F Cornud1, Gaby Khoury2, Naim Bouazza3, Frederic Beuvon4, Michael Peyromaure5, Thierry Flam5, Marc Zerbib5, Paul Legmann2, Nicolas B Delongchamps5. 1. Department of Radiology, Hôpital Cochin, Paris Descartes University, Sorbonne Paris Cité, Paris, France. Electronic address: frcornud@imagerie-tourville.com. 2. Department of Radiology, Hôpital Cochin, Paris Descartes University, Sorbonne Paris Cité, Paris, France. 3. Department of Clinical Research, Assistance Publique-Hôpitaux de Paris, Tarnier Hospital, Paris Descartes University, Sorbonne Paris Cité, Paris, France. 4. Department of Pathology, Hôpital Cochin, Paris Descartes University, Sorbonne Paris Cité, Paris, France. 5. Department of Urology, Hôpital Cochin, Paris Descartes University, Sorbonne Paris Cité, Paris, France.
Abstract
PURPOSE: We determined whether endorectal multiparametric magnetic resonance imaging at 1.5 Tesla could predict tumor target volume in the perspective of focal therapy of prostate cancer. MATERIALS AND METHODS: A total of 84 consecutive patients underwent multiparametric magnetic resonance imaging before radical prostatectomy. The volume of each suspicious area detected on magnetic resonance imaging and of all surgical histological foci was determined by planimetry. We first used each magnetic resonance imaging sequence (T2-weighted, diffusion weighted and dynamic contrast enhanced) and then the sequence showing the largest tumor area (multiparametric volume). Finally, the largest area of any sequence was used to calculate a target volume according to the volume of a cylinder. Agreement between magnetic resonance imaging and pathological findings was assessed by linear regression and residual analysis. RESULTS: Histology revealed 99 significant tumors with a volume of greater than 0.2 cc and/or a Gleason score of greater than 6. Of the tumors 16 (16.2%) were undetected by multiparametric magnetic resonance imaging. Linear regression analysis showed that tumor volume estimated by T2-weighted or diffusion weighted imaging correlated significantly with pathological volume (r(2) = 0.82 and 0.83, respectively). Residuals from diffusion weighted imaging volume estimations did not significantly differ from 0. Nevertheless, diffusion weighted imaging underestimated pathological volume in 43 of 87 cases (49%) by a mean of 0.56 cc (range 0.005 to 2.84). Multiparametric and target volumes significantly overestimated pathological volume by a mean of 16% and 44% with underestimation in 28 (32%) and 15 cases (17%), respectively. Volume underestimation was significantly higher for tumor foci less than 0.5 cc. The percent of Gleason grade 4 did not influence tumor volume estimation. CONCLUSIONS: Magnetic resonance imaging can detect most significant tumors. However, delineating a target volume may require further adjustment before planning magnetic resonance imaging targeted focal treatment.
PURPOSE: We determined whether endorectal multiparametric magnetic resonance imaging at 1.5 Tesla could predict tumor target volume in the perspective of focal therapy of prostate cancer. MATERIALS AND METHODS: A total of 84 consecutive patients underwent multiparametric magnetic resonance imaging before radical prostatectomy. The volume of each suspicious area detected on magnetic resonance imaging and of all surgical histological foci was determined by planimetry. We first used each magnetic resonance imaging sequence (T2-weighted, diffusion weighted and dynamic contrast enhanced) and then the sequence showing the largest tumor area (multiparametric volume). Finally, the largest area of any sequence was used to calculate a target volume according to the volume of a cylinder. Agreement between magnetic resonance imaging and pathological findings was assessed by linear regression and residual analysis. RESULTS: Histology revealed 99 significant tumors with a volume of greater than 0.2 cc and/or a Gleason score of greater than 6. Of the tumors 16 (16.2%) were undetected by multiparametric magnetic resonance imaging. Linear regression analysis showed that tumor volume estimated by T2-weighted or diffusion weighted imaging correlated significantly with pathological volume (r(2) = 0.82 and 0.83, respectively). Residuals from diffusion weighted imaging volume estimations did not significantly differ from 0. Nevertheless, diffusion weighted imaging underestimated pathological volume in 43 of 87 cases (49%) by a mean of 0.56 cc (range 0.005 to 2.84). Multiparametric and target volumes significantly overestimated pathological volume by a mean of 16% and 44% with underestimation in 28 (32%) and 15 cases (17%), respectively. Volume underestimation was significantly higher for tumor foci less than 0.5 cc. The percent of Gleason grade 4 did not influence tumor volume estimation. CONCLUSIONS: Magnetic resonance imaging can detect most significant tumors. However, delineating a target volume may require further adjustment before planning magnetic resonance imaging targeted focal treatment.
Authors: Nima Nassiri; Daniel J Margolis; Shyam Natarajan; Devi S Sharma; Jiaoti Huang; Frederick J Dorey; Leonard S Marks Journal: J Urol Date: 2016-09-14 Impact factor: 7.450
Authors: R Diamand; M Oderda; W Al Hajj Obeid; S Albisinni; R Van Velthoven; G Fasolis; G Simone; M Ferriero; J-B Roche; T Piechaud; A Pastore; A Carbone; G Fiard; J-L Descotes; G Marra; P Gontero; E Altobelli; R Papalia; P Kumar; D Eldred-Evans; A Giacobbe; G Muto; V Lacetera; V Beatrici; T Roumeguere; A Peltier Journal: World J Urol Date: 2019-01-16 Impact factor: 4.226