Imaging of castration-resistant prostrate cancer

Morisson, Courtney; Jeraj, Robert; Liu, Glenn

doi:10.1097/mou.0b013e32835e9edc

Cited by 14 publications

(5 citation statements)

References 38 publications

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“…The NaF and FDG are two promising tracers for imaging of osseous metastases, but several other promising PET tracers exists, including 11 C-labeled or 18 F-labeled choline, 11 C-labeled or 18 F-labeled acetate and 68 Ga-labeled PSMA. In addition, MRI techniques for imaging of osseous metastases of prostate cancer also show some potential 5 . While this study found that NaF and FDG responses are highly correlated under some circumstances and the benefit of using both tracers is limited, that might not be the case for combinations with different tracers.…”

Section: Discussionmentioning

confidence: 99%

“…In the absence of quantitative treatment response imaging biomarker, the Prostate Cancer Clinical Trials Working Group currently advocates the use of a time to event, such as radiographic progression-free survival, as a preferred endpoint for early drug development in prostate cancer 4 . It is anticipated that out of many imaging modalities, which have been shown to be able to detect metastases arising from CRPC, some have the potential to be used for quantitative treatment response assessment 5 .…”

Section: Introductionmentioning

confidence: 99%

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Comparison of NaF and FDG PET/CT for Assessment of Treatment Response in Castration-Resistant Prostate Cancers With Osseous Metastases

Simončič

Perlman

Liu

et al. 2015

Clinical Genitourinary Cancer

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Background Assessment of skeletal metastases response to therapy is highly relevant, but unresolved clinical problem. The main goal of this work was to compare pharmacodynamic responses to therapy assessed with NaF and FDG PET/CT. Materials and Methods Prostate cancer patients with known osseous metastases were treated with Zibotentan (ZD4054) and imaged with combined dynamic NaF/FDG PET/CT prior to therapy (Baseline), after 4 weeks of therapy (Week 4) and after 2 weeks of treatment break (Week 6). Kinetic analysis allowed comparison of voxel-based tracer uptake rate parameter Ki, vasculature parameters K1 (measuring perfusion/permeability) and Vb (measuring vasculature fraction in the tissue) together with standardized uptake values (SUVs). Results Correlations were high for the NaF and FDG peak uptake parameters (Ki and SUV correlations ranged from 0.57 to 0.88) and for vasculature parameters (K1 and Vb correlations ranged from 0.61 to 0.81). Correlation between the NaF and FDG Week 4 Ki responses was low (ρ=0.35, p=0.084), but higher for NaF and FDG Week 6 Ki responses (ρ=0.72, p<0.0001). Correlations for vasculature responses were always low (ρ<0.35). NaF and FDG uptakes in the osseous metastases were spatially dislocated, with overlap in the range from 0% to 80%. Conclusions These results showed that late NaF and FDG uptake responses are consistently correlated, but earlier uptake responses and all vasculature responses can be unrelated. This study also proved that FDG and NaF uptakes are spatially dislocated. Although treatment responses assessed with NaF and FDG may be correlated, using both tracers provides additional information.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of NaF and FDG PET/CT for Assessment of Treatment Response in Castration-Resistant Prostate Cancers With Osseous Metastases

Simončič

Perlman

Liu

et al. 2015

Clinical Genitourinary Cancer

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“…The high disease burden of metastatic prostate cancer leads to many biopsy targets, yet diagnostic yield accuracy is historically low (Wu et al , 2008). PET/CT provides a molecular imaging platform from which biologically relevant information related to disease potential can be used to monitor patients with multiple lesions (Gambhir, 2002; Weissleder, 1999; Morisson et al , 2013). In a study of PET/CT guided bone biopsies in metastatic breast cancer, CT was useful in identifying precise location of bone lesions when used in conjunction with PET, but only revealed distinct characteristics of disease on CT in half of the highly PET-positive lesions (Lavayssière et al , 2009; Nakamoto et al , 2005).…”

Section: Introductionmentioning

confidence: 99%

Molecular image-directed biopsies: improving clinical biopsy selection in patients with multiple tumors

2016

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Site selection for image-guided biopsies in patients with multiple lesions is typically based on clinical feasibility and physician preference. This study outlines the development of a selection algorithm that, in addition to clinical requirements, incorporates quantitative imaging data for automatic identification of candidate lesions for biopsy. The algorithm is designed to rank potential targets by maximizing a lesion-specific score, incorporating various criteria separated into two categories: 1) physician-feasibility category including physician-preferred lesion location and absolute volume scores, and 2) imaging-based category including various modality and application-specific metrics. This platform was benchmarked in two clinical scenarios, a pre-treatment setting and response-based setting using imaging from metastatic prostate cancer patients with high disease burden (multiple lesions) undergoing conventional treatment and receiving whole-body [18F]NaF PET/CT scans pre- and mid-treatment. Targeting of metastatic lesions was robust to different weighting ratios and candidacy for biopsy was physician confirmed. Lesion ranked as top targets for biopsy remained so for all patients in pre-treatment and post-treatment biopsy selection after sensitivity testing was completed for physician-biased or imaging-biased scenarios. After identifying candidates, biopsy feasibility was evaluated by a physician and confirmed for 90% (32/36) of high-ranking lesions, of which all top choices were confirmed. The remaining cases represented lesions with high anatomical difficulty for targeting, such as proximity to sciatic nerve. This newly developed selection method was successfully used to quantitatively identify candidate lesions for biopsies in patients with multiple lesions. In a prospective study, we were able to successfully plan, develop, and implement this technique for the selection of a pre-treatment biopsy location.

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“…Therefore, early assessment of the therapeutic response of the metastatic lesions is crucial for disease management, such as to palliate pain and to alleviate the devastating consequences. Medical imaging plays an indispensible role in the early detection and treatment response assessment of bone metastatic lesions (Silberstein et al 1973, Costelloe et al 2009, Reischauer et al 2010, Talbot et al 2011, Withofs et al 2011, Mosavi et al 2012, Damle et al 2013, Morisson et al 2013. For example, diffusion weight MRI and 18 F-fluoride PET/CT have often been applied to metastatic bone lesion detection due to their superior sensitivity and specificity (Reischauer et al 2010, Talbot et al 2011, Withofs et al 2011, Mosavi et al 2012, Damle et al 2013, Morisson et al 2013.…”

Section: Introductionmentioning

confidence: 99%

“…Despite advances in detection of metastases across imaging modalities, assessment of metastatic disease response to therapy is often based on the average responses of all lesions, or in some cases the five largest lesions (Wahl et al 2009, Doot et al 2010, Mortazavi-Jehanno et al 2012. Assessment of individual lesions can provide keys to quantify and to understand the inter-lesion response variability, subsequently improving management for the metastatic bone disease (Morisson et al 2013). Corresponding lesions on successive scans need to be accurately matched to enable the response assessment.…”

Section: Introductionmentioning

confidence: 99%

Use of articulated registration for response assessment of individual metastatic bone lesions

Yip

Jeraj

2014

Phys. Med. Biol.

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Accurate skeleton registration is necessary to match corresponding metastatic bone lesions for response assessment over multiple scans. In articulated registration (ART), whole-body skeletons are registered by auto-segmenting individual bones, then rigidly aligning them. Performance and robustness of the ART in lesion matching were evaluated and compared to other commonly used registration techniques. Sixteen prostate cancer patients were treated either with molecular targeted therapy or chemotherapy. Ten out of the 16 patients underwent the double baseline whole-body [F-18]NaF PET/CT scans for test-retest (TRT) evaluation. Twelve of the 16 patients underwent pre- and mid-treatment [F-18]NaF PET/CT scans. Skeletons at different time points were registered using ART, rigid, and deformable (DR) registration algorithms. The corresponding lesions were contoured and identified on successive PET images based on including the voxels with the standardized uptake value over 15. Each algorithm was evaluated for its ability to accurately align corresponding lesions via skeleton registration. A lesion matching score (MS) was measured for each lesion, which quantified the per cent overlap between the lesion's two corresponding contours. Three separate sensitivity studies were conducted to investigate the robustness of ART in matching: sensitivity of lesion matching to various contouring threshold levels, effects of imperfections in the bone auto-segmentation and sensitivity of mis-registration. The performance of ART (MS = 82% for both datasets, p ≪ 0.001) in lesion matching was significantly better than rigid (MS(TRT)=53%, MS(Response)= 46%) and DR (MS(TRT)=46%, MS(Response)=45%) algorithms. Neither varying threshold levels for lesion contouring nor imperfect bone segmentation had significant (p~0.10) impact on the ART matching performance as the MS remained unchanged. Despite the mis-registration reduced MS for ART, as low as 67% (p ≪ 0.001), the performance remained to be superior to the rigid and DR algorithms. ART is not only robust to contouring threshold levels for bone lesions, but also outperforms rigid and DR algorithms in lesion matching. ART therefore enables the study of TRT variability and treatment assessment of individual bone lesions.

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Imaging of castration-resistant prostrate cancer

Cited by 14 publications

References 38 publications

Comparison of NaF and FDG PET/CT for Assessment of Treatment Response in Castration-Resistant Prostate Cancers With Osseous Metastases

Comparison of NaF and FDG PET/CT for Assessment of Treatment Response in Castration-Resistant Prostate Cancers With Osseous Metastases

Molecular image-directed biopsies: improving clinical biopsy selection in patients with multiple tumors

Use of articulated registration for response assessment of individual metastatic bone lesions

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