL; µm/s), curvilinear speed (VCL; µm/s), linearity (LIN, %), percentage of fast sperm (RAP, %), and plasma and acrosomal membrane integrity were higher in group 1, with samples not being centrifuged. These data demonstrate that the canine semen freezing protocol, using the Botudog® diluent, does not recommend the centrifugation of the ejaculate, prior to freezing.

A case of eribulin-induced regression of liposarcoma of the left funiculus in a heavily pretreated patient

We report the case of a heavily pretreated male subject affected by left funiculus liposarcoma and successfully treated with eribulin mesylate. After three surgical interventions, radiotherapy on the lesion of the penile bulb for satellite nodules and an epirubicin + ifosfamide chemotherapy treatment for six cycles, eribulin was administered at the dose of 1.1 mg/m2 on days 1 and 8, every 3 weeks for a total of nine cycles. A significant reduction of the lesions was achieved after four cycles of therapy, with a good profile of tolerability.

MRI validation of Post-Prostatectomy Radiotherapy Contouring

Introduction: Level One Evidence has established the indications for, and importance of, adjuvant radiotherapy following radical prostatectomy. Several guidelines have addressed delineation of the prostate bed but with variable specification of the inferior border relative to the penile bulb or to the first CT slice distal to visible urine in the bladder neck. This work determines the correlation between the caudal aspect of the anastomosis shown by the tip of the urethrogram cone and MRI anatomy. Materials and Methods : Sixteen patients receiving adjuvant radiotherapy following prostatectomy underwent diagnostic MRI in addition to planning CT with Urethrogram. The CT Reference Slice, tip of urethrogram cone and superior aspect of penile bulb were delineated. Results: MRI clearly demonstrates the penile bulb but not the anastomosis. In these 16 patients, the tip of the urethrogram cone was a median 3.9 mm cranial to the penile bulb (range 0-10.3 mm). Conclusion: We show marked variability in the distance between penile bulb and the tip of the urethrogram cone. In all sixteen patients, placing the inferior border of the CTV 15mm cranial to the penile bulb would have failed to treat the caudal aspect of the anastomosis, a frequent site of local relapse, that cannot be reliably landmarked by any other anatomic structure. Individualizing the treatment volume to patient anatomy is the only way to ensure consistent coverage without treating a larger than necessary volume in many patients. We recommend the use of planning urethrogram to minimize the potential for geographic miss.