Rulon Mayer1,2, Charles B Simone3, Baris Turkbey4, Peter Choyke4. 1. University of Pennsylvania, Philadelphia, PA, USA. 2. OncoScore, Garrett Park, MD, USA. 3. New York Proton Center, New York, NY, USA. 4. National Institutes of Health, Bethesda, MD, USA.
Abstract
BACKGROUND: Proliferating cancer cells interacting with their microenvironment affects a tumor's spatial shape. Elongation or roundness (eccentricity) of lung, skin, and breast cancers indicates the cancer's relative aggressiveness. Non-invasive determination of the prostate tumor's shape should provide meaningful input for prognostication and clinical management. There are currently few studies of prostate tumor shape, therefore this study examines the relationship between a prostate tumor's eccentricity, derived from spatially registered multi-parametric MRI and histology slides, and Gleason scores. METHODS: A total of 26 consecutive patients were enrolled in the study. Median patient age was 60 years (range, 49 to 75 years), median PSA was 5.8 ng/mL (range, 2.3 to 23.7 ng/mL, and median Gleason score was 7 (range, 6 to 9). Multi-parametric MRI (T1, T2, Diffusion, Dynamic Contrast Enhanced) were resampled, rescaled, translated, and stitched to form spatially registered multi-parametric cubes. Multi-parametric signatures that characterize prostate tumors were inserted into a target detection algorithm (Adaptive Cosine Estimator, ACE). Various detection thresholds were applied to discriminate tumor from normal tissue. Also, tumor shape was computed from the histology slides. Blobbing, labeling, and calculation of eccentricity using moments of inertia were applied to the multi-parametric MRI and histology slides. The eccentricity measurements were compared to the Gleason scores from 25 patients. RESULTS: From histology slides analysis: the correlation coefficient between the eccentricity for the largest blob and a weighted average eccentricity against the Gleason score ranged from -0.67 to -0.78 for all 18 patients whose tumor volume exceeded 1.0 cc. From multi-parametric MRI analysis: the correlation coefficient between the eccentricity for the largest blob for varying thresholds against the Gleason score ranged from -0.60 to -0.66 for all 25 patients showing contrast uptake in the Dynamic Contrast Enhancement (DCE) MRI. CONCLUSIONS: Spherical shape prostate adenocarcinoma shows a propensity for higher Gleason score. This novel finding follows lung and breast adenocarcinomas but depart from other primary tumor types. Analysis of multi-parametric MRI can non-invasively determine the prostate tumor's morphology and add critical information for prognostication and disease management. Eccentricity of smaller tumors (<1.0 cc) from MP-MRI correlates well with Gleason score, unlike eccentricity measured using histology of wholemount prostatectomy. 2021 Quantitative Imaging in Medicine and Surgery. All rights reserved.
BACKGROUND: Proliferating cancer cells interacting with their microenvironment affects a tumor's spatial shape. Elongation or roundness (eccentricity) of lung, skin, and breast cancers indicates the cancer's relative aggressiveness. Non-invasive determination of the prostate tumor's shape should provide meaningful input for prognostication and clinical management. There are currently few studies of prostate tumor shape, therefore this study examines the relationship between a prostate tumor's eccentricity, derived from spatially registered multi-parametric MRI and histology slides, and Gleason scores. METHODS: A total of 26 consecutive patients were enrolled in the study. Median patient age was 60 years (range, 49 to 75 years), median PSA was 5.8 ng/mL (range, 2.3 to 23.7 ng/mL, and median Gleason score was 7 (range, 6 to 9). Multi-parametric MRI (T1, T2, Diffusion, Dynamic Contrast Enhanced) were resampled, rescaled, translated, and stitched to form spatially registered multi-parametric cubes. Multi-parametric signatures that characterize prostate tumors were inserted into a target detection algorithm (Adaptive Cosine Estimator, ACE). Various detection thresholds were applied to discriminate tumor from normal tissue. Also, tumor shape was computed from the histology slides. Blobbing, labeling, and calculation of eccentricity using moments of inertia were applied to the multi-parametric MRI and histology slides. The eccentricity measurements were compared to the Gleason scores from 25 patients. RESULTS: From histology slides analysis: the correlation coefficient between the eccentricity for the largest blob and a weighted average eccentricity against the Gleason score ranged from -0.67 to -0.78 for all 18 patients whose tumor volume exceeded 1.0 cc. From multi-parametric MRI analysis: the correlation coefficient between the eccentricity for the largest blob for varying thresholds against the Gleason score ranged from -0.60 to -0.66 for all 25 patients showing contrast uptake in the Dynamic Contrast Enhancement (DCE) MRI. CONCLUSIONS: Spherical shape prostate adenocarcinoma shows a propensity for higher Gleason score. This novel finding follows lung and breast adenocarcinomas but depart from other primary tumor types. Analysis of multi-parametric MRI can non-invasively determine the prostate tumor's morphology and add critical information for prognostication and disease management. Eccentricity of smaller tumors (<1.0 cc) from MP-MRI correlates well with Gleason score, unlike eccentricity measured using histology of wholemount prostatectomy. 2021 Quantitative Imaging in Medicine and Surgery. All rights reserved.
Authors: Elaine L Bearer; John S Lowengrub; Hermann B Frieboes; Yao-Li Chuang; Fang Jin; Steven M Wise; Mauro Ferrari; David B Agus; Vittorio Cristini Journal: Cancer Res Date: 2009-04-14 Impact factor: 12.701
Authors: Ryan K Berglund; Timothy A Masterson; Kinjal C Vora; Scott E Eggener; James A Eastham; Bertrand D Guillonneau Journal: J Urol Date: 2008-09-17 Impact factor: 7.450
Authors: Baris Turkbey; Haresh Mani; Vijay Shah; Ardeshir R Rastinehad; Marcelino Bernardo; Thomas Pohida; Yuxi Pang; Dagane Daar; Compton Benjamin; Yolanda L McKinney; Hari Trivedi; Celene Chua; Gennady Bratslavsky; Joanna H Shih; W Marston Linehan; Maria J Merino; Peter L Choyke; Peter A Pinto Journal: J Urol Date: 2011-09-25 Impact factor: 7.450
Authors: Hendrik Ungefroren; Susanne Sebens; Daniel Seidl; Hendrik Lehnert; Ralf Hass Journal: Cell Commun Signal Date: 2011-09-13 Impact factor: 5.712