Tristan Barrett1, Sean R H Davidson2, Brian C Wilson2, Robert A Weersink3, John Trachtenberg4, Masoom A Haider5. 1. Department of Medical Imaging, University Health Network, Toronto, ON; 2. Division of Biophysics and Bioimaging, Ontario Cancer Institute, University Health Network, Toronto, ON; 3. Laboratory for Applied Biophysics, Ontario Cancer Institute, University Health Network, Toronto, ON; 4. Division of Urology, Department of Surgical Oncology, University Health Network, Toronto, ON; 5. Department of Medical Imaging, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, ON.
Abstract
INTRODUCTION: Photodynamic therapy (PDT) can be employed as a focal therapy for prostate cancer. Dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) can potentially help identify tumour recurrence after failed external-beam radiotherapy (EBRT). The purpose of this study was to determine the ability of DCE-MRI to predict early response to PDT salvage treatment. METHODS: Patients with post-EBRT prostate cancer recurrence were prospectively enrolled into a Phase I/II trial of PDT using WST09. A 15-patient subgroup of this cohort undergoing 1.5T DCE-MRI at baseline and 1-week post-PDT was retrospectively analyzed. The reference standard was prostate biopsy obtained 6 months post-PDT. Analysis was performed on a patient-by-patient basis, by prostate gland halves, and by prostate sextants. RESULTS: Biopsy 6 months post-PDT identified cancer in 10/15 patients (66.7%), and in 24/90 sextants (26.7%). Residual cancer was identified in 22/37 sextants (59.5%) identified as being involved at baseline. DCE-MRI at 1 week correctly predicted recurrent disease with a sensitivity of 100% (10/10), specificity of 60% (3/5), positive predictive value of 83.3% (10/12), negative predictive value of 100% (3/3), and an overall accuracy of 86.7%, (13/15). When analysis was performed on prostate halves, the sensitivity and negative predictive value remained at 100%, with an improvement in specificity to 88.2% (15/17). The overall accuracy of DCE-MRI was similar regardless of analysis method: 86.7% on a patient-by-patient basis, 86.7% by prostate half and 83.3% by sextant. Changes in prostate-specific antigen (PSA) did not correlate to response. CONCLUSION: DCE-MRI shows promise as a tool to predict successful outcome when performed 1 week post-PDT and could potentially be used to inform the need for re-treatment at an early time-point.
INTRODUCTION: Photodynamic therapy (PDT) can be employed as a focal therapy for prostate cancer. Dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) can potentially help identify tumour recurrence after failed external-beam radiotherapy (EBRT). The purpose of this study was to determine the ability of DCE-MRI to predict early response to PDT salvage treatment. METHODS:Patients with post-EBRT prostate cancer recurrence were prospectively enrolled into a Phase I/II trial of PDT using WST09. A 15-patient subgroup of this cohort undergoing 1.5T DCE-MRI at baseline and 1-week post-PDT was retrospectively analyzed. The reference standard was prostate biopsy obtained 6 months post-PDT. Analysis was performed on a patient-by-patient basis, by prostate gland halves, and by prostate sextants. RESULTS: Biopsy 6 months post-PDT identified cancer in 10/15 patients (66.7%), and in 24/90 sextants (26.7%). Residual cancer was identified in 22/37 sextants (59.5%) identified as being involved at baseline. DCE-MRI at 1 week correctly predicted recurrent disease with a sensitivity of 100% (10/10), specificity of 60% (3/5), positive predictive value of 83.3% (10/12), negative predictive value of 100% (3/3), and an overall accuracy of 86.7%, (13/15). When analysis was performed on prostate halves, the sensitivity and negative predictive value remained at 100%, with an improvement in specificity to 88.2% (15/17). The overall accuracy of DCE-MRI was similar regardless of analysis method: 86.7% on a patient-by-patient basis, 86.7% by prostate half and 83.3% by sextant. Changes in prostate-specific antigen (PSA) did not correlate to response. CONCLUSION:DCE-MRI shows promise as a tool to predict successful outcome when performed 1 week post-PDT and could potentially be used to inform the need for re-treatment at an early time-point.
Authors: Daher C Chade; Shahrokh F Shariat; Angel M Cronin; Caroline J Savage; R Jeffrey Karnes; Michael L Blute; Alberto Briganti; Francesco Montorsi; Henk G van der Poel; Hendrik Van Poppel; Steven Joniau; Guilherme Godoy; Antonio Hurtado-Coll; Martin E Gleave; Marcos Dall'Oglio; Miguel Srougi; Peter T Scardino; James A Eastham Journal: Eur Urol Date: 2011-03-21 Impact factor: 20.096
Authors: Masoom A Haider; Peter Chung; Joan Sweet; Ants Toi; Kartik Jhaveri; Cynthia Ménard; Padraig Warde; John Trachtenberg; Gina Lockwood; Michael Milosevic Journal: Int J Radiat Oncol Biol Phys Date: 2007-09-19 Impact factor: 7.038
Authors: Maaike R Moman; Cornelis A T van den Berg; Arto E Boeken Kruger; Jan J Battermann; Marinus A Moerland; Uulke A van der Heide; Marco van Vulpen Journal: Int J Radiat Oncol Biol Phys Date: 2009-10-03 Impact factor: 7.038
Authors: J Trachtenberg; A Bogaards; R A Weersink; M A Haider; A Evans; S A McCluskey; A Scherz; M R Gertner; C Yue; S Appu; A Aprikian; J Savard; B C Wilson; M Elhilali Journal: J Urol Date: 2007-09-17 Impact factor: 7.450
Authors: Masoom A Haider; Sean R H Davidson; Ashwini V Kale; Robert A Weersink; Andrew J Evans; Ants Toi; Mark R Gertner; Arjen Bogaards; Brian C Wilson; Joseph L Chin; Mostafa Elhilali; John Trachtenberg Journal: Radiology Date: 2007-05-16 Impact factor: 11.105
Authors: Sean R H Davidson; Robert A Weersink; Masoom A Haider; Mark R Gertner; Arjen Bogaards; David Giewercer; Avigdor Scherz; Michael D Sherar; Mostafa Elhilali; Joseph L Chin; John Trachtenberg; Brian C Wilson Journal: Phys Med Biol Date: 2009-03-20 Impact factor: 3.609
Authors: Samir S Taneja; James Bennett; Jonathan Coleman; Robert Grubb; Gerald Andriole; Robert E Reiter; Leonard Marks; Abdel-Rahmene Azzouzi; Mark Emberton Journal: J Urol Date: 2016-06-09 Impact factor: 7.450