Current role of multiparametric magnetic resonance imaging in the management of prostate cancer

Katelaris, Nikolas; Bolton, Damien; Weerakoon, Mahesha; Toner, Liam; Katelaris, Phillip; Lawrentschuk, Nathan

doi:10.4111/kju.2015.56.5.337

Cited by 18 publications

(7 citation statements)

References 40 publications

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“…Inspired by their studies, we performed an analysis on the whole gland, which contained both information on the tumor and its surroundings . The gland segmentation can avoid the mismatching phenomenon and inaccurate segmentation caused by image deformation between T 2 WI and DWI . Meanwhile, the gland segmentation is easier to achieve than the segmentation of tumor zone, which may also support the application of automatic or semiautomatic segmentation …”

Section: Discussionmentioning

confidence: 99%

Noninvasive Prediction of High‐Grade Prostate Cancer via Biparametric MRI Radiomics

Gong

Fang

et al. 2020

Magnetic Resonance Imaging

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Background Gleason score (GS) is a histologic prognostic factor and the basis of treatment decision‐making for prostate cancer (PCa). Treatment regimens between lower‐grade (GS ≤7) and high‐grade (GS >7) PCa differ largely and have great effects on cancer progression. Purpose To investigate the use of different sequences in biparametric MRI (bpMRI) of the prostate gland for noninvasively distinguishing high‐grade PCa. Study Type Retrospective. Population In all, 489 patients (training cohort: N = 326; test cohort: N = 163) with PCa between June 2008 and January 2018. Field Strength/Sequence 3.0T, pelvic phased‐array coils, bpMRI including T2‐weighted imaging (T2WI) and diffusion‐weighted imaging (DWI); apparent diffusion coefficient map extracted from DWI. Assessment The whole prostate gland was delineated. Radiomic features were extracted and selected using the Kruskal–Wallis test, the minimum redundancy‐maximum relevance, and the sequential backward elimination algorithm. Two single‐sequence radiomic (T2WI, DWI) and two combined (T2WI‐DWI, T2WI‐DWI‐Clinic) models were respectively constructed and validated via logistic regression. Statistical Tests The Kruskal–Wallis test and chi‐squared test were utilized to evaluate the differences among variable groups. P < 0.05 determined statistical significance. The area under the receiver operating characteristic curve (AUC), specificity, sensitivity, and accuracy were used to evaluate model performance. The Delong test was conducted to compare the differences between the AUCs of all models. Result All radiomic models showed significant (P < 0.001) predictive performances. Between the single‐sequence radiomic models, the DWI model achieved the most encouraging results, with AUCs of 0.801 and 0.787 in the training and test cohorts, respectively. For the combined models, the T2WI‐DWI models acquired an AUC of 0.788, which was almost the same with DWI in the test cohort, and no significant difference was found between them (training cohort: P = 0.199; test cohort: P = 0.924). Data Conclusion Radiomics based on bpMRI can noninvasively identify high‐grade PCa before the operation, which is helpful for individualized diagnosis of PCa. Level of Evidence 4 Technical Efficacy Stage 2 J. Magn. Reson. Imaging 2020;52:1102–1109.

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Section: Discussionmentioning

confidence: 99%

Noninvasive Prediction of High‐Grade Prostate Cancer via Biparametric MRI Radiomics

Gong

Fang

et al. 2020

Magnetic Resonance Imaging

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“…However, an increasing percentage of other diagnostic tools in 2013 suggest that more advanced diagnostic and investigation/staging techniques such as transperineal prostate biopsy [ 29 ] or multiparametric magnetic resonance (mMRI), that are becoming more widely used in Australia. mMRI is emerging as a useful tool in the investigation and treatment of PCa, by identifying regions which may represent clinically significant PCa [ 30 – 32 ].…”

Section: Discussionmentioning

confidence: 99%

A retrospective analysis of Victorian and South Australian clinical registries for prostate cancer: trends in clinical presentation and management of the disease

et al. 2016

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BackgroundProstate cancer (PCa) is the most commonly diagnosed malignancy reported to Australian cancer registries with numerous studies from individual registries summarizing diagnostic and treatment characteristics. The aim of this study was to describe annual trends in clinical and treatment characteristics, and changes in surveillance practice within a large combined cohort of men with PCa in South Australia (SA) and Victoria, Australia in 2008–2013.MethodsCommon data items from clinical registries in SA and Victoria were merged to develop a cross-jurisdictional dataset consisting of 13,598 men with PCa. Frequencies were used to describe these variables using the National Comprehensive Cancer Network risk of disease progression categories in 10 year age groups. A logistic regression analysis was performed to assess the impact of a number of factors (both individually and together) on the likelihood of men receiving no active treatment within twelve months of the diagnosis (i.e. managed with active surveillance/watchful waiting).ResultsTrend analysis showed that over time: (1) men in SA and Victoria are being diagnosed at older age in 2013, 66.1 (SD = 9.7) years compared to 2009 (64.5 (SD = 9.7)); (2) diagnostic methods and characteristics have changed with time; and (3) types of the treatments have changed, with more men having no active treatment. The majority of men were diagnosed with Prostate-Specific Antigen (PSA) <10 ng/mL (66 %) and Grade Group < 4 (65 %). Nearly seventy percent received radical treatment within 12 months of diagnosis, while ~20 % had no active treatment. In 14 % of cases treatment was not recorded or had not commenced. Having no active treatment was strongly associated older age, lower PSA and lower Grade Group at diagnosis, and in 2013 it was offered more frequently (more than 3 times) than in 2009 (OR = 2.63, 95 % CI: 2.16–3.22).ConclusionsFindings of this study provide the first cross-jurisdictional description of PCa characteristics and management in Australia. These findings will provide benchmarking for ongoing monitoring and feedback of disease management and outcomes of PCa through the Prostate Cancer Outcomes Registry–Australia New Zealand to improve evidence-based practice.

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“…A review of current literature supporting utility of multi-parametric MRI (mpMRI) showed the sensitivity of mpMRI for PCa detection to be 80–90% and the specificity for suspicious lesion to be between 50% and 90%16. Despite a growing body of literature, debate over capability of mpMRI in reliably detecting significant cancer still remains17. Others have advocated saturation biopsies to enhance cancer detection rate.…”

Section: Discussionmentioning

confidence: 99%

Intraprostatic locations of tumor foci of higher grade missed by diagnostic prostate biopsy among potential candidates for active surveillance

Kim

Lee

Choe

et al. 2016

Sci Rep

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To establish optimal biopsy scheme for selection of candidates for active surveillance (AS) among prostate cancer (PCa) patients, information on topographical distribution of tumor foci of higher grade missed by contemporary biopsy amongst potential candidates of AS would certainly be useful. Thus we analyzed topographic distribution of tumor foci by examining prostatectomy specimens in 444 patients who underwent radical prostatectomy for low risk PCa. Anterior and posterior prostate areas were demarcated by a horizontal line drawn at midpoint of prostatic urethra. Among 444 subjects, patients with upgrading showed relatively higher prevalence of index tumor foci in anterior prostate than those without upgrading, though not reaching statistical significance (p = 0.252). Meanwhile, among 135 (30.4%) patients with very low risk PCa, patients with upgrading showed significantly higher prevalence of index tumor foci in anterior prostate than those without upgrading (52.2% vs 33.8%; p = 0.031). In conclusions, tumor foci of higher grade missed by diagnostic biopsy were mostly located in anterior prostate among very low risk PCa patients. Such finding would be concrete evidence to support the notion that more efforts are needed to increase accuracy in detecting tumor foci in anterior prostate among potential candidates for AS.

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Current role of multiparametric magnetic resonance imaging in the management of prostate cancer

Cited by 18 publications

References 40 publications

Noninvasive Prediction of High‐Grade Prostate Cancer via Biparametric MRI Radiomics

Noninvasive Prediction of High‐Grade Prostate Cancer via Biparametric MRI Radiomics

A retrospective analysis of Victorian and South Australian clinical registries for prostate cancer: trends in clinical presentation and management of the disease

Intraprostatic locations of tumor foci of higher grade missed by diagnostic prostate biopsy among potential candidates for active surveillance

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