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Sample records for prostate cancer imaging

  1. Molecular Imaging of Prostate Cancer

    PubMed Central

    Burger, Irene A.; Sala, Evis; Hricak, Hedvig; Weber, Wolfgang A.; Vargas, Hebert Alberto

    2016-01-01

    Prostate cancer is the most common noncutaneous malignancy among men in the Western world. The natural history and clinical course of prostate cancer are markedly diverse, ranging from small indolent intraprostatic lesions to highly aggressive disseminated disease. An understanding of this biologic heterogeneity is considered a necessary requisite in the quest for the adoption of precise and personalized management strategies. Molecular imaging offers the potential for noninvasive assessment of the biologic interactions underpinning prostate carcinogenesis. Currently, numerous molecular imaging probes are in clinical use or undergoing preclinical or clinical evaluation. These probes can be divided into those that image increased cell metabolism, those that target prostate cancer–specific membrane proteins and receptor molecules, and those that bind to the bone matrix adjacent to metastases to bone. The increased metabolism and vascular changes in prostate cancer cells can be evaluated with radiolabeled analogs of choline, acetate, glucose, amino acids, and nucleotides. The androgen receptor, prostate-specific membrane antigen, and gastrin-releasing peptide receptor (ie, bombesin) are overexpressed in prostate cancer and can be targeted by specific radiolabeled imaging probes. Because metastatic prostate cancer cells induce osteoblastic signaling pathways of adjacent bone tissue, bone-seeking radiotracers are sensitive tools for the detection of metastases to bone. Knowledge about the underlying biologic processes responsible for the phenotypes associated with the different stages of prostate cancer allows an appropriate choice of methods and helps avoid pitfalls. ©RSNA, 2015 PMID:26587888

  2. Molecular imaging of prostate cancer.

    PubMed

    Fox, Josef J; Schöder, Heiko; Larson, Steven M

    2012-07-01

    Prostate cancer is a complex and biologically heterogeneous disease that is not adequately assessed with conventional imaging alone. Molecular imaging with positron emission tomography (PET) is poised to fill this unmet need through noninvasive probing of the multiple molecular and cellular processes that are active in prostate cancer patients. Several PET tracers are active in early-stage and late-stage prostate cancer in humans. F18-Fluorodeoxyglucose (FDG), C11/F18-choline and sodium F18-fluoride have been studied most extensively. There is a growing body of literature supporting the utility of choline in early-stage prostate cancer. FDG and sodium F18-fluoride are more valuable in advanced disease, especially for assessing bone metastases, the prevalent form of metastases in this patient population. F18-fluorodihydrotestosterone is active in castrate disease and is emerging as a valuable pharmacodynamic marker in the development of novel androgen receptor-targeted therapies. Prostate-specific membrane antigen PET tracers are in the early stages of clinical development. Multiple PET tracers are currently available to aid in the detection and management of prostate cancer across the clinical spectrum of the disease. Prospective, rigorously controlled, clinical imaging trials are needed to establish the optimal role of PET in prostate cancer.

  3. Molecular Imaging of Prostate Cancer

    PubMed Central

    Fox, Josef J.; Schöder, Heiko; Larson, Steven M.

    2015-01-01

    Purpose of review Prostate cancer is a complex and biologically heterogeneous disease that is not adequately assessed with conventional imaging alone. Molecular imaging with positron emission tomography (PET) is poised to fill this unmet need through noninvasive probing of the multiple molecular and cellular processes that are active in prostate cancer patients. Recent findings Several PET tracers are active in early and late stage prostate cancer in humans. F18-FDG, C11/F18-choline and F18-sodium fluoride (NaF) have been studied most extensively. There is a growing body of literature supporting to the utility of choline in early stage prostate cancer. FDG and NaF are more valuable in advanced disease, especially for assessing bone metastases, the prevalent form of metastases in this patient population. F18-Fluoro-dihydrotestosterone is active in castrate disease and is emerging as a valuable pharmacodynamic marker in the development of novel AR-targeted therapies. Anti-PSMA PET tracers are in the early stages of clinical development. Summary Multiple PET tracers are currently available to aid in the detection and management of prostate cancer across the clinical spectrum of the disease. Prospective, rigorously controlled, clinical imaging trials are needed to establish the optimal role of PET in prostate cancer. PMID:22617062

  4. Prostate Cancer MR Imaging

    NASA Astrophysics Data System (ADS)

    Fütterer, Jurgen J.

    With a total of 192,280 new cases predicted for 2009, prostate cancer (PC) now accounts for 25% of all new male cancers diagnosed in the United States [1]. Furthermore, in their lifetime, one in six men will be clinically diagnosed with having PC, although many more men are found to have histological evidence of PC at autopsy [2,3,4]. Presently, approximately 1 in 10 men will die of PC [5,6]. The ever-aging population and wider spread use of the blood prostate-specific antigen (PSA) test [7,8], as well as the tendency to apply lower cut-off levels for this test [9], will further increase the diagnosis of this disease [10].

  5. Imaging for Prostate Cancer Recurrence.

    PubMed

    Maurer, Tobias; Eiber, Matthias; Fanti, Stefano; Budäus, Lars; Panebianco, Valeria

    2016-06-01

    Correct identification of metastatic sites in recurrent prostate cancer (PCa) is of crucial importance because it leads to further treatment decisions. To provide an overview on current imaging procedures and their performance in recurrent PCa. Medline search via PubMed was performed with the keywords imaging, recurrent, and prostate cancer as well as more detailed searches including the keywords bone scan, bone scintigraphy, computed tomography, magnetic resonance imaging, positron emission tomography, PET, choline, FDG, prostate-specific membrane antigen, and PSMA, with emphasis on recent literature from 2010 to the present. Non-English published literature was excluded. Abstracts and full-text articles were reviewed and assessed for relevant content. In diagnostic imaging and particularly with newer technologies like positron emission tomography (PET), a profound lack of prospectively designed studies in recurrent PCa has to be noted. In most studies histologic validation has only been performed in a subset of patient cohorts. Heterogeneity of included patient cohorts, lack of standardized assessment, as well as diverging end points, hamper systematic comparison of different image modalities. Thus evidence for currently used imaging in recurrent PCa is only presented descriptively. Computed tomography and magnetic resonance imaging (MRI) as well as bone scintigraphy still represent the standard imaging for recurrent PCa; however, particularly for detection of local recurrence, multiparametric MRI is a valuable imaging modality. PET using choline and particularly tracers against prostate-specific membrane antigen might improve visualization of metastatic lesions. These findings need to be validated in prospective trials. Imaging of recurrent prostate cancer (PCa) is important to guide further treatment. Computed tomography, magnetic resonance imaging, and bone scintigraphy represent the current standard. Positron emission tomography, especially with cancer

  6. Imaging Prostatic Lipids to Distinguish Aggressive Prostate Cancer

    DTIC Science & Technology

    2016-12-01

    lipids in test controls. Key Metabolomics Research Accomplishments 1) Developed unbiased mass spectrometry methods to profile 500 lipids . 2) Completed...Award Number: W81XWH-12-1-0168 TITLE: Imaging Prostatic Lipids to Distinguish Aggressive Prostate Cancer PRINCIPAL INVESTIGATOR: Jackilen...Imaging Prostatic Lipids to Distinguish Aggressive Prostate Cancer 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-12-1-0168 5c. PROGRAM ELEMENT NUMBER

  7. Imaging Prostatic Lipids to Distinguish Aggressive Prostate Cancer

    DTIC Science & Technology

    2016-11-01

    test controls. Key Metabolomics Research Accomplishments 1) Developed unbiased mass spectrometry methods to profile 500 lipids . 2) Completed...Award Number: W81XWH-12-1-0169 PC110361P1 TITLE: Imaging Prostatic Lipids to Distinguish Aggressive Prostate Cancer PRINCIPAL INVESTIGATOR...SUBTITLE Imaging Prostatic Lipids to Distinguish Aggressive Prostate Cancer 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-12-1-0169 5c. PROGRAM

  8. Molecular Imaging of Prostate Cancer: PET Radiotracers

    PubMed Central

    Jadvar, Hossein

    2012-01-01

    OBJECTIVE Recent advances in the fundamental understanding of the complex biology of prostate cancer have provided an increasing number of potential targets for imaging and treatment. The imaging evaluation of prostate cancer needs to be tailored to the various phases of this remarkably heterogeneous disease. CONCLUSION In this article, I review the current state of affairs on a range of PET radiotracers for potential use in the imaging evaluation of men with prostate cancer. PMID:22826388

  9. Functional Imaging for Prostate Cancer: Therapeutic Implications

    PubMed Central

    Aparici, Carina Mari; Seo, Youngho

    2012-01-01

    Functional radionuclide imaging modalities, now commonly combined with anatomical imaging modalities CT or MRI (SPECT/CT, PET/CT, and PET/MRI) are promising tools for the management of prostate cancer particularly for therapeutic implications. Sensitive detection capability of prostate cancer using these imaging modalities is one issue; however, the treatment of prostate cancer using the information that can be obtained from functional radionuclide imaging techniques is another challenging area. There are not many SPECT or PET radiotracers that can cover the full spectrum of the management of prostate cancer from initial detection, to staging, prognosis predictor, and all the way to treatment response assessment. However, when used appropriately, the information from functional radionuclide imaging improves, and sometimes significantly changes, the whole course of the cancer management. The limitations of using SPECT and PET radiotracers with regards to therapeutic implications are not so much different from their limitations solely for the task of detecting prostate cancer; however, the specific imaging target and how this target is reliably imaged by SPECT and PET can potentially make significant impact in the treatment of prostate cancer. Finally, while the localized prostate cancer is considered manageable, there is still significant need for improvement in noninvasive imaging of metastatic prostate cancer, in treatment guidance, and in response assessment from functional imaging including radionuclide-based techniques. In this review article, we present the rationale of using functional radionuclide imaging and the therapeutic implications for each of radionuclide imaging agent that have been studied in human subjects. PMID:22840598

  10. Imaging Prostate Cancer (PCa) Phenotype and Evolution

    DTIC Science & Technology

    2016-10-01

    1 AWARD NUMBER: W81XWH-13-1-0386 TITLE: Imaging Prostate Cancer (PCa) Phenotype and Evolution PRINCIPAL INVESTIGATOR: Jason A. Koutcher...also tumor macrophages, suggesting that DFP may have a dual activity on tumors Jason A. Koutcher Imaging Prostate Cancer (PCa) Phenotype and Evolution

  11. Functional imaging for prostate cancer: therapeutic implications.

    PubMed

    Mari Aparici, Carina; Seo, Youngho

    2012-09-01

    Functional radionuclide imaging modalities, now commonly combined with anatomical imaging modalities computed tomography (CT) or magnetic resonance imaging (single photon emission computed tomography [SPECT]/CT, positron emission tomography [PET]/CT, and PET/magnetic resonance imaging), are promising tools for the management of prostate cancer, particularly for therapeutic implications. Sensitive detection capability of prostate cancer using these imaging modalities is one issue; however, the treatment of prostate cancer using the information that can be obtained from functional radionuclide imaging techniques is another challenging area. There are not many SPECT or PET radiotracers that can cover the full spectrum of the management of prostate cancer from initial detection to staging, prognosis predictor, and all the way to treatment response assessment. However, when used appropriately, the information from functional radionuclide imaging improves, and sometimes significantly changes, the whole course of the cancer management. The limitations of using SPECT and PET radiotracers with regard to therapeutic implications are not so much different from their limitations solely for the task of detecting prostate cancer; however, the specific imaging target and how this target is reliably imaged by SPECT and PET can potentially make significant impact in the treatment of prostate cancer. Finally, although the localized prostate cancer is considered manageable, there is still significant need for improvement in noninvasive imaging of metastatic prostate cancer, in treatment guidance, and in response assessment from functional imaging, including radionuclide-based techniques. In this review article, we present the rationale of using functional radionuclide imaging and the therapeutic implications for each of radionuclide imaging agent that have been studied in human subjects.

  12. Heterobivalent Imaging Agents Targeting Prostate Cancer Training

    DTIC Science & Technology

    2011-06-01

    has been implicated as a salient player in the pathobiology of cancers of epithelial origin, e.g. prostate, cervix , ovarian, colon and...ANSI Std. Z39.18 W81XWH-10-1-0481 Heterobivalent Imaging Agents Targeting Prostate Cancer Training Aaron LeBeau University of California, San...Francisco San Francisco, CA 94103 Annual Summary 31 MAY 2010 - 1JUN 201101-06-2011 To determine the utility of imaging MT-SP1 in cancer , xenografts of

  13. Imaging of Oxidative Stress in Prostate Cancer

    DTIC Science & Technology

    2013-10-01

    Prostate Cancer PRINCIPAL INVESTIGATOR: Brian M. Zeglis CONTRACTING ORGANIZATION: Memorial Sloan-Kettering Cancer Center New York, NY...27September2012-26September2013 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Imaging of Oxidative Stress in Prostate Cancer 5b. GRANT NUMBER...NUMBER Memorial Sloan-Kettering Cancer Center 1275 York Avenue, New York, NY, 10065 9. SPONSORING / MONITORING AGENCY NAME(S

  14. Parametric PET/MR Fusion Imaging to Differentiate Aggressive from Indolent Primary Prostate Cancer with Application for Image-Guided Prostate Cancer Biopsies

    DTIC Science & Technology

    2013-10-01

    Differentiate Aggressive from Indolent Primary Prostate Cancer with Application for Image-Guided Prostate Cancer Biopsies PRINCIPAL INVESTIGATOR...Parametric PET/MR Fusion Imaging to Differentiate Aggressive from Indolent Primary Prostate Cancer with Application for Image-Guided Prostate Cancer Biopsies ...cancer using image-guided prostate biopsies . The study further aims to establish whether fusion PET/MRI-derived parametric imaging parameters

  15. Functional CT imaging of prostate cancer

    NASA Astrophysics Data System (ADS)

    Henderson, Elizabeth; Milosevic, Michael F.; Haider, Masoom A.; Yeung, Ivan W. T.

    2003-09-01

    The purpose of this paper is to investigate the distribution of blood flow (F), mean capillary transit time (Tc), capillary permeability (PS) and blood volume (vb) in prostate cancer using contrast-enhanced CT. Nine stage T2-T3 prostate cancer patients were enrolled in the study. Following bolus injection of a contrast agent, a time series of CT images of the prostate was acquired. Functional maps showing the distribution of F, Tc, PS and vb within the prostate were generated using a distributed parameter tracer kinetic model, the adiabatic approximation to the tissue homogeneity model. The precision of the maps was assessed using covariance matrix analysis. Finally, maps were compared to the findings of standard clinical investigations. Eight of the functional maps demonstrated regions of increased F, PS and vb, the locations of which were consistent with the results of standard clinical investigations. However, model parameters other than F could only be measured precisely within regions of high F. In conclusion functional CT images of cancer-containing prostate glands demonstrate regions of elevated F, PS and vb. However, caution should be used when applying a complex tracer kinetic model to the study of prostate cancer since not all parameters can be measured precisely in all areas.

  16. State-of-the-art imaging of prostate cancer.

    PubMed

    Marko, Jamie; Gould, C Frank; Bonavia, Grant H; Wolfman, Darcy J

    2016-03-01

    Prostate cancer is the most common cancer in men. Modern medical imaging is intimately involved in the diagnosis and management of prostate cancer. Ultrasound is primarily used to guide prostate biopsy to establish the diagnosis of prostate carcinoma. Prostate magnetic resonance imaging uses a multiparametric approach, including anatomic and functional imaging sequences. Multiparametric magnetic resonance imaging can be used for detection and localization of prostate cancer and to evaluate for disease recurrence. Computed tomography and scintigraphic imaging are primarily used to detect regional lymph node spread and distant metastases. Recent advancements in ultrasound, multiparametric magnetic resonance imaging, and scintigraphic imaging have the potential to change the way prostate cancer is diagnosed and managed. This article addresses the major imaging modalities involved in the evaluation of prostate cancer and updates the reader on the state of the art for each modality.

  17. Prostate cancer

    SciTech Connect

    Murphy, G.P.; Kuss, R., Khoury, S.; Chatelain, C.; Denis, L.

    1987-01-01

    This book contains over 70 selections. Some of the titles are: Place of the Computed Tomography in the Staging of Prostatic Cancer; Magnetic Resonance Imaging (MRI) in Staging of the Prostatic Cancer; Magnetic Resonance Imaging of the Prostate; Long-Term Results in Radiotherapy of Prostatic Cancer; Interstitial Irradiation Using I-125 Seeds; and Treatment of Cancer of the Prostate by Use of Physiotherapy: Long-Term Results.

  18. Novel imaging in advanced prostate cancer.

    PubMed

    Goldberg, Hanan; Hamilton, Robert J

    2017-09-01

    Prostate cancer (PCa) is the most commonly diagnosed noncutaneous cancer and second leading cause of death in men. Imaging evaluation of PCa is challenging because of the prostate's deep pelvic location, its complex zonal anatomy and its multifocal nature. Novel imaging modalities are needed to improve detection, reassessment in biochemical relapse, and disease progression in advanced metastatic stages. Current imaging modalities have distinct strengths. However, all lack the ability to diagnose micrometastases, differentiate high from low-grade disease and diagnose advanced disease, especially at low prostate specific antigen values. There is a need to combine the existing imaging methods with concepts utilizing tumor biology to differentiate biologically aggressive from indolent tumors. PET imaging with novel tracers facilitate improved imaging of PCa, but also usher in new compounds that could be useful for directing treatment as well. Most tracers have limited sensitivity, with the exception of prostate-specific membrane antigen (PSMA)-targeting tracers, that offer relatively higher sensitivity and specificity. PSMA-PET appears promising in improving the imaging yield particularly in recurrent and advanced disease states. Incorporating PSMA-PET in these settings could open or prolong windows along the trajectory of the disease that could allow new treatments or more effective use of currently existing treatments. Prospective studies focusing on novel imaging enhancement and integration with therapeutic applications are needed.

  19. Photoacoustic imaging of prostate cancer using cylinder diffuse radiation

    NASA Astrophysics Data System (ADS)

    Xie, Wenming; Li, Li; Li, Zhifang; Li, Hui

    2012-12-01

    Prostate cancer is one of diseases with high mortality in man. Many clinical imaging modalities are utilized for the detection, grading and staging of prostate cancer, such as ultrasound, CT, MRI, etc. But they lacked adequate sensitivity and specificity for finding cancer in transition or central zone of prostate. To overcome these problems, we propose a photoacoustic imaging modality based on cylinder diffuse radiation through urethra for prostate cancer detection. We measure the related parameters about this system like lateral resolution (~2mm) and axial resolution(~333μm). Finally, simulated sample was imaged by our system. The results demonstrate the feasibility for detecting prostate cancer by our system.

  20. [Significance of PSMA imaging in prostate cancer].

    PubMed

    Gasch, C; Düwel, C; Kopka, K; Kratochwil, C; Vinsensia, M; Eiber, M; Maurer, T; Haberkorn, U; Hadaschik, B; Giesel, F L

    2017-01-01

    Prostate cancer (PCa) is one of the most common malignancies of men in developed countries. To improve clinical diagnostics of PCa, (68)Ga-PSMA-11 was recently introduced as a new PET tracer. (68)Ga-PSMA-11 is able to specifically bind to the prostate-specific membrane antigen (PSMA), which is upregulated on the surface of prostate cancer cells in most patients. To analyse the current significance of (68)Ga-PSMA-11 PET imaging in prostate cancer in relation to staging of men with initial diagnosis, biochemical recurrence and metastatic disease. Retrospective analysis of current literature (PubMed search) regarding (68)Ga-PSMA-11 PET diagnostics in primary staging, in biochemical recurrence and in metastasized disease. Compared to conventional imaging, (68)Ga-PSMA-11 PET/CT reaches a higher sensitivity with an excellent specificity in the clinical diagnosis of primary staging as well as staging for recurrence and advanced, metastasized disease. In biochemical recurrence, (68)Ga-PSMA-11 PET/CT shows significantly higher detection rates in comparison to choline PET/CT, especially in patients with low PSA values. In the clinical diagnosis of recurrent disease, therapy concepts were changed in more than a quarter of the patients due to the use of (68)Ga-PSMA-11 PET/CT. The significance of staging with (68)Ga-PSMA-11 PET/CT in advanced metastasized patients remains uncertain. Due to the excellent results of (68)Ga-PSMA-11 PET imaging, even in patients with slightly elevated PSA levels, it will continue to play an important role in clinical diagnostics of prostate cancer and, thus, its clinical utilization will become more widely spread.

  1. Challenges in Clinical Prostate Cancer: Role of Imaging

    PubMed Central

    Kelloff, Gary J.; Choyke, Peter; Coffey, Donald S.

    2010-01-01

    Objective This article reviews a recent 2-day workshop on prostate cancer and imaging technology that was conducted by the Cancer Imaging Program of the National Cancer Institute. The workshop dealt with research trends and avenues for improving imaging and applications across the clinical spectrum of the disease. Conclusion After a summary of prostate cancer incidence and mortality, four main clinical challenges in prostate cancer treatment and management—diagnostic accuracy; risk stratification, initial staging, active surveillance, and focal therapy; prostate-specific antigen relapse after radiation therapy or radical prostatectomy; and assessing response to therapy in advanced disease—were discussed by the 55-member panel. The overarching issue in prostate cancer is distinguishing lethal from nonlethal disease. New technologies and fresh uses for established procedures make imaging effective in both assessing and treating prostate cancer. PMID:19457806

  2. Molecular imaging of prostate cancer: a concise synopsis.

    PubMed

    Jadvar, Hossein

    2009-01-01

    Prostate cancer is the most common malignancy in men and continues to be a major public health problem. Imaging of prostate cancer remains particularly challenging owing to disease heterogeneity. Molecular imaging can provide unprecedented opportunities for deciphering the molecular mechanisms that are involved in the development and natural progression of prostate cancer from a localized process to the hormone-refractory metastatic disease. Such understanding will be the key for targeted imaging and therapy and for predicting and evaluating treatment response and prognosis. In this article, we review briefly the contribution of multimodality molecular imaging methods for the in vivo characterization of the pathophysiology of prostate cancer.

  3. Laser Illumination Modality of Photoacoustic Imaging Technique for Prostate Cancer

    NASA Astrophysics Data System (ADS)

    Peng, Dong-qing; Peng, Yuan-yuan; Guo, Jian; Li, Hui

    2016-02-01

    Photoacoustic imaging (PAI) has recently emerged as a promising imaging technique for prostate cancer. But there was still a lot of challenge in the PAI for prostate cancer detection, such as laser illumination modality. Knowledge of absorbed light distribution in prostate tissue was essential since the distribution characteristic of absorbed light energy would influence the imaging depth and range of PAI. In order to make a comparison of different laser illumination modality of photoacoustic imaging technique for prostate cancer, optical model of human prostate was established and combined with Monte Carlo simulation method to calculate the light absorption distribution in the prostate tissue. Characteristic of light absorption distribution of transurethral and trans-rectal illumination case, and of tumor at different location was compared with each other.The relevant conclusions would be significant for optimizing the light illumination in a PAI system for prostate cancer detection.

  4. PET/CT imaging and radioimmunotherapy of prostate cancer

    PubMed Central

    Bouchelouche, Kirsten; Tagawa, Scott T.; Goldsmith, Stanley J.; Turkbey, Baris; Capala, Jacek; Choyke, Peter

    2012-01-01

    Prostate cancer is a common cancer in men and continues to be a major health problem. Imaging plays an important role in the clinical management of patients with prostate cancer. An important goal for prostate cancer imaging is more accurate disease characterization through the synthesis of anatomic, functional, and molecular imaging information. Positron emission tomography (PET)/computed tomography (CT) in oncology is emerging as an important imaging tool. The most common radiotracer for PET/CT in oncology, 18F- fluorodeoxyglucose (FDG), is not very useful in prostate cancer. However, in recent years other PET tracers have improved the accuracy of PET/CT imaging of prostate cancer. Among these, choline, labelled with 18F or 11C, 11C-acetate and 18F- fluoride have demonstrated promising results, and other new radiopharmaceuticals are currently under development and evaluation in pre-clinical and clinical studies. Large prospective clinical PET/CT trials are needed to establish the role of PET/CT in prostate cancer patients. Because there are only limited available therapeutic options for advanced metastatic prostate cancer, there is an urgent need for the development of more effective treatment modalities that could improve outcome. Prostate cancer represents an attractive target for radioimmunotherapy (RIT) for several reasons, including pattern of metastatic spread (lymph nodes and bone marrow, sites with good access to circulating antibodies), and small volume disease (ideal for antigen access and antibody delivery). Furthermore, prostate cancer is also radiation sensitive. Prostate-specific membrane antigen (PSMA) is expressed by virtually all prostate cancers, and represents an attractive target for RIT. Anti PSMA RIT demonstrates antitumor activity and is well tolerated. Clinical trials are underway to further improve upon treatment efficacy and patient selection. This review focuses on the recent advances of clinical PET/CT imaging and RIT of prostate

  5. Magnetic resonance imaging for prostate cancer clinical application

    PubMed Central

    Li, Bing; Du, Yong; Huang, Yayong; Meng, Jun; Xiao, Dongmei

    2013-01-01

    As prostate cancer is a biologically heterogeneous disease for which a variety of treatment options are available, the major objective of prostate cancer imaging is to achieve more precise disease characterization. In clinical practice, magnetic resonance imaging (MRI) is one of the imaging tools for the evaluation of prostate cancer, the fusion of MRI or dynamic contrast-enhanced MRI (DCE-MRI) with magnetic resonance spectroscopic imaging (MRSI) is improving the evaluation of cancer location, size, and extent, while providing an indication of tumor aggressiveness. This review summarizes the role of MRI in the application of prostate cancer and describes molecular MRI techniques (including MRSI and DCE-MRI) for aiding prostate cancer management. PMID:23592906

  6. Prostate cancer: multiparametric MR imaging for detection, localization, and staging.

    PubMed

    Hoeks, Caroline M A; Barentsz, Jelle O; Hambrock, Thomas; Yakar, Derya; Somford, Diederik M; Heijmink, Stijn W T P J; Scheenen, Tom W J; Vos, Pieter C; Huisman, Henkjan; van Oort, Inge M; Witjes, J Alfred; Heerschap, Arend; Fütterer, Jurgen J

    2011-10-01

    This review presents the current state of the art regarding multiparametric magnetic resonance (MR) imaging of prostate cancer. Technical requirements and clinical indications for the use of multiparametric MR imaging in detection, localization, characterization, staging, biopsy guidance, and active surveillance of prostate cancer are discussed. Although reported accuracies of the separate and combined multiparametric MR imaging techniques vary for diverse clinical prostate cancer indications, multiparametric MR imaging of the prostate has shown promising results and may be of additional value in prostate cancer localization and local staging. Consensus on which technical approaches (field strengths, sequences, use of an endorectal coil) and combination of multiparametric MR imaging techniques should be used for specific clinical indications remains a challenge. Because guidelines are currently lacking, suggestions for a general minimal protocol for multiparametric MR imaging of the prostate based on the literature and the authors' experience are presented. Computer programs that allow evaluation of the various components of a multiparametric MR imaging examination in one view should be developed. In this way, an integrated interpretation of anatomic and functional MR imaging techniques in a multiparametric MR imaging examination is possible. Education and experience of specialist radiologists are essential for correct interpretation of multiparametric prostate MR imaging findings. Supportive techniques, such as computer-aided diagnosis are needed to obtain a fast, cost-effective, easy, and more reproducible prostate cancer diagnosis out of more and more complex multiparametric MR imaging data.

  7. Fusing MRI and Mechanical Imaging for Improved Prostate Cancer Diagnosis

    DTIC Science & Technology

    2016-10-01

    find out if radiomic features extracted from CT images can identify patients with high and low TILs in non-small cell lung cancer (NSCLC). Methods...AWARD NUMBER: W81XWH-15-1-0613 TITLE: Fusing MRI and Mechanical Imaging for Improved Prostate Cancer Diagnosis PRINCIPAL INVESTIGATOR: Dr...4. TITLE AND SUBTITLE Fusing MRI and Mechanical Imaging for Improved Prostate Cancer Diagnosis 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM

  8. Imaging techniques for prostate cancer: implications for focal therapy

    PubMed Central

    Turkbey, Baris; Pinto, Peter A.; Choyke, Peter L.

    2012-01-01

    The multifocal nature of prostate cancer has necessitated whole-gland therapy in the past; however, since the widespread use of PSA screening, patients frequently present with less-advanced disease. Many men with localized disease wish to avoid the adverse effects of whole-gland therapy; therefore, focal therapy for prostate cancer is being considered as a treatment option. For focal treatment to be viable, accurate imaging is required for diagnosis, staging, and monitoring of treatment. Developments in MRI and PET have brought more attention to prostate imaging and the possibility of improving the accuracy of focal therapy. In this Review, we discuss the advantages and disadvantages of conventional methods for imaging the prostate, new developments for targeted imaging, and the possible role of image-guided biopsy and therapy for localized prostate cancer. PMID:19352394

  9. Online ultrasound image guidance for radiotherapy of prostate cancer: impact of image acquisition on prostate displacement.

    PubMed

    Artignan, Xavier; Smitsmans, Monique H P; Lebesque, Jos V; Jaffray, David A; van Her, Marcel; Bartelink, Harry

    2004-06-01

    Numerous studies reported the use of ultrasound image-guidance system to assess and correct patient setup during radiotherapy for prostate cancer. We conducted a study to demonstrate and quantify prostate displacement resulting from pressure of the probe on the abdomen during transabdominal ultrasound image acquisition for prostate localization. Ten healthy volunteers were asked to undergo one imaging procedure. The procedure was performed in a condition that simulates the localization of prostate during online ultrasound guidance. A 3D ultrasound machine was used. The procedure started with the placement of the probe on the abdomen above the pubis symphysis. The probe was tilted in a caudal and posterior direction until the prostate and seminal vesicle were visualized. The probe was then fixed with a rigid arm, which maintained the probe in a static position during image acquisition. The probe was then moved, in a short time, stepwise toward the prostate, acquiring images at each step. The prostate and seminal vesicles were identified and selected in all planes. The first 3D volume was used as reference 1, to which all other scans were matched using a gray value matching algorithm. Prostate motion was quantified as a 3D translation relative to the patient coordinate system. The resulting translations represented the amount of prostate movement as a function of probe displacement. Between 7 and 11 images were obtained per volunteer, with a maximal probe displacement ranging between 3 and 6 cm. Prostate displacement was measured in all volunteers for all the probe steps and in all directions. The largest displacements occurred in the posterior direction in all volunteers. The absolute prostate motion was less than 5 mm in 100% of the volunteers after 1 cm of probe displacement, in 80% after 1.5 cm, in 40% after 2 cm, in 10% after 2.5 cm, and 0% after 3 cm. To achieved a good-quality ultrasound images, the probe requires an average displacement of 1.2 cm, and this

  10. Feasibility of Prostate Cancer Diagnosis by Transrectal Photoacoustic Imaging

    DTIC Science & Technology

    2012-03-01

    11-1-0232 TITLE: Feasibility of Prostate Cancer Diagnosis by Transrectal Photoacoustic Imaging PRINCIPAL INVESTIGATOR: Hanli Liu... Photoacoustic Imaging Hanli Liu University of Texas at Arlington Arlington, TX 76019 There is no effective imaging tool currently available for prostate... photoacoustic (PA) imaging [4]. It has been reported that the ratio of the imaging depth to spatial resolution can reach to ~100 for PA techniques

  11. Prostate cancer detection rates of magnetic resonance imaging-guided prostate biopsy related to Prostate Imaging Reporting and Data System score.

    PubMed

    Osses, Daniël F; van Asten, Joost J; Kieft, Gerard J; Tijsterman, Jasper D

    2017-02-01

    Recent studies have shown that multiparametric magnetic resonance imaging and magnetic resonance imaging-guided prostate biopsy in patients with suspected prostate cancer increase detection rate and clinical significance of diagnosed tumors. Purpose of this study is to evaluate the detection rates of prostate cancer for magnetic resonance imaging-guided prostate biopsy related to Prostate Imaging Reporting and Data System score. We included all patients with cancer-suspicious lesions on 3-Tesla multiparametric magnetic resonance imaging-prostate who underwent magnetic resonance imaging-guided prostate biopsy in Haga Teaching Hospital between January 2013 and January 2015. In total, 155 patients were included. In 100 of 155 (65 %) men, MRI-guided prostate biopsy was positive for prostate cancer. No biopsy of PI-RADS 2-lesions was positive. PI-RADS 3- and 4-lesions were, respectively, in 10 and 77 % prostate cancer positive. Biopsies of PI-RADS 5-lesions were in 89 % of the cases positive. The majority of detected cancers (63 %) were Gleason score ≥ 7, and this number increases to 75 % in positive PI-RADS 5-lesions. Magnetic resonance imaging-guided prostate biopsy has a high detection rate of prostate cancer in men with cancer-suspicious lesions on multiparametric magnetic resonance imaging-prostate, and this rate (65 %) increases with the Prostate Imaging Reporting and Data System score (81 % in PI-RADS 4- and 5-lesions).

  12. AEG-1 promoter-mediated imaging of prostate cancer

    PubMed Central

    Bhatnagar, Akrita; Wang, Yuchuan; Mease, Ronnie C.; Gabrielson, Matthew; Sysa, Polina; Minn, Il; Green, Gilbert; Simmons, Brian; Gabrielson, Kathleen; Sarkar, Siddik; Fisher, Paul B.; Pomper, Martin G.

    2014-01-01

    We describe a new imaging method for detecting prostate cancer, whether localized or disseminated and metastatic to soft tissues and bone. The method relies on the use of imaging reporter genes under the control of the promoter of AEG-1 (MTDH), which is selectively active only in malignant cells. Through systemic, nanoparticle-based delivery of the imaging construct, lesions can be identified through bioluminescence imaging and single photon emission-computed tomography in the PC3-ML murine model of prostate cancer at high sensitivity. This approach is applicable for the detection of prostate cancer metastases, including bone lesions for which there is no current reliable agent for non-invasive clinical imaging. Further, the approach compares favorably to accepted and emerging clinical standards, including positron emission tomography with [18F]fluorodeoxyglucose and [18F]sodium fluoride. Our results offer a preclinical proof of concept that rationalizes clinical evaluation in patients with advanced prostate cancer. PMID:25145668

  13. Prostate cancer - the role of magnetic resonance imaging.

    PubMed

    Mocikova, Ingrid; Babela, Jozef; Balaz, Vladimir

    2012-06-01

    This article reviews the potential of magnetic resonance imaging (MRI) in prostate cancer diagnosis. Systematic scan of Pubmed, Ovid, Medline, Elsevier search engines was used, additional information was found through bibliographic review of relevant articles. Results. Substantial progress has been made in the imaging of prostate cancer in MR imaging, as well as in advanced MR spectroscopy. MRI is a non-invasive and direct imaging modality useful for cancer staging, therapy response, detection of recurrence and guided biopsy in previous negative biopsies. MRI with 3.0T system, whole-body MRI, dynamic contrast enhanced MRI, diffusion-weighted imaging (DWI) and MR spectroscopy (MRS) have improved tumor staging, assessment of tumor volume, aggressiveness or recurrence. Implementation of endorectal/phased array superficial MRI findings on 1.5 or 3.0T systems into nomograms for prostate pretreatment prediction is warranted. Surface phasedarray coil MRI accurately defines prostate cancer with elevated risk of extraprostatic disease.

  14. Prostate Cancer

    MedlinePlus

    ... version of this page please turn Javascript on. Prostate Cancer What is Prostate Cancer? How Tumors Form The body is made up ... the Escape (Esc) button on your keyboard.) How Prostate Cancer Occurs Prostate cancer occurs when a tumor forms ...

  15. Angiogenesis in prostate cancer: onset, progression and imaging.

    PubMed

    Russo, Giovanna; Mischi, Massimo; Scheepens, Wout; De la Rosette, Jean J; Wijkstra, Hessel

    2012-12-01

    What's known on the subject? and What does the study add? Today, angiogenesis is known to play a key role in cancer growth and development. Emerging cancer treatments are based on the suppression of angiogenesis, and modern imaging techniques investigate changes in the microvasculature that are caused by angiogenesis. As for other forms of cancers, angiogenesis is well recognised as a fundamental process in the development of prostate cancer. The novelty of this extensive report on angiogenesis in cancer, with particular attention on prostate cancer and the imaging techniques able to detect it, is the new prospective to the subject. In contrast with the other available reviews, this report goes from 'theory' to 'practice', establishing a clear link between angiogenesis development and imaged angiogenesis features. Once the key role of angiogenesis in the development of cancer and in particular prostate cancer has been fully described, attention is turned to the current imaging methods with the potential to assess the angiogenesis process and, as a consequence, to detect and localise prostate cancer. • As confirmed by all available statistics, cancer represents a major clinical and societal problem in the developed world. The form of cancer with the highest incidence in men is prostate cancer. For prostate cancer, as well as for most forms of cancer, detection of the disease at an early stage is critical to reduce mortality and morbidity. • Today, it is well known that pathological angiogenesis represents a crucial step in cancer development and progression. Comparable with most forms of cancer, angiogenesis also plays a fundamental role for prostate cancer growth. • As a consequence, angiogenesis is an ideal target not only for novel anti-angiogenic therapies, but also for modern imaging techniques that aim at cancer localisation by detection of angiogenic microvascular changes. • These techniques are mainly based on magnetic resonance, ultrasound, and

  16. Prostate Cancer: The Role of Multiparametric Magnetic Resonance Imaging.

    PubMed

    Dias, João Lopes; Pina, João Magalhães; João, Raquel; Fialho, Joana; Carmo, Sandra; Leal, Cecília; Bilhim, Tiago; Marques, Rui Mateus; Pinheiro, Luís Campos

    2015-01-01

    Multiparametric magnetic resonance imaging has been increasingly used for detection, localization and staging of prostate cancer over the last years. It combines high-resolution T2 weighted-imaging and at least two functional techniques, which include dynamic contrast-enhanced magnetic resonance imaging, diffusion-weighted imaging, and magnetic resonance imaging spectroscopy. Although the combined use of a pelvic phased-array and an endorectal coil is considered the state-of-the-art for magnetic resonance imaging evaluation of prostate cancer, endorectal coil is only absolute mandatory for magnetic resonance imaging spectroscopy at 1.5 T. Sensitivity and specificity levels in cancer detection and localization have been improving with functional technique implementation, compared to T2 weighted-imaging alone. It has been particularly useful to evaluate patients with abnormal PSA and negative biopsy. Moreover, the information added by the functional techniques may correlate to cancer aggressiveness and therefore be useful to select patients for focal radiotherapy, prostate sparing surgery, focal ablative therapy and active surveillance. However, more studies are needed to compare the functional techniques and understand the advantages and disadvantages of each one. This article reviews the basic principles of prostatic mp-magnetic resonance imaging, emphasizing its role on detection, staging and active surveillance of prostate cancer.

  17. Prostate cancer: state of the art imaging and focal treatment.

    PubMed

    Woodrum, D A; Kawashima, A; Gorny, K R; Mynderse, L A

    2017-08-01

    In 2016, it is estimated 180,890 men are newly diagnosed with prostate cancer and 3,306,760 men live with prostate cancer in the United States. The introduction of multiparametric (mp) magnetic resonance imaging (MRI) of the prostate, standardised interpretation guidelines such as Prostate Imaging Reporting and Data System (PI-RADS version 2), and MRI-based targeted biopsy has improved detection of clinically significant prostate cancer. Accurate risk stratification (Gleason grade/score and tumour stage) using imaging and image-guided targeted biopsy has become critical for the management of patients with prostate cancer. Recent advances in MRI-guided minimally invasive ablative treatment (MIAT) utilising cryoablation, laser ablation, high-intensity focused ultrasound ablation, have allowed accurate focal or regional delivery of optimal thermal energy to the biopsy proven, MRI-detected tumour, under real-time or near simultaneous MRI monitoring of the ablation zone. A contemporary review on prostate mpMRI, MRI-based targeted biopsy, and MRI-guided ablation techniques is presented. Copyright © 2017. Published by Elsevier Ltd.

  18. Prostate cancer magnetic resonance imaging (MRI): multidisciplinary standpoint.

    PubMed

    Li, Liang; Wang, Liang; Feng, Zhaoyan; Hu, Zhiquan; Wang, Guoping; Yuan, Xianglin; Wang, He; Hu, Daoyu

    2013-04-01

    Prostate cancer is the most common cancer diagnosed in men and a leading cause of death. Accurate assessment is a prerequisite for optimal clinical management and therapy selection of prostate cancer. There are several parameters and nomograms to differentiate between patients with clinically insignificant disease and patients in need of treatment. Magnetic resonance imaging (MRI) is a technique which provides more detailed anatomical images due to high spatial resolution, superior contrast resolution, and multiplanar capability. State-of-the-art MRI techniques, such as diffusion weighted imaging (DWI), MR spectroscopic imaging (MRSI), dynamic contrast enhanced MRI (DCE-MRI), improve interpretation of prostate cancer imaging. In this article, we review the major role of MRI in the advanced management of prostate cancer to noninvasively improve tumor staging, biologic potential, treatment planning, therapy response, local recurrence, and to guide target biopsy for clinical suspected cancer with previous negative biopsy. Finally, future challenges and opportunities in prostate cancer management in the area of functional MRI are discussed as well.

  19. ProxiScan™: A Novel Camera for Imaging Prostate Cancer

    SciTech Connect

    Ralph James

    2009-10-27

    ProxiScan is a compact gamma camera suited for high-resolution imaging of prostate cancer. Developed by Brookhaven National Laboratory and Hybridyne Imaging Technologies, Inc., ProxiScan won a 2009 R&D 100 Award, sponsored by R&D Magazine to recognize t

  20. MR Imaging Based Treatment Planning for Radiotherapy of Prostate Cancer

    DTIC Science & Technology

    2008-02-01

    C-M Ma. Benefit of three-dimensional image-guided stereotactic localization in the hypofractionated treatment of lung cancer. International... hypofractionated treatment of lung cancer. Medical Physics, 2006; 33: 1993 11. Chen Z, Ma C, Li J, Paskalev K, Price R, Luo W, Fan J, Stathakis S, Chen Y, Lin T...study for clinical implementation of dose hypofractionation with IMRT for prostate cancer. Proc. Medical Physics, 31(6), 1788, 2004. Lili Chen

  1. PSMA Ligands for PET Imaging of Prostate Cancer.

    PubMed

    Schwarzenboeck, Sarah M; Rauscher, Isabel; Bluemel, Christina; Fendler, Wolfgang P; Rowe, Steven P; Pomper, Martin G; Asfhar-Oromieh, Ali; Herrmann, Ken; Eiber, Matthias

    2017-10-01

    Targeting the prostate-specific membrane antigen (PSMA) with (68)Ga-labeled and (18)F-labeled PET agents has become increasingly important in recent years. Imaging of biochemically recurrent prostate cancer has been established as a widely accepted clinical indication for PSMA ligand PET/CT in many parts of the world because of the results of multiple, primarily retrospective, studies that indicate superior detection efficacy compared with standard-of-care imaging. For high-risk primary prostate cancer, evidence is growing that this modality significantly aids in the detection of otherwise occult nodal and bone metastases. For both clinical indications in recurrent as well as in primary prostate cancer, preliminary data demonstrate a substantial impact on clinical management. Emerging data imply that intraprostatic tumor localization, therapy stratification, and treatment monitoring of advanced disease in specific clinical situations might become future indications. Current criteria for image reporting of PSMA ligand PET are evolving given the expanding body of literature on physiologic and pathologic uptake patterns and pitfalls. This article intends to give an educational overview on the current status of PSMA ligand PET imaging, including imaging procedure and interpretation, clinical indications, diagnostic potential, and impact on treatment planning. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

  2. Prostate cancer diagnosis with fluorescence lifetime imaging (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Sridharan, Shamira; Gandour-Edwards, Regina F.; Dall'Era, Marc; Marcu, Laura

    2017-02-01

    More than 1 million men in the United States undergo a prostate biopsy procedure annually and approximately 200,000 men receive a diagnosis of prostate cancer. 5-10% of these men have to undergo a repeat biopsy due to insufficient tissue sampling. We are studying the utility of a multi-spectral time resolved fluorescence spectroscopy (MS-TRFS) technique for real-time prostate cancer diagnosis. The MS-TRFS imaging setup, which includes a fiberoptic set-up with a 355nm excitation light source coupled with a blue (450nm) aiming beam, was used to image ex-vivo prostatectomy specimen. The prostate tissue from 11 patients was sectioned at 2mm thickness and the fluorescence lifetime information was overlaid spatially for histology and thus, diagnostic co-registration. Initial results show that fluorescence lifetime in the 390±40nm channel, which measures collagen and elastin signatures, is longer for glandular regions than in the stromal regions. Additionally, lifetime in the 452±45nm channel, corresponding to NAD redox state, is longer in the cancerous glandular region in comparison with the normal glandular regions. Current work is focused on developing real-time quantitative algorithms to combine the fluorescence signatures from the two channels for performing prostate cancer diagnosis on biopsies.

  3. [Usefulness of magnetic resonance imaging in prostate cancer].

    PubMed

    Vilanova, J C; Comet, J; Garcia-Figueiras, R; Barceló, J; Boada, M

    2010-01-01

    In the last decade, technical advances in magnetic resonance imaging (MRI) have made it the technique of choice in the overall management of patients with suspected or confirmed prostate cancer. MR makes it possible to acquire information about morphology and function in the same examination by using techniques like spectroscopy, diffusion, and dynamic sequences with intravenous contrast material administration. Moreover, MRI enables both focused study of the prostate gland and of regional and/or whole-body involvement, depending on the clinical indications, in less than an hour. The main clinical indications for MRI of the prostate are a) staging local, regional, and/or remote disease; b) detecting prostate cancer or guiding prostate biopsy in cases of clinical suspicion or negative findings in previous biopsy specimens; and c) monitoring the response to treatment. It is important to know the different protocols with specific MRI sequences for the prostate, depending on the different clinical indications, to ensure that they are performed and interpreted correctly. This article provides up-to-date information about the use of MRI for the study of the prostate to show how the morphological and functional information can be used in clinical practice. Copyright © 2009 SERAM. Published by Elsevier Espana. All rights reserved.

  4. Prostate Cancer

    MedlinePlus

    Prostate cancer Overview Prostate cancer is cancer that occurs in the prostate — a small walnut-shaped gland in men that produces the seminal fluid that nourishes and transports sperm. Prostate cancer is one of the most common types of ...

  5. Multiparametric magnetic resonance imaging and prostate cancer: what's new?

    PubMed

    Catalá, V; Vilanova, J C; Gaya, J M; Algaba, F; Martí, T

    2017-02-21

    Prostatic multi-parametric magnetic resonance imaging (MP-MRI) has recently had a wide development becoming a key tool in the diagnostic and therapeutic decisions in prostate cancer (Pca). The fast development both in technology and in reading (PIRADS V2) requires a continuous updating of knowledge within this area. The aim of this article is to present an updated revision of technical aspects, reading patterns and prostatic MP-MRI in Pca, with a multidisciplinary approach. Currently guidelines establish the use of the MP-MRI when there is a high PSA and a negative prostatic biopsy; tumor staging; evaluation in candidates to active surveillance; focal treatments plans and tumoral recurrence evaluation. Although it is used in other indications in some centers, like its use in patients suspicious of Pca but with no previous biopsy, there is still the need of a cost/benefit assessment for its use to be wider.

  6. Imaging Prostatic Lipids to Distinguish Aggressive Prostate Cancer

    DTIC Science & Technology

    2013-09-01

    prostatectomy. Each patient will complete one proton magnetic resonance spectroscopy imaging session and provide access to his prostatectomy tissue ...identify tissues with higher FAS activity, which in turn will be those that exhibit more aggressive disease. In more aggressive cancer tissues , we expect to...prostatectomy with FAS protein expression measured in benign and cancer tissue from prostatectomy samples; 2) identify the association between FAS protein

  7. Multi-parametric MR imaging of transition zone prostate cancer: Imaging features, detection and staging

    PubMed Central

    Kayhan, Arda; Fan, Xiaobing; Oommen, Jacob; Oto, Aytekin

    2010-01-01

    Magnetic resonance (MR) imaging has been increasingly used in the evaluation of prostate cancer. As studies have suggested that the majority of cancers arise from the peripheral zone (PZ), MR imaging has focused on the PZ of the prostate gland thus far. However, a considerable number of cancers (up to 30%) originate in the transition zone (TZ), substantially contributing to morbidity and mortality. Therefore, research is needed on the TZ of the prostate gland. Recently, MR imaging and advanced MR techniques have been gaining acceptance in evaluation of the TZ. In this article, the MR imaging features of TZ prostate cancers, the role of MR imaging in TZ cancer detection and staging, and recent advanced MR techniques will be discussed in light of the literature. PMID:21161033

  8. Multiparametric magnetic resonance imaging and active surveillance: How to better select insignificant prostate cancer?

    PubMed

    Porpiglia, Francesco; Cantiello, Francesco; De Luca, Stefano; De Pascale, Agostino; Manfredi, Matteo; Mele, Fabrizio; Bollito, Enrico; Cirillo, Stefano; Damiano, Rocco; Russo, Filippo

    2016-09-01

    To evaluate the role of multiparametric magnetic resonance imaging in improving the predictive accuracy of the Prostate Cancer Research International: Active Surveillance and Epstein criteria for active surveillance in prostate cancer. A retrospective study was carried out with 126 prostate cancer patients treated with robot-assisted radical prostatectomy, but eligible for active surveillance according to the Prostate Cancer Research International: Active Surveillance criteria; 63 patients were also eligible according to the Epstein criteria. All patients underwent preoperative multiparametric magnetic resonance imaging, after at least 6 weeks from biopsy. The images from the multiparametric magnetic resonance imaging were assessed, and diagrams showing prostate sextants were used to designate regions of abnormalities within the prostate. Findings in the prostate were assigned to one of five categories according the Prostate Imaging-Reporting and Data System guidelines (v1.0), and considered positive for prostate cancer if the final Prostate Imaging-Reporting and Data System guidelines were >3 and negative if ≤3. Multivariate logistic regression analysis was carried out to evaluate the gain in accuracy of the Prostate Cancer Research International: Active Surveillance and Epstein criteria when added to multiparametric magnetic resonance imaging. Decision curve analysis was carried out to identify the net benefit of each model. The inclusion of multiparametric magnetic resonance imaging to the Epstein criteria and the Prostate Cancer Research International: Active Surveillance multivariate model significantly increased their accuracy in predicting pathologically-confirmed insignificant prostate cancer by 7% and 5%, respectively. At the decision curve analysis evaluation, the model including the Prostate Cancer Research International: Active Surveillance criteria and multiparametric magnetic resonance imaging improved the clinical risk prediction over the other

  9. Synthesis of PSA Inhibitors as SPECT- and PET-Based Imaging Agents for Prostate Cancer

    DTIC Science & Technology

    2011-06-01

    for their ability to inhibit PSA and chymotrypsin. 15. SUBJECT TERMS Prostate cancer , PSA inhibitors, boronic acids, peptidomimetics, serine protease...prostate cancer . First, all men undergoing androgen ablation, eventually relapse and no longer respond to hormone treatment . Therefore, there is an...Imaging Agents for Prostate Cancer PRINCIPAL INVESTIGATOR: Maya Kostova, Ph.D. CONTRACTING ORGANIZATION: Johns Hopkins University

  10. Gold nanocages for imaging and therapy of prostate cancer cells

    NASA Astrophysics Data System (ADS)

    Sironi, Laura; Avvakumova, Svetlana; Galbiati, Elisabetta; Locarno, Silvia A.; Macchi, Chiara; D'Alfonso, Laura; Ruscica, Massimiliano; Magni, Paolo; Collini, Maddalena; Romeo, Sergio; Chirico, Giuseppe; Prosperi, Davide

    2016-04-01

    Gold nanocages (AuNCs) have been shown to be a useful tool both for imaging and hyperthermia therapy of cancer, thanks to their outstanding optical properties, low toxicity and facile functionalization with targeting molecules, including peptides and antibodies. In particular, hyperthermia is a minimally invasive therapy which takes advantage of the peculiar properties of gold nanoparticles to efficiently convert the absorbed light into heat. Here, we use AuNCs for the selective targeting and imaging of prostate cancer cells. Moreover, we report the hyperthermic effect characterization of the AuNCs both in solution and internalized in cells. Prostate cancer cells were irradiated at different exposure times, with a pulsed near infrared laser, and the cellular viability was evaluated by confocal microscopy.

  11. Boundary delineation in transrectal ultrasound image for prostate cancer.

    PubMed

    Zhang, Ying; Sankar, Ravi; Qian, Wei

    2007-11-01

    This paper presents a new advanced automatic edge delineation model for the detection and diagnosis of prostate cancer on transrectal ultrasound (TRUS) images. The proposed model is to improve prostate boundary detection system by modifying a set of preprocessing algorithms including tree-structured nonlinear filter (TSF), directional wavelet transforms (DWT) and tree-structured wavelet transform (TSWT). The model consists of a preprocessing module and a segmentation module. The preprocessing module is implemented for noise suppression, image smoothing and boundary enhancement. The active contours model is used in the segmentation module for prostate boundary detection in two-dimensional (2D) TRUS images. Experimental results show that the addition of the preprocessing module improves the accuracy and sensitivity of the segmentation module, compared to the implementation of the segmentation module alone. It is believed that the proposed automatic boundary detection module for the TRUS images is a promising approach, which provides an efficient and robust detection and diagnosis strategy and acts as "second opinion" for the physician's interpretation of prostate cancer.

  12. Imaging of Prostate Cancer Using (64)Cu-Labeled Prostate-Specific Membrane Antigen Ligand.

    PubMed

    Singh, Aviral; Kulkarni, Harshad R; Baum, Richard P

    2017-04-01

    Prostate cancer is the most common noncutaneous cancer among men, rendering the diagnosis and staging of significant medical and public interest. One of the most interesting developments in the application of nuclear oncology has been the development of novel diagnostic agents that are able to facilitate targeted therapies using the concept of theranostics. This review summarizes the current and emerging molecular imaging techniques for the investigation of patients with prostate cancer with emphasis on the potential of (64)Cu-PSMA PET/CT in staging, restaging, and the application of theranostics.

  13. Innovations in diagnostic imaging of localized prostate cancer.

    PubMed

    Pummer, Karl; Rieken, Malte; Augustin, Herbert; Gutschi, Thomas; Shariat, Shahrokh F

    2014-08-01

    In recent years, various imaging modalities have been developed to improve diagnosis, staging, and localization of early-stage prostate cancer (PCa). A MEDLINE literature search of the time frame between 01/2007 and 06/2013 was performed on imaging of localized PCa. Conventional transrectal ultrasound (TRUS) is mainly used to guide prostate biopsy. Contrast-enhanced ultrasound is based on the assumption that PCa tissue is hypervascularized and might be better identified after intravenous injection of a microbubble contrast agent. However, results on its additional value for cancer detection are controversial. Computer-based analysis of the transrectal ultrasound signal (C-TRUS) appears to detect cancer in a high rate of patients with previous biopsies. Real-time elastography seems to have higher sensitivity, specificity, and positive predictive value than conventional TRUS. However, the method still awaits prospective validation. The same is true for prostate histoscanning, an ultrasound-based method for tissue characterization. Currently, multiparametric MRI provides improved tissue visualization of the prostate, which may be helpful in the diagnosis and targeting of prostate lesions. However, most published series are small and suffer from variations in indication, methodology, quality, interpretation, and reporting. Among ultrasound-based techniques, real-time elastography and C-TRUS seem the most promising techniques. Multiparametric MRI appears to have advantages over conventional T2-weighted MRI in the detection of PCa. Despite these promising results, currently, no recommendation for the routine use of these novel imaging techniques can be made. Prospective studies defining the value of various imaging modalities are urgently needed.

  14. Carr-Purcell-Meiboom-Gill imaging of prostate cancer: quantitative T2 values for cancer discrimination.

    PubMed

    Roebuck, Joseph R; Haker, Steven J; Mitsouras, Dimitris; Rybicki, Frank J; Tempany, Clare M; Mulkern, Robert V

    2009-05-01

    Quantitative, apparent T(2) values of suspected prostate cancer and healthy peripheral zone tissue in men with prostate cancer were measured using a Carr-Purcell-Meiboom-Gill (CPMG) imaging sequence in order to assess the cancer discrimination potential of tissue T(2) values. The CPMG imaging sequence was used to image the prostates of 18 men with biopsy-proven prostate cancer. Whole gland coverage with nominal voxel volumes of 0.54 x 1.1 x 4 mm(3) was obtained in 10.7 min, resulting in data sets suitable for generating high-quality images with variable T(2)-weighting and for evaluating quantitative T(2) values on a pixel-by-pixel basis. Region-of-interest analysis of suspected healthy peripheral zone tissue and suspected cancer, identified on the basis of both T(1)- and T(2)-weighted signal intensities and available histopathology reports, yielded significantly (P<.0001) longer apparent T(2) values in suspected healthy tissue (193+/-49 ms) vs. suspected cancer (100+/-26 ms), suggesting potential utility of this method as a tissue specific discrimination index for prostate cancer. We conclude that CPMG imaging of the prostate can be performed in reasonable scan times and can provide advantages over T(2)-weighted fast spin echo (FSE) imaging alone, including quantitative T(2) values for cancer discrimination as well as proton density maps without the point spread function degradation associated with short effective echo time FSE sequences.

  15. Tomographic needles and catheters for optical imaging of prostatic cancer

    NASA Astrophysics Data System (ADS)

    Jacques, Steven L.; Motamedi, Massoud

    1995-05-01

    Early detection of prostatic cancer currently depends on Prostate Serum Antigen or TransRectal UltraSound. Unfortunately, these techniques are not always reliable indicators for early small lesions still localized within the prostate. This paper presents a feasibility study on the use of `tomographic needles and catheters' for optical imaging of early lesions. Three needles are inserted perianeally into the prostate or two catheters are inserted into the rectal and urethral passages. Each contains a set of optical fibers which terminate at evenly spaced positions along the needle. Each termination serves as either a source or collector for light transmission as each fiber is sequentially illuminated. Application of a tomographic algorithm based on diffuse light transmission between each source/collector pair yields a fuzzy but spectrally informative image of the prostate. This paper addresses the issue of feasibility by asking whether such a technique can distinguish a large zone of slightly alter optical properties (essentially a region of normal tissue) from a small zone of strongly altered optical properties (a tumor). The paper simulates both steady-state and 3-GHz frequency-domain optical measurements.

  16. Thermoacoustic imaging of prostate cancer: comparison to histology

    NASA Astrophysics Data System (ADS)

    Patch, S. K.; Griep, S. K.; Jacobsohn, K.; See, W. A.; Hull, D.

    2014-03-01

    Ex vivo imaging of fresh prostate specimens was performed to test the hypothesis that the thermoacoustic (TA) contrast mechanism generated with very high frequency electromagnetic (EM) irradiation is sensitive to prostate cancer. Ex vivo imaging was performed immediately after radical prostatectomy, performed as part of normal care. Irradiation pulsewidth was 700 ns and duty cycle was extremely low. Typical specific absorption rate (SAR) throughout the prostate was 70-90 kW/kg during pulsing, but time-averaged SAR was below 2 W/kg. TA pressure pulses generated by rapid heating due to EM energy deposition were detected using single element transducers. 15g/L glycine powder mixed into DI water served as acoustic couplant, which was chilled to prevent autolysis. Spatial encoding was performed by scanning in tomographic "step-and-shoot" mode, with 3 mm translation between slices and 1.8-degree rotation between tomographic views. Histology slides for 3 cases scanned with 2.25 MHz transducers were marked for comparison to TA reconstructions. These three cases showed little, moderate, and severe involvement in the histology levels surrounding the verumontanum. TA signal strength decreased with percent cancerous involvement. When VHF is used for tissue heating, the TA contrast mechanism is driven by ionic content and we observed suppressed TA signal from diseased prostate tissue in the peripheral zone. For the 45 regions of interest analyzed, a reconstruction value of 0.4 mV provides 100% sensitivity but only 29% specificity.

  17. Prostate Cancer

    MedlinePlus

    ... man's bladder that produces fluid for semen. Prostate cancer is common among older men. It is rare ... younger than 40. Risk factors for developing prostate cancer include being over 65 years of age, family ...

  18. Registering Histological and MR Images of Prostate for Image-based Cancer Detection

    PubMed Central

    Zhan, Yiqiang; Ou, Yangming; Feldman, Michael; Tomaszeweski, John; Davatzikos, Christos; Shen, Dinggang

    2008-01-01

    Rationale and Objectives Needle biopsy is currently the only way to confirm prostate cancer. To increase prostate cancer diagnostic rate, needles are expected to be deployed at suspicious cancer locations. High contrast MR imaging provides a powerful tool for detecting suspicious cancerous tissues. To do this, MR appearances of cancerous tissue should be characterized and learned from a sufficient number of prostate MR images with known cancer information. However, ground-truth cancer information is only available in histological images. Therefore, it is necessary to warp ground-truth cancerous regions in histological images to MR images by a registration procedure. The objective of this paper is to develop a registration technique for aligning histological and MR images of the same prostate. Material and Methods Five pairs of histological and T2-weighted MR images of radical prostatectomy specimens are collected. For each pair, registration is guided by two sets of correspondences that can be reliably established on prostate boundaries and internal salient blob-like structures of histological and MR images. Results Our developed registration method can accurately register histological and MR images. It yields results comparable to manual registration, in terms of landmark distance and volume overlap. It also outperforms both affine registration and boundary-guided registration methods. Conclusions We have developed a novel method for deformable registration of histological and MR images of the same prostate. Besides the collection of ground-truth cancer information in MR images, the method has other potential applications. An automatic, accurate registration of histological and MR images actually builds a bridge between in vivo anatomical information and ex vivo pathological information, which is valuable for various clinical studies. PMID:17964460

  19. Molecular Imaging and Precision Medicine in Prostate Cancer.

    PubMed

    Ceci, Francesco; Fiorentino, Michelangelo; Castellucci, Paolo; Fanti, Stefano

    2017-01-01

    The aim of the present review is to discuss about the role of new probes for molecular imaging in the evaluation of prostate cancer (PCa). This review focuses particularly on the role of new promising radiotracers for the molecular imaging with PET/computed tomography in the detection of PCa recurrence. The role of these new imaging techniques to guide lesion-target therapies and the potential application of these molecular probes as theranostics agents is discussed. Finally, the molecular mechanisms underlying resistance to castration in PCa and the maintenance of active androgen receptor are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Intermittent Ultrasound Imaging of Prostate Cancer

    DTIC Science & Technology

    2005-08-01

    Gleason score for non-palpable lesions. Urology 49:709-715, 1997. Bogers HA. Sedelaar JP. Beerlage HP. de la Rosette JJ. Debruyne FM. Wijkstra H. Aarnink...Specimens in Twelve Patients. Radiology 222:361-366, 2002. xliv Eskew LA, Bare RL, McCullough DL . Systematic 5 region prostate biopsy is superior to

  1. A Review of Imaging Methods for Prostate Cancer Detection

    PubMed Central

    Sarkar, Saradwata; Das, Sudipta

    2016-01-01

    Imaging is playing an increasingly important role in the detection of prostate cancer (PCa). This review summarizes the key imaging modalities—multiparametric ultrasound (US), multiparametric magnetic resonance imaging (MRI), MRI–US fusion imaging, and positron emission tomography (PET) imaging—used in the diagnosis and localization of PCa. Emphasis is laid on the biological and functional characteristics of tumors that rationalize the use of a specific imaging technique. Changes to anatomical architecture of tissue can be detected by anatomical grayscale US and T2-weighted MRI. Tumors are known to progress through angiogenesis—a fact exploited by Doppler and contrast-enhanced US and dynamic contrast-enhanced MRI. The increased cellular density of tumors is targeted by elastography and diffusion-weighted MRI. PET imaging employs several different radionuclides to target the metabolic and cellular activities during tumor growth. Results from studies using these various imaging techniques are discussed and compared. PMID:26966397

  2. Multiparametric magnetic resonance imaging predicts the presence of prostate cancer in patients with negative prostate biopsy.

    PubMed

    Lista, F; Castillo, E; Gimbernat, H; Rodríguez-Barbero, J M; Panizo, J; Angulo, J C

    2015-03-01

    To assess the ability of multiparametric prostate magnetic resonance imaging (mpMRI) to detect prostate cancer in patients with prior negative transrectal prostate biopsy (TPB). mpMRI (TSE-T2-w, DWI and DCE sequences) was performed on 1.5T (Magnetom Avanto; Siemens Healthcare Solutions) in 150 patients suspicious of prostate cancer and with negative TPB. European Society of Urogenital Radiology (ESUR) criteria were used (score 1: clinically significant disease is highly unlikely to be present; score 2: clinically significant cancer is unlikely to be present; score 3: clinically significant cancer is equivocal; score 4: clinically significant cancer is likely to be present; score 5: clinically significant cancer is highly likely to be present). PSA measurement (total and free), digital rectal examination (DRE), transrectal ultrasound (TRU) and a second TPB (at least 14 cylinders) were performed in all patients. Variables were submitted for independent blind analysis. The accuracy of each test was measured. Stepwise selection model for prediction of prostate cancer in second TPB was developed. Mean age was 66.2± 5 years (51-77), mean PSA 11.3± 9.6ng/mL (0.9-75) and mean prostatic volume 82.2±42 (20-250) cc. DRE was suspicious in 11 (7.3%) patients. The mean number of cylinders per patient sampled in second TRB was 17.6±2.7(14-22). Second TRB was positive in 28 patients (18.7%). mpMRI was positive (score 3-5) in 102 (68%), test sensibility was 92.9% and the NPV was 95.8%. The risk of prostate cancer diagnosis in second TPB is modified by: PSA velocity > 0.75 (OR 1.04 [0.99-1.08]; P=0.06), free/total ratio PSA <15% (OR 0.37 [0.13-1.05]; P=0.06), each cc. of prostate volume (OR 0.98 [0.97-1]; P=0.017) and mpMRI 3-5 (OR 7.87 [1.78-34.7]; P=0.006). Multivariate analysis reveals that mpMRI (OR 7.41 [1.65-33.28]; P=0.009) and prostatic volume (OR 0.31 [0.12-0.78]; P=0.01) are independent risk predictors of prostate cancer. According to ESUR guidelines and in patients

  3. Recent Advances in Metabolic Profiling And Imaging of Prostate Cancer

    PubMed Central

    Thapar, Roopa; Titus, Mark A

    2015-01-01

    Cancer is a metabolic disease. Cancer cells, being highly proliferative, show significant alterations in metabolic pathways such as glycolysis, respiration, the tricarboxylic acid (TCA) cycle, oxidative phosphorylation, lipid metabolism, and amino acid metabolism. Metabolites like peptides, nucleotides, products of glycolysis, the TCA cycle, fatty acids, and steroids can be an important read out of disease when characterized in biological samples such as tissues and body fluids like urine, serum, etc. The cancer metabolome has been studied since the 1960s by analytical techniques such as mass spectrometry (MS) and nuclear magnetic resonance (NMR) spectroscopy. Current research is focused on the identification and validation of biomarkers in the cancer metabolome that can stratify high-risk patients and distinguish between benign and advanced metastatic forms of the disease. In this review, we discuss the current state of prostate cancer metabolomics, the biomarkers that show promise in distinguishing indolent from aggressive forms of the disease, the strengths and limitations of the analytical techniques being employed, and future applications of metabolomics in diagnostic imaging and personalized medicine of prostate cancer. PMID:25632377

  4. Comparison of image-guided radiotherapy technologies for prostate cancer.

    PubMed

    Das, Satya; Liu, Tian; Jani, Ashesh B; Rossi, Peter; Shelton, Joseph; Shi, Zheng; Khan, Mohammad K

    2014-12-01

    Radiation oncology has seen a rapid increase in the use of image-guided radiotherapy technology (IGRT) for prostate cancer patients over the past decade. The increase in the use of IGRT is largely driven by the fact that these technologies have been approved by the Food and Drug Administration and are now readily reimbursed by many insurance companies. Prostate cancer patients undergoing intensity modulated radiotherapy (IMRT) now have access to a wide variety of IGRTs that can cost anywhere from $500,000 or more in upfront costs, and can add anywhere from 10 to 15 thousand dollars to a course of IMRT. Some of the IGRT options include daily cone beam computed tomography, ultrasound, orthogonal x-ray units using implanted fiducial markers, implanted radiofrequency markers with the ability to localize and track prostate motion during radiotherapy (Calypso 4D), and cine magnetic resonance imaging. Although these technologies add to the cost of IMRT, there is little direct comparative effectiveness data to help patients, physicians, and policy makers decide if one technology is better than another. In our critical review, the first of its kind, we summarize the advantages, disadvantages, and the limitations of each technology. We also provide an overview of existing literature as it pertains to the comparison of existing IGRTs. Lastly, we provide insights about the need for future outcomes research that may have a significant impact on health policies as it comes to reimbursement in the modern era.

  5. Metabolic Imaging in Prostate Cancer: Where We Are

    PubMed Central

    Testa, Claudia; Pultrone, Cristian; Manners, David Neil; Schiavina, Riccardo; Lodi, Raffaele

    2016-01-01

    In recent years, the development of diagnostic methods based on metabolic imaging has been aimed at improving diagnosis of prostate cancer (PCa) and perhaps at improving therapy. Molecular imaging methods can detect specific biological processes that are different when detected within cancer cells relative to those taking place in surrounding normal tissues. Many methods are sensitive to tissue metabolism; among them, positron emission tomography (PET) and magnetic resonance spectroscopic imaging (MRSI) are widely used in clinical practice and clinical research. There is a rich literature that establishes the role of these metabolic imaging techniques as valid tools for the diagnosis, staging, and monitoring of PCa. Until recently, European guidelines for PCa detection still considered both MRSI/MRI and PET/CT to be under evaluation, even though they had demonstrated their value in the staging of high risk PCa, and in the restaging of patients presenting elevated prostatic-specific antigen levels following radical treatment of PCa, respectively. Very recently, advanced methods for metabolic imaging have been proposed in the literature: multiparametric MRI (mpMRI), hyperpolarized MRSI, PET/CT with the use of new tracers and finally PET/MRI. Their detection capabilities are currently under evaluation, as is the feasibility of using such techniques in clinical studies. PMID:27882307

  6. Prostate Cancer Screening

    MedlinePlus

    ... Genetics of Prostate Cancer Prostate Cancer Screening Research Prostate Cancer Screening (PDQ®)–Patient Version What is screening? Go ... These are called diagnostic tests . General Information About Prostate Cancer Key Points Prostate cancer is a disease in ...

  7. Molecular Imaging and Therapy of Prostate Cancer

    DTIC Science & Technology

    2015-10-01

    Our objective is to develop an arsenic-based radiopharmaceutical platform for IGF1R-targeted imaging and therapy of PCa. The hypothesis is that...arsenic-based, IGF1R-targeted radiopharmaceuticals can allow for PET imaging, IRT, and monitoring the therapeutic response of PCa. Specific Aims: Aim 1: To...models with PET imaging. Aim 3: To monitor the efficacy of 76As-based IRT of PCa with multimodality imaging.

  8. Imaging Axl expression in pancreatic and prostate cancer xenografts

    SciTech Connect

    Nimmagadda, Sridhar; Pullambhatla, Mrudula; Lisok, Ala; Hu, Chaoxin; Maitra, Anirban; Pomper, Martin G

    2014-01-10

    Highlights: •Axl is overexpressed in a variety of cancers. •Axl overexpression confers invasive phenotype. •Axl imaging would be useful for therapeutic guidance and monitoring. •Axl expression imaging is demonstrated in pancreatic and prostate cancer xenografts. •Graded levels of Axl expression imaging is feasible. -- Abstract: The receptor tyrosine kinase Axl is overexpressed in and leads to patient morbidity and mortality in a variety of cancers. Axl–Gas6 interactions are critical for tumor growth, angiogenesis and metastasis. The goal of this study was to investigate the feasibility of imaging graded levels of Axl expression in tumors using a radiolabeled antibody. We radiolabeled anti-human Axl (Axl mAb) and control IgG1 antibodies with {sup 125}I with high specific radioactivity and radiochemical purity, resulting in an immunoreactive fraction suitable for in vivo studies. Radiolabeled antibodies were investigated in severe combined immunodeficient mice harboring subcutaneous CFPAC (Axl{sup high}) and Panc1 (Axl{sup low}) pancreatic cancer xenografts by ex vivo biodistribution and imaging. Based on these results, the specificity of [{sup 125}I]Axl mAb was also validated in mice harboring orthotopic Panc1 or CFPAC tumors and in mice harboring subcutaneous 22Rv1 (Axl{sup low}) or DU145 (Axl{sup high}) prostate tumors by ex vivo biodistribution and imaging studies at 72 h post-injection of the antibody. Both imaging and biodistribution studies demonstrated specific and persistent accumulation of [{sup 125}I]Axl mAb in Axl{sup high} (CFPAC and DU145) expression tumors compared to the Axl{sup low} (Panc1 and 22Rv1) expression tumors. Axl expression in these tumors was further confirmed by immunohistochemical studies. No difference in the uptake of radioactivity was observed between the control [{sup 125}I]IgG1 antibody in the Axl{sup high} and Axl{sup low} expression tumors. These data demonstrate the feasibility of imaging Axl expression in pancreatic

  9. Incorporating imaging into personalized medicine for the detection of prostate cancer: Pharmacological research-Urogenital pharmacology.

    PubMed

    Mertan, Francesca; Turkbey, Baris

    2016-12-01

    Imaging has played an important role in the administration of personalized medicine. From diagnosing diseases to guiding therapies, imaging has become an all-encompassing modality. With respect to prostate cancer, personalized management of the disease has been transformed by imaging. Specifically, multiparametric magnetic resonance imaging has emerged as a vital player in the detection, characterization, and localization of the disease thus making the incorporation of imaging in personalized prostate cancer management integral. In this review, the current role of imaging in personalized medicine for the management of prostate cancer is discussed.

  10. Image Guidance Based on Prostate Position for Prostate Cancer Proton Therapy

    SciTech Connect

    Vargas, Carlos Wagner, Marcus; Indelicato, Daniel; Fryer, Amber; Horne, David; Chellini, Angela; McKenzie, Craig; Lawlor, Paula; Mahajan, Chaitali; Li Zuofeng; Lin Liyong; Keole, Sameer

    2008-08-01

    Purpose: To determine the target coverage for proton therapy with and without image guidance and daily prebeam reorientation. Methods and Materials: A total of 207 prostate positions were analyzed for 9 prostate cancer patients treated using our low-risk prostate proton therapy protocol (University of Florida Proton Therapy Institute 001). The planning target volume was defined as the prostate plus a 5-mm axial and 8-mm superoinferior extension. The prostate was repositioned using 5- and 10-mm shifts (anteriorly, inferiorly, posteriorly, and superiorly) and for Points A-D using a combination of 10-mm multidimensional movements (anteriorly or inferiorly; posteriorly or superiorly; and left or right). The beams were then realigned using the new prostate position. The prescription dose was 78 Gray equivalent (GE) to 95% of the planning target volume. Results: For small movements in the anterior, inferior, and posterior directions within the planning target volume ({<=}5 mm), treatment realignment demonstrated small, but significant, improvements in the clinical target volume (CTV) coverage to the prescribed dose (78 GE). The anterior and posterior shifts also significantly increased the minimal CTV dose ({delta} +1.59 GE). For prostate 10-mm movements in the inferior, posterior, and superior directions, the beam realignment produced larger and significant improvements for both the CTV V{sub 78} ({delta} +6.4%) and the CTV minimal dose ({delta} +8.22 GE). For the compounded 10-mm multidimensional shifts, realignment significantly improved the CTV V{sub 78} ({delta} +11.8%) and CTV minimal dose ({delta} +23.6 GE). After realignment, the CTV minimal dose was >76.6 GE (>98%) for all points (A-D). Conclusion: Proton beam realignment after target shift will enhance CTV coverage for different prostate positions.

  11. Imaging Prostate Cancer Microenvironment by Collagen Hybridization

    DTIC Science & Technology

    2013-10-01

    cancer community. BODY 1. Demonstration of CMP mediated in vivo targeting of tissues undergoing normal (e.g. skeleton) and pathological ...missense mutation in fibrillin-1, which was previously shown to exhibit marked skeletal pathology , including severe kyphosis) and rib overgrowth 16. Whole...fully understood; however the strong correlation between collagen remodeling and bone growth in both physiological and pathological contexts 15, as

  12. Association of multiparametric MRI quantitative imaging features with prostate cancer gene expression in MRI-targeted prostate biopsies

    PubMed Central

    Stoyanova, Radka; Pollack, Alan; Takhar, Mandeep; Lynne, Charles; Parra, Nestor; Lam, Lucia L.C.; Alshalalfa, Mohammed; Buerki, Christine; Castillo, Rosa; Jorda, Merce; Ashab, Hussam Al-deen; Kryvenko, Oleksandr N.; Punnen, Sanoj; Parekh, Dipen J.; Abramowitz, Matthew C.; Gillies, Robert J.; Davicioni, Elai; Erho, Nicholas; Ishkanian, Adrian

    2016-01-01

    Standard clinicopathological variables are inadequate for optimal management of prostate cancer patients. While genomic classifiers have improved patient risk classification, the multifocality and heterogeneity of prostate cancer can confound pre-treatment assessment. The objective was to investigate the association of multiparametric (mp)MRI quantitative features with prostate cancer risk gene expression profiles in mpMRI-guided biopsies tissues. Global gene expression profiles were generated from 17 mpMRI-directed diagnostic prostate biopsies using an Affimetrix platform. Spatially distinct imaging areas (‘habitats’) were identified on MRI/3D-Ultrasound fusion. Radiomic features were extracted from biopsy regions and normal appearing tissues. We correlated 49 radiomic features with three clinically available gene signatures associated with adverse outcome. The signatures contain genes that are over-expressed in aggressive prostate cancers and genes that are under-expressed in aggressive prostate cancers. There were significant correlations between these genes and quantitative imaging features, indicating the presence of prostate cancer prognostic signal in the radiomic features. Strong associations were also found between the radiomic features and significantly expressed genes. Gene ontology analysis identified specific radiomic features associated with immune/inflammatory response, metabolism, cell and biological adhesion. To our knowledge, this is the first study to correlate radiogenomic parameters with prostate cancer in men with MRI-guided biopsy. PMID:27438142

  13. Imaging Prostate Cancer Microenvironment by Collagen Hybridization

    DTIC Science & Technology

    2016-12-01

    680 binding (aim 3.1). 3. Three additional pancreatic cancer xenograft lines were tested to confirm CMP binding trends observed for xenograft growth...success and we tried a simple addition of re-melting the purified labeled solution following photodecaging in case radiometallation resulted in...chemical decaging of the nitrobenzoyl group with resultant refolding. Addition of an 80° C melt step immediately prior to injection into a healthy mouse

  14. Developing imaging strategies for castration resistant prostate cancer

    PubMed Central

    Fox, Josef J.; Morris, Michael J.; Larson, Steven M.; Schöder, Heiko; Scher, Howard I.

    2012-01-01

    Recent advances in the understanding of castrate-resistant prostate cancer (CRPC) have lead to a growing number of experimental therapies, many of which are directed against the androgen-receptor (AR) signaling axis. These advances generate the need for reliable molecular imaging biomarkers to non-invasively determine efficacy, and to better guide treatment selection of these promising AR-targeted drugs. Methods We draw on our own experience, supplemented by review of the current literature, to discuss the systematic development of imaging biomarkers for use in the context of CRPC, with a focus on bone scintigraphy, F-18 fluorodeoxyglucose (FDG)-positron emission tomography (PET) and PET imaging of the AR signaling axis. Results The roadmap to biomarker development mandates rigorous standardization and analytic validation of an assay before it can be qualified successfully for use in an appropriate clinical context. The Prostate Cancer Working Group 2 (PCWG2) criteria for “radiographic” progression by bone scintigraphy serve as a paradigm of this process. Implemented by the Prostate Cancer Clinical Trials Consortium (PCCTC), these consensus criteria may ultimately enable the co-development of more potent and versatile molecular imaging biomarkers. Purported to be superior to single-photon bone scanning, the added value of Na18F-PET for imaging of bone metastases is still uncertain. FDG-PET already plays an integral role in the management of many diseases, but requires further evaluation before being qualified in the context of CRPC. PET tracers that probe the AR signaling axis, such as 18F-FDHT and 89Zr-591, are now under development as pharmacodynamic markers, and as markers of efficacy, in tandem with FDG-PET. Semi-automated analysis programs for facilitating PET interpretation may serve as a valuable tool to help navigate the biomarker roadmap. Conclusions Molecular imaging strategies, particularly those that probe the AR signaling axis, have the potential

  15. Imaging Prostate Cancer Microenvironment by Collagen Hybridization

    DTIC Science & Technology

    2013-10-01

    microdialysis cassette against PBS, pH 7.5 for 1 hour. Radio TLC was used to assess radiochemical purity before and after a test-decaging. The presence of... TLC and in vivo imaging results. Radio TLC in bottom left shows multiple labeled species following photodeprotection in the presence and absence of...portion of both DTPA and DOTA-chelated radioindium complex, which is also suggested by the radio TLC data. 7    Labeling with radioiodine, however

  16. Imaging Prostate Cancer Microenvironment by collagen Hybridization

    DTIC Science & Technology

    2014-10-01

    from enlarged lymph nodes. Figure 3. Ex vivo NIRF imaging of PC-3 PIP xenograft. AI = androgen independent, AR = androgen receptor negative, PSMA ...center O.D. rim/focal ROI PC-3 rapid 0.25 ± .09 1.21 ± 0.40 PC-3 ( PSMA +) PIP rapid 0.26 ± .12 NA DU-145 slow 0.01 ± 0.01 0.06 ± 0.02 HP LNCaP

  17. [Place of contrast imaging in prostate cancer detection].

    PubMed

    Cornud, François; Rebillard, Xavier; Villers, Arnauld; Peyromaure, Michaël; Soulié, Michel; Sous-Comité de Prostate du CCAFU

    2006-06-01

    Contrast imaging of the prostate is based on rapid-sequence MRI after dynamic Gadolinium injection and contrast ultrasound after injection of microbubbles. MRI can be performed routinely on all available machines. Contrast ultrasound requires specific software not yet available on all machines. The two techniques are designed to improve the reliability of imaging, as a complement to MR spectroscopy, to localize prostate cancer MRI can detect suspicious enhancement in the peripheral zone, but especially in the transitional zone after one or a series of negative posterior biopsies to target a new series of biopsies. The sensitivity and specificity of the technique have yet to be determined. The objective of contrast ultrasound is to improve cancer detection on the first series of biopsies by multiplying sextant biopsies in sites where the contrast kinetics are suggestive of a primary lesion. However, this technique cannot yet be recommended in routine practice, as the modalities of injection of the latest generation of microbubbles (bolus or infusion) need to be evaluated.

  18. Molecular imaging of prostate cancer: translating molecular biology approaches into the clinical realm.

    PubMed

    Vargas, Hebert Alberto; Grimm, Jan; F Donati, Olivio; Sala, Evis; Hricak, Hedvig

    2015-05-01

    The epidemiology of prostate cancer has dramatically changed since the introduction of prostate-specific antigen (PSA) screening in the 1980's. Most prostate cancers today are detected at early stages of the disease and are considered 'indolent'; however, some patients' prostate cancers demonstrate a more aggressive behaviour which leads to rapid progression and death. Increasing understanding of the biology underlying the heterogeneity that characterises this disease has led to a continuously evolving role of imaging in the management of prostate cancer. Functional and metabolic imaging techniques are gaining importance as the impact on the therapeutic paradigm has shifted from structural tumour detection alone to distinguishing patients with indolent tumours that can be managed conservatively (e.g., by active surveillance) from patients with more aggressive tumours that may require definitive treatment with surgery or radiation. In this review, we discuss advanced imaging techniques that allow direct visualisation of molecular interactions relevant to prostate cancer and their potential for translation to the clinical setting in the near future. The potential use of imaging to follow molecular events during drug therapy as well as the use of imaging agents for therapeutic purposes will also be discussed. • Advanced imaging techniques allow direct visualisation of molecular interactions in prostate cancer. • MRI/PET, optical and Cerenkov imaging facilitate the translation of molecular biology. • Multiple compounds targeting PSMA expression are currently undergoing clinical translation. • Other targets (e.g., PSA, prostate-stem cell antigen, GRPR) are in development.

  19. Imaging Primary Prostate Cancer and Bone Metastasis

    DTIC Science & Technology

    2007-04-01

    tumour imaging? Nucl Med Commun 2001;22: 5 –15. [23] Krenning EP, Kwekkeboom DJ, Valkema R, Pauwels S, Kvols LK, De Jong M, et al. Peptide...Aca Gln Trp Ala Val Gly His Leu Met O 18F [18F]FB-Aca-BBN(7-14) [18F]FB-[Lys3]BBN H N N H H N N H H N N H H N N H H N NH2 O NH2 O O HN O O O O N NH O...O S O Gln Trp Ala Val Gly His Leu Met N H H N N H O H2N O O O HN O H2N O H N O O 18F NH O Asn Gly Leu Lys

  20. Translocator Protein PET Imaging in a Preclinical Prostate Cancer Model.

    PubMed

    Tantawy, Mohammed N; Charles Manning, H; Peterson, Todd E; Colvin, Daniel C; Gore, John C; Lu, Wenfu; Chen, Zhenbang; Chad Quarles, C

    2017-08-18

    The identification and targeting of biomarkers specific to prostate cancer (PCa) could improve its detection. Given the high expression of translocator protein (TSPO) in PCa, we investigated the use of [(18)F]VUIIS1008 (a novel TSPO-targeting radioligand) coupled with positron emission tomography (PET) to identify PCa in mice and to characterize their TSPO uptake. Pten(pc-/-), Trp53(pc-/-) prostate cancer-bearing mice (n = 9, 4-6 months old) were imaged in a 7T MRI scanner for lesion localization. Within 24 h, the mice were imaged using a microPET scanner for 60 min in dynamic mode following a retro-orbital injection of ~ 18 MBq [(18)F]VUIIS1008. Following imaging, tumors were harvested and stained with a TSPO antibody. Regions of interest (ROIs) were drawn around the tumor and muscle (hind limb) in the PET images. Time-activity curves (TACs) were recorded over the duration of the scan for each ROI. The mean activity concentrations between 40 and 60 min post radiotracer administration between tumor and muscle were compared. Tumor presence was confirmed by visual inspection of the MR images. The uptake of [(18)F]VUIIS1008 in the tumors was significantly higher (p < 0.05) than that in the muscle, where the percent injected dose per unit volume for tumor was 7.1 ± 1.6 % ID/ml and that of muscle was < 1 % ID/ml. In addition, positive TSPO expression was observed in tumor tissue analysis. The foregoing preliminary data suggest that TSPO may be a useful biomarker of PCa. Therefore, using TSPO-targeting PET ligands, such as [(18)F]VUIIS1008, may improve PCa detectability and characterization.

  1. Magnetic resonance spectroscopic imaging 3T and prostate cancer: correlation with transperineal ultrasound guided prostate biopsy.

    PubMed

    Castellucci, Roberto; Altieri, Vincenzo Maria; Marchioni, Michele; Castellan, Pietro; Pellegrini, Maurizio; Álvarez-Maestro, Mario; Sánchez-Gómez, Javier; De Francesco, Piergustavo; Ingrosso, Manuela; Tartaro, Armando; Tenaglia, Raffaele Lanfranco

    2015-06-01

    The aim of our study was to correlate the results obtained by 3T Magnetic Resonance Spectroscopic Imaging (MRSI3T) with those obtained by histological examination of samples of the trans-perineal ultrasound-guided prostate biopsy (TPUS-B). 34 patients were enrolled in the study. All patients had a clinical suspicion of cancer due to increased PSA and/or positive digital rectal examination. Patients were subjected to an MRSI 3T examination and subsequently to TPUS-B. Of the 22 (22/34) patients who presented abnormalities MRSI at 3T, 9 had a histological diagnosis of Prostate adenocarcinoma. Of the remaining 13 patients, 6 were found to be histologically positive for Benign Prostatic Hypertrophy and 7 Chronic Interstitial Inflammation or High Grade Prostatic Intraepithelial Neoplasia. 12 (12/34) patients found to have no peripheral alterations in their prostate on 3T MRSI, none were positive for ADK or inflammation on histology. The sensitivity, specificity, positive predictive value and negative predictive value were 100%, 48%, 40% and 100% respectively. In this study, we correlated the values obtained from 3T MRSI with the results of histologically examined prostate biopsies. Our work shows that 72.8% of the voxels in which there was a change in ratio of Cit/(Cho + Cr), corresponded to areas of prostate tissue disease. Of these, 73.2% were positive for ADK and 26.8% for CII or HG PIN. In literature, it is noted that PCa can be distinguished from areas of benign tissue, in the peripheral zone, on the basis of the values of the ratio Cit/(Cho + Cr) (17), although some benign conditions, such as prostatitis or PINHG, can alter these values (18-19). In conclusion, the use of MRSI 3T before performing prostate biopsies may represent a valid aid for the urologist in the diagnosis of PCa, allowing them to avoid unnecessary prostate biopsies that may be negative. Furthermore, it would also be possible to reduce the total number of biopsies, thus decreasing patient exposure

  2. (68)Ga-PSMA PET/MR with multimodality image analysis for primary prostate cancer.

    PubMed

    Eiber, Matthias; Nekolla, Stephan G; Maurer, Tobias; Weirich, Gregor; Wester, Hans-Jürgen; Schwaiger, Markus

    2015-08-01

    Current imaging procedures for prostate cancer including positron emission tomography (PET) exhibit considerable limitations and are not always able to meet the diagnostic needs. Recently, a (68)Gallium-labeled ligand of the prostate-specific membrane antigen ((68)Ga-PSMA) has been introduced in PET-imaging of prostate cancer with first promising results. Due to relatively exclusive expression of PSMA in prostatic tissue as well as increased expression in prostate cancer, 68 Ga-PSMA was reported to exhibit a favorable lesion to background ratio. Together with the novel development of combined PET/MRI, the combination of excellent morphological detail, multiparametric functional information, and molecular PET data might lead to a significant improvement in detection of prostate cancer. We present an exemplarily case of primary staging using multiparametric (68)Ga-PSMA PET/MR by combining molecular and structural information.

  3. New aspects of molecular imaging in prostate cancer.

    PubMed

    Ceci, Francesco; Castellucci, Paolo; Cerci, Juliano J; Fanti, Stefano

    2017-07-13

    Nowadays several new imaging modalities are available for investigating prostate cancer (PCa) such as magnet resonance imaging (MRI) in the form of whole body MRI and pelvic multiparametric MRI and positron emission tomography (PET) using choline as radiotracers. Nevertheless, these modalities proved sub-optimal accuracy for detecting PCa metastases, particularly in the recurrence setting. A new molecular probe targeting the prostate specific membrane antigen (PSMA) has been recently developed for PET imaging. PSMA, the glutamate carboxypeptidase II, is a membrane bound metallo-peptidase over-expressed in PCa cells. It has been shown that PSMA based imaging offers higher tumor detection rate compared to choline PET/CT and radiological conventional imaging, especially at very low PSA levels during biochemical recurrence. In addition PSMA, as theranostics agent, allows both radiolabeling with diagnostic (e.g. 68Ga, 18F) or therapeutic nuclides (e.g. 177Lu, 225Ac). Initial results show that PSMA-targeted radioligand therapy can potentially delay disease progression in metastatic castrate-resistant PCa. Despite still investigational, the bombesin-based radiotracers and antagonist of gastrin releasing-peptide receptor (GRP) (RM2) and anti1-amino-3-18Ffluorocyclobutane-1-carboxylic acid (18F-FACBC) are emerging as possible alternatives for investigating PCa. Considering the wide diffusion of PCa in the Europe and the United States, the presence of these new diagnostic techniques able to detect the disease with high sensitivity and specificity might have a clinical impact on the management of patients. PET/CT imaging with new radiopharmaceuticals can implement the patient management identifying lesion(s) not detectable with conventional imaging procedures. In this review article will be discussed the most promising new PET radiopharmaceuticals (68Ga-PSMA-11, 18F-FACBC, 68Ga-RM2) available at the moment, focusing the attention on their accuracy and their impact on

  4. A Novel Imaging Approach for Early Detection of Prostate Cancer Based on Endogenous Zinc Sensing

    PubMed Central

    Ghosh, Subrata K.; Kim, Pilhan; Zhang, Xiao-an; Yun, Seok-Hyun; Moore, Anna; Lippard, Stephen J.; Medarova, Zdravka

    2010-01-01

    The early detection of prostate cancer is a life-saving event in patients harboring potentially aggressive disease. With the development of malignancy there is a dramatic reduction in the zinc content of prostate tissue associated with the inability of cancer cells to accumulate the ion. In the current study, we utilized endogenous zinc as an imaging biomarker for prostate cancer detection and progression monitoring. We employed a novel fluorescent sensor for mobile zinc (ZPP1) to detect and monitor the development of prostate cancer in a transgenic mouse model of prostate adenocarcinoma, using in vivo optical imaging correlated with biological fluid-based methods. We demonstrated that the progression of prostate cancer could be monitored in vivo judging by decreasing zinc content in the prostates of tumor-bearing mice in an age-dependent manner. In a novel quantitative assay, we determine the concentration of mobile zinc in both prostate cell lysates and mouse prostate extracts through simple titration of the ZPP1 sensor. Our findings fulfill the promise of zinc-based prostate cancer diagnostics with the prospect for immediate clinical translation. PMID:20610630

  5. PSMA-targeted contrast agents for intraoperative imaging of prostate cancer.

    PubMed

    Bao, Kai; Lee, Jeong Heon; Kang, Homan; Park, G Kate; El Fakhri, Georges; Choi, Hak Soo

    2017-02-04

    Prostate-specific membrane antigen (PSMA) can serve as a molecular cell surface target for the detection and treatment of prostate cancer. Near-infrared (NIR) fluorescence imaging enables highly sensitive, rapid, and non-radioactive imaging of PSMA, though specific targeting still remains a challenge because no optimized contrast agents exist.

  6. Magnetic resonance imaging in the new paradigm for the diagnosis of prostate cancer.

    PubMed

    Vilanova, J C; Catalá, V

    For various reasons, prostate cancer is a major public health problem. It is a very common cancer, but has a very low mortality rate because it comprises two types of disease: one insignificant, indolent, and much more common, and the other aggressive, significant, and much less common. The routine diagnostic approach to prostate cancer has been systematic blind biopsies, which has low detection rates and might detect low risk, insignificant prostate cancer, leading to overdiagnosis and overtreatment of indolent cancers. The possibility of including multiparametric magnetic resonance imaging in the diagnostic management to improve the detection of aggressive cancer while reducing the overdiagnosis of indolent cancer represents a change in the diagnostic management. This article updates knowledge about the diagnostic management of prostate cancer including multiparametric magnetic resonance imaging.

  7. Parametric PET/MR Fusion Imaging to Differentiate Aggressive from Indolent Primary Prostate Cancer with Application for Image-Guided Prostate Cancer Biopsies

    DTIC Science & Technology

    2014-10-01

    PCa did not increase with overall quality of registration (US to MRI ) Mental registration is effective Conclusions (Interim Analysis) • After...Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT The study investigates whether fusion PET/ MRI imaging with 18F-choline PET/CT and...diffusion-weighted MRI can be successfully applied to target prostate cancer using image-guided prostate biopsies. The study further aims to establish

  8. Utility of multiparametric magnetic resonance imaging suspicion levels for detecting prostate cancer.

    PubMed

    Rais-Bahrami, Soroush; Siddiqui, M Minhaj; Turkbey, Baris; Stamatakis, Lambros; Logan, Jennifer; Hoang, Anthony N; Walton-Diaz, Annerleim; Vourganti, Srinivas; Truong, Hong; Kruecker, Jochen; Merino, Maria J; Wood, Bradford J; Choyke, Peter L; Pinto, Peter A

    2013-11-01

    We determine the usefulness of multiparametric magnetic resonance imaging in detecting prostate cancer, with a specific focus on detecting higher grade prostate cancer. Prospectively 583 patients who underwent multiparametric magnetic resonance imaging and subsequent prostate biopsy at a single institution were evaluated. On multiparametric magnetic resonance imaging, lesions were identified and scored as low, moderate or high suspicion for prostate cancer based on a validated scoring system. Magnetic resonance/ultrasound fusion guided biopsies of magnetic resonance imaging lesions in addition to systematic 12-core biopsies were performed. Correlations between the highest assigned multiparametric magnetic resonance imaging suspicion score and presence of cancer and biopsy Gleason score on the first fusion biopsy session were assessed using univariate and multivariate logistic regression models. Sensitivity, specificity, negative predictive value and positive predictive value were calculated and ROC curves were developed to assess the discriminative ability of multiparametric magnetic resonance imaging as a diagnostic tool for various biopsy Gleason score cohorts. Significant correlations were found between age, prostate specific antigen, prostate volume, and multiparametric magnetic resonance imaging suspicion score and the presence of prostate cancer (p<0.0001). On multivariate analyses controlling for age, prostate specific antigen and prostate volume, increasing multiparametric magnetic resonance imaging suspicion was an independent prognosticator of prostate cancer detection (OR 2.2, p<0.0001). Also, incremental increases in multiparametric magnetic resonance imaging suspicion score demonstrated stronger associations with cancer detection in patients with Gleason 7 or greater (OR 3.3, p<0.001) and Gleason 8 or greater (OR 4.2, p<0.0001) prostate cancer. Assessing multiparametric magnetic resonance imaging as a diagnostic tool for all prostate cancer, biopsy

  9. Near-infrared fluorescence imaging of prostate cancer using heptamethine carbocyanine dyes

    PubMed Central

    YUAN, JIANLIN; YI, XIAOMIN; YAN, FEI; WANG, FULI; QIN, WEIJUN; WU, GUOJUN; YANG, XIAOJIAN; SHAO, CHEN; CHUNG, LELAND W.K.

    2015-01-01

    Near-infrared fluorescence (NIRF) imaging is an attractive novel modality for the detection of cancer. A previous study defined two organic polymethine cyanine dyes as ideal NIRF probes, IR-783 and its derivative MHI-148, which have excellent optical characteristics, superior biocompatibility and cancer targeting abilities. To investigate the feasibility of NIRF dye-mediated prostate cancer imaging, dye uptake and subcellular co-localization were investigated in PC-3, DU-145 and LNCaP human prostate cancer cells and RWPE-1 normal prostate epithelial cells. Different organic anion transporting peptide (OATP) inhibitors were utilized to explore the potential role of the OATP subtype, including the nonspecific OATP inhibitor bromosulfophthalein, the OATP1 inhibitor 17β-estradiol, the selective OATP1B1 inhibitor rifampicin and the selective OATP1B3 inhibitor cholecystokinin octapeptide. NIRF dyes were also used for the simulated detection of circulating tumor cells and the rapid detection of prostate cancer in human prostate cancer tissues and prostate cancer xenografts in mouse models. The results revealed that the cancer-specific uptake of these organic dyes in prostate cancer cells occurred primarily via OATP1B3. A strong NIRF signal was detected in prostate cancer tissues, but not in normal tissues that were stained with IR-783. Prostate cancer cells were recognized with particular NIR fluorescence in isolated mononuclear cell mixtures. The results of the present study demonstrated that NIRF dye-mediated imaging is a feasible and practicable method for prostate cancer detection, although further investigative studies are required before clinical translation. PMID:25354708

  10. [Localization of prostate cancer within the central gland by endorectal MR spectroscopic imaging].

    PubMed

    Comet Batlle, Josep; Vilanova Busquets, Joan Carles; Maroto Genover, Albert; Areal Calama, Joan; Osorio Fernández, Margarita; López Bonet, Eugeni; Torrent Quer, Narcis; Ordis Dalmau, Miquel; Saladié Roig, Josep María; Barceló Vidal, Carles

    2005-03-01

    The endorectal MR spectroscopic imaging is a new imaging test which allows more accurate and reliable localization and staging of prostate cancer than simple endorectal MRI. The combination of spectroscopic MR and MRI has recently achieved technical improvements that increased reliability in the detection of prostate cancer. Our group is now working in the detection of prostate cancer with the spectroscopic MR, in co-operation with the Agency for the Evaluation of Technology for Medical Research (Agencia de Evaluación de Tecnología para la Investigación Médica-AATRM); although we are waiting for definitive results, we can advance that this technique may be used as a good alternative for localization of prostate cancer in patients with previous negative biopsies in whom the suspicion of prostate cancer persists. We present a series of 5 patients under control for permanent elevation of PSA with previous negative biopsies. We were performing ultrasound guided sextant biopsies every 6 months, after blood test for PSA. Endorectal MRI and spectroscopic MRI were performed to try to localize the prostate cancer so diminishing the number of biopsies. All patients in the series had a low intensity lesion within the normal low intensity of the central gland, with an obvious spectroscopic metabolic abnormality suggesting the existence of prostate cancer, as it was then demonstrated by biopsy. The endorectal MR spectroscopic imaging is a non invasive method which offers the ability to detect prostate cancer within the central gland with a higher reliability in selected patients. The central gland is an area in which prostate cancer is less commonly localized, but it often shows the same signal intensity than hyperplastic tissue, so that it is difficult to be detected by purely morphological methods. Endorectal MR spectroscopic imaging allows evaluating the metabolic disturbances in the whole gland, increasing the reliability of detection of prostate cancer both in the

  11. Improving PET spatial resolution and detectability for prostate cancer imaging

    NASA Astrophysics Data System (ADS)

    Bal, H.; Guerin, L.; Casey, M. E.; Conti, M.; Eriksson, L.; Michel, C.; Fanti, S.; Pettinato, C.; Adler, S.; Choyke, P.

    2014-08-01

    Prostate cancer, one of the most common forms of cancer among men, can benefit from recent improvements in positron emission tomography (PET) technology. In particular, better spatial resolution, lower noise and higher detectability of small lesions could be greatly beneficial for early diagnosis and could provide a strong support for guiding biopsy and surgery. In this article, the impact of improved PET instrumentation with superior spatial resolution and high sensitivity are discussed, together with the latest development in PET technology: resolution recovery and time-of-flight reconstruction. Using simulated cancer lesions, inserted in clinical PET images obtained with conventional protocols, we show that visual identification of the lesions and detectability via numerical observers can already be improved using state of the art PET reconstruction methods. This was achieved using both resolution recovery and time-of-flight reconstruction, and a high resolution image with 2 mm pixel size. Channelized Hotelling numerical observers showed an increase in the area under the LROC curve from 0.52 to 0.58. In addition, a relationship between the simulated input activity and the area under the LROC curve showed that the minimum detectable activity was reduced by more than 23%.

  12. Improving Prediction of Prostate Cancer Recurrence using Chemical Imaging

    NASA Astrophysics Data System (ADS)

    Kwak, Jin Tae; Kajdacsy-Balla, André; Macias, Virgilia; Walsh, Michael; Sinha, Saurabh; Bhargava, Rohit

    2015-03-01

    Precise Outcome prediction is crucial to providing optimal cancer care across the spectrum of solid cancers. Clinically-useful tools to predict risk of adverse events (metastases, recurrence), however, remain deficient. Here, we report an approach to predict the risk of prostate cancer recurrence, at the time of initial diagnosis, using a combination of emerging chemical imaging, a diagnostic protocol that focuses simultaneously on the tumor and its microenvironment, and data analysis of frequent patterns in molecular expression. Fourier transform infrared (FT-IR) spectroscopic imaging was employed to record the structure and molecular content from tumors prostatectomy. We analyzed data from a patient cohort that is mid-grade dominant - which is the largest cohort of patients in the modern era and in whom prognostic methods are largely ineffective. Our approach outperforms the two widely used tools, Kattan nomogram and CAPRA-S score in a head-to-head comparison for predicting risk of recurrence. Importantly, the approach provides a histologic basis to the prediction that identifies chemical and morphologic features in the tumor microenvironment that is independent of conventional clinical information, opening the door to similar advances in other solid tumors.

  13. ADC value and diffusion tensor imaging of prostate cancer: changes in carbon-ion radiotherapy.

    PubMed

    Takayama, Yukihisa; Kishimoto, Riwa; Hanaoka, Shouhei; Nonaka, Hiroi; Kandatsu, Susumu; Tsuji, Hiroshi; Tsujii, Hirohiko; Ikehira, Hiroo; Obata, Takayuki

    2008-06-01

    To assess the apparent diffusion coefficient (ADC) value and diffusion tensor image (DTI) including fractional anisotropy (FA) of the noncancerous prostate and prostate cancer before and after carbon-ion radiotherapy (CIRT). Nine patients with biopsy-proven prostate cancer underwent 1.5T magnetic resonance (MR) examinations. One patient with benign prostatic hypertrophy and one healthy volunteer were also examined as references. The changes in ADC values and DTI of the entire prostate calculated from b-values of 0 and 700 (s/mm(2)) were estimated between before and after CIRT. ADC values of prostate cancer significantly increased after CIRT by paired t-test (P < 0.01) but those of noncancerous inner gland (IG) and peripheral zone (PZ) showed no significant change. By analysis of variance, significant differences in ADC values were observed among prostate cancer and noncancerous IG and PZ before CIRT (P < 0.05). After CIRT, those significant differences had disappeared. FAs showed no significant differences in any comparisons. DTI showed changes in the direction of the main axis of the tensor in prostate cancer after CIRT. There were changes in ADC and DTI in prostate cancer after CIRT. They may be useful for monitoring prostatic structural changes under radiotherapy. 2008 Wiley-Liss, Inc

  14. The Diagnostic Performance of Multiparametric Magnetic Resonance Imaging to Detect Significant Prostate Cancer.

    PubMed

    Thompson, J E; van Leeuwen, P J; Moses, D; Shnier, R; Brenner, P; Delprado, W; Pulbrook, M; Böhm, M; Haynes, A M; Hayen, A; Stricker, P D

    2016-05-01

    We assess the accuracy of multiparametric magnetic resonance imaging for significant prostate cancer detection before diagnostic biopsy in men with an abnormal prostate specific antigen/digital rectal examination. A total of 388 men underwent multiparametric magnetic resonance imaging, including T2-weighted, diffusion weighted and dynamic contrast enhanced imaging before biopsy. Two radiologists used PI-RADS to allocate a score of 1 to 5 for suspicion of significant prostate cancer (Gleason 7 with more than 5% grade 4). PI-RADS 3 to 5 was considered positive. Transperineal template guided mapping biopsy of 18 regions (median 30 cores) was performed with additional manually directed cores from magnetic resonance imaging positive regions. The anatomical location, size and grade of individual cancer areas in the biopsy regions (18) as the primary outcome and in prostatectomy specimens (117) as the secondary outcome were correlated to the magnetic resonance imaging positive regions. Of the 388 men who were enrolled in the study 344 were analyzed. Multiparametric magnetic resonance imaging was positive in 77.0% of patients, 62.5% had prostate cancer and 41.6% had significant prostate cancer. The detection of significant prostate cancer by multiparametric magnetic resonance imaging had a sensitivity of 96%, specificity of 36%, negative predictive value of 92% and positive predictive value of 52%. Adding PI-RADS to the multivariate model, including prostate specific antigen, digital rectal examination, prostate volume and age, improved the AUC from 0.776 to 0.879 (p <0.001). Anatomical concordance analysis showed a low mismatch between the magnetic resonance imaging positive regions and biopsy positive regions (4 [2.9%]), and the significant prostate cancer area in the radical prostatectomy specimen (3 [3.3%]). In men with an abnormal prostate specific antigen/digital rectal examination, multiparametric magnetic resonance imaging detected significant prostate cancer

  15. Prostate cancer screening

    MedlinePlus

    Prostate cancer screening - PSA; Prostate cancer screening - digital rectal exam; Prostate cancer screening - DRE ... level of PSA could mean you have prostate cancer. But other conditions can also cause a high ...

  16. Imaging of prostate cancer local recurrences: why and how?

    PubMed

    Rouvière, Olivier; Vitry, Thierry; Lyonnet, Denis

    2010-05-01

    Because prostate cancer local recurrences can be efficiently treated by salvage therapies, it becomes critical to detect them early. The first alert is the rise of the prostate specific antigen (PSA) level after the post-treatment nadir, which can correspond to a distant recurrence, a local recurrence or both. This so-called biochemical failure (BF) is defined as PSA level > 0.2 ng/ml after radical prostatectomy (RP) and PSA level > nadir + 2 ng/ml after radiotherapy. There is no consensual definition of BF after cryotherapy, high-intensity focused ultrasound (HIFU) ablation or brachytherapy. Local recurrences after RP are treated by radiotherapy, those after radiotherapy by RP, cryotherapy, brachytherapy or HIFU ablation. Recurrences after cryotherapy or HIFU ablation can be treated by a second session or radiotherapy. Recurrences after brachytherapy are difficult to treat. In patients with BF, MRI can detect local recurrences, whatever the initial treatment was. Dynamic contrast-enhanced MRI seems particularly accurate. The role of spectroscopy remains controversial. Ultrasound-based techniques are less accurate, but this may change with the advent of ultrasonic contrast media. These recent advances in imaging may improve the outcome of salvage therapies (by improving patient selection and treatment targeting) and should open the way to focal salvage treatments in the near future.

  17. Magnetic resonance imaging of prostatic cancer: does detection vary between high and low gleason score tumors?

    PubMed

    Ikonen, S; Kärkkäinen, P; Kivisaari, L; Salo, J O; Taari, K; Vehmas, T; Tervahartiala, P; Rannikko, S

    2000-04-01

    Both Gleason score and prostate-specific antigen (PSA) concentration are prognostic factors for prostate cancer. We assessed our ability to localize cancer lesions based on Gleason scores and PSA values by endorectal coil magnetic resonance imaging (MRI). We also evaluated whether the size of the prostate affects tumor detectability. We compared the findings of MRI and histopathological results of radical prostatectomy specimens from 63 patients; they were divided into four groups, based on Gleason score and also on serum PSA concentration. Furthermore, the possible effect of prostatectomy specimen weight on MRI interpretation was examined. A highly significant difference appeared in detection of cancer lesions based on their differentiation grade. No statistically significant difference existed between PSA groups in detection of tumors, but the large size of the prostate seemed to render image interpretation more difficult. Endorectal MRI detects poorly differentiated prostate cancer lesions more accurately than clinically insignificant tumors. Copyright 2000 Wiley-Liss, Inc.

  18. IR-780 Dye for Near-Infrared Fluorescence Imaging in Prostate Cancer

    PubMed Central

    Yi, Xiaomin; Yan, Fei; Wang, Fuli; Qin, Weijun; Wu, Guojun; Yang, Xiaojian; Shao, Chen; Chung, Leland W.K.; Yuan, Jianlin

    2015-01-01

    Background The aim of this study was to investigate near-infrared fluorescence (NIRF) imaging as a novel imaging modality that allows for early detection of cancer and real-time monitoring to acquire related information. IR-780 iodide, a lipophilic dye, accumulates selectively in breast cancer cells and drug-resistant human lung cancer cells, with a peak emission at 780 nm that can be easily detected by the NIRF imaging system. The application of IR-780 for prostate cancer imaging was thoroughly investigated to further expand its clinical value. Material/Methods The impact of IR-780 on the survival of prostate cancer cells PC-3 and LNCaP as well as normal prostate epithelial cells RWPE-1 was determined. Duration of IR-780 dye staining was optimized in PC-3 cells. The involvement of specific OATP1B3 inhibitor in the selective accumulation of IR-780 was investigated. IR-780 for prostate cancer imaging was carried out in athymic nude mouse models and, acute toxicity of IR-780 was evaluated. Results IR-780 incubation resulted in a dose-dependent inhibition to cell proliferation. Mean fluorescence intensity of prostate cancer cells peaked at 20-min IR-780 incubation. Specific uptake of IR-780 dye in prostate cancer cells was mainly through the function of OATP1B3. We also demonstrated that NIRF dye effectively identified the subcutaneous prostate cancer xenografts, subsequently confirmed by histological examination. There was no significant impact on the physical activity, weight, and tissue histology of BABL/C mice with 10-fold imaging dose of 1-month IR-780 dye administration. Conclusions NIRF imaging using IR-780 dye is a feasible and practicable method for prostate cancer detection, with potential tumor-killing ability, although more investigations are needed before clinical translation. PMID:25686161

  19. IR-780 dye for near-infrared fluorescence imaging in prostate cancer.

    PubMed

    Yi, Xiaomin; Yan, Fei; Wang, Fuli; Qin, Weijun; Wu, Guojun; Yang, Xiaojian; Shao, Chen; Chung, Leland W K; Yuan, Jianlin

    2015-02-16

    The aim of this study was to investigate near-infrared fluorescence (NIRF) imaging as a novel imaging modality that allows for early detection of cancer and real-time monitoring to acquire related information. IR-780 iodide, a lipophilic dye, accumulates selectively in breast cancer cells and drug-resistant human lung cancer cells, with a peak emission at 780 nm that can be easily detected by the NIRF imaging system. The application of IR-780 for prostate cancer imaging was thoroughly investigated to further expand its clinical value. The impact of IR-780 on the survival of prostate cancer cells PC-3 and LNCaP as well as normal prostate epithelial cells RWPE-1 was determined. Duration of IR-780 dye staining was optimized in PC-3 cells. The involvement of specific OATP1B3 inhibitor in the selective accumulation of IR-780 was investigated. IR-780 for prostate cancer imaging was carried out in athymic nude mouse models and, acute toxicity of IR-780 was evaluated. IR-780 incubation resulted in a dose-dependent inhibition to cell proliferation. Mean fluorescence intensity of prostate cancer cells peaked at 20-min IR-780 incubation. Specific uptake of IR-780 dye in prostate cancer cells was mainly through the function of OATP1B3. We also demonstrated that NIRF dye effectively identified the subcutaneous prostate cancer xenografts, subsequently confirmed by histological examination. There was no significant impact on the physical activity, weight, and tissue histology of BABL/C mice with 10-fold imaging dose of 1-month IR-780 dye administration. NIRF imaging using IR-780 dye is a feasible and practicable method for prostate cancer detection, with potential tumor-killing ability, although more investigations are needed before clinical translation.

  20. A new imaging technique to detect recurrent prostate cancer is tested in new clinical trial | Center for Cancer Research

    Cancer.gov

    Standard imaging techniques cannot accurately locate sites of prostate cancer metastasis. The use of 18F-DCFPyL, a second-generation PET agent, aims to improve doctors’ ability to assess high-risk primary tumors, detect sites of recurrent prostate cancer and target therapies to specific sites of recurrence. Read more...

  1. Magnetic resonance imaging-directed transperineal limited-mapping prostatic biopsies to diagnose prostate cancer: a Scottish experience.

    PubMed

    Mukherjee, Ankur; Morton, Simon; Fraser, Sioban; Salmond, Jonathan; Baxter, Grant; Leung, Hing Y

    2014-11-01

    Transperineal prostatic biopsy is firmly established as an important tool in the diagnosis of prostate cancer. The benefit of additional imaging (magnetic resonance imaging) to target biopsy remains to be fully addressed. Using a cohort of consecutive patients undergoing transperineal template mapping biopsies, we studied positive biopsies in the context of magnetic resonance imaging findings and examined the accuracy of magnetic resonance imaging in predicting the location of transperineal template mapping biopsies-detected prostate cancer. Forty-four patients (mean age: 65 years, range 53-78) underwent transperineal template mapping biopsies. Thirty-four patients had 1-2 and 10 patients had ≥3 previous transrectal ultrasound scan-guided biopsies. The mean prostate-specific antigen was 15 ng/mL (range 2.5-79 ng/mL). High-grade prostatic intraepithelial neoplasia was found in 12 (27%) patients and prostate cancer with Gleason <7, 7 and >7 in 13, 10 and 8 patients, respectively. Suspicious lesions on magnetic resonance imaging scans were scored from 1 to 5. In 28 patients, magnetic resonance imaging detected lesions with score ≥3. Magnetic resonance imaging correctly localised transperineal template mapping biopsies-detected prostate cancer in a hemi-gland approach, particularly in a right to left manner (79% positive prediction rate), but not in a quadrant approach (33% positive prediction rate). Our findings support the notion of magnetic resonance imaging-based selection of patients for transperineal template mapping biopsies and that lesions revealed by magnetic resonance imaging are likely useful for targeted biopsies. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  2. Clinical Outcome Following Low Suspicion Multiparametric Prostate Magnetic Resonance Imaging or Benign Magnetic Resonance Imaging Guided Biopsy to Detect Prostate Cancer.

    PubMed

    Boesen, Lars; Nørgaard, Nis; Løgager, Vibeke; Thomsen, Henrik S

    2017-02-21

    We assessed the risk of significant prostate cancer being detected after low suspicion magnetic resonance imaging or suspicious magnetic resonance imaging with benign magnetic resonance imaging guided biopsies in men with prior negative systematic biopsies. Overall 289 prospectively enrolled men underwent magnetic resonance imaging followed by repeat systematic and targeted biopsies of any suspicious lesions at baseline. A total of 194 patients with low suspicion magnetic resonance imaging or benign target biopsies were suitable for this study. Those who were negative for prostate cancer at baseline were followed for at least 3 years. We calculated the negative predictive values of magnetic resonance imaging in ruling out any prostate cancer and significant prostate cancer, defined as any core with Gleason score greater than 6, or more than 2 positive cores/cancerous core 50% or greater. Prostate cancer was detected in 38 of 194 (20%) patients during the median study period of 47 months (IQR 43-52). The overall negative predictive value of magnetic resonance imaging in ruling out any and significant prostate cancer was 80% (156 of 194) and 95% (184 of 194), respectively. No patient with low suspicion magnetic resonance imaging had intermediate/high grade cancer (Gleason score greater than 6). The majority of patients with no cancer during followup (132 of 156, 85%) had a decreasing prostate specific antigen and could be monitored in primary care. Low suspicion magnetic resonance imaging in men with prior negative systematic biopsies has a high negative predictive value in ruling out longer term, significant cancer. Therefore, immediate repeat biopsies are of limited clinical value and could be avoided even if prostate specific antigen is persistently increased. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  3. [Prostate cancer].

    PubMed

    Bey, P; Beckendorf, V; Stinès, J

    2001-10-01

    Radiation therapy of prostate carcinoma with a curative intent implies to treat the whole prostate at high dose (at least 66 Gy). According to clinical stage, PSA level, Gleason's score, the clinical target volume may include seminal vesicles and less often pelvic lymph nodes. Microscopic extracapsular extension is found in 15 to 60% of T1-T2 operated on, specially in apex tumors. On contrary, cancers developing from the transitional zone may stay limited to the prostate even with a big volume and with a high PSA level. Zonal anatomy of the prostate identifies internal prostate, including the transitional zone (5% of the prostate in young people). External prostate includes central and peripheral zones. The inferior limit of the prostate is not lower than the inferior border of the pubic symphysis. Clinical and radiological examination: ultrasonography, nuclear magnetic resonance (NMR), CT-scan identify prognostic factors as tumor volume, capsule effraction, seminal vesicles invasion and lymph node extension. The identification of the clinical target volume is now done mainly by CT-Scan which identifies prostate and seminal vesicles. NMR could be helpful to identify more precisely prostate apex. The definition of margins around the clinical target volume has to take in account daily reproducibility and organ motion and of course the maximum tolerable dose for organs at risk.

  4. Image-guided diagnosis of prostate cancer can increase detection of tumors

    Cancer.gov

    In the largest prospective study to date of image-guided technology for identifying suspicious regions of the prostate to biopsy, researchers compared the ability of this technology to detect high-risk prostate cancer with that of the current standard of

  5. Molecular Engineering of Vector-Based Oncolytic and Imaging Approaches for Advanced Prostate Cancer

    DTIC Science & Technology

    2005-02-01

    same vector, each downstream of expression of reporter genes-mutant HSV1 thymidine kinase identical but independent promoters (Ray et al., 2001; Sun et...therapeutic approaches. A highly potent and prostate-specific transcriptional regulatory system (TSTA) has been utilized to restrict the expression of...our adenoviral vector specifically to prostate or prostate cancer cells. In the diagnostic approach, this TSTA system will be applied to express imaging

  6. Multi-parametric MR imaging of the anterior fibromuscular stroma and its differentiation from prostate cancer.

    PubMed

    Ward, Emily; Baad, Michael; Peng, Yahui; Yousuf, Ambereen; Wang, Shiyang; Antic, Tatjana; Oto, Aytekin

    2017-03-01

    To describe MP-MRI features of the normal anterior fibromuscular stroma (AFMS) and identify MR imaging findings that can differentiate it from anterior prostate cancer. We reviewed MP-MR images and histopathology of patients who underwent pre-operative MRI and prostatectomy between October 2012 and August 2014. Thirty-seven patients with anterior prostate cancer larger than 5 mm and 40 patients with no anterior cancer were included in this study. After correlation with histology and MR images, the size, symmetry, T2, DWI characteristics, and enhancement pattern of normal AFMS and anterior prostate cancer were compared. Normal AFMS was hypointense and symmetric on T2-weighted images (37/40, 93%), whereas anterior prostate cancers, while also hypointense on T2-weighted images, were predominantly asymmetric (6/37, 16%) (P < 0.001). On high b-value DWI, AFMS was predominantly hypointense (36/40, 90%), whereas anterior prostate cancers were predominantly hyperintense (30/37, 81%) compared to the normal peripheral zone (P < 0.001). The mean ADC and tenth percentile ADC values of anterior prostate cancers were lower than normal AFMS (7.14 vs. 8.33 (10(-4) mm(2)/s), P < 0.01) and (5.73 vs. 6.95 (10(-4) mm(2)/s), P < 0.01), respectively. On DCE-MR images, AFMS demonstrated a type 1 enhancement curve (35/39, 90%), whereas anterior prostate cancers demonstrated only either a type 3 (23/37, 62%) or type 2 enhancement curve (14/37, 38%) (P < 0.001). Symmetric T2 appearance, hypointense high b-value DWI signal, relatively higher ADC values, and Type 1 enhancement pattern of the AFMS can be helpful in its differentiation from anterior prostate cancers.

  7. Prostate cancer spectral multifeature analysis using TRUS images.

    PubMed

    Mohamed, S S; Salama, M A

    2008-04-01

    This paper focuses on extracting and analyzing different spectral features from transrectal ultrasound (TRUS) images for prostate cancer recognition. First, the information about the images' frequency domain features and spatial domain features are combined using a Gabor filter and then integrated with the expert radiologist's information to identify the highly suspicious regions of interest (ROIs). The next stage of the proposed algorithm is to scan each identified region in order to generate the corresponding 1-D signal that represents each region. For each ROI, possible spectral feature sets are constructed using different new geometrical features extracted from the power spectrum density (PSD) of each region's signal. Next, a classifier-based algorithm for feature selection using particle swarm optimization (PSO) is adopted and used to select the optimal feature subset from the constructed feature sets. A new spectral feature set for the TRUS images using estimation of signal parameters via rotational invariance technique (ESPRIT) is also constructed, and its ability to represent tissue texture is compared to the PSD-based spectral feature sets using the support vector machines (SVMs) classifier. The accuracy obtained ranges from 72.2% to 94.4%, with the best accuracy achieved by the ESPRIT feature set.

  8. Real-time elastography for the diagnosis of prostate cancer: evaluation of elastographic moving images.

    PubMed

    Miyagawa, Tomoaki; Tsutsumi, Masakazu; Matsumura, Takeshi; Kawazoe, Natsui; Ishikawa, Satoru; Shimokama, Tatsuro; Miyanaga, Naoto; Akaza, Hideyuki

    2009-06-01

    Elastography is a technique for detecting the stiffness of tissues. We applied elastography for the diagnosis of prostate cancer and evaluated the usefulness of elastography for prostate biopsy. The subjects of this study were 311 patients who underwent elastography during prostate needle biopsy at Hitachi General Hospital. Strain images obtained during compression of the prostate tissue were displayed on a monitor and recorded on the computer. The elastographic moving images (EMI) were evaluated retrospectively. The evaluable images and biopsy results were compared in terms of the feasibility and accuracy. The median patient age was 67 years (range 50-85 years), the median serum level of prostate-specific antigen was 8.4 ng/ml (range 0.3-82.5 ng/ml) and the median prostate volume was 42.6 ml (range 12-150 ml). Among the 311 patients, prostate cancer was detected in 95 patients (30%) by biopsy. The diagnostic sensitivity was 37.9% for digital rectal examination (DRE) and 59.0% for transrectal ultrasonography (TRUS), whereas it was 72.6% for elastography and 89.5% for the combination of TRUS and elastography. Elastography-positive EMIs with negative biopsies were eventually determined to be due to benign prostatic hyperplasia. Elastography has a significantly higher sensitivity for the detection of prostate cancer than the conventionally used examinations including DRE and TRUS. It is a useful real-time diagnostic method because it is not invasive, and simultaneous evaluation is possible while performing TRUS.

  9. A Pilot Study to Evaluate the Role of Magnetic Resonance Imaging for Prostate Cancer Screening in the General Population.

    PubMed

    Nam, Robert K; Wallis, Christopher J D; Stojcic-Bendavid, Jessica; Milot, Laurent; Sherman, Christopher; Sugar, Linda; Haider, Masoom A

    2016-08-01

    To our knowledge the role of magnetic resonance imaging as a first line screening test for prostate cancer is unknown. We performed a pilot study to evaluate the feasibility of prostate magnetic resonance imaging as the primary screening test for prostate cancer. We recruited unselected men from the general population. Prostate multiparametric magnetic resonance imaging and random or targeted biopsies were performed in all patients, in addition to prostate specific antigen testing. We compared the performance of prostate magnetic resonance imaging and prostate specific antigen test results to predict prostate cancer. Of the 47 recruited patients 18 (38.3%) had cancer while 29 (61.7%) had no evidence of cancer. The adjusted OR of prostate cancer was significantly higher for magnetic resonance imaging score than for prostate specific antigen level (2.7, 95% CI 1.4-5.4, p = 0.004 vs 1.1, 95% CI 0.9-1.4, p = 0.21). Among the 30 patients with a normal prostate specific antigen (less than 4.0 ng/ml) the positive predictive value in those with a magnetic resonance imaging score of 4 or more was 66.7% (6 of 9) and the negative predictive value in those with a magnetic resonance imaging score of 3 or less was 85.7% (18 of 21, p = 0.004). In this pilot study we determined the feasibility of using multiparametric prostate magnetic resonance imaging as the primary screening test for prostate cancer. Initial results showed that prostate magnetic resonance imaging was better to predict prostate cancer than prostate specific antigen in an unselected sample of the general population. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  10. Regional-Level Correlations in Inappropriate Imaging Rates for Prostate and Breast Cancers

    PubMed Central

    Makarov, Danil V.; Soulos, Pamela R.; Gold, Heather T.; Yu, James B.; Sen, Sounok; Ross, Joseph S.; Gross, Cary P.

    2015-01-01

    IMPORTANCE The association between regional norms of clinical practice and appropriateness of care is incompletely understood. Understanding regional patterns of care across diseases might optimize implementation of programs like Choosing Wisely, an ongoing campaign to decrease wasteful medical expenditures. OBJECTIVE To determine whether regional rates of inappropriate prostate and breast cancer imaging were associated. DESIGN, SETTING, AND PARTICIPANTS Retrospective cohort study using the the Surveillance, Epidemiology, and End Results–Medicare linked database. We identified patients diagnosed from 2004 to 2007 with low-risk prostate (clinical stage T1c/T2a; Gleason score, ≤6; and prostate-specific antigen level, <10 ng/mL) or breast cancer (in situ, stage I, or stage II disease), based on Choosing Wisely definitions. MAIN OUTCOMES AND MEASURES In a hospital referral region (HRR)-level analysis, our dependent variable was HRR-level imaging rate among patients with low-risk prostate cancer. Our independent variable was HRR-level imaging rate among patients with low-risk breast cancer. In a subsequent patient-level analysis we used multivariable logistic regression to model prostate cancer imaging as a function of regional breast cancer imaging and vice versa. RESULTS We identified 9219 men with prostate cancer and 30 398 women with breast cancer residing in 84 HRRs. We found high rates of inappropriate imaging for both prostate cancer (44.4%) and breast cancer (41.8%). In the first, second, third, and fourth quartiles of breast cancer imaging, inappropriate prostate cancer imaging was 34.2%, 44.6%, 41.1%, and 56.4%, respectively. In the first, second, third, and fourth quartiles of prostate cancer imaging, inappropriate breast cancer imaging was 38.1%, 38.4%, 43.8%, and 45.7%, respectively. At the HRR level, inappropriate prostate cancer imaging rates were associated with inappropriate breast cancer imaging rates (ρ = 0.35; P < .01). At the patient level, a

  11. Restriction spectrum imaging improves MRI-based prostate cancer detection

    PubMed Central

    McCammack, Kevin C.; Schenker-Ahmed, Natalie M.; White, Nathan S.; Best, Shaun R.; Marks, Robert M.; Heimbigner, Jared; Kane, Christopher J.; Parsons, J. Kellogg; Kuperman, Joshua M.; Bartsch, Hauke; Desikan, Rahul S.; Rakow-Penner, Rebecca A.; Liss, Michael A.; Margolis, Daniel J. A.; Raman, Steven S.; Shabaik, Ahmed; Dale, Anders M.; Karow, David S.

    2017-01-01

    Purpose To compare the diagnostic performance of restriction spectrum imaging (RSI), with that of conventional multi-parametric (MP) magnetic resonance imaging (MRI) for prostate cancer (PCa) detection in a blinded reader-based format. Methods Three readers independently evaluated 100 patients (67 with proven PCa) who underwent MP-MRI and RSI within 6 months of systematic biopsy (N = 67; 23 with targeting performed) or prostatectomy (N = 33). Imaging was performed at 3 Tesla using a phased-array coil. Readers used a five-point scale estimating the likelihood of PCa present in each prostate sextant. Evaluation was performed in two separate sessions, first using conventional MP-MRI alone then immediately with MP-MRI and RSI in the same session. Four weeks later, another scoring session used RSI and T2-weighted imaging (T2WI) without conventional diffusion-weighted or dynamic contrast-enhanced imaging. Reader interpretations were then compared to prostatectomy data or biopsy results. Receiver operating characteristic curves were performed, with area under the curve (AUC) used to compare across groups. Results MP-MRI with RSI achieved higher AUCs compared to MP-MRI alone for identifying high-grade (Gleason score greater than or equal to 4 + 3=7) PCa (0.78 vs. 0.70 at the sextant level; P < 0.001 and 0.85 vs. 0.79 at the hemigland level; P = 0.04). RSI and T2WI alone achieved AUCs similar to MP-MRI for high-grade PCa (0.71 vs. 0.70 at the sextant level). With hemigland analysis, high-grade disease results were similar when comparing RSI + T2WI with MP-MRI, although with greater AUCs compared to the sextant analysis (0.80 vs. 0.79). Conclusion Including RSI with MP-MRI improves PCa detection compared to MP-MRI alone, and RSI with T2WI achieves similar PCa detection as MP-MRI. PMID:26910114

  12. Second harmonic generation (SHG) imaging of cancer heterogeneity in ultrasound guided biopsies of prostate in men suspected with prostate cancer.

    PubMed

    Ling, Yuting; Li, Chunhui; Feng, Kairui; Palmer, Scott; Appleton, Paul L; Lang, Stephen; McGloin, David; Huang, Zhihong; Nabi, Ghulam

    2017-06-01

    Prostate cancer is a multifocal disease with characteristic heterogeneity and foci that can range from low grade indolent to aggressive disease. The latter is characterised by the well-established histopathological Gleason grading system used in the current clinical care. Nevertheless, a large discrepancy exists on initial biopsy and after the final radical prostatectomy. Moreover, there is no reliable imaging modality to study these foci, in particular at the level of the cells and surrounding matrix. Extracellular matrix (ECM) remodelling is significant in cancer progression with collagen as the dominant structural component providing mechanical strength and flexibility of tissue. In this study, the collagen assembly in prostate tissue was investigated with second harmonic generation (SHG) microscopy: malignant foci demonstrated a reticular pattern, with a typical collagen pattern for each Gleason score. The orientation of collagen for each biopsy was computed by applying a ratio of the anisotropic and isotropic collagen fibres. This value was found to be distinct for each Gleason score. The findings suggest that this approach can not only be used to detect prostate cancer, but also can act as a potential biomarker for cancer aggressiveness. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  13. Carr-Purcell-Meiboom-Gill (CPMG) Imaging of Prostate Cancer: Quantitative T2 Values for Cancer Discrimination

    PubMed Central

    Roebuck, Joseph R.; Haker, Steven J.; Mitsouras, Dimitris; Rybicki, Frank J.; Tempany, Clare M.; Mulkern, Robert V.

    2009-01-01

    Quantitative, apparent T2 values of suspected prostate cancer and healthy peripheral zone tissue in men with prostate cancer were measured using a Carr-Purcell-Meiboom-Gill (CPMG) imaging sequence in order to assess the cancer discrimination potential of tissue T2 values. The CPMG imaging sequence was used to image the prostates of 18 men with biopsy proven prostate cancer. Whole gland coverage with nominal voxel volumes of 0.54 × 1.1 × 4 mm3 was obtained in 10.7 minutes, resulting in data sets suitable for generating high quality images with variable T2-weighting and for evaluating quantitative T2 values on a pixel-by-pixel basis. Region-of-interest analysis of suspected healthy peripheral zone tissue and suspected cancer, identified on the basis of both T1- and T2-weighted signal intensities and available histopathology reports, yielded significantly (p < 0.0001) longer apparent T2 values in suspected healthy tissue (193 ± 49 ms) vs. suspected cancer (100 ± 26 ms), suggesting potential utility of this method as a tissue specific discrimination index for prostate cancer. We conclude that CPMG imaging of the prostate can be performed in reasonable scan times and can provide advantages over T2-weighted fast spin echo imaging alone, including quantitative T2 values for cancer discrimination as well as proton density maps without the point spread function degradation associated with short effective echo time fast spin echo (FSE) sequences. PMID:18823731

  14. A Rare Case of Omentum Invasive Prostate Cancer: Staging With PSMA PET/CT Imaging and Response to Systemic Therapy.

    PubMed

    Ladwa, Rahul; Gustafson, Sonja; McCaffrey, Elizabeth; Miles, Kenneth; O'Byrne, Kenneth

    2017-02-24

    The omentum is a rare metastatic site for prostatic adenocarcinoma. We present a case of metastatic castrate-resistant prostate cancer, with progressive omentum invasive prostate cancer identified on prostate-specific membrane antigen (PSMA) PET/CT scan. Omental biopsy revealed metastatic prostate adenocarcinoma, and cabazitaxel chemotherapy was instituted with a prostate-specific antigen biochemical response. Repeat PSMA PET/CT imaging revealed increased avidity in omental metastasis. Despite prostate-specific antigen response, PSMA PET/CT did not correlate with a therapeutic response.

  15. PET Imaging in Prostate Cancer: Focus on Prostate-Specific Membrane Antigen

    PubMed Central

    Mease, Ronnie C.; Foss, Catherine A.; Pomper, Martin G.

    2014-01-01

    Prostate cancer (PCa) is the second leading cause of cancer-related death in American men. Positron emission tomography/computed tomography (PET/CT) with emerging radiopharmaceuticals promises accurate staging of primary disease, restaging of recurrent disease, detection of metastatic lesions and, ultimately, for predicting the aggressiveness of disease. Prostate-specific membrane antigen (PSMA) is a well-characterized imaging biomarker of PCa. Because PSMA levels are directly related to androgen independence, metastasis and progression, PSMA could prove an important target for the development of new radiopharmaceuticals for PET. Preclinical data for new PSMA-based radiotracers are discussed and include new 89Zr- and 64Cu-labeled anti-PSMA antibodies and antibody fragments, 64Cu-labeled aptamers, and 11C-, 18F-, 68Ga-, 64Cu-, and 86Y-labeled low molecular weight inhibitors of PSMA. Several of these agents, namely 68Ga-HBED-CC conjugate 15, 18F-DCFBC 8, and BAY1075553 are particularly promising, each having detected sites of PCa in initial clinical studies. These early clinical results suggest that PET/CT using PSMA-targeted agents, especially with compounds of low molecular weight, will make valuable contributions to the management of PCa. PMID:23590171

  16. Prostate cancer

    PubMed Central

    Mazhar, D; Waxman, J

    2002-01-01

    It is a paradigm in cancer treatment that early detection and treatment improves survival. However, although screening measures lead to a higher rate of detection, for small bulk localised prostate cancer it remains unclear whether early detection and early treatment will lead to an overall decrease in mortality. The management options include surveillance, radiotherapy, and radical prostatectomy but there is no evidence base to evaluate the benefits of each approach. Advanced prostate cancer is managed by hormonal therapy. There have been major changes in treatment over the last two decades with the use of more humane treatment and developments in both chemotherapy and radiation. In this article we review the natural history and management of prostate cancer. PMID:12415080

  17. Radiohalogenated Prostate-Specific Membrane Antigen (PSMA)-Based Ureas as Imaging Agents for Prostate Cancer

    PubMed Central

    Chen, Ying; Foss, Catherine A.; Byun, Youngjoo; Nimmagadda, Sridhar; Pullambhatla, Mrudula; Fox, James J.; Castanares, Mark; Lupold, Shawn E.; Babich, John W.; Mease, Ronnie C.

    2009-01-01

    To extend our development of new imaging agents targeting the prostate-specific membrane antigen (PSMA), we have used the versatile intermediate 2-[3-(5-amino-1-carboxy-pentyl)-ureido]-pentanedioic acid (Lys-C(O)-Glu), which allows ready incorporation of radiohalogens for single photon emission computed tomography (SPECT) and positron emission tomography (PET). We prepared 2-[3-[1-carboxy-5-(4-[125I]iodo-benzoylamino)-pentyl]-ureido]-pentanedioic acid ([125I]3), 2-[3-[1-carboxy-5-(4-[18F]fluoro-benzoylamino)-pentyl]-ureido]-pentanedioic acid ([18F]6) and 2-(3-[1-carboxy-5-[(5-[125I]iodo-pyridine-3-carbonyl)-amino]-pentyl]-ureido)-pentanedioic acid ([125I]8) in 65 - 80% (non-decay-corrected), 30 - 35% (decay corrected) and 59 - 75% (non-decay-corrected) radiochemical yields. Compound [125I]3 demonstrated 8.8 ± 4.7 percent injected dose per gram (%ID/g) within PSMA+ PC-3 PIP tumor at 30 min postinjection, which persisted, with clear delineation of the tumor by SPECT. Similar tumor uptake values at early time points were demonstrated for [18F]6 (using PET) and [125I]8. Because of the many radiohalogenated moieties that can be attached via the ε amino group, the intermediate Lys-C(O)-Glu is an attractive template upon which to develop new imaging agents for prostate cancer. PMID:19053825

  18. Phosphorus magnetic resonance spectroscopic imaging at 7 T in patients with prostate cancer.

    PubMed

    Lagemaat, Miriam W; Vos, Eline K; Maas, Marnix C; Bitz, Andreas K; Orzada, Stephan; van Uden, Mark J; Kobus, Thiele; Heerschap, Arend; Scheenen, Tom W J

    2014-05-01

    The aim of this study was to identify characteristics of phosphorus (P) spectra of the human prostate and to investigate changes of individual phospholipid metabolites in prostate cancer through in vivo P magnetic resonance spectroscopic imaging (MRSI) at 7 T. In this institutional review board-approved study, 15 patients with biopsy-proven prostate cancer underwent T2-weighted magnetic resonance imaging and 3-dimensional P MRSI at 7 T. Voxels were selected at the tumor location, in normal-appearing peripheral zone tissue, normal-appearing transition zone tissue, and in the base of the prostate close to the seminal vesicles. Phosphorus metabolite ratios were determined and compared between tissue types. Signals of phosphoethanolamine (PE) and phosphocholine (PC) were present and well resolved in most P spectra in the prostate. Glycerophosphocholine signals were observable in 43% of the voxels in malignant tissue, but in only 10% of the voxels in normal-appearing tissue away from the seminal vesicles. In many spectra, independent of tissue type, 2 peaks resonated in the chemical shift range of inorganic phosphate, possibly representing 2 separate pH compartments. The PC/PE ratio in the seminal vesicles was highly elevated compared with the prostate in 5 patients. A considerable overlap of P metabolite ratios was found between prostate cancer and normal-appearing prostate tissue, preventing direct discrimination of these tissues. The only 2 patients with high Gleason scores tumors (≥4+5) presented with high PC and glycerophosphocholine levels in their cancer lesions. Phosphorus MRSI at 7 T shows distinct features of phospholipid metabolites in the prostate gland and its surrounding structures. In this exploratory study, no differences in P metabolite ratios were observed between prostate cancer and normal-appearing prostate tissue possibly because of the partial volume effects of small tumor foci in large MRSI voxels.

  19. Preclinical and Clinical Evaluation of Novel Agents for Noninvasive Imaging of Prostate Cancer

    DTIC Science & Technology

    1999-08-01

    recurrence is often impossible. We have developed new radioactive compounds, NM404 and NM412, which are radioiodinated phospholipid ether analogs and...have shown that they can localize to prostate cancer in rodent models of prostate cancer. We have recently shown that NM404 (1125 labeled) develops ...rabbit models. Dosimetry calculations for the radio labeled compounds have been completed. These data have allowed for development of protocols to begin human imaging studies, after appropriate approvals are obtained.

  20. Prostate cancer detection by prebiopsy 3.0-Tesla magnetic resonance imaging.

    PubMed

    Nishida, Sachiyo; Kinoshita, Hidefumi; Mishima, Takao; Kurokawa, Hiroaki; Sakaida, Noriko; Matsuda, Tadashi

    2011-09-01

    The diagnostic value of 3.0-Tesla magnetic resonance imaging (MRI) for prostate cancer remains to be determined. The aim of the present study was to assess the features of prostate cancer detectable by prebiopsy 3.0-Tesla MRI. From January 2007 through to December 2008, 116 patients who were examined by prebiopsy 3.0-Tesla MRI underwent radical prostatectomy for localized prostate cancer. Prostate specimens were examined to see whether the largest cancer area was the same as the area indicated on the MRI. Univariate and multivariate logistic regression analyses were conducted to identify variables predictive of agreement between MRI and histopathological findings. Sixty-six (56.9%) patients were suspected of having prostate cancer on the basis of MRI findings. In 49 of these patients (74.2%), it was considered that there was agreement between the abnormal area on the MRI and the index tumor. Univariate analysis revealed that there were significant differences in abnormal digital rectal examination, capsular penetration, the diameter of the index tumor of the radical prostatectomy specimen, and the Gleason scores of the biopsy and radical prostatectomy specimens. Multivariate analysis revealed that the Gleason score of the radical prostatectomy specimen was associated with the accurate detection of the prostate cancer by MRI (P = 0.0177). In conclusion, 3.0-Tesla MRI tends to accurately diagnose prostate cancer with high tumor burden and aggressiveness. Multimodal examination (T2-weighted imaging, dynamic contrast-enhanced imaging, and diffusion-weighted imaging) is recommended for the diagnosis of prostate cancer using 3.0-Tesla MRI. © 2011 The Japanese Urological Association.

  1. Development of Targeted Near-Infrared Imaging Agents for Prostate Cancer

    PubMed Central

    Wang, Xinning; Huang, Steve S.; Heston, Warren D.W.; Guo, Hong; Wang, Bing-Cheng; Basilion, James P.

    2015-01-01

    Prostate cancer is the most common noncutaneous malignancy affecting men in North America. Radical prostatectomy remains a definitive treatment for prostate cancer. However, prostate surgeries are still performed “blindly” with the extent of tumor infiltration past the margins of the surgery only being determined postoperatively. An imaging modality that can be used during surgery is needed to help define the tumor margins. With its abundant expression in prostate cancer, prostate-specific membrane antigen (PSMA) is an ideal target for detection of prostate cancer. The purpose of this study was to develop PSMA-targeted near-infrared (NIR) optical imaging probes for intraoperative visualization of prostate cancer. We synthesized a high-affinity PSMA ligand (PSMA-1) with low molecular weight and further labeled it with commercially available NIR dyes IRDy800 and Cy5.5. PSMA-1 and PSMA-1–NIR conjugates had binding affinities better than the parent ligand Cys-CO-Glu. Selective binding was measured for each of the probes in both in vitro and in vivo studies using competitive binding and uptake studies. Interestingly, the results indicated that the pharmacokinetics of the probes was dependent of the fluorophore conjugated to the PSMA-1 ligand and varied widely. These data suggest that PSMA-targeted probes have the potential to be further developed as contrast agents for clinical intraoperative fluorescence-guided surgery. PMID:25239933

  2. Prostate cancer - resources

    MedlinePlus

    Resources - prostate cancer ... The following organizations are good resources for information on prostate cancer : American Cancer Society -- www.cancer.org/cancer/prostatecancer/index National Cancer Institute -- www.cancer.gov/cancertopics/ ...

  3. Prostate Cancer Detection Using Near Infrared Spectral Polarization Imaging

    DTIC Science & Technology

    2005-07-01

    Electrical Engineering 2Department of Physics Introduction The City College of the City Univ. of NY The increasing incidence and mortality rate of...imaging methods on human rectum-membrane-prostate semiconductor, quantum well- based semiconductor devices, optical imaging samples using light... lasers , photonics, biomedical optics, condensed matter physics , and nonlinear optics. He has been one of the prime movers in optical biopsy and

  4. Novel Tracers and Their Development for the Imaging of Metastatic Prostate Cancer

    PubMed Central

    Apolo, Andrea B.; Pandit-Taskar, Neeta; Morris, Michael J.

    2012-01-01

    There are presently no accurate methods of imaging prostate cancer metastases to bone. An unprecedented number of novel imaging agents, based on the biology of the disease, are now available for testing. We reviewed contemporary molecular imaging modalities that have been tested in humans with metastatic prostate cancer, with consideration of the studies' adherence to current prostate cancer clinical trial designs. Articles from the years 2002 to 2008 on PET using 18F-FDG, 11C-choline, 18F-choline, 18F-flouride, 11C-acetate, 11C-methionine, and 18F-fluoro-5α-dihydrotestosterone in patients with metastatic prostate cancer were reviewed. Although these studies are encouraging, most focus on the rising population with prostate-specific antigen, and many involve small numbers of patients and do not adhere to consensus criteria for clinical trial designs in prostate cancer. Hence, although many promising agents are available for testing, such studies would benefit from closer collaboration between those in the fields of medical oncology and nuclear medicine. PMID:18997047

  5. Novel tracers and their development for the imaging of metastatic prostate cancer.

    PubMed

    Apolo, Andrea B; Pandit-Taskar, Neeta; Morris, Michael J

    2008-12-01

    There are presently no accurate methods of imaging prostate cancer metastases to bone. An unprecedented number of novel imaging agents, based on the biology of the disease, are now available for testing. We reviewed contemporary molecular imaging modalities that have been tested in humans with metastatic prostate cancer, with consideration of the studies' adherence to current prostate cancer clinical trial designs. Articles from the years 2002 to 2008 on PET using (18)F-FDG, (11)C-choline, (18)F-choline, (18)F-flouride, (11)C-acetate, (11)C-methionine, and (18)F-fluoro-5alpha-dihydrotestosterone in patients with metastatic prostate cancer were reviewed. Although these studies are encouraging, most focus on the rising population with prostate-specific antigen, and many involve small numbers of patients and do not adhere to consensus criteria for clinical trial designs in prostate cancer. Hence, although many promising agents are available for testing, such studies would benefit from closer collaboration between those in the fields of medical oncology and nuclear medicine.

  6. Evaluation of a novel label-free photonic-crystal biosensor imaging system for the detection of prostate cancer cells

    NASA Astrophysics Data System (ADS)

    DeLuna, Frank; Ding, XiaoFie; Sun, Lu-Zhe; Ye, Jing Yong

    2017-02-01

    Biomarker screening for prostate-specific antigen (PSA) is the current clinical standard for detection of prostate cancer. However this method has shown many limitations, mainly in its specificity, which can lead to a high false positive rate. Thus, there is a growing need in developing a more specific detection system for prostate cancer. Using a Photonic- Crystal-based biosensor in a Total-Internal-Reflection (PC-TIR) configuration, we demonstrate the use of refractive index (RI) to accomplish label-free detection of prostate cancer cells against non-cancerous prostate epithelial cells. The PC-TIR biosensor possesses an open microcavity, which in contrast to traditional closed microcavities, allows for easier access of analyte molecules or cells to interact with its sensing surface. In this study, an imaging system was designed using the PC-TIR biosensor to quantify cell RI as the contrast parameter for prostate cancer detection. Non-cancerous BPH-1 prostate epithelial cells and prostate cancer PC-3 cells were placed on a single biosensor and measured concurrently. Recorded image data was then analyzed through a home-built MatLab program. Results demonstrate that RI is a suitable variable for differentiation between prostate cancer cells and non-cancerous prostate epithelial cells. Our study shows clinical potential in utilizing RI test for the detection of prostate cancer.

  7. Challenges in accurate registration of 3D medical imaging and histopathology in primary prostate cancer

    PubMed Central

    Meyer, Charles; Ma, Bing; Kunju, Lakshmi P; Davenport, Matthew; Piert, Morand

    2013-01-01

    Due to poor correlation of slice thickness and orientation, verification of medical imaging results with histology is difficult. Often validation of imaging findings of lesions suspicious for prostate cancer is driven by a subjective, visual approach to correlate in vivo images with histopathology. This manuscript describes fallacious assumptions for correlation of imaging findings with pathology and identifies the lack of accurate registration as a major obstacle in the validation of PET and PET/CT imaging in primary prostate cancer. Specific registration techniques that facilitate the most difficult part of the registration process—the mapping of pathology onto high-resolution imaging, preferably aided by the ex vivo prostate specimen—are discussed. PMID:23503575

  8. [Usefulness of imaging studies in prostate cancer: Analysis of 241 patients].

    PubMed

    Martínez M, Nagel; Calvo, Carlos; Ibarra, Álvaro; Ramos, Christian; Zambrano, Norman

    2017-05-01

    The role of staging studies in patients with prostate cancer (PCa) is a topic of discussion. To evaluate the usefulness of imaging studies in patients with prostate cancer. We reviewed the pathology service records to identify patients with prostate cancer diagnosed between 2003 and 2013. We reviewed the electronic medical records of those patients identified as having a prostate cancer. Patients were grouped according D’amico’s classification of cancer dissemination risk. We analized the frequency of imaging studies requested and their efficacy to detect metastases in each risk group. We identified 241 patients with a mean age of 67 years. Fifty two percent of patients were classified as low-risk, 32% as intermediate-risk and 16% as high risk. At least one imaging study was requested to 64% of patients (49, 78 and 87% of patients with low, intermediate and high risk respectively). Among the 155 patients in whom an imaging study was requested, no metastases were found in the low risk group. On the other hand, dissemination was found in 7% of the intermediate-risk group and 62% of the high-risk group. Half of patients with prostate cancer were classified as low risk. In half of this group of low risk patients, staging studies were requested and the probability of detecting metastases was low or nil. The odds of detecting metastases increased in higher risk groups.

  9. The role of imaging in the diagnosis of primary prostate cancer

    PubMed Central

    Harvey, Hugh; deSouza, Nandita M

    2016-01-01

    Ultrasound and magnetic resonance imaging (MRI) are key imaging modalities in prostate cancer diagnosis. MRI offers a range of intrinsic contrast mechanisms (T2, diffusion-weighted imaging (DWI), MR spectroscopy (MRS)) and extrinsic contrast-generating options based on tumour vascular state following injection of weakly paramagnetic agents such as gadolinium. Together these parameters are referred to as multiparametric (mp)MRI and are used for detecting and guiding biopsy and staging prostate cancer. Although sensitivity of mpMRI is <75% for disease detection, specificity is >90% and a standardised reporting system together with MR-guided targeted biopsy is the optimal diagnostic pathway. Shear wave ultrasound elastography is a new technique which also holds promise for future studies. This article describes the developments in imaging the primary site of prostate cancer and reviews their current and future utility for screening, diagnosis and T-staging the disease. PMID:28344811

  10. Risks of Prostate Cancer Screening

    MedlinePlus

    ... Genetics of Prostate Cancer Prostate Cancer Screening Research Prostate Cancer Screening (PDQ®)–Patient Version What is screening? Go ... These are called diagnostic tests . General Information About Prostate Cancer Key Points Prostate cancer is a disease in ...

  11. Prediction of Prostate Cancer Recurrence Using Quantitative Phase Imaging

    NASA Astrophysics Data System (ADS)

    Sridharan, Shamira; Macias, Virgilia; Tangella, Krishnarao; Kajdacsy-Balla, André; Popescu, Gabriel

    2015-05-01

    The risk of biochemical recurrence of prostate cancer among individuals who undergo radical prostatectomy for treatment is around 25%. Current clinical methods often fail at successfully predicting recurrence among patients at intermediate risk for recurrence. We used a label-free method, spatial light interference microscopy, to perform localized measurements of light scattering in prostatectomy tissue microarrays. We show, for the first time to our knowledge, that anisotropy of light scattering in the stroma immediately adjoining cancerous glands can be used to identify patients at higher risk for recurrence. The data show that lower value of anisotropy corresponds to a higher risk for recurrence, meaning that the stroma adjoining the glands of recurrent patients is more fractionated than in non-recurrent patients. Our method outperformed the widely accepted clinical tool CAPRA-S in the cases we interrogated irrespective of Gleason grade, prostate-specific antigen (PSA) levels and pathological tumor-node-metastasis (pTNM) stage. These results suggest that QPI shows promise in assisting pathologists to improve prediction of prostate cancer recurrence.

  12. Androgen-independent Molecular Imaging Vectors to Detect Castration-Resistant and Metastatic Prostate Cancer

    PubMed Central

    Jiang, Ziyue Karen; Sato, Makoto; Wei, Liu H.; Kao, Chinghai; Wu, Lily

    2011-01-01

    Prostate specific promoters are frequently employed in gene mediated molecular imaging and therapeutic vectors to diagnose and treat castration resistant prostate cancer (CRPC) that emerges from hormone ablation therapy. Many of the conventional prostate specific promoters rely on the androgen axis to drive gene expression. However, considering the cancer heterogeneity and varying androgen receptor status, we herein evaluated the utility of prostate specific enhancing sequence (PSES), an androgen-independent promoter in CRPC. The PSES is a fused enhancer derived from the prostate specific antigen (PSA) and prostate specific membrane antigen (PSMA) gene regulatory region. We augmented the activity of PSES by the two-step transcriptional amplification (TSTA) system to drive the expression of imaging reporter genes for either bioluminescent or positron emission tomography (PET) imaging. The engineered PSES-TSTA system exhibits greatly elevated transcriptional activity, androgen-independency and strong prostate specificity, verified in cell culture and preclinical animal experimentations. These advantageous features of PSES-TSTA elicit superior gene expression capability for CRPC in comparison to the androgen-dependent PSA promoter driven system. In preclinical settings, we demonstrated robust PET imaging capacity of PSES-TSTA in a castrated prostate xenograft model. Moreover, intravenous administrated PSES-TSTA bioluminescent vector correctly identified tibial bone marrow metastases in 9 out of 9 animals while NaF- and FDG-PET was unable to detect the lesions. Taken together, this study demonstrated that the promising utility of a potent, androgen-independent and prostate cancer-specific expression system in directing gene-based molecular imaging in CRPC even in the context of androgen deprivation therapy. PMID:21933883

  13. Targeted prostate biopsy: value of multiparametric magnetic resonance imaging in detection of localized cancer

    PubMed Central

    Le, Jesse D; Huang, Jiaoti; Marks, Leonard S

    2014-01-01

    Prostate cancer is the second most common cancer in men, with 1.1 million new cases worldwide reported by the World Health Organization in one recent year. Transrectal ultrasound (TRUS)-guided biopsy has been used for the diagnosis of prostate cancer for over 2 decades, but the technique is usually blind to cancer location. Moreover, the false negative rate of TRUS biopsy has been reported to be as high as 47%. Multiparametric magnetic resonance imaging (mp-MRI) includes T1- and T2-weighted imaging as well as dynamic contrast-enhanced (DCE) and diffusion-weighted imaging (DWI). mp-MRI is a major advance in the imaging of prostate cancer, enabling targeted biopsy of suspicious lesions. Evolving targeted biopsy techniques—including direct in-bore biopsy, cognitive fusion and software-based MRI-ultrasound (MRI-US) fusion—have led to a several-fold improvement in cancer detection compared to the earlier method. Importantly, the detection of clinically significant cancers has been greatly facilitated by targeting, compared to systematic biopsy alone. Targeted biopsy via MRI-US fusion may dramatically alter the way prostate cancer is diagnosed and managed. PMID:24589455

  14. Evaluation of the Prostate Imaging Reporting and Data System for Magnetic Resonance Imaging Diagnosis of Prostate Cancer in Patients with Prostate-specific Antigen <20 ng/ml

    PubMed Central

    Wang, Xuan; Wang, Jian-Ye; Li, Chun-Mei; Zhang, Ya-Qun; Wang, Jian-Long; Wan, Ben; Zhang, Wei; Chen, Min; Li, Sa-Ying; Wan, Gang; Liu, Ming

    2016-01-01

    Background: The European Society of Urogenital Radiology has built the Prostate Imaging Reporting and Data System (PI-RADS) for standardizing the diagnosis of prostate cancer (PCa). This study evaluated the PI-RADS diagnosis method in patients with prostate-specific antigen (PSA) <20 ng/ml. Methods: A total of 133 patients with PSA <20 ng/ml were prospectively recruited. T2-weighted (T2WI) and diffusion-weighted (DWI) magnetic resonance images of the prostate were acquired before a 12-core transrectal prostate biopsy. Each patient's peripheral zone was divided into six regions on the images; each region corresponded to two of the 12 biopsy cores. T2WI, DWI, and T2WI + DWI scores were computed according to PI-RADS. The diagnostic accuracy of the PI-RADS score was evaluated using histopathology of prostate biopsies as the reference standard. Results: PCa was histologically diagnosed in 169 (21.2%) regions. Increased PI-RADS score correlated positively with increased cancer detection rate. The cancer detection rate for scores 1 to 5 was 2.8%, 15.0%, 34.6%, 52.6%, and 88.9%, respectively, using T2WI and 12.0%, 20.2%, 48.0%, 85.7%, and 93.3%, respectively, using DWI. For T2WI + DWI, the cancer detection rate was 1.5% (score 2), 13.5% (scores 3–4), 41.3% (scores 5–6), 75.9% (scores 7–8), and 92.3% (scores 9–10). The area under the curve for cancer detection was 0.700 (T2WI), 0.735 (DWI) and 0.749 (T2WI + DWI). The sensitivity and specificity were 53.8% and 89.2%, respectively, when using scores 5–6 as the cutoff value for T2WI + DWI. Conclusions: The PI-RADS score correlates with the PCa detection rate in patients with PSA <20 ng/ml. The summed score of T2WI + DWI has the highest accuracy in detection of PCa. However, the sensitivity should be further improved. PMID:27270538

  15. 6 Common Cancers - Prostate Cancer

    MedlinePlus

    ... Bar Home Current Issue Past Issues 6 Common Cancers - Prostate Cancer Past Issues / Spring 2007 Table of Contents For ... early screening. Photo: AP Photo/Danny Moloshok Prostate Cancer The prostate gland is a walnut-sized structure ...

  16. Preclinical Evaluation of (18)F-PSMA-1007, a New Prostate-Specific Membrane Antigen Ligand for Prostate Cancer Imaging.

    PubMed

    Cardinale, Jens; Schäfer, Martin; Benešová, Martina; Bauder-Wüst, Ulrike; Leotta, Karin; Eder, Matthias; Neels, Oliver C; Haberkorn, Uwe; Giesel, Frederik L; Kopka, Klaus

    2017-03-01

    In recent years, several radiotracers targeting the prostate-specific membrane antigen (PSMA) have been introduced. Some of them have had a high clinical impact on the treatment of patients with prostate cancer. However, the number of (18)F-labeled tracers addressing PSMA is still limited. Therefore, we aimed to develop a radiofluorinated molecule resembling the structure of therapeutic PSMA-617. Methods: The nonradioactive reference compound PSMA-1007 and the precursor were produced by solid-phase chemistry. The radioligand (18)F-PSMA-1007 was produced by a 2-step procedure with the prosthetic group 6-(18)F-fluoronicotinic acid 2,3,5,6-tetrafluorophenyl ester. The binding affinity of the ligand for PSMA and its internalization properties were evaluated in vitro with PSMA-positive LNCaP (lymph node carcinoma of the prostate) cells. Further, organ distribution studies were performed with mice bearing LNCaP and PC-3 (prostate cancer cell line; PSMA-negative) tumors. Finally, small-animal PET imaging of an LNCaP tumor-bearing mouse was performed. Results: The identified ligand had a binding affinity of 6.7 ± 1.7 nM for PSMA and an exceptionally high internalization ratio (67% ± 13%) in vitro. In organ distribution studies, high and specific tumor uptake (8.0 ± 2.4 percentage injected dose per gram) in LNCaP tumor-bearing mice was observed. In the small-animal PET experiments, LNCaP tumors were clearly visualized. Conclusion: The radiofluorinated PSMA ligand showed promising characteristics in its preclinical evaluation, and the feasibility of prostate cancer imaging was demonstrated by small-animal PET studies. Therefore, we recommend clinical transfer of the radioligand (18)F-PSMA-1007 for use as a diagnostic PET tracer in prestaging and monitoring of prostate cancer. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

  17. Automated classification of histopathology images of prostate cancer using a Bag-of-Words approach

    NASA Astrophysics Data System (ADS)

    Sanghavi, Foram M.; Agaian, Sos S.

    2016-05-01

    The goals of this paper are (1) test the Computer Aided Classification of the prostate cancer histopathology images based on the Bag-of-Words (BoW) approach (2) evaluate the performance of the classification grade 3 and 4 of the proposed method using the results of the approach proposed by the authors Khurd et al. in [9] and (3) classify the different grades of cancer namely, grade 0, 3, 4, and 5 using the proposed approach. The system performance is assessed using 132 prostate cancer histopathology of different grades. The system performance of the SURF features are also analyzed by comparing the results with SIFT features using different cluster sizes. The results show 90.15% accuracy in detection of prostate cancer images using SURF features with 75 clusters for k-mean clustering. The results showed higher sensitivity for SURF based BoW classification compared to SIFT based BoW.

  18. ProxiScan™: A Novel Camera for Imaging Prostate Cancer

    ScienceCinema

    Ralph James

    2016-07-12

    ProxiScan is a compact gamma camera suited for high-resolution imaging of prostate cancer. Developed by Brookhaven National Laboratory and Hybridyne Imaging Technologies, Inc., ProxiScan won a 2009 R&D 100 Award, sponsored by R&D Magazine to recognize t

  19. Hyperspectral stimulated Raman scattering imaging facilitates accurate diagnosis of human prostate cancer

    NASA Astrophysics Data System (ADS)

    Cui, Sishan; Wang, Ping; Yue, Shuhua

    2017-02-01

    Due to the subject nature of histopathology, there is a significant inter-observer discordance for the differentiation between low-risk prostate cancer (Gleason score <= 6), which can be left without treatment, and high-risk prostate cancer (Gleason score >6), which requires active treatment. Our previous study using Raman spectromicroscopy reveals that cholesteryl ester accumulation underlies human prostate cancer aggressiveness. However, Raman spectromicroscopy could only provide compositional information of certain lipid droplets of interest, which overlooked cell-to-cell variation and hindered translation to accurate automated diagnosis. Here, we demonstrated quantitative mapping of cholesteryl ester molar percentage in human prostate cancer tissues using hyperspectral stimulated Raman scattering microscopy that renders compositional information for every pixel in the image. Specifically, hundreds of SRS images at Raman shift between 2800 3000 cm-1 were taken, and multivariate curve resolution algorism was used to retrieve concentration images of lipid, lipofuscin, and protein. We found that the height ratio between the prominent cholesterol band at 2870 cm-1 and the CH2 stretching band at 2850 cm-1 was proportional to the molar percentage of cholesteryl ester present in the total lipids. Based on the calibration curve, we were able to quantitatively map cholesteryl ester level in intact prostate cancer tissues. Our data showed that not only the amount of cholesteryl ester-rich lipid droplets, but also the CE molar percentage, was significantly greater in prostate cancer tissues with Gleason score > 6 compared to the ones with Gleason score <= 6. Our study offers an opportunity towards more accurate prostate cancer diagnosis.

  20. Update on prostate imaging.

    PubMed

    Afnan, Jalil; Tempany, Clare M

    2010-02-01

    Successful and accurate imaging of prostate cancer is integral to its clinical management from detection and staging to subsequent monitoring. Various modalities are used including ultrasound, computed tomography, and magnetic resonance imaging, with the greatest advances seen in the field of magnetic resonance. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  1. Prostate-specific membrane antigen as a target for cancer imaging and therapy

    PubMed Central

    KIESS, A. P.; BANERJEE, S. R.; MEASE, R. C.; ROWE, S. P.; RAO, A.; FOSS, C. A.; CHEN, Y.; YANG, X.; CHO, S. Y.; NIMMAGADDA, S.; POMPER, M. G.

    2016-01-01

    The prostate-specific membrane antigen (PSMA) is a molecular target whose use has resulted in some of the most productive work toward imaging and treating prostate cancer over the past two decades. A wide variety of imaging agents extending from intact antibodies to low-molecular-weight compounds permeate the literature. In parallel there is a rapidly expanding pool of antibody-drug conjugates, radiopharmaceutical therapeutics, small-molecule drug conjugates, theranostics and nanomedicines targeting PSMA. Such productivity is motivated by the abundant expression of PSMA on the surface of prostate cancer cells and within the neovasculature of other solid tumors, with limited expression in most normal tissues. Animating the field is a variety of small-molecule scaffolds upon which the radionuclides, drugs, MR-detectable species and nanoparticles can be placed with relative ease. Among those, the urea-based agents have been most extensively leveraged, with expanding clinical use for detection and more recently for radiopharmaceutical therapy of prostate cancer, with surprisingly little toxicity. PSMA imaging of other cancers is also appearing in the clinical literature, and may overtake FDG for certain indications. Targeting PSMA may provide a viable alternative or first-line approach to managing prostate and other cancers. PMID:26213140

  2. The utility of monoclonal antibodies in the imaging of prostate cancer.

    PubMed

    Yao, Daniel; Trabulsi, Edouard J; Kostakoglu, Lale; Vallabhajosula, Shankar; Joyce, Maureen A; Nanus, David M; Milowsky, Matthew; Liu, He; Goldsmith, Stanley J

    2002-08-01

    Monoclonal antibodies (mAbs) to prostate-specific antigens, such as PSMA, have great potential as diagnostic and therapeutic tools in the management of advanced prostate cancer. PSMA is a very attractive target for mAb-based imaging. It is expressed by virtually all prostate cancers and its expression is further increased in poorly differentiated, metastatic, and hormone-refractory carcinomas. The ProstaScint scan (Cytogen, Princeton, NJ), based on the mAb 7E11-C5.3, is currently approved for the imaging of prostate cancer in soft tissue but is not approved for imaging bone metastases. It appears superior to conventional imaging studies for soft-tissue disease but has limitations attributed to its intracellular binding site on PSMA. Overcoming this limitation, new mAbs to the extracellular domain of PSMA have been developed. The radioisotopes, (111)Indium, (90)Yttrium, and (177)Lutetium have been conjugated to one such mAb, J591. Radioimmunoscintigraphy with this immunoconjugate has demonstrated excellent tumor targeting of prostate cancer sites not only in soft tissue but also in bone. Copyright 2002, Elsevier Science (USA). All rights reserved.

  3. Magnetic resonance imaging of prostate cancer: diffusion-weighted imaging in comparison with sextant biopsy.

    PubMed

    Yamamura, Jin; Salomon, Georg; Buchert, Ralph; Hohenstein, Arne; Graessner, Joachim; Huland, Hartwig; Graefen, Markus; Adam, Gerhard; Wedegaertner, Ulrike

    2011-01-01

    To retrospectively evaluate the impact of diffusion-weighted imaging (DWI) on the detection of prostate cancer in comparison with sextant biopsy. Fifty patients with clinical suspicion of prostate cancer underwent a combined endorectal-body-phased array magnetic resonance imaging examination at a 1.5 T magnetic resonance imaging (Siemens, Erlangen, Germany). The DWI was performed using b values of 50, 400, 800 s/mm. The prostate was divided into sextants, including the apex, the middle aspect, and the base for the left and right sides, separately. Regions of interest were placed in the peripheral zone of each sextant to evaluate the apparent diffusion coefficient (ADC) values. The results of the DWI were compared side by side with the findings of the histological examination of endorectal sonographically guided sextant biopsy. The sensitivity and specificity of ADC for the identification of the tumor tissue were computed for variable discrimination thresholds to evaluate its receiver operating characteristic. An association between ADC and Gleason score was tested for both the whole study group and on an individual basis using the nonparametric Spearman ρ test and the Pearson correlation, respectively. Histopathology identified tumor tissue in 21 (42%) of the 50 patients. The ADC value was 1.65 ± 0.32 mm/s 10 in normal tissue and 0.96 ± 0.24 mm/s 10 in tumor tissue (mean ± 1 SD). The area under the receiver operating characteristic curve was 0.966. Using the discrimination threshold 1.21 mm/s 10, for example, the ADC value provided a sensitivity of 0.92 and a specificity of 0.93. There was a highly significant negative correlation between the ADC value and the Gleason score in the tumor-positive tissue probes (n = 62, ρ = -0.405, P = 0.001) in the whole study group. On the individual patient basis, the Pearson correlation revealed a mean coefficient of r = -0.89 (SD ± 0.12) with a P < 0.001. Diffusion-weighted imaging of the prostate can be used to

  4. Diagnostic value of biparametric magnetic resonance imaging (MRI) as an adjunct to prostate-specific antigen (PSA)-based detection of prostate cancer in men without prior biopsies.

    PubMed

    Rais-Bahrami, Soroush; Siddiqui, M Minhaj; Vourganti, Srinivas; Turkbey, Baris; Rastinehad, Ardeshir R; Stamatakis, Lambros; Truong, Hong; Walton-Diaz, Annerleim; Hoang, Anthony N; Nix, Jeffrey W; Merino, Maria J; Wood, Bradford J; Simon, Richard M; Choyke, Peter L; Pinto, Peter A

    2015-03-01

    To determine the diagnostic yield of analysing biparametric (T2- and diffusion-weighted) magnetic resonance imaging (B-MRI) for prostate cancer detection compared with standard digital rectal examination (DRE) and prostate-specific antigen (PSA)-based screening. Review of patients who were enrolled in a trial to undergo multiparametric-prostate (MP)-MRI and MR/ultrasound fusion-guided prostate biopsy at our institution identified 143 men who underwent MP-MRI in addition to standard DRE and PSA-based prostate cancer screening before any prostate biopsy. Patient demographics, DRE staging, PSA level, PSA density (PSAD), and B-MRI findings were assessed for association with prostate cancer detection on biopsy. Men with detected prostate cancer tended to be older, with a higher PSA level, higher PSAD, and more screen-positive lesions (SPL) on B-MRI. B-MRI performed well for the detection of prostate cancer with an area under the curve (AUC) of 0.80 (compared with 0.66 and 0.74 for PSA level and PSAD, respectively). We derived combined PSA and MRI-based formulas for detection of prostate cancer with optimised thresholds. (i) for PSA and B-MRI: PSA level + 6 x (the number of SPL) > 14 and (ii) for PSAD and B-MRI: 14 × (PSAD) + (the number of SPL) >4.25. AUC for equations 1 and 2 were 0.83 and 0.87 and overall accuracy of prostate cancer detection was 79% in both models. The number of lesions positive on B-MRI outperforms PSA alone in detection of prostate cancer. Furthermore, this imaging criteria coupled as an adjunct with PSA level and PSAD, provides even more accuracy in detecting clinically significant prostate cancer. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

  5. Appropriateness of Prostate Cancer Imaging among Veterans in a Delivery System without Incentives for Overutilization.

    PubMed

    Makarov, Danil V; Hu, Elaine Y C; Walter, Dawn; Braithwaite, R Scott; Sherman, Scott; Gold, Heather T; Zhou, Xiao-Hua Andrew; Gross, Cary P; Zeliadt, Steven B

    2016-06-01

    To determine the frequency of appropriate and inappropriate prostate cancer imaging in an integrated health care system. Veterans Health Administration Central Cancer Registry linked to VA electronic medical records and Medicare claims (2004-2008). We performed a retrospective cohort study of VA patients diagnosed with prostate cancer (N = 45,084). Imaging (CT, MRI, bone scan, PET) use was assessed among patients with low-risk disease, for whom guidelines recommend against advanced imaging, and among high-risk patients for whom guidelines recommend it. We found high rates of inappropriate imaging among men with low-risk prostate cancer (41 percent) and suboptimal rates of appropriate imaging among men with high-risk disease (70 percent). Veterans utilizing Medicare-reimbursed care had higher rates of inappropriate imaging [OR: 1.09 (1.03-1.16)] but not higher rates of appropriate imaging. Veterans treated in middle [OR: 0.51 (0.47-0.56)] and higher [OR: 0.50 (0.46-0.55)] volume medical centers were less likely to undergo inappropriate imaging without compromising appropriate imaging. Our results highlight the overutilization of imaging, even in an integrated health care system without financial incentives encouraging provision of health care services. Paradoxically, imaging remains underutilized among high-risk patients who could potentially benefit from it most. © Health Research and Educational Trust.

  6. Focal Laser Ablation of Prostate Cancer: Feasibility of Magnetic Resonance Imaging-Ultrasound Fusion for Guidance.

    PubMed

    Natarajan, Shyam; Jones, Tonye A; Priester, Alan M; Geoghegan, Rory; Lieu, Patricia; Delfin, Merdie; Felker, Ely; Margolis, Daniel J A; Sisk, Anthony; Pantuck, Allan; Grundfest, Warren; Marks, Leonard S

    2017-10-01

    Focal laser ablation is a potential treatment in some men with prostate cancer. Currently focal laser ablation is performed by radiologists in a magnetic resonance imaging unit (in bore). We evaluated the safety and feasibility of performing focal laser ablation in a urology clinic (out of bore) using magnetic resonance imaging-ultrasound fusion for guidance. A total of 11 men with intermediate risk prostate cancer were enrolled in this prospective, institutional review board approved pilot study. Magnetic resonance imaging-ultrasound fusion was used to guide laser fibers transrectally into regions of interest harboring intermediate risk prostate cancer. Thermal probes were inserted for real-time monitoring of intraprostatic temperatures during laser activation. Multiparametric magnetic resonance imaging (3 Tesla) was done immediately after treatment and at 6 months along with comprehensive fusion biopsy. Ten of 11 patients were successfully treated while under local anesthesia. Mean procedure time was 95 minutes (range 71 to 105). Posttreatment magnetic resonance imaging revealed a confined zone of nonperfusion in all 10 men. Mean zone volume was 4.3 cc (range 2.1 to 6.0). No CTCAE grade 3 or greater adverse events developed and no changes were observed in urinary or sexual function. At 6 months magnetic resonance imaging-ultrasound fusion biopsy of the treatment site showed no cancer in 3 patients, microfocal Gleason 3 + 3 in another 3 and persistent intermediate risk prostate cancer in 4. Focal laser ablation of prostate cancer appears safe and feasible with the patient under local anesthesia in a urology clinic using magnetic resonance imaging-ultrasound fusion for guidance and thermal probes for monitoring. Further development is necessary to refine out of bore focal laser ablation and additional studies are needed to determine appropriate treatment margins and oncologic efficacy. Copyright © 2017 American Urological Association Education and Research, Inc

  7. What Medical, Urologic, and Radiation Oncologists Want from Molecular Imaging of Prostate Cancer.

    PubMed

    Ballas, Leslie K; de Castro Abreu, Andre Luis; Quinn, David I

    2016-10-01

    As molecular imaging better delineates the state of prostate cancer, clinical management will evolve. The currently licensed imaging modalities are limited by lack of specificity or sensitivity for the extent of cancer and for predicting outcome in response to therapy. Clinicians want molecular imaging that-by being more reliable in tailoring treatment and monitoring response for each patient-will become a key facet of precision medicine, surgery, and radiation therapy. Identifying patients who are candidates for specific or novel treatments is important, but equally important is the finding that a given patient may not be a good candidate for single-modality therapy. This article presents prostate cancer scenarios in which managing clinicians would welcome molecular imaging innovations to help with decision making. The potential role of newer techniques that may help fill this wish list is discussed. © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

  8. Role of serial multiparametric magnetic resonance imaging in prostate cancer active surveillance

    PubMed Central

    Vos, Larissa J; Janoski, Michele; Wachowicz, Keith; Yahya, Atiyah; Boychak, Oleksandr; Amanie, John; Pervez, Nadeem; Parliament, Matthew B; Pituskin, Edith; Fallone, B Gino; Usmani, Nawaid

    2016-01-01

    AIM: To examine whether addition of 3T multiparametric magnetic resonance imaging (mpMRI) to an active surveillance protocol could detect aggressive or progressive prostate cancer. METHODS: Twenty-three patients with low risk disease were enrolled on this active surveillance study, all of which had Gleason score 6 or less disease. All patients had clinical assessments, including digital rectal examination and prostate specific antigen (PSA) testing, every 6 mo with annual 3T mpMRI scans with gadolinium contrast and minimum sextant prostate biopsies. The MRI images were anonymized of patient identifiers and clinical information and each scan underwent radiological review without the other results known. Descriptive statistics for demographics and follow-up as well as the sensitivity and specificity of mpMRI to identify prostate cancer and progressive disease were calculated. RESULTS: During follow-up (median 24.8 mo) 11 of 23 patients with low-risk prostate cancer had disease progression and were taken off study to receive definitive treatment. Disease progression was identified through upstaging of Gleason score on subsequent biopsies for all 11 patients with only 2 patients also having a PSA doubling time of less than 2 years. All 23 patients had biopsy confirmed prostate cancer but only 10 had a positive index of suspicion on mpMRI scans at baseline (43.5% sensitivity). Aggressive disease prediction from baseline mpMRI scans had satisfactory specificity (81.8%) but low sensitivity (58.3%). Twenty-two patients had serial mpMRI scans and evidence of disease progression was seen for 3 patients all of whom had upstaging of Gleason score on biopsy (30% specificity and 100% sensitivity). CONCLUSION: Addition of mpMRI imaging in active surveillance decision making may help in identifying aggressive disease amongst men with indolent prostate cancer earlier than traditional methods. PMID:27158428

  9. Diffusion-weighted magnetic resonance imaging in patients with prostate cancer treated with radiotherapy.

    PubMed

    Iannelli, Giancarlo; Caivano, Rocchina; Rago, Luciana; Simeon, Vittorio; Lotumolo, Antonella; Rabasco, Paola; Villonio, Antonio; Gioioso, Matilde; Mastrangelo, Pietro; Barchetti, Flavio; Panebianco, Valeria; Macarini, Luca; Guglielmi, Giuseppe; Cammarota, Aldo

    2016-01-01

    To evaluate the utility of a multiparametric 3T magnetic resonance imaging (MRI) study using diffusion-weighted images (DWI) for the assessment of prostate cancer before and after radiotherapy (RT). A total of 34 patients, who received a histologic diagnosis of prostate adenocarcinoma, underwent MRI examination before and after local RT for the assessment of response to treatment. Apparent diffusion coefficient (ADC) values were calculated and compared. Before RT, DWI shows pathologic restriction of signal, while after RT pathologic restriction of signal was reduced or disappeared. The ADC values were significantly increased after therapy (p<0.05). The use of DWI with ADC measurements may be an imaging biomarker in the assessment of prostate cancer.

  10. Prostate cancer diagnosis using quantitative phase imaging and machine learning algorithms

    NASA Astrophysics Data System (ADS)

    Nguyen, Tan H.; Sridharan, Shamira; Macias, Virgilia; Balla, Andre K.; Do, Minh N.; Popescu, Gabriel

    2015-03-01

    We report, for the first time, the use of Quantitative Phase Imaging (QPI) images to perform automatic prostate cancer diagnosis. A machine learning algorithm is implemented to learn textural behaviors of prostate samples imaged under QPI and produce labeled maps of different regions for testing biopsies (e.g. gland, stroma, lumen etc.). From these maps, morphological and textural features are calculated to predict outcomes of the testing samples. Current performance is reported on a dataset of more than 300 cores of various diagnosis results.

  11. Localized Prostate Cancer

    MedlinePlus

    ... a decision aid for men with clinically localized prostate cancer (available at http://effectivehealthcare.ahrq.gov/prostate_da) ... A Decision Aid for Men With Clinically Localized Prostate Cancer Page 1 of 24 Introduction Men with clinically ...

  12. Image segmentation in treatment planning for prostate cancer using the region growing technique.

    PubMed

    Mazonakis, M; Damilakis, J; Varveris, H; Prassopoulos, P; Gourtsoyiannis, N

    2001-03-01

    The purpose of this study was to evaluate the performance of a region growing technique for segmenting prostate, bladder and rectum in CT images of prostate cancer patients. Prostate, bladder and rectum were segmented in all CT images of 10 patients using the region growing technique and manual tracing. Volumes of the above organs computed with the region growing technique were compared with those from manually traced images on a slice-by-slice basis. Measurement reproducibility of both segmentation techniques was evaluated using the data obtained from four independent observers. The region growing technique was 1.5 times faster than manual tracing. There was no statistical difference between the slice volumes of prostate, bladder and rectum obtained by the two segmentation techniques (p > 0.05, paired Student's t-test). Correlation between slice volumes of all organs of interest provided both by region growing and by manual tracing was very good (prostate r2 = 0.84; bladder r2 = 0.93; rectum r2 = 0.85). An overall reasonable agreement was found between the two segmentation techniques. The intraobserver and interobserver variations for prostate, bladder and rectum volume segmentation were found to be lower with the region growing technique than with manual tracing. The suggested semi-automatic technique allows the possibility of generating accurate and reproducible segmentation of prostate, bladder and rectum from CT data with great saving in labour.

  13. Five-year follow-up using a prostate stent as fiducial in image-guided radiotherapy of prostate cancer.

    PubMed

    Carl, Jesper; Sander, Lotte

    2015-06-01

    To report results from the five-year follow-up on a previously reported study using image-guided radiotherapy (IGRT) of localized or locally advanced prostate cancer (PC) and a removable prostate stent as fiducial. Patients with local or locally advanced PC were treated using five-field 3D conformal radiotherapy (3DRT). The clinical target volumes (CTV) were treated to 78 Gy in 39 fractions using daily on-line image guidance (IG). Late genito-urinary (GU) and gastro-intestinal (GI) toxicities were scored using the radiotherapy oncology group (RTOG) score and the common toxicity score of adverse events (CTC) score. Urinary symptoms were also scored using the international prostate symptom score (IPSS). Median observation time was 5.4 year. Sixty-two of the 90 patients from the original study cohort were eligible for toxicity assessment. Overall survival, cancer-specific survival and biochemical freedom from failure were 85%, 96% and 80%, respectively at five years after radiotherapy. Late toxicity GU and GI RTOG scores≥2 were 5% and 0%. Comparing pre- and post-radiotherapy IPSS scores indicate that development in urinary symptoms after radiotherapy may be complex. Prostate image-guided radiotherapy using a prostate stent demonstrated survival data comparable with recently published data. GU and GI toxicities at five-year follow-up were low and comparable to the lowest toxicity rates reported. These findings support that the precision of the prostate stent technique is at least as good as other techniques. IPSS revealed a complex development in urinary symptoms after radiotherapy.

  14. Magnetic resonance spectroscopic imaging for improved treatment planning of prostate cancer

    NASA Astrophysics Data System (ADS)

    Venugopal, Niranjan

    Prostate cancer is the most common malignancy afflicting Canadian men in 2011. Physicians use digital rectal exams (DRE), blood tests for prostate specific antigen (PSA) and transrectal ultrasound (TRUS)-guided biopsies for the initial diagnosis of prostate cancer. None of these tests detail the spatial extent of prostate cancer - information critical for using new therapies that can target cancerous prostate. With an MRI technique called proton magnetic resonance spectroscopic imaging (1H-MRSI), biochemical analysis of the entire prostate can be done without the need for biopsy, providing detailed information beyond the non-specific changes in hardness felt by an experienced urologist in a DRE, the presence of PSA in blood, or the "blind-guidance" of TRUS-guided biopsy. A hindrance to acquiring high quality 1H-MRSI data comes from signal originating from fatty tissue surrounding prostate that tends to mask or distort signal from within the prostate, thus reducing the overall clinical usefulness of 1H-MRSI data. This thesis has three major areas of focus: 1) The development of an optimized 1H-MRSI technique, called conformal voxel magnetic resonance spectroscopy (CV-MRS), to deal the with removal of unwanted lipid contaminating artifacts at short and long echo times. 2) An in vivo human study to test the CV-MRS technique, including healthy volunteers and cancer patients scheduled for radical prostatectomy or radiation therapy. 3) A study to determine the efficacy of using the 1H-MRSI data for optimized radiation treatment planning using modern delivery techniques like intensity modulated radiation treatment. Data collected from the study using the optimized CV-MRS method show significantly reduced lipid contamination resulting in high quality spectra throughout the prostate. Combining the CV-MRS technique with spectral-spatial excitation further reduced lipid contamination and opened up the possibility of detecting metabolites with short T2 relaxation times

  15. MR Imaging Based Treatment Planning for Radiotherapy of Prostate Cancer

    DTIC Science & Technology

    2007-02-01

    image- guided stereotactic localization in the hypofractionated treatment of lung cancer. Int. J. Rad. Oncol. Bio. Phys. 66: 738-747, 2006. Chapters...L, Ma C. Benefit of 3D image-guided stereotactic localization in the hypofractionated treatment of lung cancer. Proc. Medical Physics, 33(6), 1993...9. Amer AM, Mott J, Mackay RI, et al. Prediction of the benefits from dose-escalated hypofractionated intensity-modulated radiotherapy for

  16. Image-guided adaptive radiotherapy for prostate and head-and-neck cancers

    NASA Astrophysics Data System (ADS)

    O'Daniel, Jennifer C.

    In the current practice of radiation therapy, daily patient alignments have been based on external skin marks or on bone. However, internal organ variation (both motion and volumetric changes) between treatment fractions can displace the treatment target, causing target underdosage and normal tissue overdosage. In order to deliver the radiation treatment as planned, more accurate knowledge of the daily internal anatomy was needed. Additionally, treatments needed to adapt to these variations by either shifting the patient to account for the daily target position or by altering the treatment plan. In this dissertation, the question of whether inter-fractional variations in internal patient anatomy combined with external set-up uncertainties produced measurable differences between planned and delivered doses for prostate and head-and-neck cancer patients was investigated. Image-guided adaptive treatment strategies to improve tumor coverage and/or reduce normal tissue dose were examined. Treatment deliveries utilizing various alignment procedures for ten prostate cancer patients and eleven head-and-neck cancer patients, each of whom received multiple CT scans over the course of treatment, were simulated. The largest prostate dose losses between planning and delivery were correlated with anterior/posterior and superior/inferior prostate displacement. Daily bone alignment sufficiently maintained target coverage for 70% of patients, ultrasound for 90%, and CT for 100%. A no-action-level correction protocol, which corrected the daily bone alignment for the systematic internal displacement of the prostate based on a pre-determined number of CT image sets, successfully improved the prostate and seminal vesicle dosimetric coverage. Three CT image sets were sufficient to accurately correct the bone alignment scheme for the prostate internal systematic shifts. For head-and-neck cancer patient treatment, setup uncertainties and internal organ variations did not greatly affect

  17. Non-invasive molecular imaging of prostate cancer lymph node metastasis

    PubMed Central

    Pouliot, Frédéric; Johnson, Mai; Wu, Lily

    2009-01-01

    Imaging in medicine has been classically based on the anatomical description of organs. In the past 15 years, new imaging techniques based on gene expression that characterize a pathological process have been developed. Molecular imaging is the use of such molecules to image cell-specific characteristics. Here, we review recent advances in molecular imaging, taking as our prime example lymph node (LN) metastasis in prostate cancer. We describe the new techniques and compare their accuracy in detecting LN metastasis in prostate cancer. We also present new molecular strategies for improving tumor detection using adenoviruses, molecular promoters and amplification systems. Finally, we present the concept of ‘in vivo pathology’, which envisages using molecular imaging to accurately localize metastatic lesions based on the molecular signature of the disease. PMID:19482514

  18. Possibility of transrectal photoacoustic imaging-guided biopsy for detection of prostate cancer

    NASA Astrophysics Data System (ADS)

    Ishihara, Miya; Shinchi, Masayuki; Horiguchi, Akio; Shinmoto, Hiroshi; Tsuda, Hitoshi; Irisawa, Kaku; Wada, Takatsugu; Asano, Tomohiko

    2017-03-01

    A transrectral ultrasonography (TRUS) guided prostate biopsy is mandatory for histological diagnosis in patients with an elevated serum prostate-specific antigen (PSA), but its diagnostic accuracy is not satisfactory; therefore, a considerable number of patients are forced to have an unnecessary repeated biopsy. Photoacoustic (PA) imaging has the ability to visualize the distribution of hemoglobin clearly. Thus, there is the potential to acquire different maps of small vessel networks between cancerous and normal tissue. We developed an original TRUS-type PA probe consisting of a microconvex array transducer with an optical illumination system providing coregistered PA and ultrasound images. The purpose of this study is to demonstrate the clinical possibility of a transrectral PA image. The prostate biopsy cores obtained by transrectal systemic biopsies under TRUS guidance were stained with HE staining and anti-CD34 antibodies as a marker of the endothelium of the blood vessel in order to find a pattern in the map of a small vessel network, which allows for imaging-based identification of prostate cancer. We analyzed the association of PA signal patterns, the cancer location by a magnetic resonance imaging (MRI) study, and the pathological diagnosis with CD34 stains as a prospective intervention study. In order to demonstrate the TRUS-merged-with-PA imaging guided targeted biopsy combined with a standard biopsy for capturing the clinically significant tumors, we developed a puncture needle guide attachment for the original TRUS-type PA probe.

  19. Magnetic Resonance Imaging Underestimation of Prostate Cancer Geometry: Use of Patient Specific Molds to Correlate Images with Whole Mount Pathology.

    PubMed

    Priester, Alan; Natarajan, Shyam; Khoshnoodi, Pooria; Margolis, Daniel J; Raman, Steven S; Reiter, Robert E; Huang, Jiaoti; Grundfest, Warren; Marks, Leonard S

    2017-02-01

    We evaluated the accuracy of magnetic resonance imaging in determining the size and shape of localized prostate cancer. The subjects were 114 men who underwent multiparametric magnetic resonance imaging before radical prostatectomy with patient specific mold processing of the specimen from 2013 to 2015. T2-weighted images were used to contour the prostate capsule and cancer suspicious regions of interest. The contours were used to design and print 3-dimensional custom molds, which permitted alignment of excised prostates with magnetic resonance imaging scans. Tumors were reconstructed in 3 dimensions from digitized whole mount sections. Tumors were then matched with regions of interest and the relative geometries were compared. Of the 222 tumors evident on whole mount sections 118 had been identified on magnetic resonance imaging. For the 118 regions of interest mean volume was 0.8 cc and the longest 3-dimensional diameter was 17 mm. However, for matched pathological tumors, of which most were Gleason score 3 + 4 or greater, mean volume was 2.5 cc and the longest 3-dimensional diameter was 28 mm. The median tumor had a 13.5 mm maximal extent beyond the magnetic resonance imaging contour and 80% of cancer volume from matched tumors was outside region of interest boundaries. Size estimation was most accurate in the axial plane and least accurate along the base-apex axis. Magnetic resonance imaging consistently underestimates the size and extent of prostate tumors. Prostate cancer foci had an average diameter 11 mm longer and a volume 3 times greater than T2-weighted magnetic resonance imaging segmentations. These results may have important implications for the assessment and treatment of prostate cancer. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  20. Positron emission tomography in imaging evaluation of staging, restaging, treatment response, and prognosis in prostate cancer

    PubMed Central

    Jadvar, Hossein

    2017-01-01

    Prostate cancer is a prevalent public health problem worldwide. While imaging has played a major role in this disease, there still remain many challenges and opportunities. Positron emission tomography with various physiologically based radiotracers is fundamentally suited to interrogate this biologically and clinically heterogeneous disease along the course of its natural history. In this article, I review briefly the published evidence for the use of positron emission tomography with 18F-fluorodeoxyglucose, 11C-acetate, and 18F- or 11C-choline in the imaging evaluation of prostate cancer. Although the focus of the article will be on these radiotracers given the accumulated experience with them, but I will also comment on the outlook for the use of other emerging PET radiotracers such as those targeted to the prostate-specific membrane antigen and the amino acid metabolism pathway. It is anticipated that PET will play major role in the evaluation of prostate cancer in the current evidence-based medicine environment. There will also be exciting novel prospects for the use of therapeutic-diagnostic (theransotic) pairs in the management of patients with prostate cancer. PMID:27193789

  1. The role of positron emission tomography/computed tomography imaging with radiolabeled choline analogues in prostate cancer.

    PubMed

    Navarro-Pelayo Láinez, M M; Rodríguez-Fernández, A; Gómez-Río, M; Vázquez-Alonso, F; Cózar-Olmo, J M; Llamas-Elvira, J M

    2014-11-01

    prostate cancer is the most frequent solid malignant tumor in Western Countries. Positron emission tomography/x-ray computed tomography imaging with radiolabeled choline analogues is a useful tool for restaging prostate cancer in patients with rising prostate-specific antigen after radical treatment (in whom conventional imaging techniques have important limitations) as well as in the initial assessment of a selected group of prostate cancer patients. For this reason a literature review is necessary in order to evaluate the usefulness of this imaging test for the diagnosis and treatment of prostate cancer. a MEDLINE (PubMed way) literature search was performed using the search parameters: «Prostate cancer» and «Choline-PET/CT». Other search terms were «Biochemical failure» and/or «Staging» and/or «PSA kinetics». English and Spanish papers were selected; original articles, reviews, systematic reviews and clinical guidelines were included. according to available data, radiolabeled choline analogues plays an important role in the management of prostate cancer, especially in biochemical relapse because technique accuracy is properly correlated with prostate-specific antigen values and kinetics. Although is an emerging diagnostic technique useful in treatment planning of prostate cancer, final recommendations have not been submitted. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

  2. Serial Magnetic Resonance Imaging in Active Surveillance of Prostate Cancer: Incremental Value.

    PubMed

    Felker, Ely R; Wu, Jason; Natarajan, Shyam; Margolis, Daniel J; Raman, Steven S; Huang, Jiaoti; Dorey, Fred; Marks, Leonard S

    2016-05-01

    We assessed whether changes in serial multiparametric magnetic resonance imaging can help predict the pathological progression of prostate cancer in men on active surveillance. A retrospective cohort study was conducted of 49 consecutive men with Gleason 6 prostate cancer who underwent multiparametric magnetic resonance imaging at baseline and again more than 6 months later, each followed by a targeted prostate biopsy, between January 2011 and May 2015. We evaluated whether progression on multiparametric magnetic resonance imaging (an increase in index lesion suspicion score, increase in index lesion volume or decrease in index lesion apparent diffusion coefficient) could predict pathological progression (Gleason 3 + 4 or greater on subsequent biopsy, in systematic or targeted cores). Diagnostic performance of multiparametric magnetic resonance imaging was determined with and without clinical data using a binary logistic regression model. The mean interval between baseline and followup multiparametric magnetic resonance imaging was 28.3 months (range 11 to 43). Pathological progression occurred in 19 patients (39%). The sensitivity, specificity, positive predictive value and negative predictive value of multiparametric magnetic resonance imaging was 37%, 90%, 69% and 70%, respectively. Area under the receiver operating characteristic curve was 0.63. A logistic regression model using clinical information (maximum cancer core length greater than 3 mm on baseline biopsy or a prostate specific antigen density greater than 0.15 ng/ml(2) at followup biopsy) had an AUC of 0.87 for predicting pathological progression. The addition of serial multiparametric magnetic resonance imaging data significantly improved the AUC to 0.91 (p=0.044). Serial multiparametric magnetic resonance imaging adds incremental value to prostate specific antigen density and baseline cancer core length for predicting Gleason 6 upgrading in men on active surveillance. Copyright © 2016

  3. Echo-Planar Imaging Based J-Resolved Spectroscopic Imaging for Improved Metabolite Detection in Prostate Cancer

    DTIC Science & Technology

    2013-10-01

    patients, which included a 3D water- and fat -suppressed spectroscopic acquisition. 3D MRSI parameters of the endorectal and external phased array... fat . Artif Cells Blood Substit Immobil Biotechnol. 1994;22(4): 1477–83. 12. Maio A, Rifkin MD. Magnetic resonance imaging of prostate cancer...axial MRI of the abdomen is shown displaying the VOI covering the prostate localized by the PRESS sequence and the EP-JRESI grids. The split-Bregman

  4. An MR Contrast Agent for Intra-Prostatic Imaging of Prostatic Cancer

    DTIC Science & Technology

    2005-01-01

    nanoparticle MR contrast targeted to the gastrin releasing peptide receptor (GRP receptor) that will be used to image the intra-prostatic distribution of...develop a magnetic nanoparticle MR contrast targeted to the gastrin releasing peptide receptor (GRP receptor) that will be used to image the intra...the receptor in a convenient animal model, the normal mouse. The GRP receptor is expressed at high levels in the normal rodent pancreas. I. Synthesis

  5. COMPACT CdZnTe-BASED GAMMA CAMERA FOR PROSTATE CANCER IMAGING

    SciTech Connect

    CUI, Y.; LALL, T.; TSUI, B.; YU, J.; MAHLER, G.; BOLOTNIKOV, A.; VASKA, P.; DeGERONIMO, G.; O'CONNOR, P.; MEINKEN, G.; JOYAL, J.; BARRETT, J.; CAMARDA, G.; HOSSAIN, A.; KIM, K.H.; YANG, G.; POMPER, M.; CHO, S.; WEISMAN, K.; SEO, Y.; BABICH, J.; LaFRANCE, N.; AND JAMES, R.B.

    2011-10-23

    In this paper, we discuss the design of a compact gamma camera for high-resolution prostate cancer imaging using Cadmium Zinc Telluride (CdZnTe or CZT) radiation detectors. Prostate cancer is a common disease in men. Nowadays, a blood test measuring the level of prostate specific antigen (PSA) is widely used for screening for the disease in males over 50, followed by (ultrasound) imaging-guided biopsy. However, PSA tests have a high false-positive rate and ultrasound-guided biopsy has a high likelihood of missing small cancerous tissues. Commercial methods of nuclear medical imaging, e.g. PET and SPECT, can functionally image the organs, and potentially find cancer tissues at early stages, but their applications in diagnosing prostate cancer has been limited by the smallness of the prostate gland and the long working distance between the organ and the detectors comprising these imaging systems. CZT is a semiconductor material with wide band-gap and relatively high electron mobility, and thus can operate at room temperature without additional cooling. CZT detectors are photon-electron direct-conversion devices, thus offering high energy-resolution in detecting gamma rays, enabling energy-resolved imaging, and reducing the background of Compton-scattering events. In addition, CZT material has high stopping power for gamma rays; for medical imaging, a few-mm-thick CZT material provides adequate detection efficiency for many SPECT radiotracers. Because of these advantages, CZT detectors are becoming popular for several SPECT medical-imaging applications. Most recently, we designed a compact gamma camera using CZT detectors coupled to an application-specific-integrated-circuit (ASIC). This camera functions as a trans-rectal probe to image the prostate gland from a distance of only 1-5 cm, thus offering higher detection efficiency and higher spatial resolution. Hence, it potentially can detect prostate cancers at their early stages. The performance tests of this camera

  6. Compact CdZnTe-based gamma camera for prostate cancer imaging

    NASA Astrophysics Data System (ADS)

    Cui, Yonggang; Lall, Terry; Tsui, Benjamin; Yu, Jianhua; Mahler, George; Bolotnikov, Aleksey; Vaska, Paul; De Geronimo, Gianluigi; O'Connor, Paul; Meinken, George; Joyal, John; Barrett, John; Camarda, Giuseppe; Hossain, Anwar; Kim, Ki Hyun; Yang, Ge; Pomper, Marty; Cho, Steve; Weisman, Ken; Seo, Youngho; Babich, John; LaFrance, Norman; James, Ralph B.

    2011-06-01

    In this paper, we discuss the design of a compact gamma camera for high-resolution prostate cancer imaging using Cadmium Zinc Telluride (CdZnTe or CZT) radiation detectors. Prostate cancer is a common disease in men. Nowadays, a blood test measuring the level of prostate specific antigen (PSA) is widely used for screening for the disease in males over 50, followed by (ultrasound) imaging-guided biopsy. However, PSA tests have a high falsepositive rate and ultrasound-guided biopsy has a high likelihood of missing small cancerous tissues. Commercial methods of nuclear medical imaging, e.g. PET and SPECT, can functionally image the organs, and potentially find cancer tissues at early stages, but their applications in diagnosing prostate cancer has been limited by the smallness of the prostate gland and the long working distance between the organ and the detectors comprising these imaging systems. CZT is a semiconductor material with wide band-gap and relatively high electron mobility, and thus can operate at room temperature without additional cooling. CZT detectors are photon-electron direct-conversion devices, thus offering high energy-resolution in detecting gamma rays, enabling energy-resolved imaging, and reducing the background of Compton-scattering events. In addition, CZT material has high stopping power for gamma rays; for medical imaging, a few-mm-thick CZT material provides adequate detection efficiency for many SPECT radiotracers. Because of these advantages, CZT detectors are becoming popular for several SPECT medical-imaging applications. Most recently, we designed a compact gamma camera using CZT detectors coupled to an application-specific-integratedcircuit (ASIC). This camera functions as a trans-rectal probe to image the prostate gland from a distance of only 1-5 cm, thus offering higher detection efficiency and higher spatial resolution. Hence, it potentially can detect prostate cancers at their early stages. The performance tests of this camera

  7. Sextant localization of prostate cancer: comparison of sextant biopsy, magnetic resonance imaging and magnetic resonance spectroscopic imaging with step section histology.

    PubMed

    Wefer, A E; Hricak, H; Vigneron, D B; Coakley, F V; Lu, Y; Wefer, J; Mueller-Lisse, U; Carroll, P R; Kurhanewicz, J

    2000-08-01

    We compared the accuracy of endorectal magnetic resonance imaging (MRI) and magnetic resonance spectroscopic imaging with that of sextant biopsy for the sextant localization of prostate cancer. Sextant biopsy, MRI, magnetic resonance spectroscopic imaging and radical prostatectomy with step section histology were done in 47 patients with prostate cancer. For each sextant we categorized biopsy and imaging results as positive or negative for cancer. Step section histology was used as the standard of reference. For sextant localization of prostate cancer MRI and magnetic resonance spectroscopic imaging were more sensitive but less specific than biopsy (67% and 76% versus 50%, and 69% and 68% versus 82%, respectively). The sensitivity of sextant biopsy was significantly less in the prostate apex than in the mid prostate or prostate base (38% versus 52% and 62%, respectively). MRI and magnetic resonance spectroscopic imaging had similar efficacy throughout the prostate compared with biopsy only as well as better sensitivity and specificity in the prostate apex (60% and 75%, and 86% and 68%, respectively). A positive biopsy or imaging result had 94% sensitivity for cancer and concordant positivity by all 3 tests was highly specific at 98%. Overall MRI and magnetic resonance spectroscopic imaging have accuracy similar to biopsy for intraprostatic localization of cancer and they are more accurate than biopsy in the prostate apex. These 2 imaging modalities may supplement biopsy results by increasing physician confidence when evaluating intraprostatic tumor location, which may be important for planning disease targeted therapy.

  8. Tuberculous prostatitis: mimicking a cancer.

    PubMed

    Aziz, El Majdoub; Abdelhak, Khallouk; Hassan, Farih Moulay

    2016-01-01

    Genitourinary tuberculosis is a common type of extra-pulmonary tuberculosis . The kidneys, ureter, bladder or genital organs are usually involved. Tuberculosis of the prostate has mainly been described in immune-compromised patients. However, it can exceptionally be found as an isolated lesion in immune-competent patients. Tuberculosis of the prostate may be difficult to differentiate from carcinoma of the prostate and the chronic prostatitis when the prostate is hard and nodular on digital rectal examination and the urine is negative for tuberculosis bacilli. In many cases, a diagnosis of tuberculous prostatitis is made by the pathologist, or the disease is found incidentally after transurethral resection. Therefore, suspicion of tuberculous prostatitis requires a confirmatory biopsy of the prostate. We report the case of 60-year-old man who presented a low urinary tract syndrome. After clinical and biological examination, and imaging, prostate cancer was highly suspected. Transrectal needle biopsy of the prostate was performed and histological examination showed tuberculosis lesions.

  9. Usefulness of Diffusion-Weighted Imaging in the Localization of Prostate Cancer

    SciTech Connect

    Kajihara, Hiroo; Hayashida, Yoshiko; Murakami, Ryuji Katahira, Kazuhiro; Nishimura, Ryuichi; Hamada, Yasuyuki; Kitani, Kousuke; Kitaoka, Mitsuhiko; Suzuki, Yasuko; Kitajima, Mika; Hirai, Toshinori; Morishita, Shoji; Awai, Kazuo; Yamashita, Yasuyuki

    2009-06-01

    Purpose: Advances in high-precision radiation therapy techniques for patients with prostate cancer permit selective escalation of the radiation dose delivered to the dominant intraprostatic lesion and improve the therapeutic ratio. We evaluated the value of diffusion-weighted imaging (DWI) for dominant intraprostatic lesion assessment. Methods and Materials: The study population consisted of 23 patients with early prostate cancer. Before undergoing total prostatectomy, they were evaluated by means of magnetic resonance imaging, including DWI. T2-weighted imaging (T2WI) with and without DWI were retrospectively assessed by six independent observers. Imaging findings were compared with pathologic results from whole prostate specimens on a lesion-by-lesion basis. Results: Pathologic study identified 43 lesions in 23 patients. On magnetic resonance imaging, the six observers correctly identified 11-22 of 43 lesions (sensitivity, 26-51%) on T2WI alone and 20-31 (sensitivity, 47-72%) on T2WI plus DWI. Positive predictive values were 42-73% on T2WI alone and 58-80% on T2WI plus DWI. For all observers, detection was higher on combined T2WI and DWI than on T2WI alone. Conclusion: Because the addition of DWI to T2WI improves the detectability of prostate cancer, DWI may offer a promising new approach for radiation therapy planning.

  10. State-of-the-art uroradiologic imaging in the diagnosis of prostate cancer.

    PubMed

    Heijmink, Stijn W T P J; Fütterer, Jurgen J; Strum, Stephen S; Oyen, Wim J G; Frauscher, Ferdinand; Witjes, J Alfred; Barentsz, Jelle O

    2011-06-01

    In the diagnostic process of prostate cancer, several radiologic imaging modalities significantly contribute to the detection and localization of the disease. These range from transrectal ultrasound (TRUS) and magnetic resonance imaging (MRI) to positron emission tomography (PET). Within this review, after evaluation of the literature, we will discuss the advantages and disadvantages of these imaging modalities in clarifying the patient's clinical status as to whether he has prostate cancer or not and if so, where it is located, so that therapy appropriate to the patient's disease may be administered. TRUS, specifically with the usage of intravenous contrast agents, provides an excellent way of directing biopsy towards suspicious areas within the prostate in the general (screening) population. MRI using functional imaging techniques allows for highly accurate detection and localization, particularly in patients with prior negative ultrasound guided biopsies. A promising new development is the performance of biopsy within the magnetic resonance scanner. Subsequently, a proposal for optimal use of radiologic imaging is presented and compared with the European and American urological guidelines on prostate cancer.

  11. Monitoring the clinical outcomes in advanced prostate cancer: what imaging modalities and other markers are reliable?

    PubMed

    Morris, Michael J; Autio, Karen A; Basch, Ethan M; Danila, Daniel C; Larson, Steven; Scher, Howard I

    2013-06-01

    Effective patient care and efficient drug development require accurate tools to assess treatment effects. For metastatic castration-resistant prostate cancer (mCRPC), response biomarkers have historically been poorly reproducible, inaccurate, inconsistently applied, or only loosely associated with tangible clinical benefits such as survival. However, the field of response assessments for prostate cancer is maturing, in compliance with a rigorous process defined by analytic validation, clinical validation, and clinical qualification. For example, bone imaging with technetium-99m scintigraphy has historically been poorly used in prostate cancer clinical trials and routine patient care, and frequently has led to poor decision-making. However, contemporary clinical trial consensus criteria (Prostate Cancer Working Group 2 [PCWG2]) have standardized the definition of progression on bone scintigraphy and the clinical trials endpoint of radiographic progression-free survival (rPFS). A validated bone scan interpretation form captures the relevant data elements. rPFS and the forms have been undergoing prospective testing in multiple phase III studies. The first of these trials demonstrated a high degree of reproducibility and correlation with overall survival, and rPFS was used by the US Food and Drug Administration (FDA) for approval of abiraterone in chemotherapy-naïve mCRPC. Circulating tumor cells (CTC) are another class of assays with significant promise as response-indicator biomarkers. CTC enumeration has undergone analytic validation and has been FDA-cleared for monitoring patients with prostate cancer in conjunction with other clinical methods. It is not yet a surrogate for survival. Patient-reported outcomes (PROs) are direct indicators of patient benefit. The assays to measure PROs must undergo each of the steps of biomarker development, and are increasingly being standardized and used as clinical trial endpoints. In this review, we critically assess each of

  12. Capromab pendetide. A review of its use as an imaging agent in prostate cancer.

    PubMed

    Lamb, H M; Faulds, D

    1998-04-01

    Capromab pendetide, radiolabelled with indium-111, is a radioimmunoscintigraphic imaging agent used in patients with prostate cancer. It consists of a murine monoclonal antibody (7E11-C5.3) covalently jointed to a linker-chelator molecule. 7E11-C5.3 is thought to be directed against the intracellular domain of human prostate-specific membrane antigen (PSMA), a transmembrane glycoprotein expressed by prostate epithelial cells. The diagnostic utility of capromab pendetide has been investigated in 2 distinct patient groups. In patients with untreated prostate cancer at high risk for pelvic lymph node metastases, capromab pendetide imaging had respective sensitivities and specificities of 52 and 96% in 1 study and 62 and 72% in another, as confirmed by pelvic lymph node dissection biopsy results. In patients with suspected occult recurrent or residual disease after prostatectomy, capromab pendetide had respective sensitivities and specificities of 49 and 71% in 1 study and 77 and 35% in another for detection of cancer in the prostate bed. Almost half of these patients also had evidence of lesions outside the prostate fossa (usually in the pelvic and abdominal lymph nodes) according to immunoscintigraphic scans, but too few cases were confirmed to allow an evaluation of capromab pendetide. Four per cent of patients who received single doses of capromab pendetide experienced adverse events. Elevated bilirubin levels, hypertension and hypotension each affected 1% of patients and elevated liver enzymes and injection site reactions < 1% of patients. Detectable human anti-mouse antibodies were reported in 8% of patients after a single dose of capromab pendetide and in 19% of patients after repeat infusions. Capromab pendetide offers improved sensitivity in the detection of prostate cancer over other noninvasive techniques. When used in conjunction with other techniques, it offers the possibility of defining the extent of localised and metastatic disease, thereby refining

  13. Prostate Cancer Detection with Multiparametric Magnetic Resonance Imaging: Prostate Imaging Reporting and Data System Version 1 versus Version 2

    PubMed Central

    Feng, Zhao-Yan; Wang, Liang; Min, Xiang-De; Wang, Shao-Gang; Wang, Guo-Ping; Cai, Jie

    2016-01-01

    Background: Prostate Imaging Reporting and Data System (PI-RADS) is a globally acceptable standardization for multiparametric magnetic resonance imaging (mp-MRI) in prostate cancer (PCa) diagnosis. The American College of Radiology revised the PI-RADS to address the limitations of version 1 in December 2014. This study aimed to determine whether the PI-RADS version 2 (PI-RADS v2) scoring system improves the diagnostic accuracy of mp-MRI of the prostate compared with PI-RADS v1. Methods: This retrospective study was approved by the institutional review board. A total of 401 consecutive patients, with clinically suspicious PCa undergoing 3.0 T mp-MRI (T2-weighted imaging + diffusion-weighted imaging + DCE) before transrectal ultrasound-guided biopsy between June 2013 and July 2015, were included in the study. All patients were scored using the 5-point PI-RADS scoring system based on either PI-RADS v1 or v2. Receiver operating characteristics were calculated for statistical analysis. Sensitivity, specificity, and diagnostic accuracy were compared using McNemar's test. Results: PCa was present in 150 of 401 (37.41%) patients. When we pooled data from both peripheral zone (PZ) and transition zone (TZ), the areas under the curve were 0.889 for PI-RADS v1 and 0.942 for v2 (P = 0.0001). Maximal accuracy was achieved with a score threshold of 4. At this threshold, in the PZ, similar sensitivity, specificity, and accuracy were achieved with v1 and v2 (all P > 0.05). In the TZ, sensitivity was higher for v2 than for v1 (96.36% vs. 76.36%, P = 0.003), specificity was similar for v2 and v1 (90.24% vs. 84.15%, P = 0.227), and accuracy was higher for v2 than for v1 (92.70% vs. 81.02%, P = 0.002). Conclusions: Both v1 and v2 showed good diagnostic performance for the detection of PCa. However, in the TZ, the performance was better with v2 than with v1. PMID:27748338

  14. [Prostate cancer].

    PubMed

    Morote, Joan; Maldonado, Xavier; Morales-Bárrera, Rafael

    2016-02-05

    The Vall d'Hebron multidisciplinary prostate cancer (PC) team reviews recent advances in the management of this neoplasm. Screening studies with long follow-up show a reduction in mortality, whereas active surveillance is emerging as a therapeutic approach of non-aggressive cancers. New markers increase the specificity of PSA and also allow targeting suspected aggressive cancers. Multiparametric magnetic resonance (mMRI) has emerged as the most effective method in the selection of patients for biopsy and also for local tumor staging. The paradigm of random prostatic biopsy is changing through the fusion techniques that allow guiding ultrasonography-driven biopsy of suspicious areas detected in mMRI. Radical prostatectomy (RP) and radiotherapy (RT) are curative treatments of localized PC and both have experienced significant technological improvements. RP is highly effective and the incorporation of robotic surgery is reducing morbidity. Modern RT allows the possibility of high tumor dose with minimal adjacent dose reducing its toxicity. Androgen deprivation therapy with LHRH analogues remains the treatment of choice for advanced PC, but should be limited to this indication. The loss of bone mass and adverse metabolic effects increases the frequency of fractures and cardiovascular morbimortality. After castration resistance in metastatic disease, new hormone-based drugs have demonstrated efficacy even after chemotherapy resistance. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  15. Comparison of transrectal photoacoustic, Doppler, and magnetic resonance imaging for prostate cancer detection

    NASA Astrophysics Data System (ADS)

    Ishihara, Miya; Horiguchi, Akio; Shinmoto, Hiroshi; Tsuda, Hitoshi; Irisawa, Kaku; Wada, Takatsugu; Asano, Tomohiko

    2016-03-01

    Transrectal ultrasonography (TRUS) is the most popular imaging modality for diagnosing and treating prostate cancer. TRUS-guided prostate biopsy is mandatory for the histological diagnosis of patients with elevated serum prostatespecific antigen (PSA), but its diagnostic accuracy is not satisfactory due to TRUS's low resolution. As a result, a considerable number of patients are required to undergo an unnecessary repeated biopsy. Photoacoustic imaging (PAI) can be used to provide microvascular network imaging using hemoglobin as an intrinsic, optical absorption molecule. We developed an original TRUS-type PAI probe consisting of a micro-convex array transducer with an optical illumination system to provide superimposed PAI and ultrasound images. TRUS-type PAI has the advantage of having much higher resolution and greater contrast than does Doppler TRUS. The purpose of this study was to demonstrate the clinical feasibility of the transrectal PAI system. We performed a clinical trial to compare the image of the cancerous area obtained by transrectal PAI with that obtained by TRUS Doppler during prostate biopsy. The obtained prostate biopsy cores were stained with anti-CD34 antibodies to provide a microvascular distribution map. We also confirmed its consistency with PAI and pre-biopsy MRI findings. Our study demonstrated that transrectal identification of tumor angiogenesis under superimposed photoacoustic and ultrasound images was easier than that under TRUS alone. We recognized a consistent relationship between PAI and MRI findings in most cases. However, there were no correspondences in some cases.

  16. Multimodal imaging guided preclinical trials of vascular targeting in prostate cancer

    PubMed Central

    Kalmuk, James; Folaron, Margaret; Buchinger, Julian; Pili, Roberto; Seshadri, Mukund

    2015-01-01

    The high mortality rate associated with castration-resistant prostate cancer (CRPC) underscores the need for improving therapeutic options for this patient population. The purpose of this study was to examine the potential of vascular targeting in prostate cancer. Experimental studies were carried out in subcutaneous and orthotopic Myc-CaP prostate tumors implanted into male FVB mice to examine the efficacy of a novel microtubule targeted vascular disrupting agent (VDA), EPC2407 (Crolibulin™). A non-invasive multimodality imaging approach based on magnetic resonance imaging (MRI), bioluminescence imaging (BLI), and ultrasound (US) was utilized to guide preclinical trial design and monitor tumor response to therapy. Imaging results were correlated with histopathologic assessment, tumor growth and survival analysis. Contrast-enhanced MRI revealed potent antivascular activity of EPC2407 against subcutaneous and orthotopic Myc-CaP tumors. Longitudinal BLI of Myc-CaP tumors expressing luciferase under the androgen response element (Myc-CaP/ARE-luc) revealed changes in AR signaling and reduction in intratumoral delivery of luciferin substrate following castration suggestive of reduced blood flow. This reduction in blood flow was validated by US and MRI. Combination treatment resulted in sustained vascular suppression, inhibition of tumor regrowth and conferred a survival benefit in both models. These results demonstrate the therapeutic potential of vascular targeting in combination with androgen deprivation against prostate cancer. PMID:26203773

  17. The roles of multiparametric magnetic resonance imaging, PCA3 and prostate health index-which is the best predictor of prostate cancer after a negative biopsy?

    PubMed

    Porpiglia, Francesco; Russo, Filippo; Manfredi, Matteo; Mele, Fabrizio; Fiori, Cristian; Bollito, Enrico; Papotti, Mauro; Molineris, Ivan; Passera, Roberto; Regge, Daniele

    2014-07-01

    In patients with a negative prostate biopsy and persistent suspicion of prostate cancer, additional analyses such as the PCA3 score, PHI and multiparametric magnetic resonance imaging have been proposed to reduce the number of unnecessary repeat biopsies. In this study we evaluate the diagnostic accuracy of PCA3, PHI, multiparametric magnetic resonance imaging and various combinations of these tests in the repeat biopsy setting. A total of 170 patients with an initial negative prostate biopsy and persistent suspicion of prostate cancer were enrolled in this prospective study. The patients underwent measurements of the total prostate specific antigen and free prostate specific antigen rate, along with PHI, PCA3 tests and multiparametric magnetic resonance imaging before standard repeat biopsy that was performed by urologists blinded to the multiparametric magnetic resonance imaging results. Multivariate logistic regression models with various combinations of PCA3, PHI and multiparametric magnetic resonance imaging were used to identify the predictors of prostate cancer with repeat biopsy, and the performance of these models was compared using ROC curves, AUC analysis and decision curve analysis. In the ROC analysis the most significant contribution was provided by multiparametric magnetic resonance imaging (AUC 0.936), which was greater than the contribution of the PHI+PCA3 model (p <0.001). In the multivariate logistic regression analysis only multiparametric magnetic resonance imaging was a significant independent predictor of prostate cancer diagnosis with repeat biopsy (p <0.001). The results of the decision curve analysis confirmed that the most significant improvement in the net benefit was provided by multiparametric magnetic resonance imaging. Multiparametric magnetic resonance imaging provides high diagnostic accuracy in identifying patients with prostate cancer in the repeat biopsy setting compared with PCA3 and PHI. Copyright © 2014 American Urological

  18. Comparative analysis of image guidance in two institutions for prostate cancer patients

    PubMed Central

    Piotrowski, Tomasz; Yartsev, Slav; Rodrigues, George; Bajon, Tomasz

    2014-01-01

    Aim/Background The analysis of systematic and random errors obtained from the pooled data on inter-fraction prostate motion during radiation therapy in two institutions. Materials and methods Data of 6085 observations for 216 prostate cancer patients treated on tomotherapy units in two institutions of position correction shifts obtained by co-registration of planning and daily CT studies were investigated. Three independent variables: patient position (supine or prone), target (prostate or prostate bed), and imaging mode (normal or coarse) were analyzed. Systematic and random errors were evaluated and used to calculate the margins for different options of referencing based on the position corrections observed with one, three, or five imaging sessions. Results Statistical analysis showed that only the difference between normal and coarse modes of imaging was significant, which allowed to merge the supine and prone position sub-groups as well as the prostate and prostate bed patients. In the normal and coarse imaging groups, the margins calculated using systematic and random errors in the medio-lateral and cranio-caudal directions (5.5 mm and 4.5 mm, respectively) were similar, but significantly different (5.3 mm for the normal mode and 7.1 mm for the coarse mode) in the anterio-posterior direction. The reference scheme based on the first three fractions (R3) was found to be the optimal one. Conclusions The R3 reference scheme effectively reduced systematic and random errors. Larger margins in the anterio-posterior direction should be used during prostate treatment on the tomotherapy unit, as coarse imaging mode is chosen in order to reduce imaging time and dose. PMID:24936341

  19. Comparison study of distinguishing cancerous and normal prostate epithelial cells by confocal and polarization diffraction imaging

    NASA Astrophysics Data System (ADS)

    Jiang, Wenhuan; Lu, Jun Qing; Yang, Li V.; Sa, Yu; Feng, Yuanming; Ding, Junhua; Hu, Xin-Hua

    2016-07-01

    Accurate classification of malignant cells from benign ones can significantly enhance cancer diagnosis and prognosis by detection of circulating tumor cells (CTCs). We have investigated two approaches of quantitative morphology and polarization diffraction imaging on two prostate cell types to evaluate their feasibility as single-cell assay methods toward CTC detection after cell enrichment. The two cell types have been measured by a confocal imaging method to obtain their three-dimensional morphology parameters and by a polarization diffraction imaging flow cytometry (p-DIFC) method to obtain image texture parameters. The support vector machine algorithm was applied to examine the accuracy of cell classification with the morphology and diffraction image parameters. Despite larger mean values of cell and nuclear sizes of the cancerous prostate cells than the normal ones, it has been shown that the morphologic parameters cannot serve as effective classifiers. In contrast, accurate classification of the two prostate cell types can be achieved with high classification accuracies on measured data acquired separately in three measurements. These results provide strong evidence that the p-DIFC method has the potential to yield morphology-related "fingerprints" for accurate and label-free classification of the two prostate cell types.

  20. Comparison study of distinguishing cancerous and normal prostate epithelial cells by confocal and polarization diffraction imaging.

    PubMed

    Jiang, Wenhuan; Lu, Jun Qing; Yang, Li V; Sa, Yu; Feng, Yuanming; Ding, Junhua; Hu, Xin-Hua

    2016-07-01

    Accurate classification of malignant cells from benign ones can significantly enhance cancer diagnosis and prognosis by detection of circulating tumor cells (CTCs). We have investigated two approaches of quantitative morphology and polarization diffraction imaging on two prostate cell types to evaluate their feasibility as single-cell assay methods toward CTC detection after cell enrichment. The two cell types have been measured by a confocal imaging method to obtain their three-dimensional morphology parameters and by a polarization diffraction imaging flow cytometry (p-DIFC) method to obtain image texture parameters. The support vector machine algorithm was applied to examine the accuracy of cell classification with the morphology and diffraction image parameters. Despite larger mean values of cell and nuclear sizes of the cancerous prostate cells than the normal ones, it has been shown that the morphologic parameters cannot serve as effective classifiers. In contrast, accurate classification of the two prostate cell types can be achieved with high classification accuracies on measured data acquired separately in three measurements. These results provide strong evidence that the p-DIFC method has the potential to yield morphology-related “fingerprints” for accurate and label-free classification of the two prostate cell types.

  1. What is Prostate Cancer?

    MedlinePlus

    ... their doctors even knew they had it. Possible pre-cancerous conditions of the prostate Some research suggests that prostate cancer starts out as a pre-cancerous condition, although this is not yet known ...

  2. Photo-Acoustic Ultrasound Imaging to Distinguish Benign from Malignant Prostate Cancer

    DTIC Science & Technology

    2016-09-01

    An ultrasound transducer delivers a pulse of acoustic energy into the area of interest and listens for the echoes which return as the sound waves... ultrasound probe developed in this project (Figure 13C). The images from the IVUS probe are relatively low quality and highly scattering targets...AWARD NUMBER: W81XWH-15-1-0137 TITLE: Photo-Acoustic Ultrasound Imaging to Distinguish Benign from Malignant Prostate Cancer PRINCIPAL

  3. Development of a combined ultrasound and electrical impedance imaging system for prostate cancer detection

    NASA Astrophysics Data System (ADS)

    Wan, Yuqing

    Approximately 240,890 men were diagnosed with prostate cancer and 33,720 men were expected to die from it in the year of 2011 in the United States. Unfortunately, the current clinical diagnostic methods (e.g. prostate-specific antigen (PSA), digital rectal examination, ultrasound guided biopsy) used for detecting and staging prostate cancer are limited. It has been shown that cancerous prostate tissue has significantly different electrical properties when compared to benign tissues. Based on these electrical property findings, a transrectal electrical impedance tomography (TREIT) system is proposed as a novel prostate imaging modality. An ultrasound probe is incorporated with TREIT to achieve anatomic information of the prostate and guide electrical property reconstruction. Without the guidance of the ultrasound, the TREIT system can easily discern high contrast inclusions of 1 cm in diameter at distances centered at two times the radius of the TREIT probe away from the probe surface. Furthermore, we have demonstrated that our system is able to detect low contrast inclusions. With the guidance of the ultrasound, our system is capable of detecting a plastic inclusion embedded in a gelatin phantom, indicating the potential to detect cancer. In addition, the results of preliminary in vivo clinical trials using the imaging system are also presented in the thesis. After collecting data for a total 66 patients, we demonstrated that the in vivo conductivity of cancerous tissue is significantly greater than that of benign tissue (p=0.0015 at 400 Hz) and the conductivity of BPH tissue is significantly lower than that of normal tissue (p=0.0009 at 400 Hz). Additionally at 25.6 kHz, the dual-modal imaging system is able to differentiate cancerous tissue from benign tissue with sensitivity of 0.6012 and specificity of 0.5498, normal tissue from BPH tissue with sensitivity of 0.6085 and specificity of 0.5813 and differentiate cancerous tissue from BPH tissue with sensitivity of

  4. Time-gated optical imaging to detect positive prostate cancer margins

    NASA Astrophysics Data System (ADS)

    Lin, Zi-Jing; Alexandrakis, George; Patel, Nimit; Shen, Jinhui; Tang, Liping; Liu, Hanli

    2009-02-01

    Laparoscopic radical prostatectomy (LRP) has revolutionized the surgical treatment of prostate cancer. This procedure permits complete removal of the prostate and seminal vesicles while minimizing pain and recovery time. However, the laparoscopic approach greatly limits the surgeon's tactile sensation during the procedure. This is particularly true with robot-assisted LRP where no tactile feedback is available forcing the surgeon to rely solely on visual cues. The surgeon and pathologist perform intraoperative frozen section pathologic analysis of a few select tissue fragments, but this is time consuming and costly. Concrete conclusions based on such samples are unreliable as they do not reflect the entire surgical margin status. In this case a conservative approach might dictate removal of more marginal material than necessary, thereby compromising the important nerve-sparing aspects of the procedure. In this study, we demonstrate the feasibility of using multi-modal time-gated optical imaging, i.e. time-resolved light reflectance and auto-fluorescence life-time imaging performed by an ICCD (Intensified Charge-Coupled Device) imaging system to enable clinicians to detect positive tumor margins with high sensitivity and specificity over the prostate. Results from animal experiments present the potential of identifying differences in optical signals between prostate cancer and control tissues. Results also show that the use of classification algorithms can identify cancerous regions with high sensitivity and specificity.

  5. Target Definition in Salvage Radiotherapy for Recurrent Prostate Cancer: The Role of Advanced Molecular Imaging.

    PubMed

    Amzalag, Gaël; Rager, Olivier; Tabouret-Viaud, Claire; Wissmeyer, Michael; Sfakianaki, Electra; de Perrot, Thomas; Ratib, Osman; Miralbell, Raymond; Giovacchini, Giampiero; Garibotto, Valentina; Zilli, Thomas

    2016-01-01

    Salvage radiotherapy (SRT) represents the main treatment option for relapsing prostate cancer in patients after radical prostatectomy. Several open questions remain unanswered in terms of target volumes definition and delivered doses for SRT: the effective dose necessary to achieve biochemical control in the SRT setting may be different if the tumor recurrence is micro- or macroscopic. At the same time, irradiation of only the prostatic bed or of the whole pelvis will depend on the localization of the recurrence, local or locoregional. In the "theragnostic imaging" era, molecular imaging using positron emission tomography (PET) constitutes a useful tool for clinicians to define the site of the recurrence, the extent of disease, and individualize salvage treatments. The best option currently available in clinical routine is the combination of radiolabeled choline PET imaging and multiparametric magnetic resonance imaging (MRI), associating the nodal and distant metastases identification based on PET with the local assessment by MRI. A new generation of targeted tracers, namely, prostate-specific membrane antigen, show promising results, with a contrast superior to choline imaging and a higher detection rate even for low prostate-specific antigen levels; validation studies are ongoing. Finally, imaging targeting bone remodeling, using whole-body SPECT-CT, is a relevant complement to molecular/metabolic PET imaging when bone involvement is suspected.

  6. A qualitative study to understand guideline-discordant use of imaging to stage incident prostate cancer.

    PubMed

    Makarov, Danil V; Sedlander, Erica; Braithwaite, R Scott; Sherman, Scott E; Zeliadt, Steven; Gross, Cary P; Curnyn, Caitlin; Shedlin, Michele

    2016-09-02

    Approximately half of veterans with low-risk prostate cancer receive guideline-discordant imaging. Our objective was to identify and describe (1) physician knowledge, attitudes, and practices related to the use of imaging to stage prostate cancer, (2) patient attitudes and behaviors related to use of imaging, and (3) to compare responses across three VA medical centers (VAMCs). A qualitative approach was used to explore patient and provider knowledge and behaviors relating to the use of imaging. We conducted 39 semi-structured interviews total-including 22 interviews with patients with newly diagnosed with prostate cancer and 17 interviews with physicians caring for them-between September 2014 and July 2015 at three VAMCs representing a spectrum of inappropriate imaging rates. After core theoretical concepts were identified, the Theoretical Domains Framework (TDF) was selected to explore linkages between themes within the dataset and existing domains within the framework. Interviews were audio-recorded, transcribed verbatim, and then coded and analyzed using Nvivo software. Themes from patient interviews were categorized within four TDF domains. Patients reported little interest in staging as compared to disease treatment (goals), and many could not remember if they had imaging at all (knowledge). Patients tended to trust their doctor to make decisions about appropriate tests (beliefs about capabilities). Some patients expressed a minor concern for radiation exposure, but anxiety about cancer outcomes outweighed these fears (emotion). Themes from physician interviews were categorized within five TDF domains. Most physicians self-reported that they know and trust imaging guidelines (knowledge) yet some were still likely to follow their own intuition, whether due to clinical suspicion or years of experience (beliefs about capabilities). Additionally, physicians reported that medico-legal concerns, fear of missing associated diagnoses (beliefs about consequences

  7. Phase II Evaluation of Magnetic Resonance Imaging Guided Focal Laser Ablation of Prostate Cancer.

    PubMed

    Eggener, Scott E; Yousuf, Ambereen; Watson, Sydeaka; Wang, Shiyang; Oto, Aytekin

    2016-12-01

    Magnetic resonance imaging guided focal laser ablation is an investigational strategy for the treatment of prostate cancer. This phase II evaluation of focal laser ablation included men with stage T1c-T2a, prostate specific antigen less than 15 ng/ml or prostate specific antigen density less than 0.15 ng/ml(3), Gleason 7 or less in 25% or less of biopsies and magnetic resonance imaging with 1 or 2 lesions concordant with biopsy detected cancer. At 3 months all patients underwent magnetic resonance imaging with biopsy of ablation zone(s). At 12 months all underwent magnetic resonance imaging and systematic biopsy. I-PSS (International Prostate Symptom Score) and SHIM (Sexual Health Inventory for Men) scores were collected before focal laser ablation, and at 1, 3 and 12 months. The primary end point was no cancer on the 3-month ablation zone biopsy. Secondary end points were safety, 12-month biopsy, and urinary and sexual function. In the 27 men median age was 62 years and mean prostate specific antigen was 4.4 ng/ml. Biopsy Gleason score was 6 in 23 patients (85%) and Gleason 7 in 4 (15%). Seven men (26%) had low volume Gleason 6 disease outside the intended ablation zone(s). At 3 months 26 patients (96%) had no evidence of cancer on magnetic resonance imaging guided biopsy of the ablation zone. No significant I-PSS changes were observed (each p >0.05). SHIM was lower at 1 month (p = 0.03), marginally lower at 3 months (p = 0.05) and without a significant difference at 12 months (p = 0.38). At 12-month biopsy cancer was identified in 10 patients (37%), including in the ablation zone(s) in 3 (11%) and outside the ablation zone(s) in 8 (30%) with cancer in and outside the ablation zone in 1. In select men with localized prostate cancer and visible magnetic resonance imaging lesions focal laser ablation has an acceptable morbidity profile and is associated with encouraging short-term oncologic outcomes. Significantly longer followup is mandatory to fully assess this

  8. Time-Resolved Spectroscopy and Near Infrared Imaging for Prostate Cancer Detection: Receptor-targeted and Native Biomarker

    NASA Astrophysics Data System (ADS)

    Pu, Yang

    Optical spectroscopy and imaging using near-infrared (NIR) light provides powerful tools for non-invasive detection of cancer in tissue. Optical techniques are capable of quantitative reconstructions maps of tissue absorption and scattering properties, thus can map in vivo the differences in the content of certain marker chromophores and/or fluorophores in normal and cancerous tissues (for example: water, tryptophan, collagen and NADH contents). Potential clinical applications of optical spectroscopy and imaging include functional tumor detection and photothermal therapeutics. Optical spectroscopy and imaging apply contrasts from intrinsic tissue chromophores such as water, collagen and NADH, and extrinsic optical contrast agents such as Indocyanine Green (ICG) to distinguish disease tissue from the normal one. Fluorescence spectroscopy and imaging also gives high sensitivity and specificity for biomedical diagnosis. Recent developments on specific-targeting fluorophores such as small receptor-targeted dye-peptide conjugate contrast agent offer high contrast between normal and cancerous tissues hence provide promising future for early tumour detection. This thesis focus on a study to distinguish the cancerous prostate tissue from the normal prostate tissues with enhancement of specific receptor-targeted prostate cancer contrast agents using optical spectroscopy and imaging techniques. The scattering and absorption coefficients, and anisotropy factor of cancerous and normal prostate tissues were investigated first as the basis for the biomedical diagnostic and optical imaging. Understanding the receptors over-expressed prostate cancer cells and molecular target mechanism of ligand, two small ICG-derivative dye-peptides, namely Cypate-Bombesin Peptide Analogue Conjugate (Cybesin) and Cypate-Octreotate Peptide Conjugate (Cytate), were applied to study their clinical potential for human prostate cancer detection. In this work, the steady-state and time

  9. Imaging of Prostate Cancer Using Urokinase-Type Plasminogen Activator Receptor PET.

    PubMed

    Skovgaard, Dorthe; Persson, Morten; Kjaer, Andreas

    2017-04-01

    Urokinase-type plasminogen activator receptor (uPAR) overexpression is an important biomarker for aggressiveness in cancer including prostate cancer (PC) and provides independent clinical information in addition to prostate-specific antigen and Gleason score. This article focuses on uPAR PET as a new diagnostic and prognostic imaging biomarker in PC. Many preclinical uPAR-targeted PET imaging studies using AE105 in cancer models have been undertaken with promising results. A major breakthrough was obtained with the recent human translation of uPAR PET in using (64)Cu- and (68)Ga-labelled versions of AE105, respectively. Clinical results from patients with PC included in these studies are encouraging and support continuation with large-scale clinical trials.

  10. Optimising the Diagnosis of Prostate Cancer in the Era of Multiparametric Magnetic Resonance Imaging: A Cost-effectiveness Analysis Based on the Prostate MR Imaging Study (PROMIS).

    PubMed

    Faria, Rita; Soares, Marta O; Spackman, Eldon; Ahmed, Hashim U; Brown, Louise C; Kaplan, Richard; Emberton, Mark; Sculpher, Mark J

    2017-09-18

    The current recommendation of using transrectal ultrasound-guided biopsy (TRUSB) to diagnose prostate cancer misses clinically significant (CS) cancers. More sensitive biopsies (eg, template prostate mapping biopsy [TPMB]) are too resource intensive for routine use, and there is little evidence on multiparametric magnetic resonance imaging (MPMRI). To identify the most effective and cost-effective way of using these tests to detect CS prostate cancer. Cost-effectiveness modelling of health outcomes and costs of men referred to secondary care with a suspicion of prostate cancer prior to any biopsy in the UK National Health Service using information from the diagnostic Prostate MR Imaging Study (PROMIS). Combinations of MPMRI, TRUSB, and TPMB, using different definitions and diagnostic cut-offs for CS cancer. Strategies that detect the most CS cancers given testing costs, and incremental cost-effectiveness ratios (ICERs) in quality-adjusted life years (QALYs) given long-term costs. The use of MPMRI first and then up to two MRI-targeted TRUSBs detects more CS cancers per pound spent than a strategy using TRUSB first (sensitivity = 0.95 [95% confidence interval {CI} 0.92-0.98] vs 0.91 [95% CI 0.86-0.94]) and is cost effective (ICER = £7,076 [€8350/QALY gained]). The limitations stem from the evidence base in the accuracy of MRI-targeted biopsy and the long-term outcomes of men with CS prostate cancer. An MPMRI-first strategy is effective and cost effective for the diagnosis of CS prostate cancer. These findings are sensitive to the test costs, sensitivity of MRI-targeted TRUSB, and long-term outcomes of men with cancer, which warrant more empirical research. This analysis can inform the development of clinical guidelines. We found that, under certain assumptions, the use of multiparametric magnetic resonance imaging first and then up to two transrectal ultrasound-guided biopsy is better than the current clinical standard and is good value for money. Copyright

  11. In Vivo Photoacoustic Imaging of Prostate Cancer Using Targeted Contrast Agent

    DTIC Science & Technology

    2015-09-01

    detection of early stage prostate cancer, development of near infrared dyes - labeled RNA aptamer that recognizes the prostate specific cell surface protein...the application of PAI for the detection of early stage prostate cancer, development of a NIR dye - labeled RNA aptamer that recognizes the prostate...proposed to enhance the application of PAI for the detection of early stage PrCa: 1. Use of a NIR dye labeled RNA aptamer that recognizes the prostate

  12. [The Diagnostic Value of Pre-Biopsy Magnetic Resonance Imaging (MRI) for Detecting Prostate Cancer].

    PubMed

    Mori, Kohei; Miyoshi, Yasuhide; Yoneyama, Shuko; Ishida, Hiroaki; Hattori, Yusuke; Teranishi, Jun-ichi; Kondo, Keiichi; Noguchi, Kazumi

    2016-01-01

    We examined the value of pre-biopsy magnetic resonance imaging (MRI) for detecting prostate cancer. We analyzed 267 men with prostate-specific antigen (PSA) levels of 3-10 ng/ml who underwent systematic prostate needle biopsy. From April 2009 to March 2011, a total of 98 male patients underwent 16-core prostatic biopsies without pre-biopsy magnetic resonance imaging (MRI) (nonenforcement group). From April 2011 to March 2013, 169 men underwent pre-biopsy MRI [T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI)] (enforcement group). When MRI findings indicated cancer in the latter group, in addition to the systematic 16-core biopsy one or two targeted biopsies were performed. Patients without suspicious MRI findings underwent only systematic 16-core biopsy. Cancer detection rates in the nonenforcement and enforcement groups were 42.9% (48/92) and 46. 2% (78/169), respectively. The difference did not reach significance (p=0.612). Although the cancer detection rates were 39.4% (41/104) in the MRI-negative group and 56. 9% (37/65) in the MRI-positive group (p=0.039), the sensitivity and specificity for cancer detection by MRI were relatively low: 47.4% and 69.2%, respectively. By receiver-operating curve analysis, the area under the curve for cancer detection by MRI was only 0.583. There were two study limitations. First, the patient sample size was small. Second, it is unclear whether an adequate sample of the suspicious lesion was obtained by biopsy. We thus demonstrated that it might be improper to base a diagnosis solely on pre-biopsy MRI (T2WI and DWI) findings in men with serum PSA levels of 3-10 ng/ml.

  13. Imaging techniques for local recurrence of prostate cancer: for whom, why and how?

    PubMed

    Rouvière, O

    2012-04-01

    Since there are salvage solutions, it is important to detect local recurrence of prostate cancer as early as possible. The first sign is "biochemical failure" in that the prostate specific antigen (PSA) concentration rises again. The definition of biochemical failure varies depending on the initial treatment: PSA greater than 0.2ng/mL after prostatectomy, nadir+2ng/mL after radiotherapy. There is no standardised definition of biochemical failure after cryotherapy, focused ultrasound, or brachytherapy. Magnetic resonance imaging (MRI) (particularly dynamic MRI) can detect local recurrence with good sensitivity. The role of spectroscopy is still under discussion. For the moment, ultrasound techniques are less effective than MRI.

  14. Imaging-guided preclinical trials of vascular targeting in prostate cancer

    NASA Astrophysics Data System (ADS)

    Kalmuk, James

    Purpose: Prostate cancer is the most common non-cutaneous malignancy in American men and is characterized by dependence on androgens (Testosterone/Dihydrotestosterone) for growth and survival. Although reduction of serum testosterone levels by surgical or chemical castration transiently inhibits neoplastic growth, tumor adaptation to castrate levels of androgens results in the generation of castration-resistant prostate cancer (CRPC). Progression to CRPC following androgen deprivation therapy (ADT) has been associated with changes in vascular morphology and increased angiogenesis. Based on this knowledge, we hypothesized that targeting tumor vasculature in combination with ADT would result in enhanced therapeutic efficacy against prostate cancer. Methods: To test this hypothesis, we examined the therapeutic activity of a tumor-vascular disrupting agent (tumor-VDA), EPC2407 (Crolibulin(TM)), alone and in combination with ADT in a murine model of prostate cancer (Myc-CaP). A non-invasive multimodality imaging approach based on magnetic resonance imaging (MRI), bioluminescence imaging (BLI), and ultrasound (US) was utilized to characterize tumor response to therapy and to guide preclinical trial design. Imaging results were correlated with histopathologic (H&E) and immunohistochemical (CD31) assessment as well as tumor growth inhibition and survival analyses. Results: Our imaging techniques were able to capture an acute reduction (within 24 hours) in tumor perfusion following castration and VDA monotherapy. BLI revealed onset of recurrent disease 5-7 days post castration prior to visible tumor regrowth suggestive of vascular recovery. Administration of VDA beginning 1 week post castration for 3 weeks resulted in sustained vascular suppression, inhibition of tumor regrowth, and conferred a more pronounced survival benefit compared to either monotherapy. Conclusion: The high mortality rate associated with CRPC underscores the need for investigating novel treatment

  15. Bone-Targeted Imaging and Radionuclide Therapy in Prostate Cancer

    PubMed Central

    Iagaru, Andrei H.; Mittra, Erik; Colletti, Patrick M.

    2016-01-01

    Although selective metabolic and receptor-based molecular agents will surely be included in the future of prostate cancer diagnosis and therapy, currently available inorganic compounds—such as 18F-NaF for the diagnosis of bony disease and 223RaCl2 for the therapy of bone metastases—were recently shown to be superior to standard 99mTc-phosphonates for diagnosis and 153Sm-ethylenediaminetetramethylene phosphonate or 89SrCl2 for therapy. The advantages of 18F-NaF include improved lesion detection and, when used in combination with CT, improved diagnostic confidence and specificity. In addition to being the first approved α-emitter, 223RaCl2 is the first radiopharmaceutical to show an increase in overall survival, a decrease in skeletal events, palliation of bone pain, and a low profile of adverse reactions (which are mild and manageable). The management of metastatic bone disease with 223RaCl2 is uniquely satisfying, as patients can be monitored directly during their monthly treatment visits. PMID:27694165

  16. Decision support system for localizing prostate cancer based on multiparametric magnetic resonance imaging

    PubMed Central

    Shah, Vijay; Turkbey, Baris; Mani, Haresh; Pang, Yuxi; Pohida, Thomas; Merino, Maria J.; Pinto, Peter A.; Choyke, Peter L.; Bernardo, Marcelino

    2012-01-01

    Purpose: There is a growing need to localize prostate cancers on magnetic resonance imaging (MRI) to facilitate the use of image guided biopsy, focal therapy, and active surveillance follow up. Our goal was to develop a decision support system (DSS) for detecting and localizing peripheral zone prostate cancers by using machine learning approach to calculate a cancer probability map from multiparametric MR images (MP-MRI). Methods: This IRB approved Health Insurance Portability and Accountability Act compliant retrospective study consisted of 31 patients (mean age and serum prostate specific antigen of 60.4 and 6.62 ng/ml, respectively) who had MP-MRI at 3 T followed by radical prostatectomy. Seven patients were excluded due to technical issues with their MP-MRI (e.g., motion artifact, failure to perform all sequences). Cancer and normal regions were identified in the peripheral zone by correlating them to whole mount histology slides of the excised prostatectomy specimens. To facilitate the correlation, tissue blocks matching the MR slices were obtained using a MR-based patient-specific mold. Segmented regions on the MP-MRI were correlated to histopathology and used as training sets for the learning system that generated the cancer probability maps. Leave-one-patient-out cross-validation on the cancer and normal regions was performed to determine the learning system's efficacy, an evolutionary strategies approach (also known as a genetic algorithm) was used to find the optimal values for a set of parameters, and finally a cancer probability map was generated. Results: For the 24 patients that were used in the study, 225 cancer and 264 noncancerous regions were identified from the region maps. The efficacy of DSS was first determined without optimizing support vector machines (SVM) parameters, where a region having a cancer probability greater than or equal to 50% was considered as a correct classification. The nonoptimized system had an f-measure of 85% and the

  17. Biomarkers in Prostate Cancer Epidemiology

    PubMed Central

    Verma, Mukesh; Patel, Payal; Verma, Mudit

    2011-01-01

    Understanding the etiology of a disease such as prostate cancer may help in identifying populations at high risk, timely intervention of the disease, and proper treatment. Biomarkers, along with exposure history and clinical data, are useful tools to achieve these goals. Individual risk and population incidence of prostate cancer result from the intervention of genetic susceptibility and exposure. Biochemical, epigenetic, genetic, and imaging biomarkers are used to identify people at high risk for developing prostate cancer. In cancer epidemiology, epigenetic biomarkers offer advantages over other types of biomarkers because they are expressed against a person's genetic background and environmental exposure, and because abnormal events occur early in cancer development, which includes several epigenetic alterations in cancer cells. This article describes different biomarkers that have potential use in studying the epidemiology of prostate cancer. We also discuss the characteristics of an ideal biomarker for prostate cancer, and technologies utilized for biomarker assays. Among epigenetic biomarkers, most reports indicate GSTP1 hypermethylation as the diagnostic marker for prostate cancer; however, NKX2-5, CLSTN1, SPOCK2, SLC16A12, DPYS, and NSE1 also have been reported to be regulated by methylation mechanisms in prostate cancer. Current challenges in utilization of biomarkers in prostate cancer diagnosis and epidemiologic studies and potential solutions also are discussed. PMID:24213111

  18. Quantitative Ultrasound Spectroscopic Imaging for Characterization of Disease Extent in Prostate Cancer Patients1

    PubMed Central

    Sadeghi-Naini, Ali; Sofroni, Ervis; Papanicolau, Naum; Falou, Omar; Sugar, Linda; Morton, Gerard; Yaffe, Martin J.; Nam, Robert; Sadeghian, Alireza; Kolios, Michael C.; Chung, Hans T.; Czarnota, Gregory J.

    2015-01-01

    Three-dimensional quantitative ultrasound spectroscopic imaging of prostate was investigated clinically for the noninvasive detection and extent characterization of disease in cancer patients and compared to whole-mount, whole-gland histopathology of radical prostatectomy specimens. Fifteen patients with prostate cancer underwent a volumetric transrectal ultrasound scan before radical prostatectomy. Conventional-frequency (~ 5 MHz) ultrasound images and radiofrequency data were collected from patients. Normalized power spectra were used as the basis of quantitative ultrasound spectroscopy. Specifically, color-coded parametric maps of 0-MHz intercept, midband fit, and spectral slope were computed and used to characterize prostate tissue in ultrasound images. Areas of cancer were identified in whole-mount histopathology specimens, and disease extent was correlated to that estimated from quantitative ultrasound parametric images. Midband fit and 0-MHz intercept parameters were found to be best associated with the presence of disease as located on histopathology whole-mount sections. Obtained results indicated a correlation between disease extent estimated noninvasively based on midband fit parametric images and that identified histopathologically on prostatectomy specimens, with an r2 value of 0.71 (P < .0001). The 0-MHz intercept parameter demonstrated a lower level of correlation with histopathology. Spectral slope parametric maps offered no discrimination of disease. Multiple regression analysis produced a hybrid disease characterization model (r2 = 0.764, P < .05), implying that the midband fit biomarker had the greatest correlation with the histopathologic extent of disease. This work demonstrates that quantitative ultrasound spectroscopic imaging can be used for detecting prostate cancer and characterizing disease extent noninvasively, with corresponding gross three-dimensional histopathologic correlation. PMID:25749174

  19. Quantitative ultrasound spectroscopic imaging for characterization of disease extent in prostate cancer patients.

    PubMed

    Sadeghi-Naini, Ali; Sofroni, Ervis; Papanicolau, Naum; Falou, Omar; Sugar, Linda; Morton, Gerard; Yaffe, Martin J; Nam, Robert; Sadeghian, Alireza; Kolios, Michael C; Chung, Hans T; Czarnota, Gregory J

    2015-02-01

    Three-dimensional quantitative ultrasound spectroscopic imaging of prostate was investigated clinically for the noninvasive detection and extent characterization of disease in cancer patients and compared to whole-mount, whole-gland histopathology of radical prostatectomy specimens. Fifteen patients with prostate cancer underwent a volumetric transrectal ultrasound scan before radical prostatectomy. Conventional-frequency (~5MHz) ultrasound images and radiofrequency data were collected from patients. Normalized power spectra were used as the basis of quantitative ultrasound spectroscopy. Specifically, color-coded parametric maps of 0-MHz intercept, midband fit, and spectral slope were computed and used to characterize prostate tissue in ultrasound images. Areas of cancer were identified in whole-mount histopathology specimens, and disease extent was correlated to that estimated from quantitative ultrasound parametric images. Midband fit and 0-MHz intercept parameters were found to be best associated with the presence of disease as located on histopathology whole-mount sections. Obtained results indicated a correlation between disease extent estimated noninvasively based on midband fit parametric images and that identified histopathologically on prostatectomy specimens, with an r(2) value of 0.71 (P<.0001). The 0-MHz intercept parameter demonstrated a lower level of correlation with histopathology. Spectral slope parametric maps offered no discrimination of disease. Multiple regression analysis produced a hybrid disease characterization model (r(2)=0.764, P<.05), implying that the midband fit biomarker had the greatest correlation with the histopathologic extent of disease. This work demonstrates that quantitative ultrasound spectroscopic imaging can be used for detecting prostate cancer and characterizing disease extent noninvasively, with corresponding gross three-dimensional histopathologic correlation. Copyright © 2014 Neoplasia Press, Inc. Published by

  20. Prostate Cancer Diagnosis on Repeat Magnetic Resonance Imaging-Transrectal Ultrasound Fusion Biopsy of Benign Lesions: Recommendations for Repeat Sampling.

    PubMed

    Chelluri, Raju; Kilchevsky, Amichai; George, Arvin K; Sidana, Abhinav; Frye, Thomas P; Su, Daniel; Fascelli, Michele; Ho, Richard; Abboud, Steven F; Turkbey, Baris; Merino, Maria J; Choyke, Peter L; Wood, Bradford J; Pinto, Peter A

    2016-07-01

    Urologists face a dilemma when a lesion identified on multiparametric magnetic resonance imaging is benign on image guided fusion biopsy. We investigated the detection rate of prostate cancer on repeat fusion biopsy in multiparametric magnetic resonance imaging lesions initially found to be pathologically benign on fusion biopsy. We reviewed the records of all patients from 2007 to 2014 who underwent multiparametric magnetic resonance imaging and image guided fusion biopsy. We identified men who underwent rebiopsy of the same discrete lesion after initial fusion biopsy results were benign. Data were documented on a per lesion basis. We manually reviewed UroNav system (Invivo, Gainesville, Florida) needle tracking to verify accurate image registration. Multivariate analysis was used to identify clinical and imaging factors predictive of prostate cancer detection at repeat fusion biopsy. A total of 131 unique lesions were rebiopsied in 90 patients. Of these 131 resampled lesions 21 (16%) showed prostate cancer, which in 13 (61.9%) was Gleason 3 + 3. On multivariate analysis only lesion growth on repeat multiparametric magnetic resonance imaging was significantly associated with prostate cancer detection at repeat biopsy (HR 3.274, 95% CI 1.205-8.896, p = 0.02). Pathologically benign multiparametric magnetic resonance imaging lesions on initial image guided fusion biopsy are rarely found to harbor clinically significant prostate cancer on repeat biopsy. When prostate cancer was identified, most disease was low risk. An increase in lesion diameter was an independent predictor of prostate cancer detection. While these data are retrospective, they may provide some confidence in the reliability of negative initial image guided fusion biopsies despite a positive multiparametric magnetic resonance imaging finding. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  1. MR-CT registration using a Ni-Ti prostate stent in image-guided radiotherapy of prostate cancer

    SciTech Connect

    Korsager, Anne Sofie; Ostergaard, Lasse Riis; Carl, Jesper

    2013-06-15

    Purpose: In image-guided radiotherapy of prostate cancer defining the clinical target volume often relies on magnetic resonance (MR). The task of transferring the clinical target volume from MR to standard planning computed tomography (CT) is not trivial due to prostate mobility. In this paper, an automatic local registration approach is proposed based on a newly developed removable Ni-Ti prostate stent.Methods: The registration uses the voxel similarity measure mutual information in a two-step approach where the pelvic bones are used to establish an initial registration for the local registration.Results: In a phantom study, the accuracy was measured to 0.97 mm and visual inspection showed accurate registration of all 30 data sets. The consistency of the registration was examined where translation and rotation displacements yield a rotation error of 0.41 Degree-Sign {+-} 0.45 Degree-Sign and a translation error of 1.67 {+-} 2.24 mm.Conclusions: This study demonstrated the feasibility for an automatic local MR-CT registration using the prostate stent.

  2. Dynamic contrast-enhanced MR imaging findings of bone metastasis in patients with prostate cancer

    PubMed Central

    Kayhan, Arda; Yang, Cheng; Soylu, Fatma Nur; Lakadamyalı, Hatice; Sethi, Ila; Karczmar, Gregory; Stadler, Walter; Oto, Aytekin

    2011-01-01

    AIM: To evaluate the dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) findings of bone metastasis in prostate cancer patients. METHODS: Sixteen men with a diagnosis of metastatic prostate cancer to bones were examined with DCE-MRI at 1.5 Tesla. The mean contrast agent concentration vs time curves for bone metastasis and normal bone were calculated and Ktrans and ve values were estimated and compared. RESULTS: An early significant enhancement (wash-out: n = 6, plateau: n = 8 and persistent: n = 2) was detected in all bone metastases (n = 16). Bone metastasis from prostate cancer showed significant enhancement and high Ktrans and ve values compared to normal bone which does not enhance in the elderly population. The mean Ktrans was 0.101/min and 0.0051/min (P < 0.001), the mean ve was 0.141 and 0.0038 (P < 0.001), for bone metastases and normal bone, respectively. CONCLUSION: DCE-MRI and its quantitative perfusion parameters may have a role in improving the detection of skeletal metastasis in prostate cancer patients. PMID:22229077

  3. Molecular imaging of prostate cancer with 18F-fluorodeoxyglucose PET

    PubMed Central

    Jadvar, Hossein

    2009-01-01

    Prostate cancer poses a major public health problem, particularly in the US and Europe, where it constitutes the most common type of malignancy among men, excluding nonmelanoma skin cancers. The disease is characterized by a wide spectrum of biological and clinical phenotypes, and its evaluation by imaging remains a challenge in view of this heterogeneity. Imaging in prostate cancer can be used in the initial diagnosis of the primary tumor, to determine the occurrence and extent of any extracapsular spread, for guidance in delivery and evaluation of local therapy in organ-confined disease, in locoregional lymph node staging, to detect locally recurrent and metastatic disease in biochemical relapse, to predict and assess tumor response to systemic therapy or salvage therapy, and in disease prognostication (in terms of the length of time taken for castrate-sensitive disease to become refractory to hormones and overall patient survival). Evidence from animal-based translational and human-based clinical studies points to a potential and emerging role for PET, using 18F-fluorodeoxyglucose as a radiotracer, in the imaging evaluation of prostate cancer. PMID:19434102

  4. Salvage image-guided intensity modulated or stereotactic body reirradiation of local recurrence of prostate cancer

    PubMed Central

    Jereczek-Fossa, B A; Fodor, C; Bazzani, F; Maucieri, A; Ronchi, S; Ferrario, S; Colangione, S P; Gerardi, M A; Caputo, M; Cecconi, A; Gherardi, F; Vavassori, A; Comi, S; Cambria, R; Garibaldi, C; Cattani, F; De Cobelli, O; Orecchia, R

    2015-01-01

    Objective: To retrospectively evaluate external beam reirradiation (re-EBRT) delivered to the prostate/prostatic bed for local recurrence, after radical or adjuvant/salvage radiotherapy (RT). Methods: 32 patients received re-EBRT between February 2008 and October 2013. All patients had clinical/radiological local relapse in the prostate or prostatic bed and no distant metastasis. re-EBRT was delivered with selective RT technologies [stereotactic RT including CyberKnifeTM (Accuray, Sunnyvale, CA); image-guidance and intensity-modulated RT etc.]. Toxicity was evaluated using the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria. Biochemical control was assessed according to the Phoenix definition (NADIR + 2 ng ml−1). Results: Acute urinary toxicity: G0, 24 patients; G1, 6 patients; G2, 2 patients. Acute rectal toxicity: G0, 28 patients; G1, 2 patients; and G2, 1 patient. Late urinary toxicity (evaluated in 30 cases): G0, 23 patients; G1, 6 patients; G2, 1 patient. Late renal toxicity: G0, 25 patients; G1, 5 patients. A mean follow-up of 21.3 months after re-EBRT showed that 13 patients were free of cancer, 3 were alive with biochemical relapse and 12 patients were alive with clinically evident disease. Four patients had died: two of disease progression and two of other causes. Conclusion: re-EBRT using modern technology is a feasible approach for local prostate cancer recurrence offering 2-year tumour control in about half of the patients. Toxicity of re-EBRT is low. Future studies are needed to identify the patients who would benefit most from this treatment. Advances in knowledge: Our series, based on experience in one hospital alone, shows that re-EBRT for local relapse of prostate cancer is feasible and offers a 2-year cure in about half of the patients. PMID:26055506

  5. The gastrin/cholecystokinin-B receptor on prostate cells--a novel target for bifunctional prostate cancer imaging.

    PubMed

    Sturzu, Alexander; Klose, Uwe; Sheikh, Sumbla; Echner, Hartmut; Kalbacher, Hubert; Deeg, Martin; Nägele, Thomas; Schwentner, Christian; Ernemann, Ulrike; Heckl, Stefan

    2014-02-14

    The means of identifying prostate carcinoma and its metastases are limited. The contrast agents used in magnetic resonance imaging clinical diagnostics are not taken up into the tumor cells, but only accumulate in the interstitial space of the highly vasculated tumor. We examined the gastrin/cholecystokinin-B receptor as a possible target for prostate-specific detection using the C-terminal seven amino acid sequence of the gastrin peptide hormone. The correct sequence and a scrambled control sequence were coupled to the fluorescent dye rhodamine and the magnetic resonance imaging contrast agent gadolinium (Gd)-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA). Expression analysis of the gastrin receptor mRNA was performed by reverse transcriptase polymerase chain reaction on PC3 prostate carcinoma cells, U373 glioma, U2OS osteosarcoma and Colo205 colon carcinoma cells. After having confirmed elevated expression of gastrin receptor in PC3 cells and very low expression of the receptor in Colo205 cells, these two cell lines were used to create tumor xenografts on nude mice for in vivo experiments. Confocal lasers scanning microscopy and magnetic resonance imaging showed a high specificity of the correct conjugate for the PC3 xenografts. Staining of the PC3 xenografts was much weaker with the scrambled conjugate while the Colo205 xenografts showed no marked staining with any of the conjugates. In vitro experiments comparing the correct and scrambled conjugates on PC3 cells by magnetic resonance relaxometry and fluorescence-activated cell sorting confirmed markedly higher specificity of the correct conjugate. The investigations show that the gastrin receptor is a promising tumor cell surface target for future prostate-cancer-specific imaging applications.

  6. PSMA Ligands for Radionuclide Imaging and Therapy of Prostate Cancer: Clinical Status

    PubMed Central

    Lütje, Susanne; Heskamp, Sandra; Cornelissen, Alexander S.; Poeppel, Thorsten D.; van den Broek, Sebastiaan A. M. W.; Rosenbaum-Krumme, Sandra; Bockisch, Andreas; Gotthardt, Martin; Rijpkema, Mark; Boerman, Otto C.

    2015-01-01

    Prostate cancer (PCa) is the most common malignancy in men worldwide, leading to substantial morbidity and mortality. At present, imaging of PCa has become increasingly important for staging, restaging, and treatment selection. Until recently, choline-based positron emission tomography/computed tomography (PET/CT) represented the state-of-the-art radionuclide imaging technique for these purposes. However, its application is limited to patients with high PSA levels and Gleason scores. Prostate-specific membrane antigen (PSMA) is a promising new target for specific imaging of PCa, because it is upregulated in the majority of PCa. Moreover, PSMA can serve as a target for therapeutic applications. Currently, several small-molecule PSMA ligands with excellent in vivo tumor targeting characteristics are being investigated for their potential in theranostic applications in PCa. Here, a review of the recent developments in PSMA-based diagnostic imaging and therapy in patients with PCa with radiolabeled PSMA ligands is provided. PMID:26681984

  7. PSMA Ligands for Radionuclide Imaging and Therapy of Prostate Cancer: Clinical Status.

    PubMed

    Lütje, Susanne; Heskamp, Sandra; Cornelissen, Alexander S; Poeppel, Thorsten D; van den Broek, Sebastiaan A M W; Rosenbaum-Krumme, Sandra; Bockisch, Andreas; Gotthardt, Martin; Rijpkema, Mark; Boerman, Otto C

    2015-01-01

    Prostate cancer (PCa) is the most common malignancy in men worldwide, leading to substantial morbidity and mortality. At present, imaging of PCa has become increasingly important for staging, restaging, and treatment selection. Until recently, choline-based positron emission tomography/computed tomography (PET/CT) represented the state-of-the-art radionuclide imaging technique for these purposes. However, its application is limited to patients with high PSA levels and Gleason scores. Prostate-specific membrane antigen (PSMA) is a promising new target for specific imaging of PCa, because it is upregulated in the majority of PCa. Moreover, PSMA can serve as a target for therapeutic applications. Currently, several small-molecule PSMA ligands with excellent in vivo tumor targeting characteristics are being investigated for their potential in theranostic applications in PCa. Here, a review of the recent developments in PSMA-based diagnostic imaging and therapy in patients with PCa with radiolabeled PSMA ligands is provided.

  8. Identification of Threshold Prostate Specific Antigen Levels to Optimize the Detection of Clinically Significant Prostate Cancer by Magnetic Resonance Imaging/Ultrasound Fusion Guided Biopsy

    PubMed Central

    Shakir, Nabeel A.; George, Arvin K.; Siddiqui, M. Minhaj; Rothwax, Jason T.; Rais-Bahrami, Soroush; Stamatakis, Lambros; Su, Daniel; Okoro, Chinonyerem; Raskolnikov, Dima; Walton-Diaz, Annerleim; Simon, Richard; Turkbey, Baris; Choyke, Peter L.; Merino, Maria J.; Wood, Bradford J.; Pinto, Peter A.

    2015-01-01

    Purpose Prostate specific antigen sensitivity increases with lower threshold values but with a corresponding decrease in specificity. Magnetic resonance imaging/ultrasound targeted biopsy detects prostate cancer more efficiently and of higher grade than standard 12-core transrectal ultrasound biopsy but the optimal population for its use is not well defined. We evaluated the performance of magnetic resonance imaging/ultrasound targeted biopsy vs 12-core biopsy across a prostate specific antigen continuum. Materials and Methods We reviewed the records of all patients enrolled in a prospective trial who underwent 12-core transrectal ultrasound and magnetic resonance imaging/ultrasound targeted biopsies from August 2007 through February 2014. Patients were stratified by each of 4 prostate specific antigen cutoffs. The greatest Gleason score using either biopsy method was compared in and across groups as well as across the population prostate specific antigen range. Clinically significant prostate cancer was defined as Gleason 7 (4 + 3) or greater. Univariate and multivariate analyses were performed. Results A total of 1,003 targeted and 12-core transrectal ultrasound biopsies were performed, of which 564 diagnosed prostate cancer for a 56.2% detection rate. Targeted biopsy led to significantly more upgrading to clinically significant disease compared to 12-core biopsy. This trend increased more with increasing prostate specific antigen, specifically in patients with prostate specific antigen 4 to 10 and greater than 10 ng/ml. Prostate specific antigen 5.2 ng/ml or greater captured 90% of upgrading by targeted biopsy, corresponding to 64% of patients who underwent multiparametric magnetic resonance imaging and subsequent fusion biopsy. Conversely a greater proportion of clinically insignificant disease was detected by 12-core vs targeted biopsy overall. These differences persisted when controlling for potential confounders on multivariate analysis. Conclusions Prostate

  9. Detection of Prostate Cancer: Quantitative Multiparametric MR Imaging Models Developed Using Registered Correlative Histopathology.

    PubMed

    Metzger, Gregory J; Kalavagunta, Chaitanya; Spilseth, Benjamin; Bolan, Patrick J; Li, Xiufeng; Hutter, Diane; Nam, Jung W; Johnson, Andrew D; Henriksen, Jonathan C; Moench, Laura; Konety, Badrinath; Warlick, Christopher A; Schmechel, Stephen C; Koopmeiners, Joseph S

    2016-06-01

    Purpose To develop multiparametric magnetic resonance (MR) imaging models to generate a quantitative, user-independent, voxel-wise composite biomarker score (CBS) for detection of prostate cancer by using coregistered correlative histopathologic results, and to compare performance of CBS-based detection with that of single quantitative MR imaging parameters. Materials and Methods Institutional review board approval and informed consent were obtained. Patients with a diagnosis of prostate cancer underwent multiparametric MR imaging before surgery for treatment. All MR imaging voxels in the prostate were classified as cancer or noncancer on the basis of coregistered histopathologic data. Predictive models were developed by using more than one quantitative MR imaging parameter to generate CBS maps. Model development and evaluation of quantitative MR imaging parameters and CBS were performed separately for the peripheral zone and the whole gland. Model accuracy was evaluated by using the area under the receiver operating characteristic curve (AUC), and confidence intervals were calculated with the bootstrap procedure. The improvement in classification accuracy was evaluated by comparing the AUC for the multiparametric model and the single best-performing quantitative MR imaging parameter at the individual level and in aggregate. Results Quantitative T2, apparent diffusion coefficient (ADC), volume transfer constant (K(trans)), reflux rate constant (kep), and area under the gadolinium concentration curve at 90 seconds (AUGC90) were significantly different between cancer and noncancer voxels (P < .001), with ADC showing the best accuracy (peripheral zone AUC, 0.82; whole gland AUC, 0.74). Four-parameter models demonstrated the best performance in both the peripheral zone (AUC, 0.85; P = .010 vs ADC alone) and whole gland (AUC, 0.77; P = .043 vs ADC alone). Individual-level analysis showed statistically significant improvement in AUC in 82% (23 of 28) and 71% (24 of 34

  10. Screening for Prostate Cancer

    MedlinePlus

    Understanding Task Force Recommendations Screening for Prostate Cancer The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation on Screening for Prostate Cancer . This recommendation is for ...

  11. Prostate Cancer FAQs

    MedlinePlus

    ... Coffey – Holden Prostate Cancer Academy Awards Challenge Awards Creativity Awards Young Investigator Awards Scientific Retreat – Meeting Agenda ... Retreat Coffey – Holden Prostate Cancer Academy Challenge Awards Creativity Awards Young Investigator Awards Featured Scientific Retreat – Meeting ...

  12. Prostate Cancer Symptoms

    MedlinePlus

    ... Coffey – Holden Prostate Cancer Academy Awards Challenge Awards Creativity Awards Young Investigator Awards Scientific Retreat – Meeting Agenda ... Retreat Coffey – Holden Prostate Cancer Academy Challenge Awards Creativity Awards Young Investigator Awards Featured Scientific Retreat – Meeting ...

  13. Cryotherapy for prostate cancer

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000907.htm Cryotherapy for prostate cancer To use the sharing features ... first treatment for prostate cancer. What Happens During Cryotherapy Before the procedure, you will be given medicine ...

  14. Prostate MR Imaging: An Update.

    PubMed

    Shaish, Hiram; Taneja, Samir S; Rosenkrantz, Andrew B

    2017-03-01

    Improvements in prostate MR imaging techniques and the introduction of MR imaging-targeted biopsies have had central roles in prostate cancer (PCa) management. The role of MR imaging has progressed from largely staging patients with biopsy-proven PCa to detecting, characterizing, and guiding the biopsy of suspected PCa. These diagnostic advances, combined with improved therapeutic interventions, have led to a more sophisticated and individually tailored approach to patients' unique PCa profile. This review discusses the MR imaging, a standardized reporting scheme, and the role of fusion-targeted prostate biopsy.

  15. AUA Policy Statement on the Use of Multiparametric Magnetic Resonance Imaging in the Diagnosis, Staging and Management of Prostate Cancer.

    PubMed

    Fulgham, Pat F; Rukstalis, Daniel B; Turkbey, Ismail Baris; Rubenstein, Jonathan N; Taneja, Samir; Carroll, Peter R; Pinto, Peter A; Bjurlin, Marc A; Eggener, Scott

    2017-10-01

    We summarize the available data about the clinical and economic effectiveness of magnetic resonance imaging in the diagnosis and management of prostate cancer, and provide practical recommendations for its use in the screening, diagnosis, staging and surveillance of prostate cancer. A panel of clinicians with expertise in the diagnosis and management of prostate cancer evaluated the current published literature on the use and effectiveness of magnetic resonance imaging for this disease. When adequate studies were available for analysis, recommendations were made on the basis of data and when adequate studies were not available, recommendations were made on the basis of expert consensus. At this time the data support the use of magnetic resonance imaging in patients with a previous negative biopsy and ongoing concerns about increased risk of prostate cancer. The data regarding its usefulness for initial biopsy suggest a possible role for magnetic resonance imaging in some circumstances. There is currently insufficient evidence to recommend magnetic resonance imaging for screening, staging or surveillance of prostate cancer. Although it adds cost to the management of prostate cancer, magnetic resonance imaging offers superior anatomic detail, and the ability to evaluate cellular density based on water diffusion and blood flow based on contrast enhancement. Imaging targeted biopsy may increase the diagnosis of clinically significant cancers by identifying specific lesions not visible on conventional ultrasound. The clinical indications for the use of magnetic resonance imaging in the management of prostate cancer are rapidly evolving. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  16. Image-Guided Hypofractionated Radiotherapy in Low-Risk Prostate Cancer Patients

    PubMed Central

    Valeriani, Maurizio; Carnevale, Alessia; Bonome, Paolo; Montalto, Adelaide; Nicosia, Luca; Osti, Mattia F.; De Sanctis, Vitaliana; Minniti, Giuseppe; Maurizi Enrici, Riccardo

    2014-01-01

    Aim. To evaluate efficacy and toxicity of image-guided hypofractionated radiotherapy (HFRT) in the treatment of low-risk prostate cancer. Outcomes and toxicities of this series of patients were compared to another group of 32 low-risk patients treated with conventional fractionation (CFRT). Methods. Fifty-nine patients with low-risk prostate cancer were analysed. Total dose for the prostate and proximal seminal vesicles was 60 Gy delivered in 20 fractions. Results. The median follow-up was 30 months. The actuarial 4-year overall survival, biochemical free survival, and disease specific survival were 100%, 97.4%, and 97.4%, respectively. Acute grade 1-2 gastrointestinal (GI) and genitourinary (GU) toxicity rates were 11.9% and 40.7%, respectively. Grade 1 GI and GU late toxicity rates were 8.5% and 13.6%, respectively. No grade ≥2 late toxicities were recorded. Acute grade 2-3 GU toxicity resulted significantly lower (P = 0.04) in HFRT group compared to the CFRT group. The cumulative 4-year incidence of grade 1-2 GU toxicity was significantly higher (P < 0.001) for HFRT patients. Conclusions. Our study demonstrated that hypofractionated regimen provided excellent biochemical control in favorable risk prostate cancer patients. The incidence of GI and GU toxicity was low. However, HFRT presented higher cumulative incidence of low-grade late GU toxicity than CFRT. PMID:24864248

  17. Significance of Image Guidance to Clinical Outcomes for Localized Prostate Cancer

    PubMed Central

    Zhong, Qiuzi; Gao, Hong; Li, Gaofeng; Xiu, Xia; Wu, Qinhong; Li, Ming; Xu, Yonggang

    2014-01-01

    Purpose. To compare toxicity profiles and biochemical tumor control outcomes between patients treated with image-guided intensity-modulated radiotherapy (IG-IMRT) and non-IGRT intensity-modulated radiotherapy (IMRT) for clinically localized prostate cancer. Materials and Methods. Between 2009 and 2012, 65 patients with localized prostate cancer were treated with IG-IMRT. This group of patients was retrospectively compared with a similar cohort of 62 patients who were treated between 2004 and 2009 with IMRT to the same dose without image guidance. Results. The median follow-up time was 4.8 years. The rectal volume receiving ≥40 and ≥70 Gy was significantly lower in the IG-IMRT group. Grade 2 and higher acute and late GI and GU toxicity rates were lower in IG-IMRT group, but there was no statistical difference. No significant improvement in biochemical control at 5 years was observed in two groups. In a Cox regression analysis identifying predictors for PSA relapse-free survival, only preradiotherapy PSA was significantly associated with biochemical control; IG-IMRT was not a statistically significant indicator. Conclusions. The use of image guidance in the radiation of prostate cancer at our institute did not show significant reduction in the rates of GI and GU toxicity and did not improve the biochemical control compared with IMRT. PMID:25110701

  18. Bone imaging in prostate cancer: the evolving roles of nuclear medicine and radiology.

    PubMed

    Cook, Gary J R; Azad, Gurdip; Padhani, Anwar R

    2016-01-01

    The bone scan continues to be recommended for both the staging and therapy response assessment of skeletal metastases from prostate cancer. However, it is widely recognised that bone scans have limited sensitivity for disease detection and is both insensitive and non-specific for determining treatment response, at an early enough time point to be clinically useful. We, therefore, review the evolving roles of nuclear medicine and radiology for this application. We have reviewed the published literature reporting recent developments in imaging bone metastases in prostate cancer, and provide a balanced synopsis of the state of the art. The development of single-photon emission computed tomography combined with computed tomography has improved detection sensitivity and specificity but has not yet been shown to lead to improvements in monitoring therapy. A number of bone-specific and tumour-specific tracers for positron emission tomography/computed tomography (PET/CT) are now available for advanced prostate cancer that show promise in both clinical settings. At the same time, the development of whole-body magnetic resonance imaging (WB-MRI) that incorporates diffusion-weighted imaging also offers significant improvements for detection and therapy response assessment. There are emerging data showing comparative SPECT/CT, PET/CT, and WB-MRI test performance for disease detection, but no compelling data on the usefulness of these technologies in response assessment have yet emerged.

  19. Prostate cancer recurrence after radical prostatectomy: the role of 3-T diffusion imaging in multi-parametric magnetic resonance imaging.

    PubMed

    Panebianco, Valeria; Barchetti, Flavio; Sciarra, Alessandro; Musio, Daniela; Forte, Valerio; Gentile, Vincenzo; Tombolini, Vincenzo; Catalano, Carlo

    2013-06-01

    To validate the role of 3-T diffusion-weighted imaging (DWI) in the detection of local prostate cancer recurrence after radical prostatectomy (RP). T2-weighted imaging, DWI and dynamic contrast-enhanced MRI (DCE-MRI) were performed with a 3-T magnet in 262 patients after RP. Twenty out of 262 patients evaluated were excluded. MRI results were validated by prostate-specific antigen (PSA) reduction after external beam radiotherapy in group A (126 patients, local recurrence size range 4-8 mm) and by transrectal ultrasound biopsy in group B (116 patients, local recurrence size range 9-15 mm). In group A combined T2-weighted and DCE-MRI (T2+DCE) shows 98 % sensitivity, 94 % specificity and 93 % accuracy in identifying local recurrence; combined T2-weighted and DWI with a b value of 3,000 s/mm(2) (T2+DW3) displays 97 % sensitivity, 95 % specificity and 92 % accuracy, while with a b value of 1,000 s/mm(2) (T2+DW1) affords 93 % sensitivity, 89 % specificity and 88 % accuracy. In group B T2+DCE shows 100 % sensitivity, 97 % specificity and 91 % accuracy in detecting local cancer recurrence; T2+DW3 displays 98 % sensitivity, 96 % specificity and 89 % accuracy; T2+DW1 has 94 % sensitivity, 92 % specificity and 86 % accuracy. DCE-MRI is the most reliable technique in detecting local prostate cancer recurrence after RP, though DWI can be proposed as a reliable alternative. • Diffusion-weighted magnetic resonance imaging (DWI-MRI) is being increasingly used in oncology. • PSA analysis does not distinguish prostate cancer recurrence from distant metastasis. • DWI-MR can diagnose local prostate cancer recurrence after radical prostatectomy. • DWI-MR is almost comparable to DCE-MRI in detecting local recurrence.

  20. Evaluation of an Automated Analysis Tool for Prostate Cancer Prediction Using Multiparametric Magnetic Resonance Imaging

    PubMed Central

    Roethke, Matthias C.; Kuru, Timur H.; Mueller-Wolf, Maya B.; Agterhuis, Erik; Edler, Christopher; Hohenfellner, Markus; Schlemmer, Heinz-Peter; Hadaschik, Boris A.

    2016-01-01

    Objective To evaluate the diagnostic performance of an automated analysis tool for the assessment of prostate cancer based on multiparametric magnetic resonance imaging (mpMRI) of the prostate. Methods A fully automated analysis tool was used for a retrospective analysis of mpMRI sets (T2-weighted, T1-weighted dynamic contrast-enhanced, and diffusion-weighted sequences). The software provided a malignancy prediction value for each image pixel, defined as Malignancy Attention Index (MAI) that can be depicted as a colour map overlay on the original images. The malignancy maps were compared to histopathology derived from a combination of MRI-targeted and systematic transperineal MRI/TRUS-fusion biopsies. Results In total, mpMRI data of 45 patients were evaluated. With a sensitivity of 85.7% (with 95% CI of 65.4–95.0), a specificity of 87.5% (with 95% CI of 69.0–95.7) and a diagnostic accuracy of 86.7% (with 95% CI of 73.8–93.8) for detection of prostate cancer, the automated analysis results corresponded well with the reported diagnostic accuracies by human readers based on the PI-RADS system in the current literature. Conclusion The study revealed comparable diagnostic accuracies for the detection of prostate cancer of a user-independent MAI-based automated analysis tool and PI-RADS-scoring-based human reader analysis of mpMRI. Thus, the analysis tool could serve as a detection support system for less experienced readers. The results of the study also suggest the potential of MAI-based analysis for advanced lesion assessments, such as cancer extent and staging prediction. PMID:27454770

  1. A magnetic resonance imaging-based workflow for planning radiation therapy for prostate cancer.

    PubMed

    Greer, Peter B; Dowling, Jason A; Lambert, Jonathon A; Fripp, Jurgen; Parker, Joel; Denham, James W; Wratten, Chris; Capp, Anne; Salvado, Olivier

    2011-02-21

    Dose planning for prostate radiation therapy is performed using computed tomography (CT) scans that provide the electron density information needed for individual patients' radiation dose calculations. For visualising the prostate and determining the target volume for radiation treatment, magnetic resonance imaging (MRI) gives vastly superior soft-tissue contrast. However, currently, MRI scans cannot be used for dose planning, as they do not provide the electron density information. We aimed to develop an alternative and efficient MRI-only image-based workflow, enabling both organ delineation and dose planning to be performed using MRI, with "pseudo-CT scans" generated from MRI scans supplying the information for dose planning. The feasibility of implementing MRI-based prostate radiation therapy planning is being investigated through collaboration between the clinical and medical physics group at the Calvary Mater Newcastle Hospital/University of Newcastle and the biomedical imaging processing group at the CSIRO (Commonwealth Scientific and Industrial Research Organisation) Australian e-Health Research Centre. Results comparing Hounsfield units calculated from CT scans and from MRI-based pseudo-CT scans for 39 patients showed very similar average values for the prostate, bladder, bones and rectum, confirming that pseudo-CT scans can replace CT scans for accurate radiation dose calculations. MRI-based radiotherapy planning can also be used for tumours in other locations, such as head and neck, and breast cancers.

  2. Evaluation of Online/Offline Image Guidance/Adaptation Approaches for Prostate Cancer Radiation Therapy

    SciTech Connect

    Qin, An; Sun, Ying; Liang, Jian; Yan, Di

    2015-04-01

    Purpose: To evaluate online/offline image-guided/adaptive treatment techniques for prostate cancer radiation therapy with daily cone-beam CT (CBCT) imaging. Methods and Materials: Three treatment techniques were evaluated retrospectively using daily pre- and posttreatment CBCT images on 22 prostate cancer patients. Prostate, seminal vesicles (SV), rectal wall, and bladder were delineated on all CBCT images. For each patient, a pretreatment intensity modulated radiation therapy plan with clinical target volume (CTV) = prostate + SV and planning target volume (PTV) = CTV + 3 mm was created. The 3 treatment techniques were as follows: (1) Daily Correction: The pretreatment intensity modulated radiation therapy plan was delivered after online CBCT imaging, and position correction; (2) Online Planning: Daily online inverse plans with 3-mm CTV-to-PTV margin were created using online CBCT images, and delivered; and (3) Hybrid Adaption: Daily Correction plus an offline adaptive inverse planning performed after the first week of treatment. The adaptive plan was delivered for all remaining 15 fractions. Treatment dose for each technique was constructed using the daily posttreatment CBCT images via deformable image registration. Evaluation was performed using treatment dose distribution in target and critical organs. Results: Treatment equivalent uniform dose (EUD) for the CTV was within [85.6%, 100.8%] of the pretreatment planned target EUD for Daily Correction; [98.7%, 103.0%] for Online Planning; and [99.2%, 103.4%] for Hybrid Adaptation. Eighteen percent of the 22 patients in Daily Correction had a target dose deficiency >5%. For rectal wall, the mean ± SD of the normalized EUD was 102.6% ± 2.7% for Daily Correction, 99.9% ± 2.5% for Online Planning, and 100.6% ± 2.1% for Hybrid Adaptation. The mean ± SD of the normalized bladder EUD was 108.7% ± 8.2% for Daily Correction, 92.7% ± 8.6% for Online Planning, and 89.4% ± 10.8% for Hybrid

  3. A Comparison of daily megavoltage CT and ultrasound image guided radiation therapy for prostate cancer

    SciTech Connect

    Peng Cheng; Kainz, Kristofer; Lawton, Colleen; Li, X. Allen

    2008-12-15

    In order to quantify the differences between ultrasound-imaging and megavoltage-CT (MVCT) daily prostate localization in prostate-cancer radiotherapy and their dosimetric impacts, daily shifts were analyzed for a total of 140 prostate cancer patients; 106 positioned using ultrasound-based imaging [B-mode Acquisition and Targeting (BAT)], and 34 using the MVCT from a TomoTherapy Hi-Art unit. The shifts indicated by the two systems were compared statistically along the right/left (R/L), superior/inferior (S/I), and anterior/posterior (A/P) directions. The systematic and random variations among the daily alignments were calculated. Margins to account for these shifts were estimated. The mean shifts and standard deviations along the R/L, S/I, and A/P directions were -0.11{+-}3.80, 0.67{+-}4.67, and 2.71{+-}6.31 mm for BAT localizations and -0.98{+-}5.13, 0.27{+-}3.35, and 1.00{+-}4.22 mm for MVCT localizations, respectively. The systematic and random variations in daily shifts based on MVCT were generally smaller than those based on BAT, especially along the A/P direction. A t-test showed this difference to be statistically significant. The planning target volume margins in the A/P direction estimated to account for daily variations were 8.81 and 14.66 mm based on MVCT and BAT data, respectively. There was no statistically significant difference in the daily prostate movement pattern between the first few fractions and the remaining fractions. Dosimetric comparison of MVCT and BAT prostate alignments was performed for seven fractions from a patient. The degradation from the plan caused by the MVCT alignment is trivial, while that by BAT is substantial. The MVCT technique results in smaller variations in daily shifts than ultrasound imaging, indicating that MVCT is more reliable and precise for prostate localization. Ultrasound-based localization may overestimate the daily prostate motion, particularly in the A/P direction, negatively impacting prostate dose coverage

  4. Predictive value of magnetic resonance imaging determined tumor contact length for extracapsular extension of prostate cancer.

    PubMed

    Baco, Eduard; Rud, Erik; Vlatkovic, Ljiljana; Svindland, Aud; Eggesbø, Heidi B; Hung, Andrew J; Matsugasumi, Toru; Bernhard, Jean-Christophe; Gill, Inderbir S; Ukimura, Osamu

    2015-02-01

    Tumor contact length is defined as the amount of prostate cancer in contact with the prostatic capsule. We evaluated the ability of magnetic resonance imaging determined tumor contact length to predict microscopic extracapsular extension compared to existing predictors of extracapsular extension. We retrospectively analyzed the records of 111 consecutive patients with magnetic resonance imaging/ultrasound fusion targeted, biopsy proven prostate cancer who underwent radical prostatectomy from January 2010 to July 2013. Median patient age was 64 years and median prostate specific antigen was 8.9 ng/ml. Clinical stage was cT1 in 93 cases (84%) and cT2 in 18 (16%). Postoperative pathological analysis confirmed pT2 in 71 patients (64%) and pT3 in 40 (36%). We evaluated 1) in the radical prostatectomy specimen the correlation of microscopic extracapsular extension with pathological cancer volume, pathological tumor contact length and Gleason score, 2) the correlation between microscopic extracapsular extension and magnetic resonance imaging tumor contact length, and 3) the ability of preoperative variables to predict microscopic extracapsular extension. Logistic regression analysis revealed that pathological tumor contact length correlated better with microscopic extracapsular extension than the predictive power of pathological cancer volume (0.821 vs 0.685). The Spearman correlation between pathological and magnetic resonance imaging tumor contact length was r = 0.839 (p <0.0001). ROC AUC analysis revealed that magnetic resonance imaging tumor contact length outperformed cancer core involvement on targeted biopsy and the Partin tables to predict microscopic extracapsular extension (0.88 vs 0.70 and 0.63, respectively). At a magnetic resonance imaging tumor contact length threshold of 20 mm the accuracy for diagnosing microscopic extracapsular extension was superior to that of conventional magnetic resonance imaging criteria (82% vs 67%, p = 0.015). We developed a

  5. Radiotherapy treatment planning of prostate cancer using magnetic resonance imaging alone.

    PubMed

    Lee, Young K; Bollet, Marc; Charles-Edwards, Geoffrey; Flower, Maggie A; Leach, Martin O; McNair, Helen; Moore, Elizabeth; Rowbottom, Carl; Webb, Steve

    2003-02-01

    Accurate anatomical delineation of the gross tumour volume (GTV) is crucial for effective radiotherapy (RT) treatment of prostate cancers. Although reference to pelvic magnetic resonance (MR) for improved delineation of the prostate is a regular practice in some clinics, MR has not replaced CT due to its geometrical distortions and lack of electron-density information. The possibility and practicality of using MR only for RT treatment planning were studied. The addition of electron-density information to MR images for conformal radiotherapy (CRT) planning of the prostate was quantified by comparing dose distributions created on the homogeneous density- and bulk-density assigned images to original CT for four patients. To quantify the MR geometrical distortions measurements of a phantom imaged in CT (Siemens Somatom Plus 4) and FLASH 3D T1-weighted MR (1.5 T whole body Siemens Magnetom Vision) were compared. Dose statistics from CRT treatment plans made on CT and MR for five patient data were compared to determine if MR-only treatment plans can be made. The differences between dose-plans on bulk-density assigned images when compared to CT were less than 2% when water and bone values were assigned. Dose differences greater than 2% were observed when images of homogeneous-density assignment were compared to the CT. Phantom measurements showed that the distortions in the FLASH 3D T1-weighted MR averaged 2 mm in the volume of interest for prostate RT planning. For the CT and MR prostate planning study, doses delivered to the planning target volume (PTV) in CT and MR were always inside a 93-107% dose range normalised to the isocentre. Also, the doses to the organs-at-risk in the MR images were similar to the doses delivered to the volumes in the registered CT image when the organ volumes between the two images were similar. Negligible differences were observed in dose distribution between CRT plans using bone+water CT number bulk-assigned image and original CT. Also, the

  6. Inverse Relationship Between Biochemical Outcome and Acute Toxicity After Image-Guided Radiotherapy for Prostate Cancer

    SciTech Connect

    Vesprini, Danny; Catton, Charles; Jacks, Lindsay; Lockwood, Gina; Rosewall, Tara; Bayley, Andrew; Chung, Peter; Gospodarowicz, Mary; Menard, Cynthia; Milosevic, Michael; Nichol, Alan; Skala, Marketa; Warde, Padraig; Bristow, Robert G.

    2012-06-01

    Purpose: Prostate cancer patients exhibit variability in normal tissue reactions and biochemical failure. With the use of image-guided radiotherapy (IGRT), there is a greater likelihood that the differences in normal tissue and tumor response are due to biological rather than physical factors. We tested the hypothesis that prospectively scored acute toxicity is associated with biochemical failure-free rate (BFFR) in prostate cancer patients treated with IGRT. Methods and Materials: We retrospectively analyzed BFFR in 362 patients with localized prostate cancer treated with IGRT. We compared BFFR with prospectively collected Radiation Therapy Oncology Group (RTOG) maximum acute gastrointestinal (GI) and genitourinary (GU) toxicity scores. Median follow-up for all patients was 58.3 months after total radiotherapy doses of 75.6-79.8 Gy. Results: Patients reporting RTOG acute GU or GI toxicity scores of {>=}2 were considered 'sensitive' (n = 141, 39%) and patients reporting scores <2 were considered 'nonsensitive' (n = 221, 61%). When calculating biochemical failure (BF) using the American Society for Therapeutic Radiology and Oncology definition at 5 years, 76% (CI 70-82%) of the 'nonsensitive' patients were failure free, compared with only 53% (CI 43-62%) of the 'sensitive' patients (log-rank test, p < 0.0001). This difference was also observed using the Phoenix definition; 'nonsensitive' 5-year BFFR was 81% (CI 74-86%) vs. 'sensitive' BFFR was 68% (CI 58-76%; log-rank test p = 0.0012). The difference in BF between cohorts remained significant when controlled for radiation dose (75.6 vs. 79.8 Gy), prognostic stratification (T category, prostate-specific antigen, and Gleason score), and prostate volume. Conclusions: This study unexpectedly shows that prostate cancer patients who develop {>=}Grade 2 RTOG acute toxicity during radiotherapy are less likely to remain BFF at 5 years. These results deserve further study and, if validated in other large IGRT cohorts

  7. Selection and characterization of DNA aptamer for metastatic prostate cancer recognition and tissue imaging

    PubMed Central

    Wu, Xiaoqiu; Sun, Yang; Li, Jianglin; Hu, Xiaoxiao; Lin, Wei; Han, Dongmei; Zhao, Yifan; Liu, Jing; Ye, Mao; Tan, Weihong

    2016-01-01

    Prostate cancer (PCa) is the second leading cause of death and most prevalent cancer in men. The absence of curative options for castration-resistant metastatic prostate cancer and biomarkers able to discriminate between indolent and aggressive tumors contribute to these statistics. In this study, a DNA aptamer termed DML-7 was successfully selected against human PCa cell line DU145 by using the cell-based systematic evolution of ligands by exponential enrichment (SELEX) method. The selected aptamer DML-7 was found to internalize into target cells in a temperature-dependent manner and exhibit high binding affinity for target cells with dissociation constants in the nanomolar range. Binding analysis further revealed that DML-7 only binds to DU145 and PC-3 cells with metastatic potential, but not to LNCaP or 22Rv1 cells with low or nonmetastatic potential, demonstrating that DML-7 has excellent selectivity for the recognition of the metastatic PCa cells. Clinical tissue imaging further confirmed these results. Therefore, both high binding affinity and specificity to metastatic PCa cells and tissues afford DML-7 with the potential for development into a novel tool for diagnosis and targeted drug delivery against metastatic prostate cancer. PMID:27183906

  8. PET guidance in prostate cancer radiotherapy: Quantitative imaging to predict response and guide treatment.

    PubMed

    Cattaneo, G M; Bettinardi, V; Mapelli, P; Picchio, M

    2016-03-01

    Positron emission tomography (PET) allows a monitoring and recording of the spatial and temporal distribution of molecular/cellular processes for diagnostic and therapeutic applications. The aim of this review is to describe the current applications and to explore the role of PET in prostate cancer management, mainly in the radiation therapy (RT) scenario. The state-of-the art of PET for prostate cancer will be presented together with the impact of new specific PET tracers and technological developments aiming at obtaining better imaging quality, increased tumor detectability and more accurate volume delineation. An increased number of studies have been focusing on PET quantification methods as predictive biomarkers capable of guiding individualized treatment and improving patient outcome; the sophisticated advanced intensity modulated and imaged guided radiation therapy techniques (IMRT/IGRT) are capable of boosting more radioresistant tumor (sub)volumes. The use of advanced feature analyses of PET images is an approach that holds great promise with regard to several oncological diseases, but needs further validation in managing prostate diseases. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  9. A curated collection of tissue microarray images and clinical outcome data of prostate cancer patients.

    PubMed

    Zhong, Qing; Guo, Tiannan; Rechsteiner, Markus; Rüschoff, Jan H; Rupp, Niels; Fankhauser, Christian; Saba, Karim; Mortezavi, Ashkan; Poyet, Cédric; Hermanns, Thomas; Zhu, Yi; Moch, Holger; Aebersold, Ruedi; Wild, Peter J

    2017-03-14

    Microscopy image data of human cancers provide detailed phenotypes of spatially and morphologically intact tissues at single-cell resolution, thus complementing large-scale molecular analyses, e.g., next generation sequencing or proteomic profiling. Here we describe a high-resolution tissue microarray (TMA) image dataset from a cohort of 71 prostate tissue samples, which was hybridized with bright-field dual colour chromogenic and silver in situ hybridization probes for the tumour suppressor gene PTEN. These tissue samples were digitized and supplemented with expert annotations, clinical information, statistical models of PTEN genetic status, and computer source codes. For validation, we constructed an additional TMA dataset for 424 prostate tissues, hybridized with FISH probes for PTEN, and performed survival analysis on a subset of 339 radical prostatectomy specimens with overall, disease-specific and recurrence-free survival (maximum 167 months). For application, we further produced 6,036 image patches derived from two whole slides. Our curated collection of prostate cancer data sets provides reuse potential for both biomedical and computational studies.

  10. A curated collection of tissue microarray images and clinical outcome data of prostate cancer patients

    PubMed Central

    Zhong, Qing; Guo, Tiannan; Rechsteiner, Markus; Rüschoff, Jan H.; Rupp, Niels; Fankhauser, Christian; Saba, Karim; Mortezavi, Ashkan; Poyet, Cédric; Hermanns, Thomas; Zhu, Yi; Moch, Holger; Aebersold, Ruedi; Wild, Peter J.

    2017-01-01

    Microscopy image data of human cancers provide detailed phenotypes of spatially and morphologically intact tissues at single-cell resolution, thus complementing large-scale molecular analyses, e.g., next generation sequencing or proteomic profiling. Here we describe a high-resolution tissue microarray (TMA) image dataset from a cohort of 71 prostate tissue samples, which was hybridized with bright-field dual colour chromogenic and silver in situ hybridization probes for the tumour suppressor gene PTEN. These tissue samples were digitized and supplemented with expert annotations, clinical information, statistical models of PTEN genetic status, and computer source codes. For validation, we constructed an additional TMA dataset for 424 prostate tissues, hybridized with FISH probes for PTEN, and performed survival analysis on a subset of 339 radical prostatectomy specimens with overall, disease-specific and recurrence-free survival (maximum 167 months). For application, we further produced 6,036 image patches derived from two whole slides. Our curated collection of prostate cancer data sets provides reuse potential for both biomedical and computational studies. PMID:28291248

  11. Molecular imaging for prostate cancer: Performance analysis of (68)Ga-PSMA PET/CT versus choline PET/CT.

    PubMed

    Michaud, L; Touijer, K A

    2017-06-01

    There is a need for a precise and reliable imaging to improve the management of prostate cancer. In recent years the PET/CT with choline has changed the handling of prostate cancer in Europe, and it is commonly used for initial stratification or for the diagnosis of a biochemical recurrence, although it does not lack limitations. Other markers are being tested, including the ligand of prostate-specific membrane antigen (PSMA), that seems to offer encouraging prospects. The goal of this piece of work was to critically review the role of choline and PSMA PET/CT in prostate cancer. A systematic literature review of databases PUBMED/MEDLINE and EMBASE was conducted searching for articles fully published in English on the PET marker in prostate cancer and its clinical application. It seems as 68Ga-PSMA PET/CT is better than PET/CT in prostate cancer to detect primary prostate lesions, initial metastases in the lymph nodes and recurrence. However, further research is required to obtain high-level tests. Also, other PET markers are studied. Moreover, the emergence of a new PET/MR camera could change the performance of PET imaging. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. PET imaging of prostate-specific membrane antigen in prostate cancer: current state of the art and future challenges

    PubMed Central

    Rowe, SP; Gorin, MA; Allaf, ME; Pienta, KJ; Tran, PT; Pomper, MG; Ross, AE; Cho, SY

    2016-01-01

    BACKGROUND Prostate-specific membrane antigen (PSMA) is a cell surface enzyme that is highly expressed in prostate cancer (PCa) and is currently being extensively explored as a promising target for molecular imaging in a variety of clinical contexts. Novel antibody and small-molecule PSMA radiotracers labeled with a variety of radionuclides for positron emission tomography (PET) imaging applications have been developed and explored in recent studies. METHODS A great deal of progress has been made in defining the clinical utility of this class of PET agents through predominantly small and retrospective clinical studies. The most compelling data to date has been in the setting of biochemically recurrent PCa, where PSMA-targeted radiotracers have been found to be superior to conventional imaging and other molecular imaging agents for the detection of locally recurrent and metastatic PCa. RESULTS Early data, however, suggest that initial lymph node staging before definitive therapy in high-risk primary PCa patients may be limited, although intraoperative guidance may still hold promise. Other examples of potential promising applications for PSMA PET imaging include non-invasive characterization of primary PCa, staging and treatment planning for PSMA-targeted radiotherapeutics, and guidance of focal therapy for oligometastatic disease. CONCLUSIONS However, all of these indications and applications for PCa PSMA PET imaging are still lacking and require large, prospective, systematic clinical trials for validation. Such validation trials are needed and hopefully will be forthcoming as the fields of molecular imaging, urology, radiation oncology and medical oncology continue to define and refine the utility of PSMA-targeted PET imaging to improve the management of PCa patients. PMID:27136743

  13. Schedule for CT image guidance in treating prostate cancer with helical tomotherapy

    PubMed Central

    Beldjoudi, G; Yartsev, S; Bauman, G; Battista, J; Van Dyk, J

    2010-01-01

    The aim of this study was to determine the effect of reducing the number of image guidance sessions and patient-specific target margins on the dose distribution in the treatment of prostate cancer with helical tomotherapy. 20 patients with prostate cancer who were treated with helical tomotherapy using daily megavoltage CT (MVCT) imaging before treatment served as the study population. The average geometric shifts applied for set-up corrections, as a result of co-registration of MVCT and planning kilovoltage CT studies over an increasing number of image guidance sessions, were determined. Simulation of the consequences of various imaging scenarios on the dose distribution was performed for two patients with different patterns of interfraction changes in anatomy. Our analysis of the daily set-up correction shifts for 20 prostate cancer patients suggests that the use of four fractions would result in a population average shift that was within 1 mm of the average obtained from the data accumulated over all daily MVCT sessions. Simulation of a scenario in which imaging sessions are performed at a reduced frequency and the planning target volume margin is adapted provided significantly better sparing of organs at risk, with acceptable reproducibility of dose delivery to the clinical target volume. Our results indicate that four MVCT sessions on helical tomotherapy are sufficient to provide information for the creation of personalised target margins and the establishment of the new reference position that accounts for the systematic error. This simplified approach reduces overall treatment session time and decreases the imaging dose to the patient. PMID:19505966

  14. COMPUTER-AIDED GLEASON GRADING OF PROSTATE CANCER HISTOPATHOLOGICAL IMAGES USING TEXTON FORESTS

    PubMed Central

    Khurd, Parmeshwar; Bahlmann, Claus; Maday, Peter; Kamen, Ali; Gibbs-Strauss, Summer; Genega, Elizabeth M.; Frangioni, John V.

    2010-01-01

    The Gleason score is the single most important prognostic indicator for prostate cancer candidates and plays a significant role in treatment planning. Histopathological imaging of prostate tissue samples provides the gold standard for obtaining the Gleason score, but the manual assignment of Gleason grades is a labor-intensive and error-prone process. We have developed a texture classification system for automatic and reproducible Gleason grading. Our system characterizes the texture in images belonging to a tumor grade by clustering extracted filter responses at each pixel into textons (basic texture elements). We have used random forests to cluster the filter responses into textons followed by the spatial pyramid match kernel in conjunction with an SVM classifier. We have demonstrated the efficacy of our system in distinguishing between Gleason grades 3 and 4. PMID:21221421

  15. Quality of life in patients with prostate cancer treated with radical image-guided radiotherapy

    PubMed Central

    Tabor, Kamil; Prokop, Elżbieta; Kulik, Roland

    2014-01-01

    Aim of the study The evaluation of quality of life during image-guided radiotherapy (IGRT) in patients with prostate cancer. Materials and methods The study consisted of 180 prostate cancer patients treated with radical radiotherapy (IGRT). The patients were irradiated using conformal or dynamic techniques with 2 Gy fractionation doses to a total dose of 76 Gy. Patients in the high-risk group (41%) were also irradiated to the pelvic lymph nodes. Quality of life was assessed with EORTC questionnaires: general QLQ-C30 and prostate-specific module QLQ-PR25, which were filled in by patients before and upon completion of radiotherapy. A change of ≥ 10 points in a linearised scale (0–100) was considered clinically significant. Results Global quality of life decreased slightly during radiotherapy (from 61 to 57 points), but from the clinical point of view, likewise most of the other quality of life parameters remained stable. In the general module (QLQ-C30) only diarrhoea changed in a clinically relevant way, i.e. by 10 points (from 10 to 20 points), which was mainly observed in patients with elective pelvic irradiation (increase of 18 points, from 10 to 28 points). In the prostate-specific module (QLQ-PR25) only urinary symptoms changed significantly, i.e. by 13 points (from 24 to 37 points). Conclusions The quality of life in patients with prostate cancer does not change in a clinically significant way during radiotherapy, which corroborates good treatment tolerance. Increased urinary symptoms and, in the case of pelvic irradiation, also increased diarrhoea have a negative impact on symptom-related quality of life. PMID:25258588

  16. MR Imaging Based Treatment Planning for Radiotherapy of Prostate Cancer

    DTIC Science & Technology

    2005-02-01

    Ma C, Paskalev K, Jacob R, Chen L, Feigenberg S, Movsas B. Feasibility study for clinical implementation of dose hypofractionation with IMRT for...from or supported in part by this grant: NIH R01 (PI: Wang L): Improving treatment accuracy for hypofractionated SRT (submitted in Oct. 2004...E E K et al 2003 Evidence for efficacy without increased toxicity of hypofractionated radiotherapy for prostate carcinoma: early results of a Phase

  17. Selenoproteins and Prostate Cancer

    DTIC Science & Technology

    2005-11-01

    1-0009 TITLE: Selenoproteins and Prostate Cancer PRINCIPAL INVESTIGATOR: Veda Navsariwala, Ph.D...Annual Summary 3. DATES COVERED (From - To) 15 Oct 2004 – 14 Oct 2005 4. TITLE AND SUBTITLE Selenoproteins and Prostate Cancer 5a. CONTRACT NUMBER...ABSTRACT For this postdoctoral fellowship the specific role of selenoproteins in prostate carcinogenesis is being investigated using a cell

  18. The Efficacy of Multiparametric Magnetic Resonance Imaging and Magnetic Resonance Imaging Targeted Biopsy in Risk Classification for Patients with Prostate Cancer on Active Surveillance.

    PubMed

    Recabal, Pedro; Assel, Melissa; Sjoberg, Daniel D; Lee, Daniel; Laudone, Vincent P; Touijer, Karim; Eastham, James A; Vargas, Hebert A; Coleman, Jonathan; Ehdaie, Behfar

    2016-08-01

    We determined whether multiparametric magnetic resonance imaging targeted biopsies may replace systematic biopsies to detect higher grade prostate cancer (Gleason score 7 or greater) and whether biopsy may be avoided based on multiparametric magnetic resonance imaging among men with Gleason 3+3 prostate cancer on active surveillance. We identified men with previously diagnosed Gleason score 3+3 prostate cancer on active surveillance who underwent multiparametric magnetic resonance imaging and a followup prostate biopsy. Suspicion for higher grade cancer was scored on a standardized 5-point scale. All patients underwent a systematic biopsy. Patients with multiparametric magnetic resonance imaging regions of interest also underwent magnetic resonance imaging targeted biopsy. The detection rate of higher grade cancer was estimated for different multiparametric magnetic resonance imaging scores with the 3 biopsy strategies of systematic, magnetic resonance imaging targeted and combined. Of 206 consecutive men on active surveillance 135 (66%) had a multiparametric magnetic resonance imaging region of interest. Overall, higher grade cancer was detected in 72 (35%) men. A higher multiparametric magnetic resonance imaging score was associated with an increased probability of detecting higher grade cancer (Wilcoxon-type trend test p <0.0001). Magnetic resonance imaging targeted biopsy detected higher grade cancer in 23% of men. Magnetic resonance imaging targeted biopsy alone missed higher grade cancers in 17%, 12% and 10% of patients with multiparametric magnetic resonance imaging scores of 3, 4 and 5, respectively. Magnetic resonance imaging targeted biopsies increased the detection of higher grade cancer among men on active surveillance compared to systematic biopsy alone. However, a clinically relevant proportion of higher grade cancer was detected using only systematic biopsy. Despite the improved detection of disease progression using magnetic resonance imaging

  19. Magnetic resonance imaging for localization of prostate cancer in the setting of biochemical recurrence.

    PubMed

    Panebianco, Valeria; Barchetti, Flavio; Grompone, Marcello Domenico; Colarieti, Anna; Salvo, Vincenzo; Cardone, Gianpiero; Catalano, Carlo

    2016-07-01

    The clinical suspicion of local recurrence of prostate cancer after radical treatment is based on the onset of biochemical failure. The use of multiparametric magnetic resonance imaging (MRI) for prostate cancer has increased over recent years, mainly for detection, staging, and active surveillance. However, suspicion of recurrence in the set of biochemical failure is becoming a significant reason for clinicians to request multiparametric MRI. Radiologists should be able to recognize the normal posttreatment MRI findings. Fibrosis and atrophic remnant seminal vesicles (SV) after radical prostatectomy are often found and must be differentiated from local relapse. Moreover, brachytherapy, external beam radiotherapy, and focal therapies tend to diffusely decrease the signal intensity of the peripheral zone on T2-weighted images due to the loss of water content, consequently mimicking tumor and hemorrhage. The combination of T2-weighted images and functional studies like diffusion-weighted imaging and dynamic contrast-enhanced imaging improves the identification of local relapse. Tumor recurrence tends to restrict on diffusion images and avidly enhances after contrast administration. The authors provide a review of the normal findings and the signs of local tumor relapse after radical prostatectomy, external beam radiotherapy, brachytherapy and focal therapies. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. A hybrid strategy of offline adaptive planning and online image guidance for prostate cancer radiotherapy

    NASA Astrophysics Data System (ADS)

    Lei, Yu; Wu, Qiuwen

    2010-04-01

    Offline adaptive radiotherapy (ART) has been used to effectively correct and compensate for prostate motion and reduce the required margin. The efficacy depends on the characteristics of the patient setup error and interfraction motion through the whole treatment; specifically, systematic errors are corrected and random errors are compensated for through the margins. In online image-guided radiation therapy (IGRT) of prostate cancer, the translational setup error and inter-fractional prostate motion are corrected through pre-treatment imaging and couch correction at each fraction. However, the rotation and deformation of the target are not corrected and only accounted for with margins in treatment planning. The purpose of this study was to investigate whether the offline ART strategy is necessary for an online IGRT protocol and to evaluate the benefit of the hybrid strategy. First, to investigate the rationale of the hybrid strategy, 592 cone-beam-computed tomography (CBCT) images taken before and after each fraction for an online IGRT protocol from 16 patients were analyzed. Specifically, the characteristics of prostate rotation were analyzed. It was found that there exist systematic inter-fractional prostate rotations, and they are patient specific. These rotations, if not corrected, are persistent through the treatment fraction, and rotations detected in early fractions are representative of those in later fractions. These findings suggest that the offline adaptive replanning strategy is beneficial to the online IGRT protocol with further margin reductions. Second, to quantitatively evaluate the benefit of the hybrid strategy, 412 repeated helical CT scans from 25 patients during the course of treatment were included in the replanning study. Both low-risk patients (LRP, clinical target volume, CTV = prostate) and intermediate-risk patients (IRP, CTV = prostate + seminal vesicles) were included in the simulation. The contours of prostate and seminal vesicles were

  1. Value of the Hemorrhage Exclusion Sign on T1-weighted Prostate MR Images for the Detection of Prostate Cancer

    PubMed Central

    Barrett, Tristan; Akin, Oguz; Goldman, Debra A.; Hricak, Hedvig

    2012-01-01

    Purpose: To retrospectively determine the prevalence and positive predictive value (PPV) of the hemorrhage exclusion sign on T1-weighted magnetic resonance (MR) images in conjunction with findings on T2-weighted images in the detection of prostate cancer, with use of whole-mount step-section pathologic specimens from prostatectomy as the reference standard. Materials and Methods: The institutional review board approved this retrospective study, which was compliant with HIPAA, and the requirement to obtain informed consent was waived. Two hundred ninety-two patients with biopsy-proved prostate cancer underwent endorectal MR imaging followed by prostatectomy. The hemorrhage exclusion sign was defined as the presence of a well-defined area of low signal intensity surrounded by areas of high signal intensity on T1-weighted images. Two readers independently assessed the presence and extent of postbiopsy changes and the hemorrhage exclusion sign. The presence of a corresponding area of homogeneous low signal intensity on T2-weighted images was also recorded. The prevalence and PPV of the hemorrhage exclusion sign were calculated. Results: Readers 1 and 2 found postbiopsy changes in the peripheral zone in 184 (63%) and 189 (64.7%) of the 292 patients, respectively. In these patients, the hemorrhage exclusion sign was observed in 39 of 184 patients (21.2%) by reader 1 and 36 of 189 patients (19.0%) by reader 2. A corresponding area of homogeneous low signal intensity was seen on T2-weighted images in the same location as the hemorrhage exclusion sign in 23 of 39 patients (59%) by reader 1 and 19 of 36 patients (53%) by reader 2. The PPV of the hemorrhage exclusion sign alone was 56% (22 of 39 patients) for reader 1 and 50% (18 of 36 patients) for reader 2 but increased to 96% (22 of 23 patients) and 95% (18 of 19 patients) when the sign was identified in an area of homogeneous low signal intensity on T2-weighted images. Conclusion: Postbiopsy change is a known pitfall in

  2. Functional magnetic resonance imaging and molecular pathology at the crossroad of the management of early prostate cancer.

    PubMed

    Renard-Penna, Raphaele; Cancel-Tassin, Geraldine; Comperat, Eva; Roupret, Morgan; Mozer, Pierre; Cussenot, Olivier

    2015-07-01

    According to recent reports from randomized studies comparing radical treatment or watchful waiting, the outcome of localized prostate cancer remains uncertain at individual level. It is especially true for the low-risk group (according D'Amico or CAPRA classifications), regarding the individual exposition to overtreatment by radical therapies or the opposite risk of under-treatment with active surveillance. In this review, we describe the available molecular predictor tests and functional MRI, as well as their potential role in the selection of the appropriate treatment for prostate cancer patients. The recent development of functional MRI imaging and clinical practice approval of molecular predictor tests for the assessment of the aggressive prostate cancer have brought new perspectives for the management of localized prostate cancer by active surveillance, focal ablative therapy or radical therapies.

  3. WE-EF-210-07: Development of a Minimally Invasive Photo Acoustic Imaging System for Early Prostate Cancer Detection

    SciTech Connect

    Sano, M; Yousefi, S; Xing, L

    2015-06-15

    Purpose: The objective of this work is to design, implement and characterize a catheter-based ultrasound/photoacoustic imaging probe for early-diagnosis of prostate cancer and to aid in image-guided radiation therapy. Methods: The need to image across 6–10cm of tissue to image the whole prostate gland limits the resolution achievable with a transrectal ultrasound approach. In contrast, the urethra bisects the prostate gland, providing a minimally invasive pathway for deploying a high resolution ultrasound transducer. Utilizing a high-frequency (20MHz) ultrasound/photoacoustic probe, high-resolution structural and molecular imaging of the prostate tissue is possible. A custom 3D printed probe containing a high-frequency single-element ultrasound transducer is utilized. The diameter of the probe is designed to fit inside a Foley catheter and the probe is rotated around the central axis to achieve a circular B-scan. A custom ultrasound amplifier and receiver was set up to trigger the ultrasound pulse transmission and record the reflected signal. The reconstructed images were compared to images generated by traditional 5 MHz ultrasound transducers. Results: The preliminary results using the high-frequency ultrasound probe show that it is possible to resolve finely detailed information in a prostate tissue phantom that was not achievable with previous low-frequency ultrasound systems. Preliminary ultrasound imaging was performed on tissue mimicking phantom and sensitivity and signal-to-noise ratio of the catheter was measured. Conclusion: In order to achieve non-invasive, high-resolution, structural and molecular imaging for early-diagnosis and image-guided radiation therapy of the prostate tissue, a transurethral catheter was designed. Structural/molecular imaging using ultrasound/photoacoustic of the prostate tissue will allow for localization of hyper vascularized areas for early-stage prostate cancer diagnosis.

  4. Screening for prostate cancer

    NASA Technical Reports Server (NTRS)

    Weirich, Stephen A.

    1993-01-01

    Despite recent advances in both the survival and cure rates for many forms of cancer, unfortunately the same has not been true for prostate cancer. In fact, the age-adjusted death rate from prostate cancer has not significantly improved since 1949, and prostate cancer remains the most common cancer in American men, causing the second highest cancer mortality rate. Topics discussed include the following: serum testosterone levels; diagnosis; mortality statistics; prostate-sppecific antigen (PSA) tests; and the Occupational Medicine Services policy at LeRC.

  5. Transrectal high-intensity focused ultrasound ablation of prostate cancer: effective treatment requiring accurate imaging.

    PubMed

    Rouvière, Olivier; Souchon, Rémi; Salomir, Rarès; Gelet, Albert; Chapelon, Jean-Yves; Lyonnet, Denis

    2007-09-01

    Transrectal HIFU ablation has become a reasonable option for the treatment of localized prostate cancer in non-surgical patients, with 5-year disease-free survival similar to that of radiation therapy. It is also a promising salvage therapy of local recurrence after radiation therapy. These favourable results are partly due to recent improvements in prostate cancer imaging. However, further improvements are needed in patient selection, pre-operative localization of the tumor foci, assessment of the volume treated and early detection of recurrence. A better knowledge of the factors influencing the HIFU-induced tissue destruction and a better pre-operative assessment of them by imaging techniques should improve treatment outcome. Whereas prostate HIFU ablation is currently performed under transrectal ultrasound guidance, MR guidance with real-time operative monitoring of temperature will be available in the near future. If this technique will give better targeting and more uniform tissue destruction, its cost-effectiveness will have to be carefully evaluated. Finally, a recently reported synergistic effect between HIFU ablation and chemotherapy opens possibilities for treatment in high-risk or clinically advanced tumors.

  6. Lesion volume predicts prostate cancer risk and aggressiveness: validation of its value alone and matched with prostate imaging reporting and data system score.

    PubMed

    Martorana, Eugenio; Pirola, Giacomo Maria; Scialpi, Michele; Micali, Salvatore; Iseppi, Andrea; Bonetti, Luca Reggiani; Kaleci, Shaniko; Torricelli, Pietro; Bianchi, Giampaolo

    2017-07-01

    To demonstrate the association between magnetic resonance imaging (MRI) estimated lesion volume (LV), prostate cancer detection and tumour clinical significance, evaluating this variable alone and matched with Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) score. We retrospectively analysed 157 consecutive patients, with at least one prior negative systematic prostatic biopsy, who underwent transperineal prostate MRI/ultrasonography fusion-targeted biopsy between January 2014 and February 2016. Suspicious lesions were delineated using a 'region of interest' and the system calculated prostate volume and LV. Patients were divided in groups considering LV (≤0.5, 0.5-1, ≥1 mL) and PI-RADS score (1-5). We considered clinically significant prostate cancer as all cancers with a Gleason score of ≥3 + 4 as suggested by PI-RADS v2. A direct comparison between MRI estimated LV (MRI LV) and histological tumour volume (HTV) was done in 23 patients who underwent radical prostatectomy during the study period. Differences between MRI LV and HTV were assessed using the paired sample t-test. MRI LV and HTV concordance was verified using a Bland-Altman plot. The chi-squared test and logistic and ordinal regression models were used to evaluate difference in frequencies. The MRI LV and PI-RADS score were associated both with prostate cancer detection (both P < 0.001) and with significant prostate cancer detection (P < 0.001 and P = 0.008, respectively). When the two variables were matched, increasing LV increased the risk within each PI-RADS group. Prostate cancer detection was 1.4-times higher for LVs of 0.5-1 mL and 1.8-times higher for LVs of ≥1 mL; significant prostate cancer detection was 2.6-times for LVs of 0.5-1 mL and 4-times for LVs of ≥1 mL. There was a positive correlation between MRI LV and HTV (r = 0.9876, P < 0.001). Finally, Bland-Altman analysis showed that MRI LV was underestimated by 4.2% compared to HTV. Study limitations include its

  7. Echo-Planar Imaging-Based, J-Resolved Spectroscopic Imaging for Improved Metabolite Detection in Prostate Cancer

    DTIC Science & Technology

    2014-10-01

    benign prostatic hyperplasia (BPH), prior-knowledge fitting 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF...H, MacDonald JM, Konety B, Narayan P. Citrate as an in vivo marker to discriminate prostate cancer from benign prostatic hyperplasia and normal... prostatic hyperplasia (BPH) patients and healthy prostates . 3) To develop and further optimize the ProFit algorithm to post- process the multi-dimensional

  8. Contrast-ultrasound dispersion imaging for prostate cancer localization by improved spatiotemporal similarity analysis.

    PubMed

    Kuenen, M P J; Saidov, T A; Wijkstra, H; Mischi, M

    2013-09-01

    Angiogenesis plays a major role in prostate cancer growth. Despite extensive research on blood perfusion imaging aimed at angiogenesis detection, the diagnosis of prostate cancer still requires systematic biopsies. This may be due to the complex relationship between angiogenesis and microvascular perfusion. Analysis of ultrasound-contrast-agent dispersion kinetics, determined by multipath trajectories in the microcirculation, may provide better characterization of the microvascular architecture. We propose the physical rationale for dispersion estimation by an existing spatiotemporal similarity analysis. After an intravenous ultrasound-contrast-agent bolus injection, dispersion is estimated by coherence analysis among time-intensity curves measured at neighbor pixels. The accuracy of the method is increased by time-domain windowing and anisotropic spatial filtering for speckle regularization. The results in 12 patient data sets indicated superior agreement with histology (receiver operating characteristic curve area = 0.88) compared with those obtained by reported perfusion and dispersion analyses, providing a valuable contribution to prostate cancer localization. Copyright © 2013 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  9. Incidental Malignancies identified during staging for Prostate Cancer with (68)Ga -PSMA HBED-CC PET imaging.

    PubMed

    Joshi, Andre; Nicholson, Cheryl; Rhee, Handoo; Gustafson, Sonja; Miles, Ken; Vela, Ian

    2017-03-20

    The rapid uptake of 68Ga Prostate-Specific Membrane Antigen (PSMA) HBED-CC PET imaging for prostate cancer staging has led to concerns regarding its specificity, with uptake in both malignant and non-malignant tissues. We describe three separate malignancies identified on 68Ga PSMA HBED-CC PET imaging. The misnomer of "prostate specific membrane antigen" is demonstrated by this case and highlights the importance of continued investigation of the potential role for 68Ga PSMA HBED-CC PET in other malignancies.

  10. In vivo prostate cancer detection and grading using restriction spectrum imaging-MRI.

    PubMed

    McCammack, K C; Kane, C J; Parsons, J K; White, N S; Schenker-Ahmed, N M; Kuperman, J M; Bartsch, H; Desikan, R S; Rakow-Penner, R A; Adams, D; Liss, M A; Mattrey, R F; Bradley, W G; Margolis, D J A; Raman, S S; Shabaik, A; Dale, A M; Karow, D S

    2016-06-01

    Magnetic resonance imaging (MRI) is emerging as a robust, noninvasive method for detecting and characterizing prostate cancer (PCa), but limitations remain in its ability to distinguish cancerous from non-cancerous tissue. We evaluated the performance of a novel MRI technique, restriction spectrum imaging (RSI-MRI), to quantitatively detect and grade PCa compared with current standard-of-care MRI. In a retrospective evaluation of 33 patients with biopsy-proven PCa who underwent RSI-MRI and standard MRI before radical prostatectomy, receiver-operating characteristic (ROC) curves were performed for RSI-MRI and each quantitative MRI term, with area under the ROC curve (AUC) used to compare each term's ability to differentiate between PCa and normal prostate. Spearman rank-order correlations were performed to assess each term's ability to predict PCa grade in the radical prostatectomy specimens. RSI-MRI demonstrated superior differentiation of PCa from normal tissue, with AUC of 0.94 and 0.85 for RSI-MRI and conventional diffusion MRI, respectively (P=0.04). RSI-MRI also demonstrated superior performance in predicting PCa aggressiveness, with Spearman rank-order correlation coefficients of 0.53 (P=0.002) and -0.42 (P=0.01) for RSI-MRI and conventional diffusion MRI, respectively, with tumor grade. RSI-MRI significantly improves upon current noninvasive PCa imaging and may potentially enhance its diagnosis and characterization.

  11. In vivo prostate cancer detection and grading using restriction spectrum imaging-MRI

    PubMed Central

    McCammack, KC; Kane, CJ; Parsons, JK; White, NS; Schenker-Ahmed, NM; Kuperman, JM; Bartsch, H; Desikan, RS; Rakow-Penner, RA; Adams, D; Liss, MA; Mattrey, RF; Bradley, WG; Margolis, DJA; Raman, SS; Shabaik, A; Dale, AM; Karow, DS

    2017-01-01

    BACKGROUND Magnetic resonance imaging (MRI) is emerging as a robust, noninvasive method for detecting and characterizing prostate cancer (PCa), but limitations remain in its ability to distinguish cancerous from non-cancerous tissue. We evaluated the performance of a novel MRI technique, restriction spectrum imaging (RSI-MRI), to quantitatively detect and grade PCa compared with current standard-of-care MRI. METHODS In a retrospective evaluation of 33 patients with biopsy-proven PCa who underwent RSI-MRI and standard MRI before radical prostatectomy, receiver-operating characteristic (ROC) curves were performed for RSI-MRI and each quantitative MRI term, with area under the ROC curve (AUC) used to compare each term’s ability to differentiate between PCa and normal prostate. Spearman rank-order correlations were performed to assess each term’s ability to predict PCa grade in the radical prostatectomy specimens. RESULTS RSI-MRI demonstrated superior differentiation of PCa from normal tissue, with AUC of 0.94 and 0.85 for RSI-MRI and conventional diffusion MRI, respectively (P = 0.04). RSI-MRI also demonstrated superior performance in predicting PCa aggressiveness, with Spearman rank-order correlation coefficients of 0.53 (P = 0.002) and − 0.42 (P = 0.01) for RSI-MRI and conventional diffusion MRI, respectively, with tumor grade. CONCLUSIONS RSI-MRI significantly improves upon current noninvasive PCa imaging and may potentially enhance its diagnosis and characterization. PMID:26754261

  12. Genetics Home Reference: prostate cancer

    MedlinePlus

    ... Email Facebook Twitter Home Health Conditions prostate cancer prostate cancer Printable PDF Open All Close All Enable Javascript to view the expand/collapse boxes. Description Prostate cancer is a common disease that affects men, usually ...

  13. Hormone therapy for prostate cancer

    MedlinePlus

    ... gov/ency/patientinstructions/000908.htm Hormone therapy for prostate cancer To use the sharing features on this page, ... the growth of prostate cancer. Male Hormones and Prostate Cancer Androgens are male sex hormones. Testosterone is one ...

  14. Imaging of prostate cancer with PET/CT using 18F-Fluorocholine

    PubMed Central

    Vali, Reza; Loidl, Wolfgang; Pirich, Christian; Langesteger, Werner; Beheshti, Mohsen

    2015-01-01

    While 18F-Fluorodeoxyglucose (18F-FDG) Positron-Emission Tomography (PET) has limited value in prostate cancer (PCa), it may be useful for specific subgroups of PCa patients with hormone-resistant poorly differentiated cell types. 18F-Fluorocholine (18F-FCH) PET/CT has been increasingly used in primary and recurrent PCa and has been shown to add valuable information. Although there is a correlation between the foci of activity and the areas of malignancy in the prostate gland, the clinical value of 18F-FCH is still controversial for detection of the malignant focus in the prostate. For the T-staging of PCa at diagnosis the value of 18F-FCH is limited. This is probably due to limited resolution of PET system and positive findings in benign prostate diseases. Conversely, 18F-FCH PET/CT is a promising imaging modality for the delineation of local and distant nodal recurrence and bone metastases and is poised to have an impact on therapy management. In this review, recent studies of 18F-FCH PET/CT in PCa are summarized. PMID:25973332

  15. 1.5-Tesla Multiparametric-Magnetic Resonance Imaging for the detection of clinically significant prostate cancer

    PubMed Central

    POPITA, CRISTIAN; POPITA, ANCA RALUCA; SITAR-TAUT, ADELA; PETRUT, BOGDAN; FETICA, BOGDAN; COMAN, IOAN

    2017-01-01

    Background and aim Multiparametric-magnetic resonance imaging (mp-MRI) is the main imaging modality used for prostate cancer detection. The aim of this study is to evaluate the diagnostic performance of mp-MRI at 1.5-Tesla (1.5-T) for the detection of clinically significant prostate cancer. Methods In this ethical board approved prospective study, 39 patients with suspected prostate cancer were included. Patients with a history of positive prostate biopsy and patients treated for prostate cancer were excluded. All patients were examined at 1.5-T MRI, before standard transrectal ultrasonography–guided biopsy. Results The overall sensitivity, specificity, positive predictive value and negative predictive value for mp-MRI were 100%, 73.68%, 80% and 100%, respectively. Conclusion Our results showed that 1.5 T mp-MRI has a high sensitivity for detection of clinically significant prostate cancer and high negative predictive value in order to rule out significant disease. PMID:28246496

  16. Prostate and Urologic Cancer | Division of Cancer Prevention

    Cancer.gov

    [[{"fid":"183","view_mode":"default","fields":{"format":"default","field_file_image_alt_text[und][0][value]":"Prostate and Urologic Cancer Research Group Homepage Logo","field_file_image_title_text[und][0][value]":"Prostate and Urologic Cancer Research Group Homepage Logo","field_folder[und]":"15"},"type":"media","attributes":{"alt":"Prostate and Urologic Cancer Research Group Homepage Logo","title":"Prostate and Urologic Cancer Research Group Homepage Logo","height":"266","width":"400","clas | Conducts and supports research on the prevention and early detection of prostate, bladder, and skin cancers.

  17. Evaluation of Multimodal Imaging Biomarkers of Prostate Cancer

    DTIC Science & Technology

    2016-11-01

    Biostatistics, Vanderbilt University (5% effort) Zhenbang Chen, Department of Biochemistry and Cancer, Meharry Medical College Wenfu Lu, Department of... Biochemistry and Cancer, Meharry Medical College Figure 9: Representative dynamic PET FMISO data in Pten/p53 tumor and muscle regions of interest. 9

  18. 68Ga-Labeled Inhibitors of Prostate-Specific Membrane antigen (PSMA) for Imaging Prostate Cancer

    PubMed Central

    Banerjee, Sangeeta Ray; Pullambhatla, Mrudula; Byun, Youngjoo; Nimmagadda, Sridhar; Green, Gilbert; Fox, James J.; Horti, Andrew; Mease, Ronnie C.; Pomper, Martin G.

    2012-01-01

    Gallium-68 is a generator-produced radionuclide for positron emission tomography (PET) that is being increasingly used for radiolabeling of tumor-targeting peptides. Compounds [68Ga]3 and [68Ga]6 are high-affinity, urea-based inhibitors of the prostate-specific membrane antigen (PSMA) that were synthesized in decay-uncorrected yields ranging from 60 – 70% and radiochemical purities of more than 99%. Compound [68Ga]3 demonstrated 3.78 ± 0.90 percent injected dose per gram of tissue (%ID/g) within PSMA+ PIP tumor at 30 min post-injection, while [68Ga]6 showed a two hour PSMA+ PIP tumor uptake value of 3.29 ± 0.77%ID/g. Target (PSMA+ PIP) to non-target (PSMA− flu) ratios were 4.6 and 18.3, respectively, at those time points. Both compounds delineated tumor clearly by small animal PET. The urea series of imaging agents for PSMA can be radiolabeled with 68Ga, a cyclotron-free isotope useful for clinical PET studies, with maintenance of target specificity. PMID:20568777

  19. Pathological Gleason prediction through gland ring morphometry in immunofluorescent prostate cancer images

    NASA Astrophysics Data System (ADS)

    Scott, Richard; Khan, Faisal M.; Zeineh, Jack; Donovan, Michael; Fernandez, Gerardo

    2016-03-01

    The Gleason score is the most common architectural and morphological assessment of prostate cancer severity and prognosis. There have been numerous quantitative techniques developed to approximate and duplicate the Gleason scoring system. Most of these approaches have been developed in standard H and E brightfield microscopy. Immunofluorescence (IF) image analysis of tissue pathology has recently been proven to be extremely valuable and robust in developing prognostic assessments of disease, particularly in prostate cancer. There have been significant advances in the literature in quantitative biomarker expression as well as characterization of glandular architectures in discrete gland rings. In this work we leverage a new method of segmenting gland rings in IF images for predicting the pathological Gleason; both the clinical and the image specific grade, which may not necessarily be the same. We combine these measures with nuclear specific characteristics as assessed by the MST algorithm. Our individual features correlate well univariately with the Gleason grades, and in a multivariate setting have an accuracy of 85% in predicting the Gleason grade. Additionally, these features correlate strongly with clinical progression outcomes (CI of 0.89), significantly outperforming the clinical Gleason grades (CI of 0.78). This work presents the first assessment of morphological gland unit features from IF images for predicting the Gleason grade.

  20. 18F-DCFBC Prostate-Specific Membrane Antigen-Targeted PET/CT Imaging in Localized Prostate Cancer: Correlation With Multiparametric MRI and Histopathology.

    PubMed

    Turkbey, Baris; Mena, Esther; Lindenberg, Liza; Adler, Stephen; Bednarova, Sandra; Berman, Rose; Ton, Anita T; McKinney, Yolanda; Eclarinal, Philip; Hill, Craig; Afari, George; Bhattacharyya, Sibaprasad; Mease, Ronnie C; Merino, Maria J; Jacobs, Paula M; Wood, Bradford J; Pinto, Peter A; Pomper, Martin G; Choyke, Peter L

    2017-10-01

    To assess the ability of (N-[N-[(S)-1,3-dicarboxypropyl]carbamoyl]-4-F-fluorobenzyl-L-cysteine) (F-DCFBC), a prostate-specific membrane antigen-targeted PET agent, to detect localized prostate cancer lesions in correlation with multiparametric MRI (mpMRI) and histopathology. This Health Insurance Portability and Accountability Act of 1996-compliant, prospective, institutional review board-approved study included 13 evaluable patients with localized prostate cancer (median age, 62.8 years [range, 51-74 years]; median prostate-specific antigen, 37.5 ng/dL [range, 3.26-216 ng/dL]). Patients underwent mpMRI and F-DCFBC PET/CT within a 3 months' window. Lesions seen on mpMRI were biopsied under transrectal ultrasound/MRI fusion-guided biopsy, or a radical prostatectomy was performed. F-DCFBC PET/CT and mpMRI were evaluated blinded and separately for tumor detection on a lesion basis. For PET image analysis, MRI and F-DCFBC PET images were fused by using software registration; imaging findings were correlated with histology, and uptake of F-DCFBC in tumors was compared with uptake in benign prostatic hyperplasia nodules and normal peripheral zone tissue using the 80% threshold SUVmax. A total of 25 tumor foci (mean size, 1.8 cm; median size, 1.5 cm; range, 0.6-4.7 cm) were histopathologically identified in 13 patients. Sensitivity rates of F-DCFBC PET/CT and mpMRI were 36% and 96%, respectively, for all tumors. For index lesions, the largest tumor with highest Gleason score, sensitivity rates of F-DCFBC PET/CT and mpMRI were 61.5% and 92%, respectively. The average SUVmax for primary prostate cancer was higher (5.8 ± 4.4) than that of benign prostatic hyperplasia nodules (2.1 ± 0.3) or that of normal prostate tissue (2.1 ± 0.4) at 1 hour postinjection (P = 0.0033). The majority of index prostate cancers are detected with F-DCFBC PET/CT, and this may be a prognostic indicator based on uptake and staging. However, for detecting prostate cancer with high sensitivity, it

  1. Active Surveillance of Prostate Cancer: Use, Outcomes, Imaging, and Diagnostic Tools

    PubMed Central

    Tosoian, Jeffrey J; Loeb, Stacy; Epstein, Jonathan I; Turkbey, Baris; Choyke, Peter; Schaeffer, Edward M

    2016-01-01

    Active surveillance (AS) has emerged as a standard management option for men with very low-risk and low-risk prostate cancer, and contemporary data indicate that use of AS is increasing in the United States and abroad. In the favorable-risk population, reports from multiple prospective cohorts indicate a less than 1% likelihood of metastatic disease and prostate cancer-specific mortality over intermediate-term follow-up (median 5 to 6 years). Higher-risk men participating in AS appear to be at increased risk of adverse outcomes, but these populations have not been adequately studied to this point. Although monitoring on AS largely relies on serial prostate biopsy, a procedure associated with significant morbidity, there is a need for improved diagnostic tools for patient selection and monitoring. Revisions from the 2014 International Society of Urologic Pathology consensus conference have yielded a more intuitive reporting system and detailed reporting of low-intermediate grade tumors, which should facilitate the practice of AS. Meanwhile, emerging modalities such as multiparametric magnetic resonance imaging and tissue-based molecular testing have shown prognostic value in some populations. At this time, however, these instruments have not been sufficiently studied to consider their routine, standardized use in the AS setting. Future studies should seek to identify those platforms most informative in the AS population and propose a strategy by which promising diagnostic tools can be safely and efficiently incorporated into clinical practice. PMID:27249729

  2. Robotic mechanical localization of prostate cancer correlates with magnetic resonance imaging scans.

    PubMed

    Shin, Tae Young; Kim, Yeong Jin; Lim, Sey Kiat; Kim, Jung; Rha, Koon Ho

    2013-07-01

    To evaluate the concordance of cancer location of the tissue mapping from a mechanical pressure transducer with magnetic resonance imaging (MRI) scans. A total of 60 indentations were performed on 5 prostate specimens obtained after radical prostatectomy utilizing a robotic indentation system. The mechanical elastic moduli of suspected malignant lesions were calculated and mapped, and their locations were compared with suspicious areas of malignancy on MRI scans. The concordance rate between the location mapping from the robotic indentation system and MRI scans results was 90.0% (54/60). The sensitivity and specificity of the robotic indentation system were 87.9% (29/33) and 92.6% (25/27), respectively. The positive predictive value and negative predictive value were 93.5% (29/31) and 93.1% (27/29), respectively. The locations of malignant lesions derived from our robotic indentation system correlated strongly with the locations of suspected areas of malignancy on MRI scans. Our robotic system may provide a more targeted biopsy of the prostate than conventional non-targeted systemic biopsy, possibly improving the diagnostic accuracy of prostatic biopsies for cancer.

  3. 68Ga-PSMA PET/CT imaging in recurrent prostate cancer: Where are we now?

    PubMed Central

    Mazurek, Andrzej; Dziuk, Mirosław

    2017-01-01

    Introduction Prostate cancer (PCa) is a major health concern worldwide with up to 60% of patients experiencing biochemical relapse after radical treatment. Early diagnosis of PCa recurrence is of high importance for successful salvage therapy. The need for accurate imaging has prompted the introduction of prostate-specific membrane antigen (PSMA)-based radiotracers for positron emission tomography (PET). Material and methods In this review we summarized and discussed the results of the studies analyzing the utility of 68Ga-PSMA PET/CT in patients who experienced a biochemical relapse of prostate cancer. Results PSMA-based PET scans have been proved to provide a superior diagnostic performance over other modalities for localization of the site of early PCa recurrence. 68Ga-PSMA has been also shown to have a higher sensitivity and specificity than other established PET radiotracers such as radiocholines. Conclusions The early studies show promising results and support the use of 68Ga-PSMA for PCa restaging. However, the number of studies concerning the utility of 68Ga-PSMA PET in the context of secondary PCa staging is limited and there is still a considerable scope for further research in this field. PMID:28461986

  4. Performance of multiparametric magnetic resonance imaging in the evaluation and management of clinically low-risk prostate cancer

    PubMed Central

    Dianat, Seyed Saeid; Carter, H. Ballentine; Macura, Katarzyna J.

    2014-01-01

    Objective The purpose of this article is to review the multiparametric magnetic resonance imaging (mMRI) of the prostate and MR-guided prostate biopsy, and their role in the evaluation and management of men with low-risk prostate cancer. Methods We performed a literature review based on the MEDLINE database search for publications on the role of mMRI (a) in detection and localization of prostate cancer, prediction of tumor aggressiveness and progression and (b) in guiding targeted prostate biopsy. Results The mMRI, particularly diffusion-weighted imaging with T2-weighted imaging, is a useful tool for tumor localization in low-risk prostate cancer as it can detect lesions that are more likely missed on extended biopsy schemes and can identify clinically significant disease requiring definitive treatment. The MR-guided biopsy of the most suspicious lesions enables more accurate and safer approach to guide enrollment into the active surveillance program. However, the MR-guided biopsy is complex. The fusion of MRI data with transrectal ultrasound for the purpose of biopsy provides a more feasible technique with documented accurate sampling. Conclusion Although the mMRI is not routinely used for risk stratification and prognostic assessment in prostate cancer, it can provide valuable information to guide management of men with low-risk disease. Incorporation of mMRI into the workup and monitoring of patients with low-risk prostate cancer can help discriminate clinically significant disease from indolent disease. Targeted biopsy of MR-suspicious lesions enables accurate sampling of potentially aggressive tumors that may affect outcomes. PMID:23787297

  5. Evaluation of Multimodal Imaging Biomarkers of Prostate Cancer

    DTIC Science & Technology

    2014-09-01

    scan duration ~ 21 min). PET imaging was performed on a Concorde Microsystems microPET Focus 220. Approximately 120 uCi of tracer was administered...acquired anatomic MRI and PET data in orthotopic tumors within the Pten/p53 mouse model, to assess tumor volume, track growth and tumor angiogenesis...In fic speciregards to PET imaging, we have further characterized the use of FMISO, FDHT and TSPO imaging to evaluate tumor hypoxia, androgen

  6. Selenoproteins and Prostate Cancer

    DTIC Science & Technology

    2006-11-01

    W81XWH-05-1-0009 TITLE: Selenoproteins and Prostate Cancer PRINCIPAL INVESTIGATOR: Veda Diwadkar-Navsariwala, Ph.D. CONTRACTING...From - To) 14 Oct 2004 – 14 Oct 2006 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Selenoproteins and Prostate Cancer 5b. GRANT NUMBER W81XWH-05...SUPPLEMENTARY NOTES 14. ABSTRACT For this postdoctoral fellowship the specific role of selenoproteins (SP) in prostate cancer (PCa) was

  7. Prostate-specific membrane antigen targeted protein contrast agents for molecular imaging of prostate cancer by MRI†

    PubMed Central

    Pu, Fan; Salarian, Mani; Xue, Shenghui; Qiao, Jingjuan; Feng, Jie; Tan, Shanshan; Patel, Anvi; Li, Xin; Mamouni, Kenza; Hekmatyar, Khan; Zou, Juan; Wu, Daqing

    2017-01-01

    Prostate-specific membrane antigen (PSMA) is one of the most specific cell surface markers for prostate cancer diagnosis and targeted treatment. However, achieving molecular imaging using non-invasive MRI with high resolution has yet to be achieved due to the lack of contrast agents with significantly improved relaxivity for sensitivity, targeting capabilities and metal selectivity. We have previously reported our creation of a novel class of protein Gd3+ contrast agents, ProCA32, which displayed significantly improved relaxivity while exhibiting strong Gd3+ binding selectivity over physiological metal ions. In this study, we report our effort in further developing biomarker-targeted protein MRI contrast agents for molecular imaging of PSMA. Among three PSMA targeted contrast agents engineered with addition of different molecular recognition sequences, ProCA32.PSMA exhibits a binding affinity of 1.1 ± 0.1 μM for PSMA while the metal binding affinity is maintained at 0.9 ± 0.1 × 10−22 M. In addition, ProCA32.PSMA exhibits r1 of 27.6 mM−1 s−1 and r2 of 37.9 mM−1 s−1 per Gd (55.2 and 75.8 mM−1 s−1 per molecule r1 and r2, respectively) at 1.4 T. At 7 T, ProCA32.PSMA also has r2 of 94.0 mM−1 s−1 per Gd (188.0 mM−1 s−1 per molecule) and r1 of 18.6 mM−1 s−1 per Gd (37.2 mM−1 s−1 per molecule). This contrast capability enables the first MRI enhancement dependent on PSMA expression levels in tumor bearing mice using both T1 and T2-weighted MRI at 7 T. Further development of these PSMA-targeted contrast agents are expected to be used for the precision imaging of prostate cancer at an early stage and to monitor disease progression and staging, as well as determine the effect of therapeutic treatment by non-invasive evaluation of the PSMA level using MRI. PMID:26961235

  8. Ultrasound Activated Contrast Imaging for Prostate Cancer Detection

    DTIC Science & Technology

    2007-03-01

    Goldberg. Nonlinear imaging with a new contrast agent. Ultrasound Med Biol, vol. 29, pp. S97, 2003. R. J. Ro, F. Forsberg, M. Knauer, W. T. Shi, P. A ... Lewin , R. Bernardi. On the temperature and concentration dependency of excitation-enhanced imaging. Proc Biomed Eng Soc Ann Fall Meetg, abstract no

  9. Prostate Cancer: Can Multiparametric MR Imaging Help Identify Patients Who Are Candidates for Active Surveillance?

    PubMed Central

    Turkbey, Baris; Mani, Haresh; Aras, Omer; Ho, Jennifer; Hoang, Anthony; Rastinehad, Ardeshir R.; Agarwal, Harsh; Shah, Vijay; Bernardo, Marcelino; Pang, Yuxi; Daar, Dagane; McKinney, Yolanda L.; Linehan, W. Marston; Kaushal, Aradhana; Merino, Maria J.; Wood, Bradford J.; Pinto, Peter A.

    2013-01-01

    Purpose: To determine whether multiparametric magnetic resonance (MR) imaging can help identify patients with prostate cancer who would most appropriately be candidates for active surveillance (AS) according to current guidelines and to compare the results with those of conventional clinical assessment scoring systems, including the D’Amico, Epstein, and Cancer of the Prostate Risk Assessment (CAPRA) systems, on the basis of findings at prostatectomy. Materials and Methods: This institutional review board–approved HIPAA-compliant retrospectively designed study included 133 patients (mean age, 59.3 years) with a mean prostate-specific antigen level of 6.73 ng/mL (median, 4.39 ng/mL) who underwent multiparametric MR imaging at 3.0 T before radical prostatectomy. Informed consent was obtained from all patients. Patients were then retrospectively classified as to whether they would have met AS eligibility criteria or were better served by surgery. AS eligibility criteria for prostatectomy specimens were a dominant tumor smaller than 0.5 mL without Gleason 4 or 5 patterns or extracapsular or seminal vesicle invasion. Conventional clinical assessment scores (the D’Amico, Epstein, and CAPRA scoring systems) were compared with multiparametric MR imaging findings for predicting AS candidates. The level of significance of difference between scoring systems was determined by using the χ2 test for categoric variables with the level of significance set at P < .05. Results: Among 133 patients, 14 were eligible for AS on the basis of prostatectomy results. The sensitivity, positive predictive value (PPV), and overall accuracy, respectively, were 93%, 25%, and 70% for the D’Amico system, 64%, 45%, and 88% for the Epstein criteria, and 93%, 20%, and 59% for the CAPRA scoring system for predicting AS candidates (P < .005 for all, χ2 test), while multiparametric MR imaging had a sensitivity of 93%, a PPV of 57%, and an overall accuracy of 92% (P < .005). Conclusion

  10. New frontiers in prostate cancer imaging: clinical utility of prostate-specific membrane antigen positron emission tomography.

    PubMed

    Afaq, Asim; Batura, Deepak; Bomanji, Jamshed

    2017-02-14

    Prostate-specific membrane antigen positron emission tomography (PSMA PET) is a relatively new method of imaging prostate cancer that increases diagnostic accuracy in detecting and guiding management in various stages of the disease pathway. Gallium-68-labelled PSMA PET has increased the sensitivity of detection of disease recurrence at low PSA levels, thus allowing an optimal window for salvage treatment. Apart from its use in disease recurrence, PSMA PET has the potential for increasing sensitivity and specificity for primary tumour localisation and in detecting lymph node disease, leading to a more accurate initial staging of the condition. In advanced disease, the use of PSMA PET may be able to assess response to treatment and also guide treatment with radionuclide therapy. Newer ligands under development might provide avenues for theranostic or personalised therapy applications with early data showing high PSA response rates. The rate of translation of PSMA PET into clinical practice has been remarkable. The use of this modality is likely to increase with future efforts to modify the radiotracer including (18)F labelling to improve availability.

  11. Imaging prostate cancer invasion with multi-nuclear magnetic resonance methods: the Metabolic Boyden Chamber.

    PubMed

    Pilatus, U; Ackerstaff, E; Artemov, D; Mori, N; Gillies, R J; Bhujwalla, Z M

    2000-01-01

    The physiological milieu within solid tumors can influence invasion and metastasis. To determine the impact of the physiological environment and cellular metabolism on cancer cell invasion, it is necessary to measure invasion during well-controlled modulation of the physiological environment. Recently, we demonstrated that magnetic resonance imaging can be used to monitor cancer cell invasion into a Matrigel layer [Artemov D, Pilatus U, Chou S, Mori N, Nelson JB, and Bhujwalla ZM (1999). Dynamics of prostate cancer cell invasion studied in vitro by NMR microscopy. Mag Res Med 42, 277-282.]. Here we have developed an invasion assay ("Metabolic Boyden Chamber") that combines this capability with the properties of our isolated cell perfusion system. Long-term experiments can be performed to determine invasion as well as cellular metabolism under controlled environmental conditions. To characterize the assay, we performed experiments with prostate cancer cell lines preselected for different invasive characteristics. The results showed invasion into, and degradation of the Matrigel layer, by the highly invasive/metastatic line (MatLyLu), whereas no significant changes were observed for the less invasive/metastatic cell line (DU-145). With this assay, invasion and metabolism was measured dynamically, together with oxygen tensions within the cellular environment and within the Matrigel layer. Such a system can be used to identify physiological and metabolic characteristics that promote invasion, and evaluate therapeutic interventions to inhibit invasion.

  12. Imaging Prostate Cancer Invasion with Multi-Nuclear Magnetic Resonance Methods: The Metabolic Boyden Chamber1

    PubMed Central

    Pilatus, Ulrich; Ackerstaff, Ellen; Artemov, Dmitri; Mori, Noriko; Gillies, Robert J; Bhujwalla, Zaver M

    2000-01-01

    Abstract The physiological milieu within solid tumors can influence invasion and metastasis. To determine the impact of the physiological environment and cellular metabolism on cancer cell invasion, it is necessary to measure invasion during well-controlled modulation of the physiological environment. Recently, we demonstrated that magnetic resonance imaging can be used to monitor cancer cell invasion into a Matrigel layer [Artemov D, Pilatus U, Chou S, Mori N, Nelson JB, and Bhujwalla ZM (1999). Dynamics of prostate cancer cell invasion studied in vitro by NMR microscopy. Mag Res Med 42, 277–282.]. Here we have developed an invasion assay (“Metabolic Boyden Chamber”) that combines this capability with the properties of our isolated cell perfusion system. Long-term experiments can be performed to determine invasion as well as cellular metabolism under controlled environmental conditions. To characterize the assay, we performed experiments with prostate cancer cell lines preselected for different invasive characteristics. The results showed invasion into, and degradation of the Matrigel layer, by the highly invasive/metastatic line (MatLyLu), whereas no significant changes were observed for the less invasive/metastatic cell line (DU-145). With this assay, invasion and metabolism was measured dynamically, together with oxygen tensions within the cellular environment and within the Matrigel layer. Such a system can be used to identify physiological and metabolic characteristics that promote invasion, and evaluate therapeutic interventions to inhibit invasion. PMID:10935513

  13. Lipids and Prostate Cancer

    PubMed Central

    Suburu, Janel; Chen, Yong Q.

    2012-01-01

    The role of lipid metabolism has gained particular interest in prostate cancer research. A large body of literature has outlined the unique upregulation of de novo lipid synthesis in prostate cancer. Concordant with this lipogenic phenotype is a metabolic shift, in which cancer cells use alternative enzymes and pathways to facilitate the production of fatty acids. These newly synthesized lipids may support a number of cellular processes to promote cancer cell proliferation and survival. Hence, de novo lipogenesis is under intense investigation as a therapeutic target. Epidemiologic studies suggest dietary fat may also contribute to prostate cancer; however, whether dietary lipids and de novo synthesized lipids are differentially metabolized remains unclear. Here, we highlight the lipogenic nature of prostate cancer, especially the promotion of de novo lipid synthesis, and the significance of various dietary lipids in prostate cancer development and progression. PMID:22503963

  14. In vivo imaging of prostate cancer using an anti-PSMA scFv fragment as a probe

    PubMed Central

    Mazzocco, Claire; Fracasso, Giulio; Germain-Genevois, Coralie; Dugot-Senant, Nathalie; Figini, Mariangela; Colombatti, Marco; Grenier, Nicolas; Couillaud, Franck

    2016-01-01

    We aimed to evaluate a fluorescent-labeled single chain variable fragment (scFv) of the anti-PSMA antibody as a specific probe for the detection of prostate cancer by in vivo fluorescence imaging. An orthotopic model of prostate cancer was generated by injecting LNCaP cells into the prostate lobe. ScFvD2B, a high affinity anti-PSMA antibody fragment, was labeled using a near-infrared fluorophore to generate a specific imaging probe (X770-scFvD2B). PSMA-unrelated scFv-X770 was used as a control. Probes were injected intravenously into mice with prostate tumors and fluorescence was monitored in vivo by fluorescence molecular tomography (FMT). In vitro assays showed that X770-scFvD2B specifically bound to PSMA and was internalized in PSMA-expressing LNCaP cells. After intravenous injection, X770-scFvD2B was detected in vivo by FMT in the prostate region. On excised prostates the scFv probe co-localized with the cancer cells and was found in PSMA-expressing cells. The PSMA-unrelated scFv used as a control did not label the prostate cancer cells. Our data demonstrate that scFvD2B is a high affinity contrast agent for in vivo detection of PSMA-expressing cells in the prostate. NIR-labeled scFvD2B could thus be further developed as a clinical probe for imaging-guided targeted biopsies. PMID:26996325

  15. A high-affinity, high-stability photoacoustic agent for imaging gastrin-releasing peptide receptor in prostate cancer.

    PubMed

    Levi, Jelena; Sathirachinda, Ataya; Gambhir, Sanjiv S

    2014-07-15

    To evaluate the utility of targeted photoacoustic imaging (PAI) in providing molecular information to complement intrinsic functional and anatomical details of the vasculature within prostate lesion. We developed a PAI agent, AA3G-740, that targets gastrin-releasing peptide receptor (GRPR), found to be highly overexpressed in prostate cancer. The binding specificity of the agent was evaluated in human prostate cancer cell lines, PC3 and LNCaP, and antagonist properties determined by cell internalization and intracellular calcium mobilization studies. The imaging sensitivity was assessed for the agent itself and for the PC3 cells labeled with agent. The in vivo stability of the agent was determined in human plasma and in the blood of living mice. The in vivo binding of the agent was evaluated in PC3 prostate tumor models in mice, and was validated ex vivo by optical imaging. AA3G-740 demonstrated strong and specific binding to GRPR. The sensitivity of detection in vitro indicated suitability of the agent to image very small lesions. In mice, the agent was able to bind to GRPR even in poorly vascularized tumors leading to nearly 2-fold difference in photoacoustic signal relative to the control agent. The ability to image both vasculature and molecular profile outside the blood vessels gives molecular PAI a unique advantage over currently used imaging techniques. The imaging method presented here can find application both in diagnosis and in image-guided biopsy. ©2014 American Association for Cancer Research.

  16. Prostate Cancer

    MedlinePlus

    ... cancers that don't respond to hormone therapy. Biological therapy Biological therapy (immunotherapy) uses your body's immune system to fight cancer cells. One type of biological therapy called sipuleucel-T (Provenge) has been developed ...

  17. Tuberculous prostatitis: mimicking a cancer

    PubMed Central

    Aziz, El Majdoub; Abdelhak, Khallouk; Hassan, Farih Moulay

    2016-01-01

    Genitourinary tuberculosis is a common type of extra-pulmonary tuberculosis . The kidneys, ureter, bladder or genital organs are usually involved. Tuberculosis of the prostate has mainly been described in immune-compromised patients. However, it can exceptionally be found as an isolated lesion in immune-competent patients. Tuberculosis of the prostate may be difficult to differentiate from carcinoma of the prostate and the chronic prostatitis when the prostate is hard and nodular on digital rectal examination and the urine is negative for tuberculosis bacilli. In many cases, a diagnosis of tuberculous prostatitis is made by the pathologist, or the disease is found incidentally after transurethral resection. Therefore, suspicion of tuberculous prostatitis requires a confirmatory biopsy of the prostate. We report the case of 60-year-old man who presented a low urinary tract syndrome. After clinical and biological examination, and imaging, prostate cancer was highly suspected. Transrectal needle biopsy of the prostate was performed and histological examination showed tuberculosis lesions. PMID:28292092

  18. Localized Prostate Cancer Detection with 18F FACBC PET/CT: Comparison with MR Imaging and Histopathologic Analysis

    PubMed Central

    Mena, Esther; Shih, Joanna; Pinto, Peter A.; Merino, Maria J.; Lindenberg, Maria L.; Bernardo, Marcelino; McKinney, Yolanda L.; Adler, Stephen; Owenius, Rikard; Choyke, Peter L.; Kurdziel, Karen A.

    2014-01-01

    Purpose To characterize uptake of 1-amino-3-fluorine 18-fluorocyclobutane-1-carboxylic acid (18F FACBC) in patients with localized prostate cancer, benign prostatic hyperplasia (BPH), and normal prostate tissue and to evaluate its potential utility in delineation of intraprostatic cancers in histopathologically confirmed localized prostate cancer in comparison with magnetic resonance (MR) imaging. Materials and Methods Institutional review board approval and written informed consent were obtained for this HIPAA-compliant prospective study. Twenty-one men underwent dynamic and static abdominopelvic 18F FACBC combined positron emission tomography (PET) and computed tomography (CT) and multiparametric (MP) 3-T endorectal MR imaging before robotic-assisted prostatectomy. PET/CT and MR images were coregistered by using pelvic bones as fiducial markers; this was followed by manual adjustments. Whole-mount histopathologic specimens were sliced with an MR-based patient-specific mold. 18F FACBC PET standardized uptake values (SUVs) were compared with those at MR imaging and histopathologic analysis for lesion- and sector-based (20 sectors per patient) analysis. Positive and negative predictive values for each modality were estimated by using generalized estimating equations with logit link function and working independence correlation structure. Results 18F FACBC tumor uptake was rapid but reversible. It peaked 3.6 minutes after injection and reached a relative plateau at 15–20 minutes (SUVmax[15–20min]). Mean prostate tumor SUVmax(15–20min) was significantly higher than that of the normal prostate (4.5 ± 0.5 vs 2.7 ± 0.5) (P < .001); however, it was not significantly different from that of BPH (4.3 ± 0.6) (P = .27). Sector-based comparison with histopathologic analysis, including all tumors, revealed sensitivity and specificity of 67% and 66%, respectively, for 18F FACBC PET/CT and 73% and 79%, respectively, for T2-weighted MR imaging. 18F FACBC PET/CT and MP MR

  19. Feasibility of Prostate Cancer Diagnosis by Transrectal Photoacoustic Imaging

    DTIC Science & Technology

    2014-05-01

    and Imaging, John Wiley & Sons (2007). 7. S. Telenkov, A. Mandelis, B. Lashkari, and M. Forcht, “Frequency-domain photothermoacoustics...2009). 31. R. Nachabé, D. J. Evers, B. H. Hendriks, G. W. Lucassen, M. van der Voort, E. J. Rutgers, M. J. Peeters , J. A. Van der Hage, H. S

  20. J-aggregate Nanoparticles as Photoacoustic Contrast Agents for Prostate Cancer Imaging

    NASA Astrophysics Data System (ADS)

    Shakiba, Mojdeh

    Management of early stage prostate cancer (PCa) is plagued with the dilemma between active surveillance that risks progression, and aggressive treatments of potentially indolent disease that significantly reduces quality of life. This results from the inability of current diagnostic techniques to accurately distinguish between indolent and aggressive disease, which has resulted in overtreatment of PCa. Photoacoutic imaging allows for imaging of specific molecular constituents in tissue. To enable for its use in PCa imaging, we designed a novel organic nanoparticle that combines the unique spectral properties and efficient photon capture of nature's photosynthetic apparatus with the stable and specific delivery offered by nanoparticles. These Jaggregate nanoparticles are shown to produce an intense, narrow photo acoustic signal and to have nanoparticle-dependent photonic properties that enable for assessment of the state of the particle. Preliminary assessment of their use in an orthotopic PCa model showed accumulation in and delineation of the tumor boundary.

  1. Prostate-specific membrane antigen targeted protein contrast agents for molecular imaging of prostate cancer by MRI

    NASA Astrophysics Data System (ADS)

    Pu, Fan; Salarian, Mani; Xue, Shenghui; Qiao, Jingjuan; Feng, Jie; Tan, Shanshan; Patel, Anvi; Li, Xin; Mamouni, Kenza; Hekmatyar, Khan; Zou, Juan; Wu, Daqing; Yang, Jenny J.

    2016-06-01

    Prostate-specific membrane antigen (PSMA) is one of the most specific cell surface markers for prostate cancer diagnosis and targeted treatment. However, achieving molecular imaging using non-invasive MRI with high resolution has yet to be achieved due to the lack of contrast agents with significantly improved relaxivity for sensitivity, targeting capabilities and metal selectivity. We have previously reported our creation of a novel class of protein Gd3+ contrast agents, ProCA32, which displayed significantly improved relaxivity while exhibiting strong Gd3+ binding selectivity over physiological metal ions. In this study, we report our effort in further developing biomarker-targeted protein MRI contrast agents for molecular imaging of PSMA. Among three PSMA targeted contrast agents engineered with addition of different molecular recognition sequences, ProCA32.PSMA exhibits a binding affinity of 1.1 +/- 0.1 μM for PSMA while the metal binding affinity is maintained at 0.9 +/- 0.1 × 10-22 M. In addition, ProCA32.PSMA exhibits r1 of 27.6 mM-1 s-1 and r2 of 37.9 mM-1 s-1 per Gd (55.2 and 75.8 mM-1 s-1 per molecule r1 and r2, respectively) at 1.4 T. At 7 T, ProCA32.PSMA also has r2 of 94.0 mM-1 s-1 per Gd (188.0 mM-1 s-1 per molecule) and r1 of 18.6 mM-1 s-1 per Gd (37.2 mM-1 s-1 per molecule). This contrast capability enables the first MRI enhancement dependent on PSMA expression levels in tumor bearing mice using both T1 and T2-weighted MRI at 7 T. Further development of these PSMA-targeted contrast agents are expected to be used for the precision imaging of prostate cancer at an early stage and to monitor disease progression and staging, as well as determine the effect of therapeutic treatment by non-invasive evaluation of the PSMA level using MRI.Prostate-specific membrane antigen (PSMA) is one of the most specific cell surface markers for prostate cancer diagnosis and targeted treatment. However, achieving molecular imaging using non-invasive MRI with high

  2. [Prostate cancer screening].

    PubMed

    Villers, Arnauld; Rébillard, Xavier; Soulié, Michel; Davin, Jean-Louis; Coloby, Patrick; Moreau, Jean-Luc; Mejean, Arnaud; Irani, Jacques; Coulange, Christian; Mangin, Philippe

    2003-04-01

    Prostate cancer has become the most frequent cancer and the second cause of cancer mortality in men. This public health problem is becoming increasingly important due to the increasing life expectancy. At the present time, prostate cancer will be discovered in one in every eight men during their lifetime. Prostate cancer represents 25% of all new cases of male cancers. Prostate cancer screening is designed to detect early stage, asymptomatic prostate cancer, as the patient's chances of cure are higher when the cancer is diagnosed at an early stage. The conclusions of the ANAES evaluation in 1998 did not recommend mass screening for prostate cancer. Several international prospective randomized studies based on serum PSA assay, sometimes associated with digital rectal examination, are currently underway. France is participating in the European ERSPC study (European Randomized Study of Screening for Cancer Prostate) and is organizing a national study on high-risk populations. While waiting for the final results of these studies, a recommendation needs to be proposed to inform general practitioners and specialists about optimal use of the currently available tests. Based on the conclusions of its oncology committee (composed of urologists, medical oncologists, radiotherapists, pathologists and radiologists), the Association Française d'Urologie proposes a recommendation concerning prostate cancer screening and defines its modalities, especially concerning the target population, screening tests and the information given to men before screening. The Association Française d'Urologie recommends prostate cancer screening by PSA assay (prostate specific antigen) and digital rectal examination annually between the ages of 50 and 75 years, and from the age of 45 years in men with a family or ethnic risk. If total PSA is above the normal value of the test or if digital rectal examination is abnormal, referral to a urologist is recommended. Information concerning the limits

  3. Phosphoramidate-based Peptidomimetic Prostate Cancer PET Imaging Agents

    DTIC Science & Technology

    2013-07-01

    develop a PET imaging agent based on modifying the peptidomimetic PSMA inhibitor which will result in improved tumor uptake and clearance mechanism...Different fluorination approaches were attempted with PSMA module compounds such as direct labeling, cupper free chemistry and the use of...labeling approaches are established, and then the labeling of the modified PSMA inhibitor analogues will be investigated in vitro as well as in vivo. 15

  4. Phosphoramidate-based Peptidomimetic Prostate Cancer PET Imaging Agents

    DTIC Science & Technology

    2013-11-01

    goal is to develop a PET imaging agent based on modifying the peptidomimetic PSMA inhibitor which will result in improved tumor uptake and clearance...mechanism. Different fluorination approaches were attempted with PSMA module compounds such as direct labeling, cupper free chemistry and the use of...the labeling approaches are established, and then the labeling of the modified PSMA inhibitor analogues will be investigated in vitro as well as in

  5. Ultrasound Activated Contrast Imaging for Prostate Cancer Detection

    DTIC Science & Technology

    2006-03-01

    539-550, 2005. F. Forsberg, W. T. Shi, M. M. Knauer, A. L. Hall, C. Vecchio, R. Bernardi . Real time excitation enhanced ultrasound contrast...simulations. Ultrasonics, 32:447-453, 1994. 5. Shi WT, Forsberg F, Bautista R, Vecchio C, Bernardi R, Goldberg BB. Image enhancement by acoustic...Phys. Fluids, 17:100603 – 100603-8, 2005. 10. Forsberg F, Shi WT, Knauer MM, Hall AL, Vecchio C, Bernardi R. Real time excitation enhanced

  6. An imaging agent to detect androgen receptor and its active splice variants in prostate cancer

    PubMed Central

    Imamura, Yusuke; Tien, Amy H.; Pan, Jinhe; Leung, Jacky K.; Banuelos, Carmen A.; Jian, Kunzhong; Wang, Jun; Mawji, Nasrin R.; Fernandez, Javier Garcia; Lin, Kuo-Shyan; Andersen, Raymond J.; Sadar, Marianne D.

    2016-01-01

    Constitutively active splice variants of androgen receptor (AR-Vs) lacking ligand-binding domain (LBD) are a mechanism of resistance to androgen receptor LBD–targeted (AR LBD–targeted) therapies for metastatic castration-resistant prostate cancer (CRPC). There is a strong unmet clinical need to identify prostate cancer patients with AR-V–positive lesions to determine whether they will benefit from further AR LBD–targeting therapies or should receive taxanes or investigational drugs like EPI-506 or galeterone. Both EPI-506 (NCT02606123) and galeterone (NCT02438007) are in clinical trials and are proposed to have efficacy against lesions that are positive for AR-Vs. AR activation function-1 (AF-1) is common to the N-terminal domains of full-length AR and AR-Vs. Here, we provide proof of concept for developing imaging compounds that directly bind AR AF-1 to detect both AR-Vs and full-length AR. 123I-EPI-002 had specific binding to AR AF-1, which enabled direct visualization of CRPC xenografts that express full-length AR and AR-Vs. Our findings highlight the potential of 123I-EPI-002 as an imaging agent for the detection of full-length AR and AR-Vs in CRPC. PMID:27525313

  7. Prediction of prostate cancer recurrence using quantitative phase imaging: Validation on a general population

    PubMed Central

    Sridharan, Shamira; Macias, Virgilia; Tangella, Krishnarao; Melamed, Jonathan; Dube, Emily; Kong, Max Xiangtian; Kajdacsy-Balla, André; Popescu, Gabriel

    2016-01-01

    Prediction of biochemical recurrence risk of prostate cancer following radical prostatectomy is critical for determining whether the patient would benefit from adjuvant treatments. Various nomograms exist today for identifying individuals at higher risk for recurrence; however, an optimistic under-estimation of recurrence risk is a common problem associated with these methods. We previously showed that anisotropy of light scattering measured using quantitative phase imaging, in the stromal layer adjacent to cancerous glands, is predictive of recurrence. That nested-case controlled study consisted of specimens specifically chosen such that the current prognostic methods fail. Here we report on validating the utility of optical anisotropy for prediction of prostate cancer recurrence in a general population of 192 patients, with 17% probability of recurrence. Our results show that our method can identify recurrent cases with 73% sensitivity and 72% specificity, which is comparable to that of CAPRA-S, a current state of the art method, in the same population. However, our results show that optical anisotropy outperforms CAPRA-S for patients with Gleason grades 7–10. In essence, we demonstrate that anisotropy is a better biomarker for identifying high-risk cases, while Gleason grade is better suited for selecting non-recurrence. Therefore, we propose that anisotropy and current techniques be used together to maximize prediction accuracy. PMID:27658807

  8. Prediction of prostate cancer recurrence using quantitative phase imaging: Validation on a general population

    NASA Astrophysics Data System (ADS)

    Sridharan, Shamira; Macias, Virgilia; Tangella, Krishnarao; Melamed, Jonathan; Dube, Emily; Kong, Max Xiangtian; Kajdacsy-Balla, André; Popescu, Gabriel

    2016-09-01

    Prediction of biochemical recurrence risk of prostate cancer following radical prostatectomy is critical for determining whether the patient would benefit from adjuvant treatments. Various nomograms exist today for identifying individuals at higher risk for recurrence; however, an optimistic under-estimation of recurrence risk is a common problem associated with these methods. We previously showed that anisotropy of light scattering measured using quantitative phase imaging, in the stromal layer adjacent to cancerous glands, is predictive of recurrence. That nested-case controlled study consisted of specimens specifically chosen such that the current prognostic methods fail. Here we report on validating the utility of optical anisotropy for prediction of prostate cancer recurrence in a general population of 192 patients, with 17% probability of recurrence. Our results show that our method can identify recurrent cases with 73% sensitivity and 72% specificity, which is comparable to that of CAPRA-S, a current state of the art method, in the same population. However, our results show that optical anisotropy outperforms CAPRA-S for patients with Gleason grades 7–10. In essence, we demonstrate that anisotropy is a better biomarker for identifying high-risk cases, while Gleason grade is better suited for selecting non-recurrence. Therefore, we propose that anisotropy and current techniques be used together to maximize prediction accuracy.

  9. Initial Evaluation of [18F]DCFPyL for Prostate-Specific Membrane Antigen (PSMA)-Targeted PET Imaging of Prostate Cancer

    PubMed Central

    Szabo, Zsolt; Mena, Esther; Rowe, Steven P.; Plyku, Donika; Nidal, Rosa; Eisenberger, Mario A.; Antonarakis, Emmanuel S.; Fan, Hong; Dannals, Robert F.; Chen, Ying; Mease, Ronnie C.; Vranesic, Melin; Bhatnagar, Akrita; Sgouros, George; Cho, Steve Y.; Pomper, Martin G.

    2015-01-01

    Purpose Prostate-specific membrane antigen (PSMA) is a recognized target for imaging prostate cancer. Here we present initial safety, biodistribution, and radiation dosimetry results with [18F]DCFPyL, a second-generation fluorine-18-labeled small-molecule PSMA inhibitor, in patients with prostate cancer. Procedures Biodistribution was evaluated using sequential positron-emission tomography (PET) scans in nine patients with prostate cancer. Time-activity curves from the most avid tumor foci were determined. The radiation dose to selected organs was estimated using OLINDA/EXM. Results No major radiotracer-specific adverse events were observed. Physiologic accumulation was observed in known sites of PSMA expression. Accumulation in putative sites of prostate cancer was observed (SUVmax up to >100, and tumor-to-blood ratios up to >50). The effective radiation dose from [18F]DCFPyL was 0.0139 mGy/MBq or 5 mGy (0.5 rem) from an injected dose of 370 MBq (10 mCi). Conclusions [18F]DCFPyL is safe with biodistribution as expected, and its accumulation is high in presumed primary and metastatic foci. The radiation dose from [18F]DCFPyL is similar to that from other PET radiotracers. PMID:25896814

  10. 64Cu-Labeled Inhibitors of Prostate-Specific Membrane Antigen for PET Imaging of Prostate Cancer

    PubMed Central

    2015-01-01

    Prostate-specific membrane antigen (PSMA) is a well-recognized target for identification and therapy of a variety of cancers. Here we report five 64Cu-labeled inhibitors of PSMA, [64Cu]3–7, which are based on the lysine–glutamate urea scaffold and utilize a variety of macrocyclic chelators, namely NOTA(3), PCTA(4), Oxo-DO3A(5), CB-TE2A(6), and DOTA(7), in an effort to determine which provides the most suitable pharmacokinetics for in vivo PET imaging. [64Cu]3–7 were prepared in high radiochemical yield (60–90%) and purity (>95%). Positron emission tomography (PET) imaging studies of [64Cu]3–7 revealed specific accumulation in PSMA-expressing xenografts (PSMA+ PC3 PIP) relative to isogenic control tumor (PSMA– PC3 flu) and background tissue. The favorable kinetics and high image contrast provided by CB-TE2A chelated [64Cu]6 suggest it as the most promising among the candidates tested. That could be due to the higher stability of [64Cu]CB-TE2A as compared with [64Cu]NOTA, [64Cu]PCTA, [64Cu]Oxo-DO3A, and [64Cu]DOTA chelates in vivo. PMID:24533799

  11. Predicting and replacing the pathological Gleason grade with automated gland ring morphometric features from immunofluorescent prostate cancer images.

    PubMed

    Khan, Faisal M; Scott, Richard; Donovan, Michael; Fernandez, Gerardo

    2017-04-01

    The Gleason grade is the most common architectural and morphological assessment of prostate cancer severity and prognosis. There have been numerous algorithms developed to approximate and duplicate the Gleason scoring system, mostly developed in standard H&E brightfield microscopy. Immunofluorescence (IF) image analysis of tissue pathology has recently been proven to be robust in developing prognostic assessments of disease, particularly in prostate cancer. We leverage a method of segmenting gland rings in IF images for predicting the pathological Gleason, both the clinical and the image specific grades, which may not necessarily be the same. We combine these measures with nuclear specific characteristics. In 324 images from 324 patients, our individual features correlate well univariately with the Gleason grades and in a multivariate setting have an accuracy of 85% in predicting the Gleason grade. Additionally, these features correlate strongly with clinical progression outcomes [concordance index (CI) of 0.89], significantly outperforming the clinical Gleason grades (CI of 0.78). Finally, in multivariate models for multiple prostate cancer progression endpoints, replacing the Gleason with these features results in equivalent or improved performances. This work presents the first assessment of morphological gland unit features from IF images for predicting the Gleason grade, and even replacing it in prostate cancer prognostics.

  12. Detection of radiorecurrent prostate cancer using diffusion-weighted imaging and targeted biopsies.

    PubMed

    Rud, Erik; Baco, Eduard; Lien, Diep; Klotz, Dagmar; Eggesbø, Heidi B

    2014-03-01

    The primary purpose of this study was to evaluate the detection rate of local radiorecurrent prostate cancer by using diffusion-weighted MR imaging (DWI) and targeted biopsies. The secondary purpose was to assess the value of performing random biopsies. This study included 42 consecutive patients with biochemical recurrence after external beam radiation therapy (EBRT). At the time of biopsy, the mean age±SD was 67±6 years, median serum prostate-specific antigen level was 4.0±3.0 ng/mL, and mean elapsed time between EBRT and biopsy was 5.6±2.8 years. MRI examination included high-resolution axial T2-weighted and DWI sequences and was classified as either negative or positive. Transrectal ultrasound-guided targeted biopsies were obtained from all patients with positive findings on MRI using a soft image fusion system. Random sextant biopsies were obtained from both lobes in patients with negative findings on MRI and from the lobe contralateral to the MRI target in patients with positive findings on MRI. The biopsy results were classified as negative or positive and defined as the criterion standard. MRI findings were positive in 40 of 42 (95%) patients, and the overall positive biopsy rate was 79% (33 of 42 patients). Targeted biopsies were positive in 33 of 40 (83%) patients. Random biopsies were positive in 6 of 30 (20%) patients, all of whom had positive targeted biopsies. DWI is highly sensitive for detecting radiorecurrent prostate cancer, and a few targeted biopsies may confirm a positive diagnosis. However, random biopsies may assess the tumor burden more exactly.

  13. Prostate Cancer Biorepository Network

    DTIC Science & Technology

    2015-10-01

    annotated with the biospecimens. Specialized processing consists of tissue microarray design and construction. Biospecimens (mainly tissue ...provide much sought after biospecimens for prostate cancer research. 15. SUBJECT TERMS Prostate Cancer, Biorepository, tissue microarrays, tissue ...and harmonizing a set of common data elements (CDEs): Completed in 1st quarter (October 2014) Task 3. Submit SOPs currently in use to Coordinating

  14. Prostate cancer staging

    MedlinePlus

    ... test. A faster increase could show a more aggressive tumor. A prostate biopsy is done in your ... suggest the cancer is slow growing and not aggressive. Higher numbers indicate a faster growing cancer that ...

  15. Automatic Gleason grading of prostate cancer using quantitative phase imaging and machine learning

    NASA Astrophysics Data System (ADS)

    Nguyen, Tan H.; Sridharan, Shamira; Macias, Virgilia; Kajdacsy-Balla, Andre; Melamed, Jonathan; Do, Minh N.; Popescu, Gabriel

    2017-03-01

    We present an approach for automatic diagnosis of tissue biopsies. Our methodology consists of a quantitative phase imaging tissue scanner and machine learning algorithms to process these data. We illustrate the performance by automatic Gleason grading of prostate specimens. The imaging system operates on the principle of interferometry and, as a result, reports on the nanoscale architecture of the unlabeled specimen. We use these data to train a random forest classifier to learn textural behaviors of prostate samples and classify each pixel in the image into different classes. Automatic diagnosis results were computed from the segmented regions. By combining morphological features with quantitative information from the glands and stroma, logistic regression was used to discriminate regions with Gleason grade 3 versus grade 4 cancer in prostatectomy tissue. The overall accuracy of this classification derived from a receiver operating curve was 82%, which is in the range of human error when interobserver variability is considered. We anticipate that our approach will provide a clinically objective and quantitative metric for Gleason grading, allowing us to corroborate results across instruments and laboratories and feed the computer algorithms for improved accuracy.

  16. Iterative normalization method for improved prostate cancer localization with multispectral magnetic resonance imaging

    NASA Astrophysics Data System (ADS)

    Liu, Xin; Samil Yetik, Imam

    2012-04-01

    Use of multispectral magnetic resonance imaging has received a great interest for prostate cancer localization in research and clinical studies. Manual extraction of prostate tumors from multispectral magnetic resonance imaging is inefficient and subjective, while automated segmentation is objective and reproducible. For supervised, automated segmentation approaches, learning is essential to obtain the information from training dataset. However, in this procedure, all patients are assumed to have similar properties for the tumor and normal tissues, and the segmentation performance suffers since the variations across patients are ignored. To conquer this difficulty, we propose a new iterative normalization method based on relative intensity values of tumor and normal tissues to normalize multispectral magnetic resonance images and improve segmentation performance. The idea of relative intensity mimics the manual segmentation performed by human readers, who compare the contrast between regions without knowing the actual intensity values. We compare the segmentation performance of the proposed method with that of z-score normalization followed by support vector machine, local active contours, and fuzzy Markov random field. Our experimental results demonstrate that our method outperforms the three other state-of-the-art algorithms, and was found to have specificity of 0.73, sensitivity of 0.69, and accuracy of 0.79, significantly better than alternative methods.

  17. (68)Ga-PSMA PET/CT: Joint EANM and SNMMI procedure guideline for prostate cancer imaging: version 1.0.

    PubMed

    Fendler, Wolfgang P; Eiber, Matthias; Beheshti, Mohsen; Bomanji, Jamshed; Ceci, Francesco; Cho, Steven; Giesel, Frederik; Haberkorn, Uwe; Hope, Thomas A; Kopka, Klaus; Krause, Bernd J; Mottaghy, Felix M; Schöder, Heiko; Sunderland, John; Wan, Simon; Wester, Hans-Jürgen; Fanti, Stefano; Herrmann, Ken

    2017-03-10

    The aim of this guideline is to provide standards for the recommendation, performance, interpretation and reporting of (68)Ga-PSMA PET/CT for prostate cancer imaging. These recommendations will help to improve accuracy, precision, and repeatability of (68)Ga-PSMA PET/CT for prostate cancer essentially needed for implementation of this modality in science and routine clinical practice.

  18. The economic effect of using magnetic resonance imaging and magnetic resonance ultrasound fusion biopsy for prostate cancer diagnosis.

    PubMed

    Hutchinson, Ryan C; Costa, Daniel N; Lotan, Yair

    2016-07-01

    Prostate magnetic resonance imaging (MRI) is a maturing imaging modality that has been used to improve detection and staging of prostate cancer. The goal of this review is to evaluate the economic effect of the use of MRI and MRI fusion in the diagnosis of prostate cancer. A literature review was used to identify articles regarding efficacy and cost of MRI and MRI-guided biopsies. There are currently a limited number of studies evaluating cost of incorporating MRI into clinical practice. These studies are primarily models projecting cost estimates based on meta-analyses of the literature. There is considerable variance in the effectiveness of MRI-guided biopsies, both cognitive and fusion, based on user experience, type of MRI (3T vs. 1.5T), use of endorectal coil and type of scoring system for abnormalities such that there is still potential for improvement in accuracy. There is also variability in assumed costs of incorporating MRI into clinical practice. The addition of MRI to the diagnostic algorithm for prostate cancer has caused a shift in how we understand the disease and in what tumors are found on initial and repeat biopsies. Further risk stratification may allow more men to pursue noncurative therapy, which in and of itself is cost-effective in properly selected men. As prostate cancer care comes under increasing scrutiny on a national level, there is pressure on providers to be more accurate in their diagnoses. This in turn can lead to additional testing including Multiparametric MRI, which adds upfront cost. Whether the additional cost of prostate MRI is warranted in detection of prostate cancer is an area of intense research. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Newer Imaging Modalities to Assist With Target Localization in the Radiation Treatment of Prostate Cancer and Possible Lymph Node Metastases

    SciTech Connect

    John, Subhash S. Zietman, Anthony L.; Shipley, William U.; Harisinghani, Mukesh G.

    2008-05-01

    Precise localization of prostate cancer and the drainage lymph nodes is mandatory to define an accurate clinical target volume for conformal radiotherapy. Better target definition and delineation on a daily basis is surely important in quality assurance for fractionated radiation therapy. This article reviews the evidence for major emerging techniques that show promise in better identifying the clinical target volume. Partial prostate boost by brachytherapy, intensity-modulated radiation therapy, or protons has become possible not only with standard imaging techniques but also with the availability of metabolic images obtained by magnetic resonance spectroscopy. Even though fluorine-18 fluorodeoxyglucose ({sup 18}F-FDG) positron emission tomography has not been found to be useful, novel radiolabeled tracers may eventually prove of value in the diagnosis and treatment planning of prostate cancer. For the metastatic lymph nodes, lymphotropic nanoparticle-enhanced magnetic resonance imaging using ultra-small superparamagnetic iron oxide particles has greater accuracy as compared with conventional techniques and has been instrumental in delineating the lymphatic drainage of the prostate gland. These novel investigational techniques could further help in optimizing conformal radiotherapy for patients with prostate cancer. The concepts of biologic target volume, real target volume, and multidimensional conformal radiotherapy are being explored.

  20. Newer imaging modalities to assist with target localization in the radiation treatment of prostate cancer and possible lymph node metastases.

    PubMed

    John, Subhash S; Zietman, Anthony L; Shipley, William U; Harisinghani, Mukesh G

    2008-01-01

    Precise localization of prostate cancer and the drainage lymph nodes is mandatory to define an accurate clinical target volume for conformal radiotherapy. Better target definition and delineation on a daily basis is surely important in quality assurance for fractionated radiation therapy. This article reviews the evidence for major emerging techniques that show promise in better identifying the clinical target volume. Partial prostate boost by brachytherapy, intensity-modulated radiation therapy, or protons has become possible not only with standard imaging techniques but also with the availability of metabolic images obtained by magnetic resonance spectroscopy. Even though fluorine-18 fluorodeoxyglucose ((18)F-FDG) positron emission tomography has not been found to be useful, novel radiolabeled tracers may eventually prove of value in the diagnosis and treatment planning of prostate cancer. For the metastatic lymph nodes, lymphotropic nanoparticle-enhanced magnetic resonance imaging using ultra-small superparamagnetic iron oxide particles has greater accuracy as compared with conventional techniques and has been instrumental in delineating the lymphatic drainage of the prostate gland. These novel investigational techniques could further help in optimizing conformal radiotherapy for patients with prostate cancer. The concepts of biologic target volume, real target volume, and multidimensional conformal radiotherapy are being explored.

  1. Clinical implications of a multiparametric magnetic resonance imaging based nomogram applied to prostate cancer active surveillance.

    PubMed

    Siddiqui, M Minhaj; Truong, Hong; Rais-Bahrami, Soroush; Stamatakis, Lambros; Logan, Jennifer; Walton-Diaz, Annerleim; Turkbey, Baris; Choyke, Peter L; Wood, Bradford J; Simon, Richard M; Pinto, Peter A

    2015-06-01

    Multiparametric magnetic resonance imaging may be beneficial in the search for rational ways to decrease prostate cancer intervention in patients on active surveillance. We applied a previously generated nomogram based on multiparametric magnetic resonance imaging to predict active surveillance eligibility based on repeat biopsy outcomes. We reviewed the records of 85 patients who met active surveillance criteria at study entry based on initial biopsy and who then underwent 3.0 Tesla multiparametric magnetic resonance imaging with subsequent magnetic resonance imaging/ultrasound fusion guided prostate biopsy between 2007 and 2012. We assessed the accuracy of a previously published nomogram in patients on active surveillance before confirmatory biopsy. For each cutoff we determined the number of biopsies avoided (ie reliance on magnetic resonance imaging alone without rebiopsy) over the full range of nomogram cutoffs. We assessed the performance of the multiparametric magnetic resonance imaging active surveillance nomogram based on a decision to perform biopsy at various nomogram generated probabilities. Based on cutoff probabilities of 19% to 32% on the nomogram the number of patients who could be spared repeat biopsy was 27% to 68% of the active surveillance cohort. The sensitivity of the test in this interval was 97% to 71% and negative predictive value was 91% to 81%. Multiparametric magnetic resonance imaging based nomograms may reasonably decrease the number of repeat biopsies in patients on active surveillance by as much as 68%. Analysis over the full range of nomogram generated probabilities allows patient and caregiver preference based decision making on the risk assumed for the benefit of fewer repeat biopsies. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  2. Missing the Mark: Prostate Cancer Upgrading by Systematic Biopsy over Magnetic Resonance Imaging/Transrectal Ultrasound Fusion Biopsy.

    PubMed

    Muthigi, Akhil; George, Arvin K; Sidana, Abhinav; Kongnyuy, Michael; Simon, Richard; Moreno, Vanessa; Merino, Maria J; Choyke, Peter L; Turkbey, Baris; Wood, Bradford J; Pinto, Peter A

    2017-02-01

    Multiparametric magnetic resonance imaging and fusion biopsy detect more high risk prostate cancer and less low risk prostate cancer than systematic biopsy. However, there remains a small subset of patients in whom systematic biopsy captures higher grade disease than fusion biopsy. We sought to identify potential mechanisms of the failure of fusion biopsy in the detection of clinically significant prostate cancer. We reviewed a prospectively maintained database of patients who underwent multiparametric magnetic resonance imaging followed by fusion biopsy and systematic biopsy from 2007 to 2014. In patients in whom disease was upgraded to clinically significant disease (Gleason 7 or greater) by systematic biopsy over fusion biopsy, independent re-review of magnetic resonance imaging, archived biopsy imaging and whole mount pathology as well as needle coordinate mapping were performed. Multivariate logistic regression analysis was done to determine predictors of upgrading by systematic biopsy. Disease was upgraded based on systematic biopsy over fusion biopsy in 135 of 1,003 patients (13.5%), of whom only 62 (6.2%) were upgraded to intermediate (Gleason 7) and high risk (Gleason 8 or greater) prostate cancer (51 or 5.1% and 11 or 1.1%, respectively). On multivariate analysis lower prostate specific antigen (p <0.001), higher magnetic resonance imaging prostate volume (p <0.001) and a lower number of target cores (p = 0.001) were predictors of upgrading by systematic biopsy. Main mechanisms of under grading by fusion biopsy included multiparametric magnetic resonance imaging reader oversight, presence of magnetic resonance imaging invisible cancer, fusion biopsy technique error and intralesion Gleason heterogeneity. Magnetic resonance imaging and fusion biopsy rarely missed clinically significant prostate cancer as only 62 of 1,003 cases (6.2%) were upgraded to clinically significant disease by systematic biopsy. Imaging and biopsy techniques are continually refined

  3. Pharmacokinetics, biodistribution and metabolism of a novel selective androgen receptor modulator designed for prostate cancer imaging.

    PubMed

    Yang, Jun; Wu, Zengru; Wu, Di; Darby, Michael V; Hong, Seoung Soo; Miller, Duane D; Dalton, James T

    2010-01-01

    Knowledge of the presence and extent of disease plays a major role in clinical management of prostate cancer, as it provides meaningful information as to which therapy to choose and who might benefit from this therapy. The wide expression of androgen receptor (AR) in primary and metastatic prostate tumors offers a cellular target for receptor-mediated imaging of prostate cancer. In our previous study, a non-steroidal AR ligand, S-26 [S-3-(4-fluorophenoxy)-2-hydroxy-2-methyl-N-(4-cyano-3-iodophenyl)-propionamide] showed promising in vitro pharmacological properties as an AR-mediated imaging agent, with high AR binding affinity and AR specificity. The overall goal of this study was to characterize the in vivo metabolic and biodistribution profile of S-26 in rats. Non-compartmental pharmacokinetic analysis of S-26 in rat plasma showed that clearance (CL), volume of distribution (Vd(ss)), and half-life (T(1/2)) of S-26 were 0.30 + or - 0.07 l/h/kg, 1.44 + or - 0.33 l/kg, and 4 h, respectively, after intravenous (i.v.) administration. Dose proportionality (1, 10 and 30 mg/kg) studies suggested that the pharmacokinetics of S-26 are dose-independent. The plasma concentrations of all 3 doses were further simultaneously fitted with a two-compartmental model and the results were similar to those obtained from non-compartmental analysis. Biodistribution studies using (125)I-labeled S-26 indicated that it did not specifically target AR-rich tissue (e.g. prostate). A substantial amount of radioactivity recovered from thyroid gland indicated the release of free iodine. In metabolism studies, unchanged S-26 and its metabolites were detected in rat urine and fecal samples. Oxidation, de-iodination, hydrolysis, and sulfate conjugation were the major metabolic pathways of S-26 in rats, with de-iodination representing a unique metabolic pathway of S-26 among other selective androgen receptor modulators. In conclusion, the extensive plasma clearance and de-iodination of S-26 likely

  4. Automatic classification of prostate cancer Gleason scores from multiparametric magnetic resonance images

    PubMed Central

    Fehr, Duc; Veeraraghavan, Harini; Wibmer, Andreas; Gondo, Tatsuo; Matsumoto, Kazuhiro; Vargas, Herbert Alberto; Sala, Evis; Hricak, Hedvig; Deasy, Joseph O.

    2015-01-01

    Noninvasive, radiological image-based detection and stratification of Gleason patterns can impact clinical outcomes, treatment selection, and the determination of disease status at diagnosis without subjecting patients to surgical biopsies. We present machine learning-based automatic classification of prostate cancer aggressiveness by combining apparent diffusion coefficient (ADC) and T2-weighted (T2-w) MRI-based texture features. Our approach achieved reasonably accurate classification of Gleason scores (GS) 6(3+3) vs. ≥7 and 7(3+4) vs. 7(4+3) despite the presence of highly unbalanced samples by using two different sample augmentation techniques followed by feature selection-based classification. Our method distinguished between GS 6(3+3) and ≥7 cancers with 93% accuracy for cancers occurring in both peripheral (PZ) and transition (TZ) zones and 92% for cancers occurring in the PZ alone. Our approach distinguished the GS 7(3+4) from GS 7(4+3) with 92% accuracy for cancers occurring in both the PZ and TZ and with 93% for cancers occurring in the PZ alone. In comparison, a classifier using only the ADC mean achieved a top accuracy of 58% for distinguishing GS 6(3+3) vs. GS ≥7 for cancers occurring in PZ and TZ and 63% for cancers occurring in PZ alone. The same classifier achieved an accuracy of 59% for distinguishing GS 7(3+4) from GS 7(4+3) occurring in the PZ and TZ and 60% for cancers occurring in PZ alone. Separate analysis of the cancers occurring in TZ alone was not performed owing to the limited number of samples. Our results suggest that texture features derived from ADC and T2-w MRI together with sample augmentation can help to obtain reasonably accurate classification of Gleason patterns. PMID:26578786

  5. Defining the radiobiology of prostate cancer progression: An important question in translational prostate cancer research

    PubMed Central

    Vourganti, Srinivas; Donaldson, Jeffrey; Johnson, Linda; Turkbey, Baris; Bratslavsky, Gennady; Kotula, Leszek

    2015-01-01

    Prostate cancer is one of the most common malignancies affecting men worldwide. High mortality rates from advanced and metastatic prostate cancer in the United States are contrasted by a relatively indolent course in the majority of cases. This gives hope for finding methods that could direct personalized diagnostic, preventative, and treatment approaches to patients with prostate cancer. Recent advances in multiparametric magnetic resonance imaging (MP-MRI) offer a noninvasive diagnostic intervention which allows correlation of prostate tumor image characteristics with underlying biologic evidence of tumor progression. The power of MP-MRI includes examination of both local invasion and nodal disease and might overcome the challenges of analyzing the multifocal nature of prostate cancer. Future directions include a careful analysis of the genomic signature of individual prostatic lesions utilizing image-guided biopsies. This review examines the diagnostic potential of MRI in prostate cancer. PMID:24879423

  6. Magnetic resonance imaging - ultrasound fusion targeted biopsy outperforms standard approaches in detecting prostate cancer: A meta-analysis

    PubMed Central

    Jiang, Xuping; Zhang, Jiayi; Tang, Jingyuan; Xu, Zhen; Zhang, Wei; Zhang, Qing; Guo, Hongqian; Zhou, Weimin

    2016-01-01

    The aim of the present study was to determine whether magnetic resonance imaging - ultrasound (MRI-US) fusion prostate biopsy is superior to systematic biopsy for making a definitive diagnosis of prostate cancer. The two strategies were also compared regarding their ability to detect clinically significant and insignificant prostate cancer. A literature search was conducted through the PubMed, EMBASE and China National Knowledge Infrastructure databases using appropriate search terms. A total of 3,415 cases from 21 studies were included in the present meta-analysis. Data were expressed as relative risk (RR) and 95% confidence interval. The results revealed that MRI-US fusion biopsy achieved a higher rate of overall prostate cancer detection compared with systematic biopsy (RR=1.09; P=0.047). Moreover, MRI-US fusion biopsy detected more clinically significant cancers compared with systematic biopsy (RR=1.22; P<0.01). It is therefore recommended that multi-parametric MRI-US is performed in men suspected of having prostate cancer to optimize the detection of clinically significant disease, while reducing the burden of biopsies. PMID:27446568

  7. [Benign prostatic hypertrophy and prostate cancer].

    PubMed

    Mourey, Loïc; Doumerc, Nicolas; Gaudin, Clément; Gérard, Stéphane; Balardy, Laurent

    2014-01-01

    Prostatic diseases are extremely common, especially in older men. Amongst them, benign prostatic hypertrophy may affect significantly the quality of life of patients by the symptoms it causes. It requires appropriate care. Prostate cancer is the second most common cancer in men after lung cancer and the fifth leading cause of cancer deaths in the world. It affects preferentially older men. An oncogeriatric approach is required for personalised care.

  8. Chemoprevention of prostate cancer.

    PubMed

    Vemana, Goutham; Hamilton, Robert J; Andriole, Gerald L; Freedland, Stephen J

    2014-01-01

    Large prospective randomized trials, such as the Prostate Cancer Prevention Trial (PCPT), Reduction by Dutasteride of Prostate Cancer Events (REDUCE) trial, and Selenium and Vitamin E Cancer Prevention Trial (SELECT), have provided practitioners with considerable data regarding methods of treatment and prevention of prostate cancer. The best-studied medications for prevention are 5 alpha-reductase inhibitors. Their efficacy and side effects are well characterized. Other medications, dietary nutrients, and supplements have not been as well studied and generally do not demonstrate efficacy for disease prevention with an acceptable level of evidence.

  9. Biomarkers for prostate cancer.

    PubMed

    Leman, Eddy S; Getzenberg, Robert H

    2009-09-01

    The detection of prostate cancer using a blood test has by many standards changed the face of the disease. Despite this tremendous success, there are limitations attributed to the use of prostate specific antigen (PSA) as a means to screen and detect prostate cancer. PSA, as its name implies, is not specific for prostate cancer and as such is often found elevated in other prostatic diseases/symptoms associated with the aging male. Clearly, more specific marker(s) that could identify which individuals actually have prostate cancer and differentiate them from those without the disease would be of tremendous value. The search for more accurate and clinically useful biomarkers of prostate cancer has been extensive. This has focused on individual markers, as well as groups of markers. Included among these are PSA isoforms, pathological indicators and stains, nucleic acids and others. This article highlights the discovery of PSA as a first blood-based biomarker for prostate cancer detection, as well as other molecular biomarkers and their potential application in detection of the disease. (c) 2009 Wiley-Liss, Inc.

  10. Molecular Imaging with Quantum Dots Probing EMT and Prostate Cancer Metastasis in Live Animals

    DTIC Science & Technology

    2005-10-01

    for the detection of cell surface PSMA protein in LNCaP model of human prostate cancer progression. This same technique will be applied for the...detection of E-cadherin and IL13 receptor α 2 expression in ARCaP EMT model. We have completed PSMA -QD 800nm for the visualization of human prostate... radiopharmaceuticals [49], should be further explored to improve the treatment of cancer metastases. CONCLUSIONS Wedemonstrated that the host microenvironment

  11. Cryosurgery for prostate cancer.

    PubMed

    Fahmy, W E; Bissada, N K

    2003-01-01

    Choice of management for patients with prostate cancer is influenced by patient and disease characteristics and life expectancy. Management options include expectance (watchful waiting), radical prostatectomy, external beam radiotherapy, brachytherapy, and cryosurgical ablation of the prostate (CSAP). The role of cryotherapy in the management of prostate cancer is still evolving. Continued research has allowed the introduction of efficient and safe cryosurgical equipment exemplified by the current third-generation cryosurgical machines. CSAP can be performed in an ambulatory surgery setting or as inpatient surgery with overnight stay. The procedure is performed under continuous ultrasonic monitoring. Mature data from the use of second-generation cryosurgical equipment indicate that CSAP is an effective therapeutic modality for managing patients with prostate cancer. Current data with the third-generation cryosurgical equipment are not mature. However, the favorable side effect profile and the good early responses seem to indicate that this modality will have a prominent role in the management of patients with prostate cancer.

  12. Prostate Cancer Research Training Program

    DTIC Science & Technology

    2014-05-01

    institutions. A major project in the lab is targeted therapy of prostate cancer using PSMA-guided aptamers. Prabhat Goswami, PhD; Professor...derived dendritic cell (DC) and T cell functional deficiencies. Long-term goals are to develop novel, immune-based therapies for advanced solid tumors...and radiolabeling of peptides and small molecules for small molecule cancer therapy , molecular imaging, and radionuclide therapy for cancer. He

  13. 68Ga-prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography for Prostate Cancer Imaging: A Narrative Literature Review

    PubMed Central

    Oliveira, Jose M.; Gomes, Catarina; Faria, Diogo B.; Vieira, Tiago S.; Silva, Fernando A.; Vale, Joana; Pimentel, Francisco L.

    2017-01-01

    The 68Ga-prostate-specific membrane antigen ( 68Ga-PSMA) has been recently developed to be used, as a ligand, in positron emission tomography/computed tomography (PET/CT) prostate cancer imaging, to detect prostate disease. The main objective of this review was to collect data and findings from other studies and articles to assess, theoretically, if 68GA-PSMA PET/CT is a more appropriate prostate cancer diagnostic technique in comparison with others available such as CT, 18F-fluoro-2-deoxyglucose PET/CT, or 18F-fluoromethylcholine ( 18F-choline) PET/CT. For that purpose, PubMed, the online scientific articles’ database, was consulted where the keywords “PSMA” and “PET” were used to find relevant articles. The clinicaltrials.gov, clinical trials’ database, was also consulted where the keywords “68Ga-PSMA” and “prostate” were used to search clinical trials. Based on the reviewed scientific literature, several studies were conducted to assess and compare the 68Ga-PSMA PET/CT detection rate in prostate cancer with other available techniques. One of those studies, conducted by Giesel et al., concluded, within study sample, that 75% of patients with lymph nodes detected by 68Ga-PSMA PET/CT would have not been identified using other conventional morphological criteria based techniques. In Eiber et al.'s study, 68Ga-PSMA PET detected prostatic disease findings in 67% of patients with prostate-specific antigen levels <1 ng/mL, when compared with choline-based PET that presented detection rates between 19% and 36%. In Bluemel et al.'s study, 68Ga-PSMA identified positive prostatic disease in 43.8% of the patients with negative findings in F-choline PET/CT. Findings from this review demonstrate that 68Ga-PSMA PET/C is more effective in detecting metastases, lymph nodes, and recurrent prostate cancer when compared to 18F-choline-based PET/CT and CT. 68Ga-PSMA PET/CT presents also more imaging contrast and can be more cost-effective. 68Ga-PSMA has already

  14. Three-dimensional conformal external beam radiotherapy compared with permanent prostate implantation in low-risk prostate cancer based on endorectal magnetic resonance spectroscopy imaging and prostate-specific antigen level

    SciTech Connect

    Pickett, Barby . E-mail: pickett@radonc17.ucsf.edu; Kurhanewicz, John; Pouliot, Jean; Weinberg, Vivian; Shinohara, Katsuto; Coakley, Fergus; Roach, Mack

    2006-05-01

    Purpose: To evaluate the metabolic response by comparing the time to resolution of spectroscopic abnormalities (TRSA) and the time to prostate-specific antigen level in low-risk prostate cancer patients after treatment with three-dimensional conformal external beam radiotherapy (3D-CRT) compared with permanent prostate implantation (PPI). Recent studies have suggested that the treatment of low-risk prostate cancer yields similar results for patients treated with 3D-CRT or PPI. Methods and Materials: A total of 50 patients, 25 in each group, who had been treated with 3D-CRT or PPI, had undergone endorectal magnetic resonance spectroscopy imaging before and/or at varying times after therapy. The 3D-CRT patients had received radiation doses of {>=}72 Gy compared with 144 Gy for the PPI patients. The spectra from all usable voxels were examined for detectable levels of metabolic signal, and the percentages of atrophic and cancerous voxels were tabulated. Results: The median time to resolution of the spectroscopic abnormalities was 32.2 and 24.8 months and the time to the nadir prostate-specific antigen level was 52.4 and 38.0 months for the 3D-CRT and PPI patients, respectively. Of the 3D-CRT patients, 92% achieved negative endorectal magnetic resonance spectroscopy imaging findings, with 40% having complete metabolic atrophy. All 25 PPI patients had negative endorectal magnetic resonance spectroscopy imaging findings, with 60% achieving complete metabolic atrophy. Conclusion: The results of this study suggest that metabolic and biochemical responses of the prostate are more pronounced after PPI. Our results have not proved PPI is more effective at curing prostate cancer, but they have demonstrated that it may be more effective at destroying prostate metabolism.

  15. Evaluation of a technetium-99m labeled bombesin homodimer for GRPR imaging in prostate cancer.

    PubMed

    Yu, Zilin; Carlucci, Giuseppe; Ananias, Hildo J K; Dierckx, Rudi A J O; Liu, Shuang; Helfrich, Wijnand; Wang, Fan; de Jong, Igle J; Elsinga, Philip H

    2013-02-01

    Multimerization of peptides can improve the binding characteristics of the tracer by increasing local ligand concentration and decreasing dissociation kinetics. In this study, a new bombesin homodimer was developed based on an ε-aminocaproic acid-bombesin(7-14) (Aca-bombesin(7-14)) fragment, which has been studied for targeting the gastrin-releasing peptide receptor (GRPR) in prostate cancer. The bombesin homodimer was conjugated to 6-hydrazinopyridine-3-carboxylic acid (HYNIC) and labeled with (99m)Tc for SPECT imaging. The in vitro binding affinity to GRPR, cell uptake, internalization and efflux kinetics of the radiolabeled bombesin dimer were investigated in the GRPR-expressing human prostate cancer cell line PC-3. Biodistribution and the GRPR-targeting potential were evaluated in PC-3 tumor-bearing athymic nude mice. When compared with the bombesin monomer, the binding affinity of the bombesin dimer is about ten times lower. However, the (99m)Tc labeled bombesin dimer showed a three times higher cellular uptake at 4 h after incubation, but similar internalization and efflux characters in vitro. Tumor uptake and in vivo pharmacokinetics in PC-3 tumor-bearing mice were comparable. The tumor was visible on the dynamic images in the first hour and could be clearly distinguished from non-targeted tissues on the static images after 4 h. The GRPR-targeting ability of the (99m)Tc labeled bombesin dimer was proven in vitro and in vivo. This bombesin homodimer provides a good starting point for further studies on enhancing the tumor targeting activity of bombesin multimers.

  16. The Role of Magnetic Resonance Imaging (MRI) in Prostate Cancer Imaging and Staging at 1.5 and 3 Tesla : The Beth Israel Deaconess Medical Center (BIDMC) Approach

    PubMed Central

    Bloch, B. Nicolas; Lenkinski, Robert. E.; Rofsky, Neil M.

    2009-01-01

    Management decisions for patients with prostate cancer present a dilemma for both patients and their clinicians because prostate cancers demonstrate a wide range in biologic activity, with the majority of cases not leading to a prostate cancer related death. Furthermore, the current treatment options have significant side effects, such as incontinence, rectal injury and impotence. Key elements for guiding appropriate treatment include: distinction of organ-confined disease from extracapsular extension (ECE); and determination of tumor volume and tumor grade, none of which have been satisfactorily accomplished in today’s pre-treatment paradigm. Magnetic resonance imaging (MRI) has the capability to assess prostate tissue, both functionally and morphologically. MRI as a staging tool has not shown enough consistency or sufficient accuracy for widespread adoption in clinical practice; yet, recent technical developments in MRI have yielded improved results. At our institution we have combined the use of new endorectal 3 Tesla MRI technology, T2-weighted, and high spatial resolution dynamic-contrast enhanced (DCE) MRI to non-invasively assess the prostate with higher signal-to-noise ratio and spatial resolution than previously achieved. This approach allows assessment of prostate-tissue morphology and kinetics, thus providing a non-invasive tool for tumor detection and staging and, consequently, directing biopsy and treatment specifically to diseased areas for a pre-treatment evaluation that can assist in the rational selection of patients for appropriate prostate cancer therapy. PMID:18957714

  17. A PSMA Ligand Labeled with Cobalt-55 for PET Imaging of Prostate Cancer.

    PubMed

    Dam, Johan Hygum; Olsen, Birgitte Brinkmann; Baun, Christina; Høilund-Carlsen, Poul Flemming; Thisgaard, Helge

    2017-09-18

    Prostate-specific membrane antigen (PSMA) comprises a recognized target for molecular imaging of prostate cancer. As such, radiolabeled PSMA inhibitors are of great value for diagnosis and staging of this disease. Herein, we disclose the preclinical characterization of [(55)Co]PSMA-617 for positron emission tomography (PET)/x-ray computed tomography (CT) imaging of prostate cancer lesions. By the application of microwave heating, PSMA-617 in acetate buffer (0.4 M, pH 4.4) was labeled with the radioisotopes cobalt-55/57. The extents of internalization and dissociation constants (K D) were determined against 2-(phosphonomethyl)-pentanedioic acid in two PSMA-positive cell lines, LNCaP, and PC3-PIP, with [(57)Co]PSMA-617 as a surrogate for [(55)Co]PSMA-617 (T½ 17.5 h, β max 1.5 MeV, Iβ 76 %). The biodistribution in LNCaP xenograft mice was investigated using [(57)Co]PSMA-617 and [(55)Co]PSMA-617 was employed for PET/CT imaging at 1, 4, and 24 h and compared to PET/CT scans using [(68)Ga]PSMA-617. The radiolabeling with cobalt-55/57 was performed in yields greater than 99.5 and 99.8 % and radiochemical purities of 99.7 and 98.9 %, respectively. The molar-specific activities were 18.2 MBq/nmol and 3.3 MBq/nmol. The cellular K D were determined to be 4.7 nM for LNCaP and 9.8 nM for PC3-PIP, correspondingly. Internalization of 76 and 71 % of the cell-associated radioactivity was found for LNCaP and PC3-PIP cells after incubation up to 240 min, respectively. In regard to the biodistribution in LNCaP xenograft mice, [(57)Co]PSMA-617 displayed a high and relatively constant uptake in the tumor (12.9 %IA/g at 1 h to 10.5 %IA/g at 24 h) with an initial but transient high uptake in the kidneys, adrenals, and spleen. Tumor-to-background ratios improved over time as normal tissue cleared of the radioligand (tumor-to-blood: 26, 258, and 3013; tumor-to-kidney: 0.11, 0.28, and 4.3 at 1, 4, and 24 h). PET/CT imaging with [(55)Co]PSMA-617 in xenograft mice

  18. Multiparametric 3-Tesla Endorectal MR Imaging after External Beam Radiation Therapy of Prostate Cancer

    PubMed Central

    Westphalen, Antonio C.; Reed, Galen D.; Vinh, Phillip P.; Sotto, Christopher; Vigneron, Daniel B.; Kurhanewicz, John

    2012-01-01

    Purpose To determine the best combination of magnetic resonance (MR) imaging parameters for the detection of locally recurrent prostate cancer after external beam radiation therapy. Materials and Methods Our IRB approved this study with a waiver of informed consent. Twenty-six patients with suspected recurrence due to biochemical failure were part of this research. The MR protocol included T2-weighted, MR spectroscopic, and diffusion-weighted MR imaging. Transrectal ultrasound-guided biopsy was the standard of reference. We used logistic regression to model the probability of a positive outcome and generalized estimating equations to account for clustering. The diagnostic performance of imaging was described using receiver operating characteristic (ROC) curves. Results The area under the ROC curve of MR spectroscopic imaging (MRSI) was 83.0% (95% CI = 75.5 to 89.1). The combination of all MR techniques did not significantly improve the performance of imaging beyond the accuracy of MRSI alone, but a trend towards improved discrimination was noted (86.9%; 95% CI = 77.6 to 93.4; P = 0.09). Conclusion In conclusion, incorporation of MRSI to T2-weighted and/or diffusion-weighted MR imaging significantly improves the assessment of patients with suspected recurrence after radiotherapy and a combined approach with all three modalities may have the best diagnostic performance. PMID:22535708

  19. Using radioactive drugs could lead to better imaging of prostate cancer | Center for Cancer Research

    Cancer.gov

    Medical imaging (x-ray, ultrasound, MRI, CT, PET scan) is a noninvasive way to view the internal structures of the body. However, these tools are not ideal for detecting cancer that has spread, or metastasized, because the precise location of these cancer cells is unknown. Researchers are now testing an experimental radiotracer called 18F-DCFPyL to help find sites of cancer in the body.  Learn more...

  20. MR elastography and diffusion-weighted imaging of ex vivo prostate cancer: quantitative comparison to histopathology.

    PubMed

    Sahebjavaher, Ramin S; Nir, Guy; Gagnon, Louis O; Ischia, Joseph; Jones, Edward C; Chang, Silvia D; Yung, Andrew; Honarvar, Mohammad; Fazli, Ladan; Goldenberg, S Larry; Rohling, Robert; Sinkus, Ralph; Kozlowski, Piotr; Salcudean, Septimiu E

    2015-01-01

    The purpose of this work was (1) to develop a magnetic resonance elastography (MRE) system for imaging of the ex vivo human prostate and (2) to assess the diagnostic power of mono-frequency and multi-frequency MRE and diffusion weighted imaging (DWI) alone and combined as correlated with histopathology in a patient study. An electromagnetic driver was designed specifically for MRE studies in small-bore MR scanners. Ex vivo prostate specimens (post-fixation) of 14 patients who underwent radical prostatectomy were imaged with MRE at 7 T (nine cases had DWI). In six patients, the MRE examination was performed at three frequencies (600, 800, 1000 Hz) to extract the power-law exponent Gamma. The images were registered to wholemount pathology slides marked with the Gleason score. The areas under the receiver-operator-characteristic curves (AUC) were calculated. The methods were validated in a phantom study and it was demonstrated that (i) the driver does not interfere with the acquisition process and (ii) the driver can generate amplitudes greater than 100 µm for frequencies less than 1 kHz. In the quantitative study, cancerous tissue with Gleason score at least 3 + 3 was distinguished from normal tissue in the peripheral zone (PZ) with an average AUC of 0.75 (Gd ), 0.75 (Gl ), 0.70 (Gamma-Gd ), 0.68 (apparent diffusion coefficient, ADC), and 0.82 (Gd  + Gl  + ADC). The differentiation between PZ and central gland was modest for Gd (p < 0.07), Gl (p < 0.06) but not significant for Gamma (p < 0.2). A correlation of 0.4 kPa/h was found between the fixation time of the prostate specimen and the stiffness of the tissue, which could affect the diagnostic power results. DWI and MRE may provide complementary information; in fact MRE performed better than ADC in distinguishing normal from cancerous tissue in some cases. Multi-frequency (Gamma) analysis did not appear to improve the results. However, in light of the effect of tissue fixation, the

  1. Improving supervised classification accuracy using non-rigid multimodal image registration: detecting prostate cancer

    NASA Astrophysics Data System (ADS)

    Chappelow, Jonathan; Viswanath, Satish; Monaco, James; Rosen, Mark; Tomaszewski, John; Feldman, Michael; Madabhushi, Anant

    2008-03-01

    Computer-aided diagnosis (CAD) systems for the detection of cancer in medical images require precise labeling of training data. For magnetic resonance (MR) imaging (MRI) of the prostate, training labels define the spatial extent of prostate cancer (CaP); the most common source for these labels is expert segmentations. When ancillary data such as whole mount histology (WMH) sections, which provide the gold standard for cancer ground truth, are available, the manual labeling of CaP can be improved by referencing WMH. However, manual segmentation is error prone, time consuming and not reproducible. Therefore, we present the use of multimodal image registration to automatically and accurately transcribe CaP from histology onto MRI following alignment of the two modalities, in order to improve the quality of training data and hence classifier performance. We quantitatively demonstrate the superiority of this registration-based methodology by comparing its results to the manual CaP annotation of expert radiologists. Five supervised CAD classifiers were trained using the labels for CaP extent on MRI obtained by the expert and 4 different registration techniques. Two of the registration methods were affi;ne schemes; one based on maximization of mutual information (MI) and the other method that we previously developed, Combined Feature Ensemble Mutual Information (COFEMI), which incorporates high-order statistical features for robust multimodal registration. Two non-rigid schemes were obtained by succeeding the two affine registration methods with an elastic deformation step using thin-plate splines (TPS). In the absence of definitive ground truth for CaP extent on MRI, classifier accuracy was evaluated against 7 ground truth surrogates obtained by different combinations of the expert and registration segmentations. For 26 multimodal MRI-WMH image pairs, all four registration methods produced a higher area under the receiver operating characteristic curve compared to that

  2. Characteristics of Prostate Cancer Found at Fifth Screening in the European Randomized Study of Screening for Prostate Cancer Rotterdam: Can We Selectively Detect High-grade Prostate Cancer with Upfront Multivariable Risk Stratification and Magnetic Resonance Imaging?

    PubMed

    Alberts, Arnout R; Schoots, Ivo G; Bokhorst, Leonard P; Drost, Frank-Jan H; van Leenders, Geert J; Krestin, Gabriel P; Dwarkasing, Roy S; Barentsz, Jelle O; Schröder, Fritz H; Bangma, Chris H; Roobol, Monique J

    2017-06-21

    The harm of screening (unnecessary biopsies and overdiagnosis) generally outweighs the benefit of reducing prostate cancer (PCa) mortality in men aged ≥70 yr. Patient selection for biopsy using risk stratification and magnetic resonance imaging (MRI) may improve this benefit-to-harm ratio. To assess the potential of a risk-based strategy including MRI to selectively identify men aged ≥70 yr with high-grade PCa. Three hundred and thirty-seven men with prostate-specific antigen ≥3.0 ng/ml at a fifth screening (71-75 yr) in the European Randomized study of Screening for Prostate Cancer Rotterdam were biopsied. One hundred and seventy-nine men received six-core transrectal ultrasound biopsy (TRUS-Bx), while 158 men received MRI, 12-core TRUS-Bx, and fusion TBx in case of Prostate Imaging Reporting and Data System ≥3 lesions. The primary outcome was the overall, low-grade (Gleason Score 3+3) and high-grade (Gleason Score ≥ 3+4) PCa rate. Secondary outcome was the low- and high-grade PCa rate detected by six-core TRUS-Bx, 12-core TRUS-Bx, and MRI ± TBx. Tertiary outcome was the reduction of biopsies and low-grade PCa detection by upfront risk stratification with the Rotterdam Prostate Cancer Risk Calculator 4. Fifty-five percent of men were previously biopsied. The overall, low-grade, and high-grade PCa rates in biopsy naïve men were 48%, 27%, and 22%, respectively. In previously biopsied men these PCa rates were 25%, 20%, and 5%. Sextant TRUS-Bx, 12-core TRUS-Bx, and MRI ± TBx had a similar high-grade PCa rate (11%, 12%, and 11%) but a significantly different low-grade PCa rate (17%, 28%, and 7%). Rotterdam Prostate Cancer Risk Calculator 4-based stratification combined with 12-core TRUS-Bx ± MRI-TBx would have avoided 65% of biopsies and 68% of low-grade PCa while detecting an equal percentage of high-grade PCa (83%) compared with a TRUS-Bx all men approach (79%). After four repeated screens and ≥1 previous biopsies in half of men, a significant

  3. Drugs Approved for Prostate Cancer

    MedlinePlus

    ... Ask about Your Treatment Research Drugs Approved for Prostate Cancer This page lists cancer drugs approved by the ... that are not listed here. Drugs Approved for Prostate Cancer Abiraterone Acetate Bicalutamide Cabazitaxel Casodex (Bicalutamide) Degarelix Docetaxel ...

  4. Chemoprevention of prostate cancer.

    PubMed

    Brand, Timothy C; Canby-Hagino, Edith D; Pratap Kumar, A; Ghosh, Rita; Leach, Robin J; Thompson, Ian M

    2006-08-01

    Prostate cancer is a common malignancy with multiple potential opportunities for cancer prevention. As the genetic basis of this malignancy is further understood, prevention strategies will be developed for individual patients based on specific risk factors and pathways of carcinogenesis. The PCPT has conclusively proven that prostate cancer prevention is possible. The results of the SELECT should be available within several years. An enormous challenge for the medical community will be the development of an efficient strategy to evaluate the substantial number of dietary, behavioral, and pharmacologic prevention opportunities. Ultimately, the goal of prostate can-cer prevention is to (1) identify men who are destined to develop clinically significant prostate cancer, and (2) provide individualized agents to prevent disease development.

  5. Automated prostate cancer detection using T2-weighted and high-b-value diffusion-weighted magnetic resonance imaging

    PubMed Central

    Kwak, Jin Tae; Xu, Sheng; Wood, Bradford J.; Turkbey, Baris; Choyke, Peter L.; Pinto, Peter A.; Wang, Shijun; Summers, Ronald M.

    2015-01-01

    Purpose: The authors propose a computer-aided diagnosis (CAD) system for prostate cancer to aid in improving the accuracy, reproducibility, and standardization of multiparametric magnetic resonance imaging (MRI). Methods: The proposed system utilizes two MRI sequences [T2-weighted MRI and high-b-value (b = 2000 s/mm2) diffusion-weighted imaging (DWI)] and texture features based on local binary patterns. A three-stage feature selection method is employed to provide the most discriminative features. The authors included a total of 244 patients. Training the CAD system on 108 patients (78 MR-positive prostate cancers and 105 benign MR-positive lesions), two validation studies were retrospectively performed on 136 patients (68 MR-positive prostate cancers, 111 benign MR-positive lesions, and 117 MR-negative benign lesions). Results: In distinguishing cancer from MR-positive benign lesions, an area under receiver operating characteristic curve (AUC) of 0.83 [95% confidence interval (CI): 0.76–0.89] was achieved. For cancer vs MR-positive or MR-negative benign lesions, the authors obtained an AUC of 0.89 AUC (95% CI: 0.84–0.93). The performance of the CAD system was not dependent on the specific regions of the prostate, e.g., a peripheral zone or transition zone. Moreover, the CAD system outperformed other combinations of MRI sequences: T2W MRI, high-b-value DWI, and the standard apparent diffusion coefficient (ADC) map of DWI. Conclusions: The novel CAD system is able to detect the discriminative texture features for cancer detection and localization and is a promising tool for improving the quality and efficiency of prostate cancer diagnosis. PMID:25979032

  6. Method for data analysis in different institutions: example of image guidance of prostate cancer patients.

    PubMed

    Piotrowski, T; Rodrigues, G; Bajon, T; Yartsev, S

    2014-03-01

    Multi-institutional collaborations allow for more information to be analyzed but the data from different sources may vary in the subgroup sizes and/or conditions of measuring. Rigorous statistical analysis is required for pooling the data in a larger set. Careful comparison of all the components of the data acquisition is indispensable: identical conditions allow for enlargement of the database with improved statistical analysis, clearly defined differences provide opportunity for establishing a better practice. The optimal sequence of required normality, asymptotic normality, and independence tests is proposed. An example of analysis of six subgroups of position corrections in three directions obtained during image guidance procedures for 216 prostate cancer patients from two institutions is presented. Copyright © 2013 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  7. Preventing and Treating Prostate Cancer Spread to Bone

    MedlinePlus

    ... Prostate Cancer Treating Prostate Cancer Preventing and Treating Prostate Cancer Spread to Bones If prostate cancer spreads to ... Away or Comes Back After Treatment More In Prostate Cancer About Prostate Cancer Causes, Risk Factors, and Prevention ...

  8. Early Outcomes From Three Prospective Trials of Image-Guided Proton Therapy for Prostate Cancer

    SciTech Connect

    Mendenhall, Nancy P.; Li Zuofeng; Hoppe, Bradford S.; Marcus, Robert B.; Mendenhall, William M.; Nichols, R. Charles; Morris, Christopher G.; Williams, Christopher R.; Costa, Joseph; Henderson, Randal

    2012-01-01

    Purpose: To report early outcomes with image-guided proton therapy for prostate cancer. Methods and Materials: We accrued 211 prostate cancer patients on prospective Institutional Review Board-approved trials of 78 cobalt gray equivalent (CGE) in 39 fractions for low-risk disease, dose escalation from 78 to 82 CGE for intermediate-risk disease, and 78 CGE with concomitant docetaxel followed by androgen deprivation for high-risk disease. Minimum follow-up was 2 years. Results: One intermediate-risk patient and 2 high-risk patients had disease progression. Pretreatment genitourinary (GU) symptom management was required in 38% of patients. A cumulative 88 (42%) patients required posttreatment GU symptom management. Four transient Grade 3 GU toxicities occurred, all among patients requiring pretreatment GU symptom management. Multivariate analysis showed correlation between posttreatment GU 2+ symptoms and pretreatment GU symptom management (p < 0.0001) and age (p = 0.0048). Only 1 Grade 3+ gastrointestinal (GI) symptom occurred. The prevalence of Grade 2+ GI symptoms was 0 (0%), 10 (5%), 12 (6%), and 8 (4%) at 6, 12, 18, and 24 months, with a cumulative incidence of 20 (10%) patients at 2 years after proton therapy. Univariate and multivariate analyses showed significant correlation between Grade 2+ rectal bleeding and proctitis and the percentage of rectal wall (rectum) receiving doses ranging from 40 CGE (10 CGE) to 80 CGE. Conclusions: Early outcomes with image-guided proton therapy suggest high efficacy and minimal toxicity with only 1.9% Grade 3 GU symptoms and <0.5% Grade 3 GI toxicities.

  9. Intensity Modulated Radiation Treatment of Prostate Cancer Guided by High Field MR Spectroscopic Imaging

    DTIC Science & Technology

    2006-05-01

    is to be reduced for dose escalation or for hypofractionated treatment22-24. III. KEY RESEARCH ACCOMPLISHMENTS • Refined the endorectal coil-based...Xing L, King C.R., Luxton G, Investigation of Linac- based Image-guided Hypofractionated Prostate Radiotherapy, Medical Dosimetry 31, 91-122, 2006...Pawlicki T., Kim G, Hsu A, Cortutz C, Boyer A, Xing L, King C.R., Luxton G, Investigation of Linac- based Image-guided Hypofractionated Prostate Radiotherapy

  10. Image-guided radiation therapy based on helical tomotherapy in prostate cancer: minimizing toxicity.

    PubMed

    Acevedo-Henao, Catalina M; Lopez Guerra, Jose L; Matute, Raul; Puebla, Fernando; Russo, Moises; Rivin, Eleonor; Sanchez-Reyes, Alberto; Ortiz, M José; Azinovic, Ignacio

    2014-01-01

    We report the clinical results and prognostic factors of image-guided radiation therapy (RT) with helical tomotherapy (HT) for localized and recurrent prostate cancer (PC). We evaluated 70 patients with PC (primary diagnosis, n = 48; adjuvant, n = 5; salvage, n = 17) treated with HT from May 2006 through January 2011. The dose prescribed to the prostate/surgical bed ranged between 60 and 78 Gy. Potential risk factors for genitourinary (GU) and gastrointestinal (GI) toxicity were assessed. The median age was 68 years (range 51-87 years). The median follow-up was 37 months (range 3-74 months). The rates of acute grade 2 GI and GU toxicities were 10 and 13%, respectively. Only 1 patient experienced acute grade 3 GU toxicity. The rates of late grade ≥ 2 GI and GU toxicities were 1% each. Multivariate analysis showed an association between rectum mean dose > median (39 Gy) and bladder median dose > median (46 Gy) with a higher grade of acute GI (p = 0.017) and GU (p = 0.019) toxicity, respectively. Additionally, older age was associated with late GU toxicity (p = 0.026). Toxicity with HT is low and is associated with higher median/mean doses in organs at risk as well as with older age. A prospective validation would be necessary to confirm these results. © 2014 S. Karger GmbH, Freiburg.

  11. Advanced Imaging for the Early Diagnosis of Local Recurrence Prostate Cancer after Radical Prostatectomy

    PubMed Central

    Musio, Daniela; Proietti, Camilla; Indino, Elena Lucia; Megna, Valentina; Schillaci, Orazio; Catalano, Carlo

    2014-01-01

    Currently the diagnosis of local recurrence of prostate cancer (PCa) after radical prostatectomy (RT) is based on the onset of biochemical failure which is defined by two consecutive values of prostate-specific antigen (PSA) higher than 0.2 ng/mL. The aim of this paper was to review the current roles of advanced imaging in the detection of locoregional recurrence. A nonsystematic literature search using the Medline and Cochrane Library databases was performed up to November 2013. Bibliographies of retrieved and review articles were also examined. Only those articles reporting complete data with clinical relevance for the present review were selected. This review article is divided into two major parts: the first one considers the role of PET/CT in the restaging of PCa after RP; the second part is intended to provide the impact of multiparametric-MRI (mp-MRI) in the depiction of locoregional recurrence. Published data indicate an emerging role for mp-MRI in the depiction of locoregional recurrence, while the performance of PET/CT still remains unclear. Moreover Mp-MRI, thanks to functional techniques, allows to distinguish between residual glandular healthy tissue, scar/fibrotic tissue, granulation tissue, and tumour recurrence and it may also be able to assess the aggressiveness of nodule recurrence. PMID:24757679

  12. Advanced imaging for the early diagnosis of local recurrence prostate cancer after radical prostatectomy.

    PubMed

    Panebianco, Valeria; Barchetti, Flavio; Musio, Daniela; De Felice, Francesca; Proietti, Camilla; Indino, Elena Lucia; Megna, Valentina; Schillaci, Orazio; Catalano, Carlo; Tombolini, Vincenzo

    2014-01-01

    Currently the diagnosis of local recurrence of prostate cancer (PCa) after radical prostatectomy (RT) is based on the onset of biochemical failure which is defined by two consecutive values of prostate-specific antigen (PSA) higher than 0.2 ng/mL. The aim of this paper was to review the current roles of advanced imaging in the detection of locoregional recurrence. A nonsystematic literature search using the Medline and Cochrane Library databases was performed up to November 2013. Bibliographies of retrieved and review articles were also examined. Only those articles reporting complete data with clinical relevance for the present review were selected. This review article is divided into two major parts: the first one considers the role of PET/CT in the restaging of PCa after RP; the second part is intended to provide the impact of multiparametric-MRI (mp-MRI) in the depiction of locoregional recurrence. Published data indicate an emerging role for mp-MRI in the depiction of locoregional recurrence, while the performance of PET/CT still remains unclear. Moreover Mp-MRI, thanks to functional techniques, allows to distinguish between residual glandular healthy tissue, scar/fibrotic tissue, granulation tissue, and tumour recurrence and it may also be able to assess the aggressiveness of nodule recurrence.

  13. Multifunctional iron platinum stealth immunomicelles: targeted detection of human prostate cancer cells using both fluorescence and magnetic resonance imaging

    PubMed Central

    Huber, Dale L.; Monson, Todd C.; Ali, Abdul-Mehdi S.; Bisoffi, Marco; Sillerud, Laurel O.

    2011-01-01

    Superparamagnetic iron oxide nanoparticles (SPIONs) are the most common type of contrast agents used in contrast agent-enhanced magnetic resonance imaging (MRI). Still, there is a great deal of room for improvement, and nanoparticles with increased MRI relaxivities are needed to increase the contrast enhancement in MRI applied to various medical conditions including cancer. We report the synthesis of superparamagnetic iron platinum nanoparticles (SIPPs) and subsequent encapsulation using PEGylated phospholipids to create stealth immunomicelles (DSPE-SIPPs) that can be specifically targeted to human prostate cancer cell lines and detected using both MRI and fluorescence imaging. SIPP cores and DSPE-SIPPs were 8.5 ± 1.6 nm and 42.9 ± 8.2 nm in diameter, respectively, and the SIPPs had a magnetic moment of 120 A m2/kg iron. J591, a monoclonal antibody against prostate specific membrane antigen (PSMA), was conjugated to the DSPE-SIPPs (J591-DSPE-SIPPs), and specific targeting of J591-DSPE-SIPPs to PSMA-expressing human prostate cancer cell lines was demonstrated using fluorescence confocal microscopy. The transverse relaxivity of the DSPE-SIPPs, measured at 4.7 Tesla, was 300.6 ± 8.5 s−1 mM−1, which is 13-fold better than commercially available SPIONs (23.8 ± 6.9 s−1 mM−1) and ~3-fold better than reported relaxivities for Feridex® and Resovist®. Our data suggest that J591-DSPE-SIPPs specifically target human prostate cancer cells in vitro, are superior contrast agents in T2-weighted MRI, and can be detected using fluorescence imaging. To our knowledge, this is the first report on the synthesis of multifunctional SIPP micelles and using SIPPs for the specific detection of prostate cancer. PMID:22121333

  14. Multifunctional iron platinum stealth immunomicelles: targeted detection of human prostate cancer cells using both fluorescence and magnetic resonance imaging

    NASA Astrophysics Data System (ADS)

    Taylor, Robert M.; Huber, Dale L.; Monson, Todd C.; Ali, Abdul-Mehdi S.; Bisoffi, Marco; Sillerud, Laurel O.

    2011-10-01

    Superparamagnetic iron oxide nanoparticles (SPIONs) are the most common type of contrast agents used in contrast agent-enhanced magnetic resonance imaging (MRI). Still, there is a great deal of room for improvement, and nanoparticles with increased MRI relaxivities are needed to increase the contrast enhancement in MRI applied to various medical conditions including cancer. We report the synthesis of superparamagnetic iron platinum nanoparticles (SIPPs) and subsequent encapsulation using PEGylated phospholipids to create stealth immunomicelles (DSPE-SIPPs) that can be specifically targeted to human prostate cancer cell lines and detected using both MRI and fluorescence imaging. SIPP cores and DSPE-SIPPs were 8.5 ± 1.6 nm and 42.9 ± 8.2 nm in diameter, respectively, and the SIPPs had a magnetic moment of 120 A m2/kg iron. J591, a monoclonal antibody against prostate specific membrane antigen (PSMA), was conjugated to the DSPE-SIPPs (J591-DSPE-SIPPs), and specific targeting of J591-DSPE-SIPPs to PSMA-expressing human prostate cancer cell lines was demonstrated using fluorescence confocal microscopy. The transverse relaxivity of the DSPE-SIPPs, measured at 4.7 Tesla, was 300.6 ± 8.5 s-1 mM-1, which is 13-fold better than commercially available SPIONs (23.8 ± 6.9 s-1 mM-1) and 3-fold better than reported relaxivities for Feridex® and Resovist®. Our data suggest that J591-DSPE-SIPPs specifically target human prostate cancer cells in vitro, are superior contrast agents in T 2-weighted MRI, and can be detected using fluorescence imaging. To our knowledge, this is the first report on the synthesis of multifunctional SIPP micelles and using SIPPs for the specific detection of prostate cancer.

  15. Granulomatous prostatitis after intravesical immunotherapy mimicking prostate cancer.

    PubMed

    Białek, Waldemar; Rudzki, Sławomir; Iberszer, Paweł; Wronecki, Lech

    2016-12-01

    Intravesical immunotherapy with attenuated strains of Mycobacterium bovis is a widely used therapeutic option in patients with non-muscle-invasive transitional cell carcinoma of the bladder. A rare complication of intravesical therapy with the Bacillus Calmette-Guérin vaccine is granulomatous prostatitis, which due to increasing levels of prostate-specific antigen and abnormalities found in transrectal examination of the prostate may suggest concomitant prostate cancer. A case of extensive granulomatous prostatitis in a 61-year-old patient which occurred after the first course of a well-tolerated Bacillus Calmette-Guérin therapy is presented. Due to abnormalities found in rectal examination and an abnormal transrectal ultrasound image of the prostate with extensive infiltration mimicking neoplastic hyperplasia a core biopsy of the prostate was performed. Histopathological examination revealed inflammatory infiltration sites of tuberculosis origin.

  16. Granulomatous prostatitis after intravesical immunotherapy mimicking prostate cancer

    PubMed Central

    Rudzki, Sławomir; Iberszer, Paweł; Wronecki, Lech

    2016-01-01

    Intravesical immunotherapy with attenuated strains of Mycobacterium bovis is a widely used therapeutic option in patients with non-muscle-invasive transitional cell carcinoma of the bladder. A rare complication of intravesical therapy with the Bacillus Calmette-Guérin vaccine is granulomatous prostatitis, which due to increasing levels of prostate-specific antigen and abnormalities found in transrectal examination of the prostate may suggest concomitant prostate cancer. A case of extensive granulomatous prostatitis in a 61-year-old patient which occurred after the first course of a well-tolerated Bacillus Calmette-Guérin therapy is presented. Due to abnormalities found in rectal examination and an abnormal transrectal ultrasound image of the prostate with extensive infiltration mimicking neoplastic hyperplasia a core biopsy of the prostate was performed. Histopathological examination revealed inflammatory infiltration sites of tuberculosis origin. PMID:28138411

  17. Cholesterol and prostate cancer.

    PubMed

    Pelton, Kristine; Freeman, Michael R; Solomon, Keith R

    2012-12-01

    Prostate cancer risk can be modified by environmental factors, however the molecular mechanisms affecting susceptibility to this disease are not well understood. As a result of a series of recently published studies, the steroidal lipid, cholesterol, has emerged as a clinically relevant therapeutic target in prostate cancer. This review summarizes the findings from human studies as well as animal and cell biology models, which suggest that high circulating cholesterol increases risk of aggressive prostate cancer, while cholesterol lowering strategies may confer protective benefit. Relevant molecular processes that have been experimentally tested and might explain these associations are described. We suggest that these promising results now could be applied prospectively to attempt to lower risk of prostate cancer in select populations.

  18. Advanced Prostate Cancer

    MedlinePlus

    ... if it has spread to: • Bones • Lungs • Liver • Brain • Lymph nodes outside the pelvis • Other organs You may be diagnosed with metastatic prostate cancer when you are first diagnosed, after having completed ...

  19. Prebiopsy Multiparametric Magnetic Resonance Imaging for Prostate Cancer Diagnosis in Biopsy-naive Men with Suspected Prostate Cancer Based on Elevated Prostate-specific Antigen Values: Results from a Randomized Prospective Blinded Controlled Trial.

    PubMed

    Tonttila, Panu P; Lantto, Juha; Pääkkö, Eija; Piippo, Ulla; Kauppila, Saila; Lammentausta, Eveliina; Ohtonen, Pasi; Vaarala, Markku H

    2016-03-01

    Multiparametric magnetic resonance imaging (MP-MRI) may improve the detection of clinically significant prostate cancer (PCa). To compare MP-MRI transrectal ultrasound (TRUS)-fusion targeted biopsy with routine TRUS-guided random biopsy for overall and clinically significant PCa detection among patients with suspected PCa based on prostate-specific antigen (PSA) values. This institutional review board-approved, single-center, prospective, randomized controlled trial (April 2011 to December 2014) included 130 biopsy-naive patients referred for prostate biopsy based on PSA values (PSA <20 ng/ml or free-to-total PSA ratio ≤0.15 and PSA <10 ng/ml). Patients were randomized 1:1 to the MP-MRI or control group. Patients in the MP-MRI group underwent prebiopsy MP-MRI followed by 10- to 12-core TRUS-guided random biopsy and cognitive MRI/TRUS fusion targeted biopsy. The control group underwent TRUS-guided random biopsy alone. MP-MRI 3-T phased-array surface coil. The primary outcome was the number of patients with biopsy-proven PCa in the MP-MRI and control groups. Secondary outcome measures included the number of positive prostate biopsies and the proportion of clinically significant PCa in the MP-MRI and control groups. Between-group analyses were performed. Overall, 53 and 60 patients were evaluable in the MP-MRI and control groups, respectively. The overall PCa detection rate and the clinically significant cancer detection rate were similar between the MP-MRI and control groups, respectively (64% [34 of 53] vs 57% [34 of 60]; 7.5% difference [95% confidence interval (CI), -10 to 25], p=0.5, and 55% [29 of 53] vs 45% [27 of 60]; 9.7% difference [95% CI, -8.5 to 27], p=0.8). The PCa detection rate was higher than assumed during the planning of this single-center trial. MP-MRI/TRUS-fusion targeted biopsy did not improve PCa detection rate compared with TRUS-guided biopsy alone in patients with suspected PCa based on PSA values. In this randomized clinical trial

  20. A dual-reporter, diagnostic vector for prostate cancer detection and tumor imaging.

    PubMed

    Richter, J R; Mahoney, M; Warram, J M; Samuel, S; Zinn, K R

    2014-10-01

    Detection of prostate-specific antigen (PSA) as a screening strategy for prostate cancer is limited by the inability of the PSA test to differentiate between malignant cancer and benign hyperplasia. Here, we report the use of a cancer-specific promoter, inhibition of differentiation-1 (Id1), to drive a dual-reporter system (Ad5/3-Id1-SEAP-Id1-mCherry) designed for detection of prostate cancer using a blood-based reporter-secreted embryonic alkaline phosphatase (SEAP) and tumor visualization using a fluorescent reporter protein, mCherry. In human prostate tumors, Id1 levels are correlated with increased Gleason grade and disease progression. To evaluate the performance of the dual-reporter system, a prostate cell panel with varying aggressive phenotypes was tested. Following infection with the Ad5/3-Id1-SEAP-Id1-mCherry vector, expression of the SEAP and mCherry reporters was shown to increase with increasing levels of cellular Id1. No correlation was observed between Id1 and PSA. To evaluate in vivo performance, flank tumors were grown in athymic male mice using three prostate cancer cell lines. Following intra-tumoral injection of the vector, tumors formed by cells with high Id1 had the greatest reporter expression. Interestingly, tumors with the lowest levels of Id1 and reporter expression produced the greatest amounts of PSA. These data support the use of Ad5/3-Id1-SEAP-Id1-mCherry as a predictor of prostate cancer malignancy and as a strategy for tumor localization.

  1. A Dual-Reporter, Diagnostic Vector for Prostate Cancer Detection and Tumor Imaging

    PubMed Central

    Richter, Jillian R.; Mahoney, Marshall; Warram, Jason M.; Samuel, Sharon; Zinn, Kurt R.

    2014-01-01

    Detection of prostate-specific antigen (PSA) as a screening strategy for prostate cancer is limited by the inability of the PSA test to differentiate between malignant cancer and benign hyperplasia. Here, we report the use of a cancer-specific promoter, inhibition of differentiation-1 (Id1), to drive a dual-reporter system (Ad5/3-Id1-SEAP-Id1-mCherry) designed for detection of prostate cancer using a blood-based reporter SEAP (secreted embryonic alkaline phosphatase) and tumor visualization using a fluorescent reporter protein, mCherry. In human prostate tumors, Id1 levels correlate with increased Gleason grade and disease progression. To evaluate the performance of the dual-reporter system, a prostate cell panel with varying aggressive phenotypes was tested. Following infection with the Ad5/3-Id1-SEAP-Id1-mCherry vector, expression of the SEAP and mCherry reporters was shown to increase with increasing levels of cellular Id1. No correlation was observed between Id1 and PSA. To evaluate in vivo performance, flank tumors were grown in athymic male mice using three prostate cancer cell lines. Following intra-tumoral injection of the vector, tumors formed by cells with high Id1 had the greatest reporter expression. Interestingly, tumors with the lowest levels of Id1 and reporter expression produced the greatest amounts of PSA. These data support the use of Ad5/3-Id1-SEAP-Id1-mCherry as a predictor of prostate cancer malignancy and a strategy for tumor localization. PMID:25056609

  2. [Paget's disease mimicking metastatic prostate cancer on bone scan image : a case report].

    PubMed

    Fukushi, Ken; Koie, Takuya; Yamamoto, Hayato; Okamoto, Akiko; Imai, Atsushi; Hatakeyama, Shingo; Yoneyama, Takahiro; Hashimoto, Yasuhiro; Ohyama, Chikara

    2013-04-01

    A 61-year-old man was referred to our hospital complaining of elevated serum prostate-specific antigen (PSA) (5.1 ng/ml). Histopathologic diagnosis with trans-rectal prostate biopsy specimen was adenocarcinoma, Gleason score 4+5 = 9. Bone scintigraphy revealed an abnormal uptake on left coxal bone. The patient was diagnosed with prostate cancer with bone metastasis. He received androgen deprivation therapy for two years. Serum PSA decreased to an undetected level. However, the abnormal activity of left coxal bone lesion was not changed on bone scintigraphy. Coxal bone biopsy was performed. The bone lesion was histopathologically diagnosed as Paget's disease of bone.

  3. Zinc and prostatic cancer

    PubMed Central

    Song, Yang; Ho, Emily

    2014-01-01

    Purpose of review Aim to understand the connection between zinc and prostatic cancer, and to summarize the recent findings about the functions of zinc in the maintenance of prostate health. Recent findings Contradictory findings have been reported by epidemiologic studies examining the association between zinc intake and the risk of prostate cancer. However, a growing body of experimental evidence support that high zinc levels are essential for prostate health. The possible mechanisms include the effects of zinc on the inhibition of terminal oxidation, induction of mitochondrial apoptogenesis, and suppression of NFκB activity. The most recent finding is the effects of zinc in the maintenance of DNA integrity in normal prostate epithelial cells (PrEC) by modulating the expression and activity of DNA repair and damage response proteins, especially p53. Zinc depletion in PrEC increased p53 expression but compromised p53 DNA binding activity resulting an impaired DNA repair function. Moreover, recent findings support the role of zinc transporters as tumor suppressors in the prostate. Summary Future studies need to discover sensitive and specific zinc biomarkers and perform more in vivo studies on the effects of zinc on prostate functions in normal animals or prostate cancer models. PMID:19684515

  4. Dual-modality image guided high intensity focused ultrasound device design for prostate cancer: A numerical study

    NASA Astrophysics Data System (ADS)

    Hobson, Dexter; Curiel, Laura; Chapelon, Jean-Yves; Pichardo, Samuel

    2012-10-01

    In this study the feasibility of designing a multi-element prostate cancer treatment device using Magnetic Resonance Imaging and ultrasound imaging for guidance was determined. A parametric study was performed to determine the optimal focal length (L), operating frequency (f), element size (a) and central hole radius for lodging an imaging probe (r) of a device that would safely treat cancerous tissue within the prostate. Images from the Visible Human Project were used to determine simulated organ sizes and treatment locations. Elliptical tumors were placed throughout the simulated prostate and their lateral and axial limits were selected as test locations. Using Tesla C1060 (NVIDIA, Santa Clara, CA, USA) graphics processors, the Bio-Heat Transfer Equation was implemented to calculate the heating produced during the simulated treatment. L, f a and r were varied from 45 to 75mm, 2.25 to 3.00MHz, 1.5 to 8 times λ and 9 to 11mm, respectively. Results indicated that a device of 761 elements with a combination of L, f a and r of 68mm, 2.75MHz, 2.05λ and 9mm, respectively, could safely ablate tumors within the prostate and spare the surrounding organs.

  5. Photoacoustic imaging with an acoustic lens detects prostate cancer cells labeled with PSMA-targeting near-infrared dye-conjugates

    NASA Astrophysics Data System (ADS)

    Dogra, Vikram; Chinni, Bhargava; Singh, Shalini; Schmitthenner, Hans; Rao, Navalgund; Krolewski, John J.; Nastiuk, Kent L.

    2016-06-01

    There is an urgent need for sensitive and specific tools to accurately image early stage, organ-confined human prostate cancers to facilitate active surveillance and reduce unnecessary treatment. Recently, we developed an acoustic lens that enhances the sensitivity of photoacoustic imaging. Here, we report the use of this device in conjunction with two molecular imaging agents that specifically target the prostate-specific membrane antigen (PSMA) expressed on the tumor cell surface of most prostate cancers. We demonstrate successful imaging of phantoms containing cancer cells labeled with either of two different PSMA-targeting agents, the ribonucleic acid aptamer A10-3.2 and a urea-based peptidomimetic inhibitor, each linked to the near-infrared dye IRDye800CW. By specifically targeting cells with these agents linked to a dye chosen for optimal signal, we are able to discriminate prostate cancer cells that express PSMA.

  6. In vivo small animal imaging for early assessment of therapeutic efficacy of photodynamic therapy for prostate cancer

    NASA Astrophysics Data System (ADS)

    Fei, Baowei; Wang, Hesheng; Chen, Xiang; Meyers, Joseph; Mulvilhill, John; Feyes, Denise; Edgehouse, Nancy; Duerk, Jeffrey L.; Pretlow, Thomas G.; Oleinick, Nancy L.

    2007-03-01

    We are developing in vivo small animal imaging techniques that can measure early effects of photodynamic therapy (PDT) for prostate cancer. PDT is an emerging therapeutic modality that continues to show promise in the treatment of cancer. At our institution, a new second-generation photosensitizing drug, the silicon phthalocyanine Pc 4, has been developed and evaluated at the Case Comprehensive Cancer Center. In this study, we are developing magnetic resonance imaging (MRI) techniques that provide therapy monitoring and early assessment of tumor response to PDT. We generated human prostate cancer xenografts in athymic nude mice. For the imaging experiments, we used a highfield 9.4-T small animal MR scanner (Bruker Biospec). High-resolution MR images were acquired from the treated and control tumors pre- and post-PDT and 24 hr after PDT. We utilized multi-slice multi-echo (MSME) MR sequences. During imaging acquisitions, the animals were anesthetized with a continuous supply of 2% isoflurane in oxygen and were continuously monitored for respiration and temperature. After imaging experiments, we manually segmented the tumors on each image slice for quantitative image analyses. We computed three-dimensional T2 maps for the tumor regions from the MSME images. We plotted the histograms of the T2 maps for each tumor pre- and post-PDT and 24 hr after PDT. After the imaging and PDT experiments, we dissected the tumor tissues and used the histologic slides to validate the MR images. In this study, six mice with human prostate cancer tumors were imaged and treated at the Case Center for Imaging Research. The T2 values of treated tumors increased by 24 +/- 14% 24 hr after the therapy. The control tumors did not demonstrate significant changes of the T2 values. Inflammation and necrosis were observed within the treated tumors 24 hour after the treatment. Preliminary results show that Pc 4-PDT is effective for the treatment of human prostate cancer in mice. The small animal MR

  7. In Vivo Small Animal Imaging for Early Assessment of Therapeutic Efficacy of Photodynamic Therapy for Prostate Cancer.

    PubMed

    Fei, Baowei; Wang, Hesheng; Chen, Xiang; Meyers, Joseph; Mulvihill, John; Feyes, Denise; Edgehouse, Nancy; Duerk, Jeffrey L; Pretlow, Thomas G; Oleinick, Nancy L

    2007-03-29

    We are developing in vivo small animal imaging techniques that can measure early effects of photodynamic therapy (PDT) for prostate cancer. PDT is an emerging therapeutic modality that continues to show promise in the treatment of cancer. At our institution, a new second-generation photosensitizing drug, the silicon phthalocyanine Pc 4, has been developed and evaluated at the Case Comprehensive Cancer Center. In this study, we are developing magnetic resonance imaging (MRI) techniques that provide therapy monitoring and early assessment of tumor response to PDT. We generated human prostate cancer xenografts in athymic nude mice. For the imaging experiments, we used a high-field 9.4-T small animal MR scanner (Bruker Biospec). High-resolution MR images were acquired from the treated and control tumors pre- and post-PDT and 24 hr after PDT. We utilized multi-slice multi-echo (MSME) MR sequences. During imaging acquisitions, the animals were anesthetized with a continuous supply of 2% isoflurane in oxygen and were continuously monitored for respiration and temperature. After imaging experiments, we manually segmented the tumors on each image slice for quantitative image analyses. We computed three-dimensional T2 maps for the tumor regions from the MSME images. We plotted the histograms of the T2 maps for each tumor pre- and post-PDT and 24 hr after PDT. After the imaging and PDT experiments, we dissected the tumor tissues and used the histologic slides to validate the MR images. In this study, six mice with human prostate cancer tumors were imaged and treated at the Case Center for Imaging Research. The T2 values of treated tumors increased by 24 ± 14% 24 hr after the therapy. The control tumors did not demonstrate significant changes of the T2 values. Inflammation and necrosis were observed within the treated tumors 24 hour after the treatment. Preliminary results show that Pc 4-PDT is effective for the treatment of human prostate cancer in mice. The small animal MR

  8. Impact of magnetic resonance imaging-guided prostate biopsy in the supine position on the detection of significant prostate cancer in an inhomogeneous patient cohort.

    PubMed

    Engelhard, Karl; Kühn, Reinhart; Osten, Artur; Bogner, Katja; Dworak, Anton; Lübke, Lars; Schneider, Florian

    2016-01-01

    The aim of this study was to determine the tumour detection rate of magnetic resonance-guided biopsy (MRGB) in the supine position for significant prostate cancer in an inhomogeneous patient cohort. Thirty-two consecutive patients with a total prostate-specific antigen > 4 ng/ml and/or a tumour-suspicious palpable lesion upon digital rectal examination and a cancer-suspicious region in multiparametric magnetic resonance imaging (MRI) underwent MRGB in a standard 1.5 T magnet. Diagnostic MRI was performed in 20 patients at the authors' institute and 12 men at another location. Eight patients were investigated at 3 T and 24 at 1.5 T. Twenty men had prior negative biopsies and 12 were biopsy naïve. All biopsies were performed in the supine position using a table-mounted device and an 18 G biopsy gun. The overall tumour detection rate was 53% (17/32). Two cores (median; range 1-4) were extracted. Clinically significant cancers were found in 94% (16/17). None of the patients showed any postbiopsy complications. The prostate volumes of patients with cancer were significantly lower (39.3 ml) than those of men without cancer (49.7 ml). No significant differences were found between the numbers of tumour-positive and tumour-negative collected cores. In a median follow-up of 14 months, no cancer was detected in the negative biopsy group. MRGB in the supine position can be a valuable tool to detect significant prostate cancer, even in a patient cohort with different prebiopsy pathways. The biopsy method could be a reasonable alternative to MRGB in the prone position.

  9. Magnetic Resonance Imaging-Ultrasound Fusion Biopsy During Prostate Cancer Active Surveillance.

    PubMed

    Tran, Geraldine N; Leapman, Michael S; Nguyen, Hao G; Cowan, Janet E; Shinohara, Katsuto; Westphalen, Antonio C; Carroll, Peter R

    2017-08-01

    Fusion biopsy using multiparametric magnetic resonance imaging (MRI) and transrectal ultrasound has demonstrated favorable detection rates of high-grade prostate cancer (PCa) among previously undiagnosed men. However, the diagnostic yield among men with active surveillance (AS) remains undefined. To determine the utility of MRI-ultrasound fusion biopsy during AS by reporting rates of PCa upgrading and comparing findings with systematic biopsy. We identified patients with low- and intermediate-risk PCa enrolled in AS who received MRI-ultrasound fusion surveillance biopsies. All completed prostate multiparametric MRI with 3-T and endorectal coil reviewed by radiologists selecting regions of interest, and all underwent MRI-ultrasound fusion biopsy with concurrent systematic biopsy. We report MRI-ultrasound fusion biopsy findings, rates of Gleason score (GS) upgrading to ≥3 + 4 (any upgrading) and to ≥4 + 3 (major upgrading), tumor involvement estimates using descriptive statistics, McNemar's test of symmetry, and multivariate logistic regression. Overall, 207 men underwent MRI-ultrasound fusion biopsy following radiologic suspicion on multiparametric MRI and met inclusion criteria. Agreement between systematic and MRI-ultrasound fusion biopsy GS was borderline statistically significant (p<0.047). In total, 83 men (40%) experienced any upgrading, including 49 (24%) on systematic sampling, 30 (14%) on MRI-targeted cores, and four (2%) on both. Among those with negative results on MRI-ultrasound fusion biopsy, seven (9%) exhibited major upgrading with systematic biopsy. MRI suspicion scores were high (4/5) for all but two patients with any upgrading and for all who experienced major upgrading. On multivariate analysis, older age was associated with higher odds of any upgrading for men with GS ≤3 + 3 on previous biopsy (odds ratio: 1.10; 95% confidence interval, 1.01-1.20; p=0.03). MRI-ultrasound fusion biopsy resulted in upgrading otherwise undetected by systematic

  10. Image-guided conformation arc therapy for prostate cancer: Early side effects

    SciTech Connect

    Soete, Guy . E-mail: guy.soete@az.vub.ac.be; Verellen, Dirk; Michielsen, Dirk; Rappe, Bernard; Keuppen, Frans; Storme, Guy

    2006-11-15

    Purpose: To evaluate early side effects in prostate cancer patients treated with image-guided conformation arc therapy (IGCAT) using a minimultileaf collimator and daily X-ray-assisted patient positioning. Methods and Materials: Between May 2000 and November 2004, 238 cT1-T3N0M0 tumors were treated with doses of 70 or 78 Gy. Seventy patients also received neoadjuvant or concurrent hormonal treatment. Median follow-up is 18 months (range, 4-55 months). Radiation Therapy Oncology Group and the European Organization for Research and Treatment of Cancer toxicity scoring system was used to evaluate early side effects. Results: Grade 1, 2, and >2 acute side effects occurred in 19, 6, and 0% (gastrointestinal) and 37, 16, and 0% (genitourinary) of the patients. No relation between radiation dose and early side effects was observed. Conclusion: Patients treated with image-guided conformation arc therapy experience a low rate of Grade 2 (i.e., requiring medication) early side effects. The definitive evaluation of late side effects and biochemical control requires further follow-up.

  11. Obesity and Prostate Cancer.

    PubMed

    Cao, Yin; Giovannucci, Edward

    Prostate cancer is a complex, heterogeneous disease. Factors related to detection, particularly PSA screening, further increase heterogeneity in the manifestation of the disease. It is thus not possible to provide a simple summary of the relationship between obesity and prostate cancer. Findings on obesity, often defined using body mass index (BMI), and total prostate cancer risk have been mixed; however, obesity is relatively consistently associated with a higher risk of aggressive prostate cancer, with aggressiveness defined in various ways (e.g., advanced stage, fatal, poorer prognosis in men with prostate cancer). Many methodologic issues (e.g., influence of PSA screening, detection bias and treatment) need to be thoroughly considered in both existing and future etiologic and prognostic research. Biological mechanisms supporting the link are under investigation, but may involve insulin and IGF axis, sex steroid hormones and alterations in metabolism. Some promising data suggest that molecular sub-types of prostate cancer may offer insights into etiology, but further study is required. A full evaluation of body fatness and weight change over the life course would not only provide insights to the underlying mechanisms but also allow more effective interventions.

  12. Prostate Cancer Pathology Resource Network

    DTIC Science & Technology

    2015-12-01

    researchers. Specimens include prostatectomy tissues (frozen, paraffin embedded, and tissue microarrays (TMAs), serum, plasma, buffy coat, prostatic fluid...Prostate Cancer, biorepository, biomarkers, tissue microarrays 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a...usage by the prostate cancer research community. The specimens in the PCBN include tissues from prostatectomies, serum, plasma, buffy coat, prostatic

  13. Stokes polarimetry imaging of dog prostate tissue

    NASA Astrophysics Data System (ADS)

    Kim, Jihoon; Johnston, William K., III; Walsh, Joseph T., Jr.

    2010-02-01

    Prostate cancer is the second leading cause of death in the United States in 2009. Radical prostatectomy (complete removal of the prostate) is the most common treatment for prostate cancer, however, differentiating prostate tissue from adjacent bladder, nerves, and muscle is difficult. Improved visualization could improve oncologic outcomes and decrease damage to adjacent nerves and muscle important for preservation of potency and continence. A novel Stokes polarimetry imaging (SPI) system was developed and evaluated using a dog prostate specimen in order to examine the feasibility of the system to differentiate prostate from bladder. The degree of linear polarization (DOLP) image maps from linearly polarized light illumination at different visible wavelengths (475, 510, and 650 nm) were constructed. The SPI system used the polarization property of the prostate tissue. The DOLP images allowed advanced differentiation by distinguishing glandular tissue of prostate from the muscular-stromal tissue in the bladder. The DOLP image at 650 nm effectively differentiated prostate and bladder by strong DOLP in bladder. SPI system has the potential to improve surgical outcomes in open or robotic-assisted laparoscopic removal of the prostate. Further in vivo testing is warranted.

  14. Echo-Planar Imaging-Based, J-Resolved Spectroscopic Imaging for Improved Metabolite Detection in Prostate Cancer

    DTIC Science & Technology

    2015-10-01

    hyperplasia (BPH), prior-knowledge fitting 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF RESPONSIBLE...unpredictable clinical course, early detection and diagnosis have become a priority for many health care professionals. Another method for staging prostate...Chan JM, et al. Active surveillance for early- stage prostate cancer: review. Cancer. 2008 Apr 15;112(8):1650-9. PMID: 18306379 2) McNeal JE. Normal

  15. Targeted molecular-genetic imaging and ligand-directed therapy in aggressive variant prostate cancer.

    PubMed

    Ferrara, Fortunato; Staquicini, Daniela I; Driessen, Wouter H P; D'Angelo, Sara; Dobroff, Andrey S; Barry, Marc; Lomo, Lesley C; Staquicini, Fernanda I; Cardó-Vila, Marina; Soghomonyan, Suren; Alauddin, Mian M; Flores, Leo G; Arap, Marco A; Lauer, Richard C; Mathew, Paul; Efstathiou, Eleni; Aparicio, Ana M; Troncoso, Patricia; Navone, Nora M; Logothetis, Christopher J; Marchiò, Serena; Gelovani, Juri G; Sidman, Richard L; Pasqualini, Renata; Arap, Wadih

    2016-10-24

    Aggressive variant prostate cancers (AVPC) are a clinically defined group of tumors of heterogeneous morphologies, characterized by poor patient survival and for which limited diagnostic and treatment options are currently available. We show that the cell surface 78-kDa glucose-regulated protein (GRP78), a receptor that binds to phage-display-selected ligands, such as the SNTRVAP motif, is a candidate target in AVPC. We report the presence and accessibility of this receptor in clinical specimens from index patients. We also demonstrate that human AVPC cells displaying GRP78 on their surface could be effectively targeted both in vitro and in vivo by SNTRVAP, which also enabled specific delivery of siRNA species to tumor xenografts in mice. Finally, we evaluated ligand-directed strategies based on SNTRVAP-displaying adeno-associated virus/phage (AAVP) particles in mice bearing MDA-PCa-118b, a patient-derived xenograft (PDX) of castration-resistant prostate cancer bone metastasis that we exploited as a model of AVPC. For theranostic (a merging of the terms therapeutic and diagnostic) studies, GRP78-targeting AAVP particles served to deliver the human Herpes simplex virus thymidine kinase type-1 (HSVtk) gene, which has a dual function as a molecular-genetic sensor/reporter and a cell suicide-inducing transgene. We observed specific and simultaneous PET imaging and treatment of tumors in this preclinical model of AVPC. Our findings demonstrate the feasibility of GPR78-targeting, ligand-directed theranostics for translational applications in AVPC.

  16. Targeted molecular-genetic imaging and ligand-directed therapy in aggressive variant prostate cancer

    PubMed Central

    Ferrara, Fortunato; Staquicini, Daniela I.; Driessen, Wouter H. P.; D’Angelo, Sara; Dobroff, Andrey S.; Barry, Marc; Lomo, Lesley C.; Staquicini, Fernanda I.; Cardó-Vila, Marina; Soghomonyan, Suren; Alauddin, Mian M.; Flores, Leo G.; Arap, Marco A.; Lauer, Richard C.; Mathew, Paul; Efstathiou, Eleni; Aparicio, Ana M.; Troncoso, Patricia; Navone, Nora M.; Logothetis, Christopher J.; Marchiò, Serena; Gelovani, Juri G.; Sidman, Richard L.; Pasqualini, Renata; Arap, Wadih

    2016-01-01

    Aggressive variant prostate cancers (AVPC) are a clinically defined group of tumors of heterogeneous morphologies, characterized by poor patient survival and for which limited diagnostic and treatment options are currently available. We show that the cell surface 78-kDa glucose-regulated protein (GRP78), a receptor that binds to phage-display-selected ligands, such as the SNTRVAP motif, is a candidate target in AVPC. We report the presence and accessibility of this receptor in clinical specimens from index patients. We also demonstrate that human AVPC cells displaying GRP78 on their surface could be effectively targeted both in vitro and in vivo by SNTRVAP, which also enabled specific delivery of siRNA species to tumor xenografts in mice. Finally, we evaluated ligand-directed strategies based on SNTRVAP-displaying adeno-associated virus/phage (AAVP) particles in mice bearing MDA-PCa-118b, a patient-derived xenograft (PDX) of castration-resistant prostate cancer bone metastasis that we exploited as a model of AVPC. For theranostic (a merging of the terms therapeutic and diagnostic) studies, GRP78-targeting AAVP particles served to deliver the human Herpes simplex virus thymidine kinase type-1 (HSVtk) gene, which has a dual function as a molecular-genetic sensor/reporter and a cell suicide-inducing transgene. We observed specific and simultaneous PET imaging and treatment of tumors in this preclinical model of AVPC. Our findings demonstrate the feasibility of GPR78-targeting, ligand-directed theranostics for translational applications in AVPC. PMID:27791181

  17. Quantitative comparison and reproducibility of pathologist scoring and digital image analysis of estrogen receptor β2 immunohistochemistry in prostate cancer.

    PubMed

    Rizzardi, Anthony E; Zhang, Xiaotun; Vogel, Rachel Isaksson; Kolb, Suzanne; Geybels, Milan S; Leung, Yuet-Kin; Henriksen, Jonathan C; Ho, Shuk-Mei; Kwak, Julianna; Stanford, Janet L; Schmechel, Stephen C

    2016-07-11

    Digital image analysis offers advantages over traditional pathologist visual scoring of immunohistochemistry, although few studies examining the correlation and reproducibility of these methods have been performed in prostate cancer. We evaluated the correlation between digital image analysis (continuous variable data) and pathologist visual scoring (quasi-continuous variable data), reproducibility of each method, and association of digital image analysis methods with outcomes using prostate cancer tissue microarrays (TMAs) stained for estrogen receptor-β2 (ERβ2). Prostate cancer TMAs were digitized and evaluated by pathologist visual scoring versus digital image analysis for ERβ2 staining within tumor epithelium. Two independent analysis runs were performed to evaluate reproducibility. Image analysis data were evaluated for associations with recurrence-free survival and disease specific survival following radical prostatectomy. We observed weak/moderate Spearman correlation between digital image analysis and pathologist visual scores of tumor nuclei (Analysis Run A: 0.42, Analysis Run B: 0.41), and moderate/strong correlation between digital image analysis and pathologist visual scores of tumor cytoplasm (Analysis Run A: 0.70, Analysis Run B: 0.69). For the reproducibility analysis, there was high Spearman correlation between pathologist visual scores generated for individual TMA spots across Analysis Runs A and B (Nuclei: 0.84, Cytoplasm: 0.83), and very high correlation between digital image analysis for individual TMA spots across Analysis Runs A and B (Nuclei: 0.99, Cytoplasm: 0.99). Further, ERβ2 staining was significantly associated with increased risk of prostate cancer-specific mortality (PCSM) when quantified by cytoplasmic digital image analysis (HR 2.16, 95 % CI 1.02-4.57, p = 0.045), nuclear image analysis (HR 2.67, 95 % CI 1.20-5.96, p = 0.016), and total malignant epithelial area analysis (HR 5.10, 95 % CI 1.70-15.34, p = 0

  18. Magnetic Resonance Imaging of the Prostate, Including Pre- and Postinterventions.

    PubMed

    Patel, Pritesh; Oto, Aytekin

    2016-09-01

    This article systematically reviews the rationale for magnetic resonance imaging in prostate cancer, in detection and following various treatment methods. A basic discussion of the identification of prostate cancer is imperative to understand postintervention imaging. Each available therapy, including surgery, radiation, hormone therapy, and focal therapies will be discussed along with associated imaging findings, providing the reader with a better understanding of current interventions in prostate cancer and imaging.

  19. Magnetic Resonance Imaging of the Prostate, Including Pre- and Postinterventions

    PubMed Central

    Patel, Pritesh; Oto, Aytekin

    2016-01-01

    This article systematically reviews the rationale for magnetic resonance imaging in prostate cancer, in detection and following various treatment methods. A basic discussion of the identification of prostate cancer is imperative to understand postintervention imaging. Each available therapy, including surgery, radiation, hormone therapy, and focal therapies will be discussed along with associated imaging findings, providing the reader with a better understanding of current interventions in prostate cancer and imaging. PMID:27582606

  20. Advances in transrectal ultrasound imaging of the prostate.

    PubMed

    Linden, Robert A; Halpern, Ethan J

    2007-08-01

    Grayscale imaging of the prostate is the basic method for diagnostic evaluation and biopsy guidance. Doppler imaging may improve sensitivity for detection of prostate cancer. Microbubble contrast agents represent a major advance to more selectively demonstrate neovascular flow within the prostate. Recently, real-time elastography has been introduced to improve detection of cancer based upon changes in tissue stiffness. As diagnostic methods improve, the ultimate hope is to eliminate biopsy in patients without cancer. New ultrasound-based treatment systems, such as high-intensity focused ultrasound ablative therapy for prostate cancer, may someday allow diagnosis and treatment of prostate cancer to be completed in one sitting.

  1. Incorporating endorectal MR elastography into multi-parametric MRI for prostate cancer imaging: Initial feasibility in volunteers.

    PubMed

    Arani, Arvin; Da Rosa, Michael; Ramsay, Elizabeth; Plewes, Don B; Haider, Masoom A; Chopra, Rajiv

    2013-11-01

    To investigate the tolerability and technical feasibility of performing endorectal MR elastography (eMRE) in human volunteers within the representative age group commonly affected by prostate cancer. Endorectal MRE was conducted on seven volunteers in a 1.5 Tesla (T) MR imager using a rigid endorectal coil. Another five volunteers were imaged on a 3T MR imager using an inflatable balloon type endorectal coil. Tolerability was accessed for vibration amplitudes of ±1-50 μm and for frequencies of 100-300 Hz. All 12 volunteers tolerated the displacements necessary to successfully perform eMRE. Shear waves with frequencies up to 300 Hz could propagate across the entire prostate using both coil designs. The results of this study motivate further investigation of eMRE in prostate cancer patients to help determine if there is an added value of integrating eMRE into existing multi-parametric prostate MRI exams. Copyright © 2013 Wiley Periodicals, Inc.

  2. Tissue-type imaging (TTI) based on ultrasonic spectral and clinical parameters for detecting, evaluating, and managing prostate cancer

    NASA Astrophysics Data System (ADS)

    Feleppa, Ernest J.; Ketterling, Jeffrey A.; Dasgupta, Shreedevi; Kalisz, Andrew; Ramachandran, Sarayu; Porter, Christopher R.

    2005-04-01

    This study seeks to develop more-sensitive and -specific ultrasonic methods of imaging cancerous prostate tissue and thereby to improve means of guiding biopsies and planning, targeting, and monitoring treatment. Ultrasonic radio-frequency, echo-signal data, and clinical variables, e.g., PSA, voiding function, etc., during biopsy examinations were acquired. Spectra of the radio-frequency signals were computed in each biopsied region, and used to train neural networks; biopsy results served as the gold standard. A lookup table gave scores for cancer likelihood on a pixel-by-pixel basis from locally computed spectral-parameter and global clinical-parameter values. ROC curves used leave-one-patient- and leave-one-biopsy-out approaches to minimize classification bias. Resulting ROC-curve areas were 0.80+/-0.03 for neural-networks versus 0.66+/-0.03 for conventional classification. TTIs generated from data acquired pre-surgically showed tumors that were unrecognized in conventional images and during surgery. 3-D renderings of prostatectomy histology and TTIs showed encouraging correlations, which shows promise for improving the detection and management of prostate cancer, e.g., for biopsy guidance, planning dose-escalation and tissue-sparing options for radiation or cryotherapy, and assessing the effects of treatment. Combining MRS parameters with US spectral parameters appears capable of further improving prostate-cancer imaging. [Work supported by NIH.

  3. SU-E-I-82: PET Radiopharmaceuticals for Prostate Cancer Imaging: A Review

    SciTech Connect

    Fernandes, F; Silva, D da; Rodrigues, L

    2015-06-15

    Purpose: The aim of this work was to review new and clinical practice PET radiopharmaceuticals for prostate cancer imaging. Methods: PET radiopharmaceuticals were reviewed on the main databases. Availability, dosimetry, accuracy and limitations were considered. Results: The following radioisotopes with respective physical half-life and mean positron energy were found: {sup 18}F (109,7 min, 249,8 keV), {sup 89}Zr (78,4 hs, 395,5 keV), {sup 11}C (20,4 min, 385,7 keV) and {sup 68}Ga (67,8 min, 836 keV). {sup 68}Ga was the only one not produced by cyclotron. Radiopharmaceuticals uptake by glucose metabolism ({sup 18}F-FDG), lipogenesis ({sup 11}C-Choline and {sup 11}C-Acetate), amino acid transport (Anti-{sup 18}F-FACBC), bone matrix ({sup 18}F-NaF), prostatespecific membrane antigen ({sup 68}Ga-PSMA and {sup 89}Zr-J591), CXCR receptors ({sup 89}Ga-Pentixafor), adrenal receptors ({sup 18}F-FDHT) and gastrin release peptide receptor (bombesin analogue). Most of radiopharmaceuticals are urinary excretion, so bladder is the critical organ. 11C-choline (pancreas), Anti-{sup 18}FFACBC (liver) and {sup 18}F-FBDC (stomach wall) are the exception. Higher effective dose was seen {sup 18}F-NaF (27 μSv/MBq) while the lowest was {sup 11}CAcetate (3,5 μSv/MBq). Conclusion: Even though {sup 18}F-FDG has a large availability its high urinary excretion and poor uptake to slow growing disease offers weak results for prostate cancer. Better accuracy is obtained when {sup 18}F-NaF is used for bone metastatic investigation although physicians tend to choose bone scintigraphy probably due to its cost and practice. Many guidelines in oncology consider {sup 11}C or {sup 18}F labeled with Choline the gold standard for biochemical relapse after radical treatment. Local, lymph node and distant metastatic relapse can be evaluated at same time with this radiopharmaceutical. There is no consensus over bigger urinary excretion for {sup 18}F labeling. Anti-{sup 18}F-FACBC, {sup 68}Ga-PSMA and {sup

  4. VPAC1 targeted 64Cu-TP3805 PET imaging of prostate cancer: preliminary evaluation in man

    PubMed Central

    Tripathi, Sushil; Trabulsi, Edouard J; Gomella, Leonard; Kim, Sung; McCue, Peter; Intenzo, Charles; Birbe, Ruth; Gandhe, Ashish; Kumar, Pardeep; Thakur, Mathew

    2015-01-01

    Objectives To evaluate 64Cu-TP3805 as a novel biomolecule, to PET image prostate cancer (PC), at the onset of which VPAC1, the superfamily of G-protein coupled receptors, is expressed in high density on PC cells, but not on normal cells. Methods 25 patients undergoing radical prostatectomy were PET/CT imaged preoperatively with 64Cu-TP3805. Standardized uptake values (SUVmax) were determined, malignant lesions (SUV > 1.0) counted, and compared with histologic findings. Whole mount pathology slides from 6 VPAC1 PET imaged patients, 3 BPH patients, one malignant and one benign lymph node underwent digital autoradiography (DAR) after 64Cu-TP3805 incubation and compared to H&E stained slides. Results In 25 patient PET imaging, 212 prostate gland lesions had SUVmax > 1.0 vs.127 lesions identified by histology of biopsy tissues. The status of the additional 85 PET identified prostate lesions remains to be determined. In 68 histological slides from 6 PET imaged patients, DAR identified 105/107 PC foci, 19/19 HGPIN, and ejaculatory ducts and verumontanum involved with cancer. Additionally, DAR found 9 PC lesions not previously identified histologically. The positive and negative lymph nodes were correctly identified and in 3/3 BPH patients and 5/5 cysts, DAR was negative. Conclusion This feasibility study demonstrated that 64Cu-TP3805 delineates PC in vivo and ex vivo, provided normal images for benign masses, and is worthy of further studies. PMID:26519886

  5. Magnetic Resonance-Based Electrical Property Tomography (MR- EPT) for Prostate Cancer Grade Imaging

    DTIC Science & Technology

    2014-07-01

    inclusion gelatin phantom. Top row shows T1 MR images along the axis of phantom; two playdough inclusions at different planes show up as low intensity ...new data published in The Prostate [6] in which we demonstrated significant electrical property differences between high- and low -grade prostate...have hypothesize that it is possible to use these properties to discriminate between normal, low -grade, and high-grade malignant formations in a

  6. Decreased acute toxicities of intensity-modulated radiation therapy for localized prostate cancer with prostate-based versus bone-based image guidance.

    PubMed

    Nakamura, Kiyonao; Mizowaki, Takashi; Inokuchi, Haruo; Ikeda, Itaru; Inoue, Takahiro; Kamba, Tomomi; Ogawa, Osamu; Hiraoka, Masahiro

    2017-07-29

    Intensity-modulated radiation therapy (IMRT) is a major therapeutic option for localized prostate cancer. Image-guided radiation therapy (IGRT) allows tumor visualization and corrects the errors caused by daily internal movement of the prostate. The current study retrospectively compared the acute toxicities and biochemical tumor control outcomes of prostate IMRT achieved using two IGRT techniques: bony structure-based IGRT (B-IGRT) and prostate-based IGRT (P-IGRT). Between February 2011 and July 2014, 96 patients with low- or intermediate-risk prostate cancer were treated using P-IGRT based on cone-beam computed tomography (CBCT; 76 Gy) without fiducial markers. This group of patients was compared with a similar cohort of 96 patients who were treated with B-IGRT (74 Gy) between July 2007 and September 2011. The planning target volume (PTV) margins were 1-3 mm smaller in the P-IGRT group than in the B-IGRT group. The median follow-up periods for all patients, the P-IGRT group, and the B-IGRT group were 42, 32, and 64 months, respectively. A significantly lower incidence of acute grade 2 or higher gastrointestinal toxicities was observed in the P-IGRT group compared with the B-IGRT group (3 vs. 11%; p = 0.049). The prostate-specific antigen failure-free survival rates at 3 years were 95.5 and 92.7% for the P-IGRT and B-IGRT groups, respectively (p = 0.534). IMRT with P-IGRT allows PTV margin reduction without sacrificing tumor control, which successfully reduces acute rectal toxicity compared with IMRT with B-IGRT.

  7. Imaging agents for in vivo molecular profiling of disseminated prostate cancer--targeting EGFR receptors in prostate cancer: comparison of cellular processing of [111In]-labeled affibody molecule Z(EGFR:2377) and cetuximab.

    PubMed

    Malmberg, Jennie; Tolmachev, Vladimir; Orlova, Anna

    2011-04-01

    Expression of receptor tyrosine-kinase (RTK) EGFR is low in normal prostate, but increases in prostate cancer. This receptor is significantly up-regulated as tumors progress into higher grade, androgen-insensitive and metastatic lesions. The up-regulated receptors could serve as targets for novel selective anti-cancer drugs, e.g. antibodies and tyrosine kinase inhibitors. Radionuclide imaging of RTK can facilitate patient stratification and monitoring of anti-RTK therapy of prostate cancer. The goal of the study was to evaluate binding and cellar processing of radiolabeled EGFR-targeting conjugates by prostate cancer cell lines. Receptor expression of EGFR was studied in three prostate cancer cell lines: DU145 (brain metastasis of PC, hormone insensitive), PC3 (bone metastasis of PC) and LNCaP (lymph node metastasis of PC, androgen and estrogen receptor positive). Uptake and internalization of anti-EGFR mAbs (cetuximab) and affibody molecule (Z2377) labeled with indium-111 was investigated. EGFR expression on prostate cancer cell lines was clearly demonstrated. Both labelled conjugates 111In-Z2377 and 111In-cetuximab bound to prostate cancer cells in the receptor mediated model. Expression levels were modest but correlate with degree of hormone independence. Internalization of Affibody molecules was relatively slow in all cell lines. Internalization of mAbs was more rapid. The level of EGFR expression in these cell lines is sufficient for in vivo molecular imaging. Slow internalization indicates possibility of the use of non-residualizing labels for affibody molecules.

  8. (68)Ga-PSMA I&T PET/CT for assessment of prostate cancer: evaluation of image quality after forced diuresis and delayed imaging.

    PubMed

    Derlin, Thorsten; Weiberg, Desiree; von Klot, Christoph; Wester, Hans-Jürgen; Henkenberens, Christoph; Ross, Tobias L; Christiansen, Hans; Merseburger, Axel S; Bengel, Frank M

    2016-12-01

    Urinary radiotracer excretion of (68)Ga-Labelled prostate-specific membrane antigen (PSMA) ligands may complicate the assessment of the prostate region and differentiation of lymph nodes from ureteral activity. The aim of this study was to assess the value of delayed imaging after forced diuresis. Sixty-six patients underwent (68)Ga-PSMA I&T PET/CT for evaluation of prostate cancer at 60 min post-injection. In subgroups of patients, this was amended by delayed imaging after 180 min post-injection, preceded by furosemide and oral hydration early, at the time of tracer injection, or delayed, at 100 min post-injection. Urinary tracer activity within the bladder and focal ureteral activity was analyzed. After forced diuresis, linear and focal visualization of ureters was significantly reduced. After delayed furosemide, mean and peak bladder activity decreased (p < 0.001), and image quality of the prostate region improved on delayed images (p < 0.001). Early furosemide co-injection with tracer resulted in increased mean and peak bladder activity (p < 0.001) and in deteriorated image quality of the prostate region on delayed images (p = 0.008). Ga-PSMA I&T PET/CT delayed imaging after forced diuresis can improve the assessment of prostate region and pelvic lymph nodes by removing excreted tracer from the lower urinary tract. • Forced diuresis can improve image quality in (68) Ga-PSMA I&T. • After forced diuresis, linear and focal visualization of ureters was reduced. • Timing of diuresis relative to (68) Ga-PSMA I&T injection is important. • Early furosemide co-injection with tracer resulted in deteriorated image quality on delayed images. • After delayed furosemide, image quality improved on delayed images.

  9. Computerized estimation of patient setup errors in portal images based on localized pelvic templates for prostate cancer radiotherapy

    PubMed Central

    Arimura, Hidetaka; Itano, Wataru; Shioyama, Yoshiyuki; Matsushita, Norimasa; Magome, Taiki; Yoshitake, Tadamasa; Anai, Shigeo; Nakamura, Katsumasa; Yoshidome, Satoshi; Yamagami, Akihiko; Honda, Hiroshi; Ohki, Masafumi; Toyofuku, Fukai; Hirata, Hideki

    2012-01-01

    We have developed a computerized method for estimating patient setup errors in portal images based on localized pelvic templates for prostate cancer radiotherapy. The patient setup errors were estimated based on a template-matching technique that compared the portal image and a localized pelvic template image with a clinical target volume produced from a digitally reconstructed radiography (DRR) image of each patient. We evaluated the proposed method by calculating the residual error between the patient setup error obtained by the proposed method and the gold standard setup error determined by consensus between two radiation oncologists. Eleven training cases with prostate cancer were used for development of the proposed method, and then we applied the method to 10 test cases as a validation test. As a result, the residual errors in the anterior–posterior, superior–inferior and left–right directions were smaller than 2 mm for the validation test. The mean residual error was 2.65 ± 1.21 mm in the Euclidean distance for training cases, and 3.10 ± 1.49 mm for the validation test. There was no statistically significant difference in the residual error between the test for training cases and the validation test (P = 0.438). The proposed method appears to be robust for detecting patient setup error in the treatment of prostate cancer radiotherapy. PMID:22843375

  10. Multiparametric magnetic resonance imaging for pre-treatment local staging of prostate cancer: A Cancer Care Ontario clinical practice guideline

    PubMed Central

    Salerno, Jennifer; Finelli, Antonio; Morash, Chris; Morgan, Scott C.; Power, Nicholas; Schieda, Nichola; Haider, Masoom A.

    2016-01-01

    Introduction: The utility of T2-weighted magnetic resonance imaging (MRI) in the local staging of prostate cancer is controversial. Due to the success of multiparametric MRI in cancer localization, there is renewed interested in MRI (± functional sequences) for local staging. Guidance on pre-treatment local staging of prostate cancer by MRI was developed using systematic review methodology and expert consultation. Methods: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and other databases were searched to identify studies comparing: (1) MRI staging vs. radical prostatectomy staging on diagnostic accuracy outcomes; and (2) MRI staging vs. routine clinical staging on clinical and patient outcomes. Studies meeting inclusion criteria were synthesized by outcome and sensitivity/specificity analysis by tumour location was performed. Evidence quality of included studies was assessed and considered in recommendation formulation. Results: The literature search identified 2510 citations; 62 studies were included. Analysis of MRI ≥1.5 T plus endorectal coil (ER) (± functional sequences) in the detection of extraprostatic extension or seminal vesicle invasion showed modest sensitivities (≥50%) and excellent specificities (>85%) among patients scheduled for radical prostatectomy. MRI upstaging was shown in 20/21 studies, with large variation in correctness (11–85%). Scarcity of clinical and patient outcomes among studies limited synthesis and evaluation. Quality assessment found non-trivial biases. Conclusions: Modest imaging performance was shown for MRI (1.5 T + ER and 3 T ± ER) ± functional sequences in regards to sensitivity. Limitations in study design, reporting of clinical and patient outcomes, and the heterogeneous use of MRI tempered the strength of the recommendations. PMID:27800062

  11. How accurate is multiparametric MR imaging in evaluation of prostate cancer volume?

    PubMed

    Bratan, Flavie; Melodelima, Christelle; Souchon, Rémi; Hoang Dinh, Au; Mège-Lechevallier, Florence; Crouzet, Sébastien; Colombel, Marc; Gelet, Albert; Rouvière, Olivier

    2015-04-01

    To assess the factors influencing multiparametric (MP) magnetic resonance (MR) imaging accuracy in estimating prostate cancer histologic volume (Vh). A prospective database of 202 patients who underwent MP MR imaging before radical prostatectomy was retrospectively used. Institutional review board approval and informed consent were obtained. Two independent radiologists delineated areas suspicious for cancer on images (T2-weighted, diffusion-weighted, dynamic contrast material-enhanced [DCE] pulse sequences) and scored their degree of suspicion of malignancy by using a five-level Likert score. One pathologist delineated cancers on whole-mount prostatectomy sections and calculated their volume by using digitized planimetry. Volumes of MR true-positive lesions were measured on T2-weighted images (VT2), on ADC maps (VADC), and on DCE images [VDCE]). VT2, VADC, VDCE and the greatest volume determined on images from any of the individual MR pulse sequences (Vmax) were compared with Vh (Bland-Altman analysis). Factors influencing MP MR imaging accuracy, or A, calculated as A = Vmax/Vh, were evaluated using generalized linear mixed models. For both readers, Vh was significantly underestimated with VT2 (P < .0001, both), VADC (P < .0001, both), and VDCE (P = .02 and P = .003, readers 1 and 2, respectively), but not with Vmax (P = .13 and P = .21, readers 1 and 2, respectively). Mean, 25th percentile, and 75th percentile, respectively, for Vmax accuracy were 0.92, 0.54, and 1.85 for reader 1 and 0.95, 0.57, and 1.77 for reader 2. At generalized linear mixed (multivariate) analysis, tumor Likert score (P < .0001), Gleason score (P = .009), and Vh (P < .0001) significantly influenced Vmax accuracy (both readers). This accuracy was good in tumors with a Gleason score of 7 or higher or a Likert score of 5, with a tendency toward underestimation of Vh; accuracy was poor in small (<0.5 cc) or low-grade (Gleason score ≤6) tumors, with a tendency toward overestimation of Vh. Vh

  12. New Prostate Cancer Treatment Target

    Cancer.gov

    Researchers have identified a potential alternative approach to blocking a key molecular driver of an advanced form of prostate cancer, called androgen-independent or castration-resistant prostate cancer.

  13. Understanding your prostate cancer risk

    MedlinePlus

    ... medlineplus.gov/ency/patientinstructions/000931.htm Understanding your prostate cancer risk To use the sharing features on this ... enable JavaScript. Are you at risk for developing prostate cancer in your lifetime? Learn about the risk factors ...

  14. The Role of Metabolic Imaging in Radiation Therapy of Prostate Cancer

    PubMed Central

    Zhang, V. Y.; Westphalen, A.; Delos Santos, L.; Tabatabai, Z.L.; Shinohara, K.; Vigneron, D.B.; Kurhanewicz, J.

    2013-01-01

    The goal of this study was to correlate prostatic metabolite concentrations from snap-frozen patient biopsies of recurrent cancer after failed radiation therapy with histopathological findings, including Ki-67 immunohistochemistry and pathologic grade, in order to identify quantitative metabolic biomarkers that predict for residual aggressive versus indolent cancer. A total of 124 snap-frozen transrectal ultrasound (TRUS) – guided biopsies were acquired from 47 men with untreated prostate cancer and from 39 men with a rising PSA and recurrent prostate cancer following radiation therapy. Biopsy tissues with Ki-67 labeling index ≤ 5% were classified as indolent cancer, while biopsy tissues with Ki-67 labeling index > 5% were classified as aggressive cancer. The majority (15 out of 17) of cancers classified as aggressive had a primary Gleason 4 pattern (Gleason score ≥ 4+3). The concentrations of choline – containing phospholipid metabolites (PC, GPC and free Cho), and lactate were significantly elevated in recurrent cancer relative to surrounding benign tissues. There was also a significant increase in [PC] and reduction in [GPC] concentration between untreated and irradiated prostate cancer biopsies. The concentration of the choline containing phospholipid metabolites was significantly higher in recurrent aggressive (≈ 2 fold) than in recurrent indolent cancer biopsies, and the receiver operating characteristic (ROC) curve analysis of total choline to creatine ratio (tCho/Cr) demonstrated an accuracy of 95% (confidence interval = 0.88 to 1.00) for predicting aggressive recurrent disease. The tCho/Cr was significantly higher for identifying recurrent aggressive versus indolent cancer (tCho/Cr = 2.4 ± 0.4 versus 1.5 ± 0.2) suggesting that use of a higher threshold tCho/Cr ratio in future in vivo 1H MRSI studies could improve the selection and therapeutic planning of patients that would benefit most from salvage focal therapy after failed radiation therapy

  15. Reduction of Dose Delivered to Organs at Risk in Prostate Cancer Patients via Image-Guided Radiation Therapy

    SciTech Connect

    Pawlowski, Jason M.; Yang, Eddy S.; Malcolm, Arnold W.; Coffey, Charles W.; Ding, George X.

    2010-03-01

    Purpose: To determine whether image guidance can improve the dose delivered to target organs and organs at risk (OARs) for prostate cancer patients treated with intensity-modulated radiotherapy (IMRT). Methods and Materials: Eight prostate cancer patients were treated with IMRT to 76 Gy at 2 Gy per fraction. Daily target localization was performed via alignment of three intraprostatic fiducials and weekly kV-cone beam computed tomography (CBCT) scans. The prostate and OARs were manually contoured on each CBCT by a single physician. Daily patient setup shifts were obtained by comparing alignment of skin tattoos with the treatment position based on fiducials. Treatment fields were retrospectively applied to CBCT scans. The dose distributions were calculated using actual treatment plans (an 8-mm PTV margin everywhere except for 6-mm posteriorly) with and without image guidance shifts. Furthermore, the feasibility of margin reduction was evaluated by reducing planning margins to 4 mm everywhere except for 3 mm posteriorly. Results: For the eight treatment plans on the 56 CBCT scans, the average doses to 98% of the prostate (D98) were 102% (range, 99-104%) and 99% (range, 45-104%) with and without image guidance, respectively. Using margin reduction, the average D98s were 100% (range, 84-104%) and 92% (range, 40-104%) with and without image guidance, respectively. Conclusions: Currently, margins used in IMRT plans are adequate to deliver a dose to the prostate with conventional patient positioning using skin tattoos or bony anatomy. The use of image guidance may facilitate significant reduction of planning margins. Future studies to assess the efficacy of decreasing margins and improvement of treatment-related toxicities are warranted.

  16. Stages of Prostate Cancer

    MedlinePlus

    ... tissues to make echoes that form a sonogram (computer picture) of the prostate. Transrectal magnetic resonance imaging ( ... uses a strong magnet, radio waves , and a computer to make a series of detailed pictures of ...

  17. Dynamic Contrast-Enhanced Magnetic Resonance Imaging for Localization of Recurrent Prostate Cancer After External Beam Radiotherapy

    SciTech Connect

    Haider, Masoom A. Chung, Peter; Sweet, Joan; Toi, Ants; Jhaveri, Kartik; Menard, Cynthia; Warde, Padraig; Trachtenberg, John; Lockwood, Gina M.Math.; Milosevic, Michael

    2008-02-01

    Purpose: To compare the performance of T2-weighted (T2w) imaging and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) of the prostate gland in the localization of recurrent prostate cancer in patients with biochemical failure after external beam radiotherapy (EBRT). Methods and Materials: T2-weighted imaging and DCE MRI were performed in 33 patients with suspected relapse after EBRT. Dynamic contrast-enhanced MRI was performed with a temporal resolution of 95 s. Voxels enhancing at 46 s after injection to a greater degree than the mean signal intensity of the prostate at 618 s were considered malignant. Results from MRI were correlated with biopsies from six regions in the peripheral zone (PZ) (base, mid, and apex). The percentage of biopsy core positive for malignancy from each region was correlated with the maximum diameter of the tumor on DCE MRI with a linear regression model. Results: On a sextant basis, DCE MRI had significantly better sensitivity (72% [21of 29] vs. 38% [11 of 29]), positive predictive value (46% [21 of 46] vs. 24% [11 of 45]) and negative predictive value (95% [144 of 152] vs. 88% [135 of 153] than T2w imaging. Specificities were high for both DCE MRI and T2w imaging (85% [144 of 169] vs. 80% [135 of 169]). There was a linear relationship between tumor diameters on DCE MRI and the percentage of cancer tissue in the corresponding biopsy core (r = 0.9, p < 0.001), with a slope of 1.2. Conclusions: Dynamic contrast-enhanced MRI performs better than T2w imaging in the detection and localization of prostate cancer in the peripheral zone after EBRT. This may be helpful in the planning of salvage therapy.

  18. Convolutional neural network based deep-learning architecture for prostate cancer detection on multiparametric magnetic resonance images

    NASA Astrophysics Data System (ADS)

    Tsehay, Yohannes K.; Lay, Nathan S.; Roth, Holger R.; Wang, Xiaosong; Kwak, Jin Tae; Turkbey, Baris I.; Pinto, Peter A.; Wood, Brad J.; Summers, Ronald M.

    2017-03-01

    Prostate cancer (PCa) is the second most common cause of cancer related deaths in men. Multiparametric MRI (mpMRI) is the most accurate imaging method for PCa detection; however, it requires the expertise of experienced radiologists leading to inconsistency across readers of varying experience. To increase inter-reader agreement and sensitivity, we developed a computer-aided detection (CAD) system that can automatically detect lesions on mpMRI that readers can use as a reference. We investigated a convolutional neural network based deep-learing (DCNN) architecture to find an improved solution for PCa detection on mpMRI. We adopted a network architecture from a state-of-the-art edge detector that takes an image as an input and produces an image probability map. Two-fold cross validation along with a receiver operating characteristic (ROC) analysis and free-response ROC (FROC) were used to determine our deep-learning based prostate-CAD's (CADDL) performance. The efficacy was compared to an existing prostate CAD system that is based on hand-crafted features, which was evaluated on the same test-set. CADDL had an 86% detection rate at 20% false-positive rate while the top-down learning CAD had 80% detection rate at the same false-positive rate, which translated to 94% and 85% detection rate at 10 false-positives per patient on the FROC. A CNN based CAD is able to detect cancerous lesions on mpMRI of the prostate with results comparable to an existing prostate-CAD showing potential for further development.

  19. A Dosimetric Comparison between Conventional Fractionated and Hypofractionated Image-guided Radiation Therapies for Localized Prostate Cancer

    PubMed Central

    Li, Ming; Li, Gao-Feng; Hou, Xiu-Yu; Gao, Hong; Xu, Yong-Gang; Zhao, Ting

    2016-01-01

    Background: Image-guided radiation therapy (IGRT) is the preferred method for curative treatment of localized prostate cancer, which could improve disease outcome and reduce normal tissue toxicity reaction. IGRT using cone-beam computed tomography (CBCT) in combination with volumetric-modulated arc therapy (VMAT) potentially allows smaller treatment margins and dose escalation to the prostate. The aim of this study was to compare the difference of dosimetric diffusion in conventional IGRT using 7-field, step-and-shoot intensity-modulated radiation therapy (IMRT) and hypofractionated IGRT using VMAT for patients with localized prostate cancer. Methods: We studied 24 patients who received 78 Gy in 39 daily fractions or 70 Gy in 28 daily fractions to their prostate with/without the seminal vesicles using IMRT (n = 12) or VMAT (n = 12) for prostate cancer between November 2013 and October 2015. Image guidance was performed using kilovoltage CBCT scans equipped on the linear accelerator. Offline planning was performed using the daily treatment images registered with simulation computed tomography (CT) images. A total of 212 IMRT plans in conventional cohort and 292 VMAT plans in hypofractionated cohort were enrolled in the study. Dose distributions were recalculated on CBCT images registered with the planning CT scanner. Results: Compared with 7-field, step-and-shoot IMRT, VMAT plans resulted in improved planning target volume (PTV) D95% (7663.17 ± 69.57 cGy vs. 7789.17 ± 131.76 cGy, P < 0.001). VMAT reduced the rectal D25 (P < 0.001), D35 (P < 0.001), and D50 (P < 0.001), bladder V50 (P < 0.001), D25 (P = 0.002), D35 (P = 0.028), and D50 (P = 0.029). However, VMAT did not statistically significantly reduce the rectal V50, compared with 7-field, step-and-shoot IMRT (25.02 ± 5.54% vs. 27.43 ± 8.79%, P = 0.087). Conclusions: To deliver the hypofractionated radiotherapy in prostate cancer, VMAT significantly increased PTV D95% dose and decreased the dose of radiation

  20. Novel Optical Methods for Identification, Imaging, and Preservation of the Cavernous Nerves Responsible for Penile Erections during Prostate Cancer Surgery

    DTIC Science & Technology

    2011-03-01

    manuscripts, 5 conference proceedings papers , and 3 abstracts, as stated in the Year 1 Report. In Year 2, we continued development and testing of...1.3481144 Keywords: optical coherence tomography; prostate gland; cavernous nerve; pros- tate cancer. Paper 09537RR received Dec. 2, 2009; revised...of posterior retinal layers in spectral optical coher- ence tomography images of the normal retina and retinal patholo- gies,” J. Biomed. Opt. 124

  1. Feasibility of Dual Optics/Ultrasound Imaging and Contrast Media for the Detection and Characterization of Prostate Cancer

    DTIC Science & Technology

    2009-03-01

    acousto - optic effect will be used to only modulate light (at the ultrasound frequency) which propagates through a small ultrasound focal zone. This...DOD Idea Development Award is concerned with the development of a novel acousto - optic detection idea based on quadrature measurements with a gain...perform acousto - optic molecular imaging of prostate cancer with incoherent photons using endogenous contrast, e.g. hypoxia, and with fluorescent probes and microbubbles for increased specificity and signal enhancement.

  2. MYC and Prostate Cancer

    PubMed Central

    Koh, Cheryl M.; Bieberich, Charles J.; Dang, Chi V.; Nelson, William G.; Yegnasubramanian, Srinivasan; De Marzo, Angelo M.

    2010-01-01

    Prostate cancer, the majority of which is adenocarcinoma, is the most common epithelial cancer affecting a majority of elderly men in Western nations. Its manifestation, however, varies from clinically asymptomatic insidious neoplasms that progress slowly and do not threaten life to one that is highly aggressive with a propensity for metastatic spread and lethality if not treated in time. A number of somatic genetic and epigenetic alterations occur in prostate cancer cells. Some of these changes, such as loss of the tumor suppressors PTEN and p53, are linked to disease progression. Others, such as ETS gene fusions, appear to be linked more with early phases of the disease, such as invasion. Alterations in chromosome 8q24 in the region of MYC have also been linked to disease aggressiveness for many years. However, a number of recent studies in human tissues have indicated that MYC appears to be activated at the earliest phases of prostate cancer (e.g., in tumor-initiating cells) in prostatic intraepithelial neoplasia, a key precursor lesion to invasive prostatic adenocarcinoma. The initiation and early progression of prostate cancer can be recapitulated in genetically engineered mouse models, permitting a richer understanding of the cause and effects of loss of tumor suppressors and activation of MYC. The combination of studies using human tissues and mouse models paints an emerging molecular picture of prostate cancer development and early progression. This picture reveals that MYC contributes to disease initiation and progression by stimulating an embryonic stem cell–like signature characterized by an enrichment of genes involved in ribosome biogenesis and by repressing differentiation. These insights pave the way to potential novel therapeutic concepts based on MYC biology. PMID:21779461

  3. The value of endorectal MR imaging to predict positive biopsies in clinically intermediate-risk prostate cancer patients.

    PubMed

    Vilanova, J C; Comet, J; Capdevila, A; Barceló, J; Dolz, J L; Huguet, M; Barceló, C; Aldomà, J; Delgado, E

    2001-01-01

    The aim of this study was to assess the effectiveness of endorectal MR imaging in predicting the positive biopsy results in patients with clinically intermediate risk for prostate cancer. We performed a prospective endorectal MR imaging study with 81 patients at intermediate risk to detect prostate cancer between January 1997 and December 1998. Intermediate risk was defined as: prostatic specific antigen (PSA) levels between 4 and 10 ng/ml or PSA levels in the range of 10-20 ng/ml but negative digital rectal examination (DRE) or PSA levels progressively higher (0.75 ng/ml year(-1)). A transrectal sextant biopsy was performed after the endorectal MR exam, and also of the area of suspicion detected by MR imaging. The accuracies were measured, both singly for MR imaging and combined for PSA level and DRE, by calculating the area index of the receiver operating characteristics (ROC) curve. Cancer was detected in 23 patients (28%). Overall sensitivity and specificity of endorectal MRI was 70 and 76%, respectively. Accuracy was 71% estimated from the area under the ROC curve for the total patient group and 84% for the group of patients with PSA level between 10-20 ng/ml. Positive biopsy rate (PBR) was 63% for the group with PSA 10-20 ng/ml and a positive MR imaging, and 15% with a negative MR exam. The PBR was 43% for the group with PSA 4-10 ng/ml and a positive MR study, and 13% with a negative MR imaging examination. We would have avoided 63% of negative biopsies, while missing 30% of cancers for the total group of patients. Endorectal MR imaging was not a sufficient predictor of positive biopsies for patients clinically at intermediate risk for prostate cancer. Although we should not avoid performing systematic biopsies in patients with endorectal MR imaging negative results, as it will miss a significant number of cancers, selected patients with a PSA levels between 10-20 ng/ml or clinical-biopsy disagreement might benefit from endorectal MR imaging.

  4. Repeatability of dose painting by numbers treatment planning in prostate cancer radiotherapy based on multiparametric magnetic resonance imaging

    NASA Astrophysics Data System (ADS)

    van Schie, Marcel A.; Steenbergen, Peter; Viet Dinh, Cuong; Ghobadi, Ghazaleh; van Houdt, Petra J.; Pos, Floris J.; Heijmink, Stijn W. T. J. P.; van der Poel, Henk G.; Renisch, Steffen; Vik, Torbjørn; van der Heide, Uulke A.

    2017-07-01

    Dose painting by numbers (DPBN) refers to a voxel-wise prescription of radiation dose modelled from functional image characteristics, in contrast to dose painting by contours which requires delineations to define the target for dose escalation. The direct relation between functional imaging characteristics and DPBN implies that random variations in images may propagate into the dose distribution. The stability of MR-only prostate cancer treatment planning based on DPBN with respect to these variations is as yet unknown. We conducted a test-retest study to investigate the stability of DPBN for prostate cancer in a semi-automated MR-only treatment planning workflow. Twelve patients received a multiparametric MRI on two separate days prior to prostatectomy. The tumor probability (TP) within the prostate was derived from image features with a logistic regression model. Dose mapping functions were applied to acquire a DPBN prescription map that served to generate an intensity modulated radiation therapy (IMRT) treatment plan. Dose calculations were done on a pseudo-CT derived from the MRI. The TP and DPBN map and the IMRT dose distribution were compared between both MRI sessions, using the intraclass correlation coefficient (ICC) to quantify repeatability of the planning pipeline. The quality of each treatment plan was measured with a quality factor (QF). Median ICC values for the TP and DPBN map and the IMRT dose distribution were 0.82, 0.82 and 0.88, respectively, for linear dose mapping and 0.82, 0.84 and 0.94 for square root dose mapping. A median QF of 3.4% was found among all treatment plans. We demonstrated the stability of DPBN radiotherapy treatment planning in prostate cancer, with excellent overall repeatability and acceptable treatment plan quality. Using validated tumor probability modelling and simple dose mapping techniques it was shown that despite day-to-day variations in imaging data still consistent treatment plans were obtained.

  5. Multiparametric magnetic resonance imaging guided diagnostic biopsy detects significant prostate cancer and could reduce unnecessary biopsies and over detection: a prospective study.

    PubMed

    Thompson, James E; Moses, Daniel; Shnier, Ron; Brenner, Phillip; Delprado, Warick; Ponsky, Lee; Pulbrook, Marley; Böhm, Maret; Haynes, Anne-Maree; Hayen, Andrew; Stricker, Phillip D

    2014-07-01

    Multiparametric magnetic resonance imaging appears to improve prostate cancer detection but prospective studies are lacking. We determined the accuracy of multiparametric magnetic resonance imaging for detecting significant prostate cancer before diagnostic biopsy in men with abnormal prostate specific antigen/digital rectal examination. In this single center, prospective study men older than 40 years with abnormal prostate specific antigen/digital rectal examination and no previous multiparametric magnetic resonance imaging underwent T2-weighted, diffusion-weighted and dynamic contrast enhanced imaging without an endorectal coil. Imaging was allocated alternately to 1.5/3.0 Tesla. Imaging was double reported independently using PI-RADS (Prostate Imaging Reporting and Data System) by specialist radiologists. Transperineal grid directed 30-core biopsy was performed with additional magnetic resonance imaging directed cores for regions of interest outside template locations. Four significant cancer definitions were tested. Chi-square and logistic regression analysis was done. Men undergoing prostatectomy were analyzed. Of the 165 men who enrolled in the study 150 were analyzed. Median age was 62.4 years, median prostate specific antigen was 5.6 ng/ml, 29% of patients had an abnormal digital rectal examination and 88% underwent initial biopsy. Multiparametric magnetic resonance imaging was positive (PI-RADS 3 to 5) in 66% of patients, 61% had prostate cancer and 30% to 41% had significant prostate cancer (definitions 1 to 4). For significant cancer sensitivity was 93% to 96%, specificity was 47% to 53%, and negative and positive predictive values were 92% to 96% and 43% to 57%, respectively (definitions 1 to 4). Radical prostatectomy results in 48 men were similar. Aggregate PI-RADS (4 to 20) performed similarly to overall PI-RADS (1 to 5). Negative and positive predictive values (100% and 71%, respectively) were similar in men at higher risk, defined as prostate

  6. [Sexuality and prostate cancer].

    PubMed

    Colson, M-H; Lechevallier, E; Rambeaud, J-J; Alimi, J-C; Faix, A; Gravis, G; Hannoun-Levi, J-M; Quintens, H; Rébillard, X; Droupy, S

    2012-09-01

    All treatments of prostate cancer have a negative effect on both sexuality and male fertility. There is a specific profile of changes in the fields of quality of life, sexual, urinary, bowel and vitality according to the treatment modalities chosen. Maintain a satisfying sex is the main concern of a majority of men facing prostate cancer and its treatment. It is essential to assess the couple's sexuality before diagnosis of prostate cancer in order to deliver complete information and to consider early and appropriate treatment options at the request of the couple. Forms of sexuality sexual preference settings stored (orgasm) may, when the erection is not yet recovered, be an alternative to the couple to maintain intimacy and complicity. In all cases, a specific management and networking will in many cases to find a satisfactory sexuality. Consequences of the treatment on male fertility should be part of the information of patients with prostate cancer and their partners. The choice of treatment must take into account the desire of paternity of the couple. A semen analysis with sperm cryopreservation before any therapy should be routinely offered in men with prostate cancer, particularly among men under 55, with a partner under 43 years old or without children. If the desire for parenthood among couples, sperm cryopreservation before treatment and medical assisted reproduction are recommended.

  7. Multimodal image registration of ex vivo 4 Tesla MRI with whole mount histology for prostate cancer detection

    NASA Astrophysics Data System (ADS)

    Chappelow, Jonathan; Madabhushi, Anant; Rosen, Mark; Tomaszeweski, John; Feldman, Michael

    2007-03-01

    In this paper we present novel methods for registration and subsequent evaluation of whole mount prostate histological sections to corresponding 4 Tesla ex vivo magnetic resonance imaging (MRI) slices to complement our existing computer-aided diagnosis (CAD) system for detection of prostatic adenocarcinoma from high resolution MRI. The CAD system is trained using voxels labeled as cancer on MRI by experts who visually aligned histology with MRI. To address voxel labeling errors on account of manual alignment and delineation, we have developed a registration method called combined feature ensemble mutual information (COFEMI) to automatically map spatial extent of prostate cancer from histology onto corresponding MRI for prostatectomy specimens. Our method improves over intensity-based similarity metrics (mutual information) by incorporating unique information from feature spaces that are relatively robust to intensity artifacts and which accentuate the structural details in the target and template images to be registered. Our registration algorithm accounts for linear gland deformations in the histological sections resulting from gland fixing and serial sectioning. Following automatic registration of MRI and histology, cancer extent from histological sections are mapped to the corresponding registered MRI slices. The manually delineated cancer areas on MRI obtained via manual alignment of histological sections and MRI are compared with corresponding cancer extent obtained via COFEMI by a novel registration evaluation technique based on use of non-linear dimensionality reduction (locally linear embedding (LLE)). The cancer map on MRI determined by COFEMI was found to be significantly more accurate compared to the manually determined cancer mask. The performance of COFEMI was also found to be superior compared to image intensity-based mutual information registration.

  8. Acute Toxicity in Definitive Versus Postprostatectomy Image-Guided Radiotherapy for Prostate Cancer

    SciTech Connect

    Cheng, Jonathan C.; Schultheiss, Timothy E. Nguyen, Khanh H.; Wong, Jeffrey Y.C.

    2008-06-01

    Purpose: To assess the incidence of acute gastrointestinal (GI) and genitourinary (GU) injury and the dose-volume response in patients with clinically localized prostate cancer treated with image-guided radiotherapy using helical tomotherapy. Methods and Materials: Between November 2004 and March 2007, 146 consecutive patients with localized prostate cancer were treated with helical tomotherapy at the City of Hope Medical Center. Of the 146 patients, 70 had undergone prostatectomy. Acute GI and GU toxicities were evaluated using the Radiation Therapy Oncology Group/European Organization for Research and Cancer of Medical scoring system. Events were scored for patients developing Grade 2 or greater morbidity within 90 days after the end of radiotherapy (RT). The dosimetric parameters included the minimal dose received by the highest 10%, 20%, 50%, 80%, and 90% of the target volume, the mean rectal dose, minimal rectal dose, maximal rectal dose, and the volume receiving {>=}45, {>=}65, and {>=}70 Gy. These variables, plus the status of radical prostatectomy, hormonal therapy, RT techniques, and medical conditions, were included in a multivariate logistic regression analysis. A goodness-of-fit evaluation was done using the Hosmer-Lemeshow statistic. Results: A dose-response function for acute GI toxicity was elicited. The acute GI Grade 2 or greater toxicity was lower in the definitive RT group than in the postoperative RT group (25% vs. 41%, p <0.05). Acute GU Grade 2 or greater toxicity was comparable between the two groups. No grade 3 or greater complications were observed. No dosimetric variable was significant for GU toxicity. For acute GI toxicity, the significant dosimetric parameters were the minimal dose received by 10%, 20%, and 50% of the target volume and the mean rectal dose; the most predictive parameter was the minimal dose received by 10% of the target volume. The dose-modifying factor was 1.2 for radical prostatectomy. Conclusion: The results of our

  9. Five-year outcomes from a prospective trial of image-guided accelerated hypofractionated proton therapy for prostate cancer.

    PubMed

    Henderson, Randal H; Bryant, Curtis; Hoppe, Bradford S; Nichols, R Charles; Mendenhall, William M; Flampouri, Stella; Su, Zhong; Li, Zuofeng; Morris, Christopher G; Mendenhall, Nancy P

    2017-07-01

    To report 5-year outcomes of a prospective trial of image-guided accelerated hypofractionated proton therapy (AHPT) for prostate cancer. 215 prostate cancer patients accrued to a prospective institutional review board-approved trial of 70Gy(RBE) in 28 fractions for low-risk disease (n = 120) and 72.5Gy(RBE) in 29 fractions for intermediate-risk disease (n = 95). This trial excluded patients with prostate volumes of ≥60 cm(3) or International Prostate Symptom Scores (IPSS) of ≥15, patients on anticoagulants or alpha-blockers, and patients in whom dose-constraint goals for organs at risk (OAR) could not be met. Toxicities were graded prospectively according to Common Terminology Criteria for Adverse Events (CTCAE), version 3.0. This trial can be found on ClinicalTrials.gov (NCT00693238). Median follow-up was 5.2 years. Five-year rates of freedom from biochemical and clinical disease progression were 95.9%, 98.3%, and 92.7% in the overall group and the low- and intermediate-risk subsets, respectively. Actuarial 5-year rates of late radiation-related CTCAE v3.0 grade 3 or higher gastrointestinal and urologic toxicities were 0.5% and 1.7%, respectively. Median IPSS before treatment and at 4+ years after treatment were 6 and 5 for low-risk patients and 4 and 6 for intermediate-risk patients. Image-guided AHPT 5-year outcomes show high efficacy and minimal physician-assessed toxicity in selected patients. These results are comparable to the 5-year results of our prospective trials of standard fractionated proton therapy for patients with low-risk and intermediate-risk prostate cancer. Longer follow-up and a larger cohort are necessary to confirm these findings.

  10. Differentiation of prostatitis and prostate cancer by using diffusion-weighted MR imaging and MR-guided biopsy at 3 T.

    PubMed

    Nagel, Klaas N A; Schouten, Martijn G; Hambrock, Thomas; Litjens, Geert J S; Hoeks, Caroline M A; ten Haken, Bennie; Barentsz, Jelle O; Fütterer, Jurgen J

    2013-04-01

    To determine if prostatitis and prostate cancer (PCa) can be distinguished by using apparent diffusion coefficients (ADCs) on magnetic resonance (MR) images, with specimens obtained at MR-guided biopsy as the standard of reference. The need for institutional review board approval and informed consent was waived. MR-guided biopsies were performed in 130 consecutive patients with cancer-suspicious regions (CSRs) on multiparametric MR images obtained at 3 T. In this retrospective study, 88 patients met the inclusion criteria. During the biopsy procedure, an axial diffusion-weighted sequence was performed and ADC maps were generated (repetition time msec/echo time msec, 2000/67; section thickness, 4 mm; in-plane resolution, 1.8 × 1.8 mm; and b values of 0, 100, 500, and 800 sec/mm(2)). Subsequently, a confirmation image with the needle left in situ was acquired and projected on the ADC map. The corresponding ADCs at the biopsy location were compared with the histopathologic outcomes of the biopsy specimens. Linear mixed-model regression analyses were used to test for ADC differences between the histopathologic groups. The study included 116 biopsy specimens. Median ADCs of normal prostate tissue, prostatitis, low-grade PCa (Gleason grade components 2 or 3), and high-grade PCa (Gleason grade components 4 or 5) were 1.22 × 10(-3) mm(2)/sec (standard deviation, ± 0.21), 1.08 × 10(-3) mm(2)/sec (± 0.18), 0.88 × 10(-3) mm(2)/sec (± 0.15), and 0.88 × 10(-3) mm(2)/sec (± 0.13), respectively. Although the median ADCs of biopsy specimens with prostatitis were significantly higher compared with low- and high-grade PCa (P < .001), there is a considerable overlap between the tissue types. Diffusion-weighted imaging is a noninvasive technique that shows differences between prostatitis and PCa in both the peripheral zone and central gland, although its usability in clinical practice is limited as a result of significant overlap in ADCs. RSNA, 2013

  11. Practice patterns and predictors of followup imaging after a negative bone scan in men with castration resistant prostate cancer: results from the SEARCH database.

    PubMed

    Sourbeer, Katharine N; Howard, Lauren E; Moreira, Daniel M; Amarasekara, Hiruni S; Chow, Lydia D; Cockrell, Dillon C; Hanyok, Brian T; Pratson, Connor L; Kane, Christopher J; Terris, Martha K; Aronson, William J; Cooperberg, Matthew R; Amling, Christopher L; Hernandez, Rohini K; Freedland, Stephen J

    2015-04-01

    We investigated imaging practice patterns in men with nonmetastatic (M0) castration resistant prostate cancer. We analyzed data on 247 patients with documented M0 CRPC from the SEARCH database. Patients were selected regardless of primary treatment modality and all had a negative bone scan after a castration resistant prostate cancer diagnosis. Cox models were used to test associations of time to a second imaging test with several demographic and clinical factors. During a median followup of 29.0 months (IQR 12.9-43.5) after a post-castration resistant prostate cancer bone scan was negative, 190 patients (77%) underwent a second imaging test. On univariable analysis patients with higher prostate specific antigen (HR 1.13, p = 0.016), shorter prostate specific antigen doubling time (HR 0.79, p < 0.001) and faster prostate specific antigen velocity (HR 1.01, p < 0.001) were more likely to undergo a second imaging test. Treatment center was also a significant predictor of a second imaging test (p = 0.010). No other factor was a significant predictor. Results were similar on multivariable analysis. It was estimated that approximately 20% of men with a prostate specific antigen doubling time of less than 3 months did not undergo an imaging test in the first year after a post-castration resistant prostate cancer negative bone scan. However, 50% of patients with prostate specific antigen doubling time 15 months or greater underwent a second imaging test in the first year. Clinicians use some known predictors of positive imaging tests to determine which patients with M0 castration resistant prostate cancer undergo a second imaging test . However, there may be under imaging in those at high risk and over imaging in those at low risk. Further studies are needed to identify risk factors for metastasis and form clear imaging guidelines in patients with M0 castration resistant prostate cancer. Copyright © 2015 American Urological Association Education and Research, Inc

  12. Promoter Hypermethylation in Prostate Cancer

    PubMed Central

    Park, Jong Y.

    2011-01-01

    Background The prostate gland is the most common site of cancer and the second leading cause of cancer mortality in American men. It is well known that epigenetic alterations such as DNA methylation within the regulatory (promoter) regions of genes are associated with transcriptional silencing in cancer. Promoter hypermethylation of critical pathway genes could be potential biomarkers and therapeutic targets for prostate cancer. Methods This review discusses current information on methylated genes associated with prostate cancer development and progression. Results Over 30 genes have been investigated for promoter methylation in prostate cancer. These methylated genes are involved in critical pathways, such as DNA repair, metabolism, and invasion/metastasis. The role of hypermethylated genes in regulation of critical pathways in prostate cancer is reviewed. Conclusions These findings may provide new information of the pathogenesis of prostate cancer. Certain epigenetic alterations in prostate tumors are being translated into clinical practice for therapeutic use. PMID:20861812

  13. Prostate cancer localization using multiparametric MR imaging: comparison of Prostate Imaging Reporting and Data System (PI-RADS) and Likert scales.

    PubMed

    Rosenkrantz, Andrew B; Kim, Sooah; Lim, Ruth P; Hindman, Nicole; Deng, Fang-Ming; Babb, James S; Taneja, Samir S

    2013-11-01

    To compare the recently proposed Prostate Imaging Reporting and Data System (PI-RADS) scale that incorporates fixed criteria and a standard Likert scale based on overall impression in prostate cancer localization using multiparametric magnetic resonance (MR) imaging. This retrospective study was HIPAA compliant and institutional review board approved. Seventy patients who underwent 3-T pelvic MR imaging, including T2-weighted imaging, diffusion-weighted imaging, and dynamic contrast material-enhanced imaging, with a pelvic phased-array coil before radical prostatectomy were included. Three radiologists, each with 6 years of experience, independently scored 18 regions (12 peripheral zone [PZ], six transition zone [TZ]) using PI-RADS (range, scores 3-15) and Likert (range, scores 1-5) scales. Logistic regression for correlated data was used to compare scales for detection of tumors larger than 3 mm in maximal diameter at prostatectomy. Maximal accuracy was achieved with score thresholds of 8 and higher and of 3 and higher for PI-RADS and Likert scales, respectively. At these thresholds, in the PZ, similar accuracy was achieved with the PI-RADS scale and the Likert scale for radiologist 1 (89.0% vs 88.2%, P = .223) and radiologist 3 (88.5% vs 88.2%, P = .739) and greater accuracy was achieved with the PI-RADS scale than the Likert scale for radiologist 2 (89.6% vs 87.1%, P = .008). In the TZ, accuracy was lower with the PI-RADS scale than with the Likert scale for radiologist 1 (70.0% vs 87.1%, P < .001), radiologist 2 (87.6% vs 92.6%, P = .002), and radiologist 3 (82.9% vs 91.2%, P < .001). For tumors with Gleason score of at least 7, sensitivity was higher with the PI-RADS scale than with the Likert scale for radiologist 1 (88.6% vs 82.6%, P = .032), and sensitivity was similar for radiologist 2 (78.0% vs 76.5, P = .467) and radiologist 3 (77.3% vs 81.1%, P = .125). Radiologists performed well with both PI-RADS and Likert scales for tumor localization, although, in

  14. Cone-Beam Computed Tomography for Image-Guided Radiation Therapy of Prostate Cancer

    DTIC Science & Technology

    2009-01-01

    enhancing image accuracy of the patient’s prostate and/or for reducing patient dose in CBCT. During the second year of the traineeship, image...lower contrast -to-noise-ratio (CNR). Image artifacts due to transverse data truncation, which would have occurred in conventional reconstruction...trajectory. In Fig. 1a, we display a two-turn conventional helical trajectory specified by s ,e= −2 ,2. In contrast , the reverse helical trajec

  15. Role of multiparametric magnetic resonance imaging (MRI) in focal therapy for prostate cancer: a Delphi consensus project.

    PubMed

    Muller, Berrend G; van den Bos, Willemien; Brausi, Maurizio; Cornud, Francois; Gontero, Paolo; Kirkham, Alexander; Pinto, Peter A; Polascik, Thomas J; Rastinehad, Ardeshir R; de Reijke, Theo M; de la Rosette, Jean J; Ukimura, Osamu; Villers, Arnauld; Walz, Jochen; Wijkstra, Hessel; Marberger, Michael

    2014-11-01

    To define the role of multiparametric MRI (mpMRI) for treatment planning, guidance and follow-up in focal therapy for prostate cancer based on a multidisciplinary Delphi consensus project. An online consensus process based on a questionnaire was circulated according to the Delphi method. Discussion points were identified by literature research and were sent to the panel via an online questionnaire in three rounds. A face-to-face consensus meeting followed the three rounds of questions that were sent to a 48-participant expert panel consisting of urologists, radiologists and engineers. Participants were presented with the results of the previous rounds. Conclusions formulated from the results of the questionnaire were discussed in the final face-to-face meeting. Consensus was reached in 41% of all key items. Patients selected for focal therapy should have biopsy-proven prostate cancer. Biopsies should ideally be performed after mpMRI of the prostate. Standardization of imaging protocols is essential and mpMRIs should be read by an experienced radiologist. In the follow-up after focal therapy, mpMRI should be performed after 6 months, followed by a yearly mpMRI. mpMRI findings should be confirmed by targeted biopsies before re-treatment. No consensus was reached on whether mpMRI could replace transperineal template saturation biopsies to exclude significant lesions outside the target lesion. Consensus was reached on a number of areas related to the conduct, interpretation and reporting of mpMRI for use in treatment planning, guidance and follow-up of focal therapy for prostate cancer. Future studies, comparing mpMRI with transperineal saturation mapping biopsies, will confirm the importance of mpMRI for a variety of purposes in focal therapy for prostate cancer. © 2013 The Authors. BJU International © 2013 BJU International.

  16. Synthesis and evaluation of a targeted nanoglobular dual-modal imaging agent for MR imaging and image-guided surgery of prostate cancer.

    PubMed

    Tan, Mingqian; Ye, Zhen; Lindner, Daniel; Brady-Kalnay, Susann M; Lu, Zheng-Rong

    2014-06-01

    To synthesize and evaluate a peptide targeted nanoglobular dual modal imaging agent specific to a cancer biomarker in tumor stroma for MRI and fluorescence visualization of prostate tumor in image-guided surgery. A peptide (CGLIIQKNEC, CLT1) targeted generation 2 nanoglobular (polylysine dendrimer with a silsesquioxane core) dual modal imaging agent, CLT1-G2-(Gd-DOTA-MA)-Cy5, was synthesized by stepwise conjugation of Gd-DOTA-MA, Cy5 and peptide to the dendrimer. Contrast enhanced MR imaging of the targeted dual imaging agent was evaluated on a Bruker 7T animal scanner with male athymic nude mice bearing orthotopic PC3-GFP prostate tumor. Fluorescence tumor imaging of the agent was carried out on a Maestro fluorescence imaging system. The targeted agent CLT1-G2-(Gd-DOTA-MA)-Cy5 produced greater contrast enhancement in the tumor tissue than the control agent KAREC-G2-(Gd-DOTA-MA)-Cy5 at a dose of 30 μmol-Gd/kg in the MR images of the tumor bearing mice. Signal-to-noise ratio (SNR) of CLT1-G2-(Gd-DOTA-MA)-Cy5 in the tumor tissue was approximately 2 fold of that of the control agent in the first 15 min post-injection. The targeted agent also resulted in bright fluorescence signals in the tumor tissue. The CLT1 peptide targeted nanoglobular dual-imaging agent CLT1-G2-(Gd-DOTA-MA)-Cy5 has a potential for MRI and fluorescence visualization of prostate tumor.

  17. Ex vivo study of prostate cancer localization using rolling mechanical imaging towards minimally invasive surgery.

    PubMed

    Li, Jichun; Liu, Hongbin; Brown, Matthew; Kumar, Pardeep; Challacombe, Benjamin J; Chandra, Ashish; Rottenberg, Giles; Seneviratne, Lakmal D; Althoefer, Kaspar; Dasgupta, Prokar

    2017-05-01

    Rolling mechanical imaging (RMI) is a novel technique towards the detection and quantification of malignant tissue in locations that are inaccessible to palpation during robotic minimally invasive surgery (MIS); the approach is shown to achieve results of higher precision than is possible using the human hand. Using a passive robotic manipulator, a lightweight and force sensitive wheeled probe is driven across the surface of tissue samples to collect continuous measurements of wheel-tissue dynamics. A color-coded map is then generated to visualize the stiffness distribution within the internal tissue structure. Having developed the RMI device in-house, we aim to compare the accuracy of this technique to commonly used methods of localizing prostate cancer in current practice: digital rectal exam (DRE), magnetic resonance imaging (MRI) and transrectal ultrasound (TRUS) biopsy. Final histology is the gold standard used for comparison. A total of 126 sites from 21 robotic-assisted radical prostatectomy specimens were examined. Analysis was performed for sensitivity, specificity, accuracy, and predictive value across all patient risk profiles (defined by PSA, Gleason score and pathological score). Of all techniques, pre-operative biopsy had the highest sensitivity (76.2%) and accuracy (64.3%) in the localization of tumor in the final specimen. However, RMI had a higher sensitivity (44.4%) and accuracy (57.9%) than both DRE (38.1% and 52.4%, respectively) and MRI (33.3% and 57.9%, respectively). These findings suggest a role for RMI towards MIS, where haptic feedback is lacking. While our approach has focused on urological tumors, RMI has potential applicability to other extirpative oncological procedures and to diagnostics (e.g., breast cancer screening). Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  18. Prostate Cancer Rates by Race and Ethnicity

    MedlinePlus

    ... HPV-Associated Lung Ovarian Skin Uterine Cancer Home Prostate Cancer Rates by Race and Ethnicity Language: English Español ( ... Tweet Share Compartir The rate of men getting prostate cancer or dying from prostate cancer varies by race ...

  19. Mn-doped ZnSe d-dots-based α-methylacyl-CoA racemase probe for human prostate cancer cell imaging.

    PubMed

    Gao, Xue; Zhang, Hao; Li, Yang; Su, Xingguang

    2012-02-01

    In this paper, we report the successful use of non-cadmium-based Mn-doped ZnSe d-dots (Mn/ZnSe) as highly efficient and nontoxic optical probes for human prostate cancer cells imaging. Mn/ZnSe d-dots are directly prepared in aqueous solution. The α-methylacyl-CoA racemase (AMACR) is overexpressed in prostate cancers; the presence of antibodies specific for AMACR is more sensitive and specific than serum prostate specific antigen levels in distinguishing patients with prostate cancers. Mn/ZnSe d-dots were linked to anti-AMACR to form Mn/ZnSe d-dots-anti-AMACR bioconjugates for the direct prostate cancer cell imaging. 3-(4,5-Dimethylthiazol-2-yl)-2 and 5-diphenyl tetrazolium bromide assay demonstrated that Mn/ZnSe d-dots exhibited favorable cytocompatibility to LNCaP cells with high concentration (1 mM) and long-time incubation (24 h). Furthermore, cellular imaging results demonstrated that Mn/ZnSe d-dots were remarkably efficacious for high-specificity cell imaging. The antibody-mediated delivery of the bioconjugates was further confirmed by the observation of no fluorescence signals in vitro targeting in nonprostate-cancer-based cell lines which are negative for AMACR. Mn/ZnSe d-dots as non-cadmium-based safe and efficient optical imaging nanoprobes could therefore be used for targeting imaging and treatment of cancers in the early stage.

  20. [Overdiagnosis in prostate cancer].

    PubMed

    Villeda, Christian; Gomez, Martha Olivia; Sotomayor, Mariano

    2014-06-01

    Prostate cancer screening is an absolutely controversial topic and under debate. The points of view from which the problem is analyzed also influence this issue; patient, physician and Health Care authorities have different interests that most of the times are not comprehensively analyzed. Currently, no clinical guideline supports the performance of a population screening with active recruitment, but they do support the credible information to the man who desires its performance of potential benefits and risks (opportunistic screening), as well as its performance in certain risk groups. Nevertheless, what is inherent to any screening program is the overdiagnosis of clinically irrelevant disease, which in prostate cancer has been calculated around 50%, and that, from our point of view, gives cause to the correct implementation of active surveillance programs to tamponade the potential deleterious effects of active therapies of prostate cancer.

  1. Hypofractionation for prostate cancer.

    PubMed

    Ritter, Mark; Forman, Jeffrey; Kupelian, Patrick; Lawton, Colleen; Petereit, Daniel

    2009-01-01

    Hypofractionation for prostate cancer was originally carried out in the pursuit of efficiency and convenience but has now attracted greatly renewed interest based upon a hypothesis that prostate cancers have a higher sensitivity to fraction size, reflected in a low alpha/beta ratio, than do late responding organs at risk such as the rectum or bladder. Tumor control and acceptable toxicity outcomes from several hypofractionation or brachytherapy analyses do in fact support an alpha/beta ratio for prostate cancer that is low, perhaps even lower that that for the normal organs that ordinarily constrain the delivery of radiation therapy. However, many of these studies lack sufficient patient numbers and follow-up, are clouded by dose inhomogeneity issues in the case of brachytherapy, or delivered effective doses that were too low by contemporary standards. Thus, the clinical efficacy of the approach has yet to be fully validated. However, a number of newer prospective trials, some randomized, are underway or have reached accrual but await sufficient follow-up for analysis. These studies, which cover a wide range of doses per fraction, should ultimately be capable of validating the utility of prostate hypofractionation and the models that predict its effects. With hypofractionation's significant potential for therapeutic gain, cost savings, and improved patient convenience, the future management of localized prostate cancer could be profoundly altered in the process.

  2. Molecular Engineering of Vector-Based Oncolytic and Imaging Approaches for Advanced Prostate Cancer

    DTIC Science & Technology

    2006-02-01

    hydroxymethylbutyl) guanine ([18F]FHBG), will lead to the trapping and accumulation of the radiolabeled tracer in cells expressing HSV1 -tk, which in turn can be...AdTSTA-sr39tk at MOI 1 and 5. The level of sr39tk protein expression was assessed by Western blot using a polyclonal HSV1 -tk antibody [15] as well as...transcriptional regulatory system (TSTA) has been utilized to restrict the expression of our adenoviral vector specifically to prostate or prostate cancer cells

  3. Factors predicting prostate cancer upgrading on magnetic resonance imaging-targeted biopsy in an active surveillance population.

    PubMed

    Lai, Win Shun; Gordetsky, Jennifer B; Thomas, John V; Nix, Jeffrey W; Rais-Bahrami, Soroush

    2017-06-01

    The objective of this study was to create a nomogram model integrating clinical and multiparametric magnetic resonance imaging (MP-MRI)-based variables to predict prostate cancer upgrading in a population of active surveillance (AS) patients. Prostate cancer patients on AS who underwent MP-MRI with magnetic resonance imaging (MRI)/ultrasound (US) fusion-guided biopsy were identified. Clinical and imaging variables, including the prostate-specific antigen density (PSAD), number of lesions, total lesion volume, total lesion density, Prostate Imaging Reporting and Data System magnetic resonance imaging suspicion score (MRI-SS), and duration between prereferral systematic and MRI/US fusion-guided biopsy sessions, were assessed. Logistic regression modeling was used to assess upgrading on MRI/US fusion-guided biopsy. A predictive model for upgrading was calculated with the significant factors identified. Seventy-six patients were analyzed with a mean age of 62.5 years and a median prostate-specific antigen (PSA) level of 5.1 ng/mL. The average duration between prereferral and MRI/US biopsies was 21 months. Twenty patients (26.32%) were upgraded. The PSAD, duration between prereferral and MRI/US biopsies, MRI-SS, and MRI total lesion density were significantly associated with upgrading. A logistic regression model using these factors to predict upgrading on confirmatory MRI/US fusion biopsy had an area under the curve (AUC) of 0.84, whereas the AUC was 0.69 with PSA alone. On the basis of this model, a nomogram was generated, and using a probability cutoff of 22% as an indication of upgrading, it produced sensitivity, specificity, positive predictive, and negative predictive values of 80%, 81.25%, 57.1%, and 92.86%, respectively. The integration of MRI findings with clinical parameters can add value to a model predicting upgrading from a Gleason score of 3 + 3 = 6 in men on AS. This can potentially be used as a noninvasive approach to confirm AS patients with low

  4. In vivo (1) H MR spectroscopic imaging of aggressive prostate cancer: can we detect lactate?

    PubMed

    Kobus, Thiele; Wright, Alan J; Van Asten, Jack J A; Heerschap, Arend; Scheenen, Tom W J

    2014-01-01

    A semi-LASER sequence was optimized for in vivo lactate detection in the prostate. The ethical committee waived the need for informed consent to measure 17 patients with high grade prostate cancer on a 3T system. A semi-LASER sequence was used with an echo time of 144 ms and optimized interpulse timing for a spectral citrate shape with high signal intensity. An LCModel basis set was developed for fitting choline, creatine, spermine, citrate, and lactate and was used to fit all spectra in tumor-containing voxels. For patients without detectable lactate, the minimal detectable lactate concentration was determined by adding in all spectra of tumor tissue a simulated lactate signal. The amplitude of the simulated lactate signal was iteratively decreased until its fit reached a Cramér Rao lower bound >20%, which was then set as the patient-specific detection limit. In none of the patients a convincing lactate signal was found. We estimated that on average the lactate levels in high grade prostate cancer are below 1.5 mM (range 0.9-3.5 mM), Interestingly, in one patient with extensive necrosis in the tumor biopsy samples (Gleason score 5+5), large lipid resonances were observed, which originated from the tumor. The minimal detectable lactate concentration of 1.5 mM in high grade prostate cancer indicates that if lactate is increased it remains at low concentrations. Copyright © 2013 Wiley Periodicals, Inc.

  5. Updates of prostate cancer staging: Prostate-specific membrane antigen

    PubMed Central

    Lamb, Alastair; Nair, Rajesh; Geurts, Nicolas; Mitchell, Catherine; Lawrentschuk, Nathan L; Moon, Daniel A; Murphy, Declan G

    2016-01-01

    The ability to accurately stage prostate cancer in both the primary and secondary staging setting can have a major impact on management. Until recently radiological staging has relied on computer tomography, magnetic resonance imaging, and nuclear bone scans to evaluate the extent of disease. However, the utility of these imaging technologies has been limited by their sensitivity and specificity especially in detecting early recurrence. Functional imaging using positron-emission tomography with a radiolabeled ligand targeted to prostate-specific membrane antigen has transformed the prostate cancer imaging landscape. Initial results suggest that it is a substantial improvement over conventional imaging in the setting of recurrence following primary therapy by having a superior ability to detect disease and to do so at an earlier stage. Additionally, it appears that the benefits seen in the secondary staging setting may also exist in the primary staging setting. PMID:27995218

  6. Urine aquaporin 1 and perilipin 2 differentiate renal carcinomas from other imaged renal masses and bladder and prostate cancer.

    PubMed

    Morrissey, Jeremiah J; Mobley, Jonathan; Figenshau, R Sherburne; Vetter, Joel; Bhayani, Sam; Kharasch, Evan D

    2015-01-01

    To evaluate the sensitivity and specificity of urine aquaporin 1 (AQP1) and perilipin 2 (PLIN2) concentrations to diagnose clear cell or papillary renal cell carcinoma (RCC) by comparing urine concentrations of these unique biomarkers in patients with RCC, noncancer renal masses, bladder cancer, and prostate cancer. From February 1, 2012, through October 31, 2012, preoperative urine samples were obtained from patients with a presumptive diagnosis of RCC based on an imaged renal mass, prostate cancer, or transitional cell bladder cancer. Imaged renal masses were diagnosed postnephrectomy—as malignant or benign—by histology. Urine AQP1 and PLIN2 concentrations were measured by using a sensitive and specific Western blot and normalized to urine creatinine concentration. Median concentrations of urine AQP1 and PLIN2 in patients with clear cell and papillary RCC (n=47) were 29 and 36 relative absorbance units/mg urine creatinine, respectively. In contrast, median concentrations in patients with bladder cancer (n=22) and prostate cancer (n=27), patients with chromophobe tumors (n=7), and patients with benign renal oncocytomas (n=9) and angiomyolipomas (n=7) were all less than 10 relative absorbance units/mg urine creatinine (Kruskal-Wallis test, P<.001 vs RCC for both biomarkers) and comparable with those in healthy controls. The area under the receiver operating characteristic curve ranged from 0.99 to 1.00 for both biomarkers. These results support the specificity and sensitivity of urine AQP1 and PLIN2 concentrations for RCC. These novel tumor-specific proteins have high clinical validity and high potential as specific screening biomarkers for clear cell and papillary RCC as well as in the differential diagnosis of imaged renal masses. clinicaltrials.gov Identifier: NCT00851994. Copyright © 2015 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  7. Prostate cancer on computed tomography: A direct comparison with multi-parametric magnetic resonance imaging and tissue pathology.

    PubMed

    Jia, Jemianne Bautista; Houshyar, Roozbeh; Verma, Sadhna; Uchio, Edward; Lall, Chandana

    2016-01-01

    Multi-parametric prostate magnetic resonance imaging (MRI) is considered the current imaging standard for detection and staging of prostate cancer. The combination of anatomical and functional imaging provided in this exam significantly increases the accuracy of prostate cancer detection. Computed tomography (CT) imaging has so far been found to be lacking in this regard, however observations at our academic institution as well as evidence present in the literature support the proposition that CT could indeed be helpful in detecting prostate abnormalities that correspond to neoplasm. The purpose of this study was to prove that areas of focal mass-like enhancement on CT imaging directly correlate with prostate neoplasms as revealed on multi-parametric MRI and follow-up targeted biopsy. This was a single institution retrospective study with 27 male subjects. Inclusion criteria required subjects to have a multi-parametric MRI of the prostate between January 1, 2014 and June 1, 2015 and a pelvic venous phase contrast-enhanced CT study between January 1, 2000 and June 1, 2015. Two blinded Radiologists read subjects' CT scans for any abnormalities of the prostate. CT and multi-parametric MRI results were compared and were considered concordant if focal or mass like enhancement to a greater degree than the background parenchyma was detected in the same areas of the prostate on CT scan as areas of decreased T2 signal, perfusion abnormalities, and restricted diffusion on multi-parametric MRI. CT results were directly compared to multi-parametric MRI findings and biopsy results. The overall agreement of MRI and CT is 85.19% (95% CI: 67.52-94.08%). The positive percent agreement is 78.95% (95% CI: 54.43-93.95%) and the negative percent agreement is 100.0% (95% CL: 63.06-100.0%). When CT results are directly compared to biopsy results, sensitivity and specificity of CT are 63.64% (95% CI: 30.79-89.07%) and 100.0% (95% CI: 47.82-100.0%). The positive predictive value (PPV) is

  8. Performance Characteristics of MR Imaging in the Evaluation of Clinically Low-Risk Prostate Cancer: A Prospective Study

    PubMed Central

    Vargas, Hebert Alberto; Akin, Oguz; Shukla-Dave, Amita; Zhang, Jingbo; Zakian, Kristen L.; Zheng, Junting; Kanao, Kent; Goldman, Debra A.; Moskowitz, Chaya S.; Reuter, Victor E.; Eastham, James A.; Scardino, Peter T.

    2012-01-01

    Purpose: To prospectively evaluate diagnostic performance of T2-weighted magnetic resonance (MR) imaging and MR spectroscopic imaging in detecting lesions stratified by pathologic volume and Gleason score in men with clinically determined low-risk prostate cancer. Materials and Methods: The institutional review board approved this prospective, HIPAA-compliant study. Written informed consent was obtained from 183 men with clinically low-risk prostate cancer (cT1–cT2a, Gleason score ≤ 6 at biopsy, prostate-specific antigen [PSA] level < 10 ng/mL [10 μg/L]) undergoing MR imaging before prostatectomy. By using a scale of 1–5 (score 1, definitely no tumor; score 5, definitely tumor), two radiologists independently scored likelihood of tumor per sextant on T2-weighted images. Two spectroscopists jointly recorded locations of lesions with metabolic features consistent with tumor on MR spectroscopic images. Whole-mount step-section histopathologic analysis constituted the reference standard. Diagnostic performance at sextant level (T2-weighted imaging) and detection sensitivities (T2-weighted imaging and MR spectroscopic imaging) for lesions of 0.5 cm3 or larger were calculated. Results: For T2-weighted imaging, areas under the receiver operating characteristic curves for sextant-level detection were 0.77 (reader 1) and 0.82 (reader 2). For lesions of ≥0.5 cm3 and ,1 imaging sensitivity was low and was not significantly affected by pathologic lesion volume or Gleason score. Conclusion: In men with clinically low-risk prostate

  9. Preclinical Evaluation of Novel Glutamate-Urea-Lysine Analogs that Target Prostate Specific Membrane Antigen as Molecular Imaging Pharmaceuticals for Prostate Cancer

    PubMed Central

    Hillier, Shawn M.; Maresca, Kevin P.; Femia, Frank J.; Marquis, John C.; Foss, Catherine A.; Nguyen, Nghi; Zimmerman, Craig N.; Barrett, John A.; Eckelman, William C.; Pomper, Martin G.; Joyal, John L.; Babich, John W.

    2014-01-01

    Prostate-specific membrane antigen (PSMA) is expressed in normal human prostate epithelium and is highly upregulated in prostate cancer. We previously reported a series of novel small molecule inhibitors targeting PSMA. Two compounds, MIP-1072, (S)-2-(3-((S)-1-carboxy-5-(4–iodobenzylamino)pentyl)ureido)pentanedioic acid and MIP-1095, (S)-2-(3-((S)-1-carboxy-5-(3-(4-iodophenyl)ureido)pentyl)ureido)pentanedioic acid, were selected for further evaluation. MIP-1072 and MIP-1095 potently inhibited the glutamate carboxypeptidase activity of PSMA (Ki = 4.6 ± 1.6 and 0.24 ± 0.14 nM, respectively), and when radiolabeled with 123I exhibited high affinity for PSMA on human prostate cancer LNCaP cells (Kd = 3.8 ± 1.3 and 0.81 ± 0.39 nM, respectively). The association of [123I]MIP-1072 and [123I]MIP-1095 with PSMA was specific; there was no binding to human prostate cancer PC3 cells, which lack PSMA, and binding was abolished by co-incubation with a structurally unrelated NAALADase inhibitor, 2-(phosphonomethyl)pentanedioic acid (PMPA). [123I]MIP-1072 and [123I]MIP-1095 internalized into LNCaP cells at 37 °C. Tissue distribution studies in mice demonstrated 17.3 ± 6.3 (at 1 hr) and 34.3 ± 12.7 (at 4 hr) % injected dose per gram of tissue, for [123I]MIP-1072 and [123I]MIP-1095, respectively. [123I]MIP-1095 exhibited greater tumor uptake but slower washout from blood and non-target tissues compared to [123I]MIP-1072. Specific binding to PSMA in vivo was demonstrated by competition with PMPA in LNCaP xenografts, and the absence of uptake in PC3 xenografts. The uptake of [123I]MIP-1072 and [123I]MIP-1095 in tumor bearing mice was corroborated by SPECT/CT imaging. PSMA-specific radiopharmaceuticals should provide a novel molecular targeting option for the detection and staging of prostate cancer. PMID:19706750

  10. Prostate cancer: sextant localization at MR imaging and MR spectroscopic imaging before prostatectomy--results of ACRIN prospective multi-institutional clinicopathologic study.

    PubMed

    Weinreb, Jeffrey C; Blume, Jeffrey D; Coakley, Fergus V; Wheeler, Thomas M; Cormack, Jean B; Sotto, Christopher K; Cho, Haesun; Kawashima, Akira; Tempany-Afdhal, Clare M; Macura, Katarzyna J; Rosen, Mark; Gerst, Scott R; Kurhanewicz, John

    2009-04-01

    To determine the incremental benefit of combined endorectal magnetic resonance (MR) imaging and MR spectroscopic imaging, as compared with endorectal MR imaging alone, for sextant localization of peripheral zone (PZ) prostate cancer. This prospective multicenter study, conducted by the American College of Radiology Imaging Network (ACRIN) from February 2004 to June 2005, was institutional review board approved and HIPAA compliant. Research associates were required to follow consent guidelines approved by the Office for Human Research Protection and established by the institutional review boards. One hundred thirty-four patients with biopsy-proved prostate adenocarcinoma and scheduled to undergo radical prostatectomy were recruited at seven institutions. T1-weighted, T2-weighted, and spectroscopic MR sequences were performed at 1.5 T by using a pelvic phased-array coil in combination with an endorectal coil. Eight readers independently rated the likelihood of the presence of PZ cancer in each sextant by using a five-point scale-first on MR images alone and later on combined MR-MR spectroscopic images. Areas under the receiver operating characteristic curve (AUCs) were calculated with sextant as the unit of analysis. The presence or absence of cancer at centralized histopathologic evaluation of prostate specimens was the reference standard. Reader-specific receiver operating characteristic curves for values obtained with MR imaging alone and with combined MR imaging-MR spectroscopic imaging were developed. The AUCs were estimated by using Mann-Whitney statistics and appropriate 95% confidence intervals. Complete data were available for 110 patients (mean age, 58 years; range, 45-72 years). MR imaging alone and combined MR imaging-MR spectroscopic imaging had similar accuracy in PZ cancer localization (AUC, 0.60 vs 0.58, respectively; P > .05). AUCs for individual readers were 0.57-0.63 for MR imaging alone and 0.54-0.61 for combined MR imaging-MR spectroscopic

  11. [Diet and prostate cancer].

    PubMed

    Romero Cagigal, I; Ferruelo Alonso, A; Berenguer Sánchez, A

    2003-06-01

    Prostate cancer is the first neoplasia in the United States accounting the second in cancer deaths. With all the treatments strategies in debate because of their side effects, is very important try to elucidate prevention mechanisms that may be implicate in the development of this disease, between these, nutrients have been of mayor importance. In the present review we tried to study the most important nutritional factors implicated in the development and prevention of prostate carcinoma. We focus our attention over the polyphenols of the red wine, which influence over cellular proliferation and apoptosis in LNCaP cells have been studied in our Department.

  12. Pilot Study of the Use of Hybrid Multidimensional T2-Weighted Imaging-DWI for the Diagnosis of Prostate Cancer and Evaluation of Gleason Score.

    PubMed

    Sadinski, Meredith; Karczmar, Gregory; Peng, Yahui; Wang, Shiyang; Jiang, Yulei; Medved, Milica; Yousuf, Ambereen; Antic, Tatjana; Oto, Aytekin

    2016-09-01

    The objective of our study was to evaluate the role of a hybrid T2-weighted imaging-DWI sequence for prostate cancer diagnosis and differentiation of aggressive prostate cancer from nonaggressive prostate cancer. Twenty-one patients with prostate cancer who underwent preoperative 3-T MRI and prostatectomy were included in this study. Patients underwent a hybrid T2-weighted imaging-DWI examination consisting of DW images acquired with TEs of 47, 75, and 100 ms and b values of 0 and 750 s/mm(2). The apparent diffusion coefficient (ADC) and T2 were calculated for cancer and normal prostate ROIs at each TE and b value. Changes in ADC and T2 as a function of increasing the TE and b value, respectively, were analyzed. A new metric termed "PQ4" was defined as the percentage of voxels within an ROI that has increasing T2 with increasing b value and has decreasing ADC with increasing TE. ADC values were significantly higher in normal ROIs than in cancer ROIs at all TEs (p < 0.0001). With increasing TE, the mean ADC increased 3% in cancer ROIs and increased 12% in normal ROIs. T2 was significantly higher in normal ROIs than in cancer ROIs at both b values (p ≤ 0.0002). The mean T2 decreased with increasing b value in cancer ROIs (ΔT2 = -17 ms) and normal ROIs (ΔT2 = -52 ms). PQ4 clearly differentiated normal ROIs from prostate cancer ROIs (p = 0.0004) and showed significant correlation with Gleason score (ρ = 0.508, p < 0.0001). Hybrid MRI measures the response of ADC and T2 to changing TEs and b values, respectively. This approach shows promise for detecting prostate cancer and determining its aggressiveness noninvasively.

  13. NBN gain is predictive for adverse outcome following image-guided radiotherapy for localized prostate cancer

    PubMed Central

    Sykes, Jenna; Zafarana, Gaetano; Chu, Kenneth C.; Ramnarine, Varune R.; Ishkanian, Adrian; Sendorek, Dorota H.S.; Pasic, Ivan; Lam, Wan L.; Jurisica, Igor; van der Kwast, Theo; Milosevic, Michael; Boutros, Paul C.; Bristow, Robert G.

    2014-01-01

    Despite the use of clinical prognostic factors (PSA, T-category and Gleason score), 20-60% of localized prostate cancers (PCa) fail primary local treatment. Herein, we determined the prognostic importance of main sensors of the DNA damage response (DDR): MRE11A, RAD50, NBN, ATM, ATR and PRKDC. We studied copy number alterations in DDR genes in localized PCa treated with image-guided radiotherapy (IGRT; n=139) versus radical prostatectomy (RadP; n=154). In both cohorts, NBN gains were the most frequent genomic alteration (14.4 and 11% of cases, respectively), and were associated with overall tumour genomic instability (p<0.0001). NBN gains were the only significant predictor of 5yrs biochemical relapse-free rate (bRFR) following IGRT (46% versus 77%; p=0.00067). On multivariate analysis, NBN gain remained a significant independent predictor of bRFR after adjusting for known clinical prognostic variables (HR=3.28, 95% CI 1.56–6.89, Wald p-value=0.0017). No DDR-sensing gene was prognostic in the RadP cohort. In vitro studies correlated NBN gene overexpression with PCa cells radioresistance. In conclusion, NBN gain predicts for decreased bRFR in IGRT, but not in RadP patients. If validated independently, Nibrin gains may be the first PCa predictive biomarker to facilitate local treatment decisions using precision medicine approaches with surgery or radiotherapy. PMID:25415046

  14. In Vivo Molecular MRI Imaging of Prostate Cancer by Targeting PSMA with Polypeptide-Labeled Superparamagnetic Iron Oxide Nanoparticles

    PubMed Central

    Zhu, Yunkai; Sun, Ying; Chen, Yaqing; Liu, Weiyong; Jiang, Jun; Guan, Wenbin; Zhang, Zhongyang; Duan, Yourong

    2015-01-01

    The prostate specific membrane antigen (PSMA) is broadly overexpressed on prostate cancer (PCa) cell surfaces. In this study, we report the synthesis, characterization, in vitro binding assay, and in vivo magnetic resonance imaging (MRI) evaluation of PSMA targeting superparamagnetic iron oxide nanoparticles (SPIONs). PSMA-targeting polypeptide CQKHHNYLC was conjugated to SPIONs to form PSMA-targeting molecular MRI contrast agents. In vitro studies demonstrated specific uptake of polypeptide-SPIONs by PSMA expressing cells. In vivo MRI studies found that MRI signals in PSMA-expressing tumors could be specifically enhanced with polypeptide-SPION, and further Prussian blue staining showed heterogeneous deposition of SPIONs in the tumor tissues. Taken altogether, we have developed PSMA-targeting polypeptide-SPIONs that could specifically enhance MRI signal in tumor-bearing mice, which might provide a new strategy for the molecular imaging of PCa. PMID:25927579

  15. American Cancer Society Recommendations for Prostate Cancer Early Detection

    MedlinePlus

    ... Prostate Cancer Prevention and Early Detection American Cancer Society Recommendations for Prostate Cancer Early Detection The American Cancer Society (ACS) recommends that men have a chance to ...

  16. Prostate Cancer: Correlation of MR Imaging and MR Spectroscopy with Pathologic Findings after Radiation Therapy—Initial Experience1

    PubMed Central

    Pucar, Darko; Shukla-Dave, Amita; Hricak, Hedvig; Moskowitz, Chaya S.; Kuroiwa, Kentaro; Olgac, Semra; Ebora, Lanie E.; Scardino, Peter T.; Koutcher, Jason A.; Zakian, Kristen L.

    2008-01-01

    PURPOSE: To prospectively evaluate magnetic resonance (MR) imaging and MR spectroscopy for depiction of local prostate cancer recurrence after external-beam radiation therapy, with step-section pathologic findings as the standard of reference. MATERIALS AND METHODS: Study received institutional approval, and written informed consent was obtained. Study was compliant with Health Insurance Portability and Accountability Act. Sextant biopsy, digital rectal examination, MR imaging, MR spectroscopy, and salvage radical prostatectomy with step-section pathologic examination were performed in nine patients with increasing prostate-specific antigen levels after external-beam radiation therapy. MR imaging criterion for tumor was a focal nodular region of reduced signal intensity at T2-weighted imaging. MR spectroscopic criteria for tumor were voxels with choline (Cho) plus creatine (Cr) to citrate (Cit) ratio ([Cho + Cr]/Cit) of at least 0.5 or voxels with detectable Cho and no Cit in the peripheral zone. Sensitivity and specificity of sextant biopsy, digital rectal examination, MR imaging, and MR spectroscopy were determined by using a prostate sextant as the unit of analysis. For feature analysis, MR imaging and MR spectroscopic findings were correlated with step-section pathologic findings. RESULTS: MR imaging and MR spectroscopy showed estimated sensitivities of 68% and 77%, respectively, while sensitivities of biopsy and digital rectal examination were 48% and 16%, respectively. MR spectroscopy appears to be less specific (78%) than the other three tests, each of which had a specificity higher than 90%. MR spectroscopic feature analysis showed that a metabolically altered benign gland could be falsely identified as tumor by using MR spectroscopic criteria; further analysis of MR spectroscopic features did not lead to improved MR spectroscopic criteria for recurrent tumor. CONCLUSION: In summary, MR imaging and MR spectroscopy may be more sensitive than sextant biopsy

  17. OCT image segmentation of the prostate nerves

    NASA Astrophysics Data System (ADS)

    Chitchian, Shahab; Weldon, Thomas P.; Fried, Nathaniel M.

    2009-08-01

    The cavernous nerves course along the surface of the prostate and are responsible for erectile function. Improvements in identification, imaging, and visualization of the cavernous nerves during prostate cancer surgery may improve nerve preservation and postoperative sexual potency. In this study, 2-D OCT images of the rat prostate were segmented to differentiate the cavernous nerves from the prostate gland. Three image features were employed: Gabor filter, Daubechies wavelet, and Laws filter. The features were segmented using a nearestneighbor classifier. N-ary morphological post-processing was used to remove small voids. The cavernous nerves were differentiated from the prostate gland with a segmentation error rate of only 0.058 +/- 0.019.

  18. A prostate cancer computer-aided diagnosis system using multimodal magnetic resonance imaging and targeted biopsy labels

    NASA Astrophysics Data System (ADS)

    Liu, Peter; Wang, Shijun; Turkbey, Baris; Grant, Kinzya; Pinto, Peter; Choyke, Peter; Wood, Bradford J.; Summers, Ronald M.

    2013-02-01

    We propose a new method for prostate cancer classification based on supervised statistical learning methods by integrating T2-weighted, diffusion-weighted, and dynamic contrast-enhanced MRI images with targeted prostate biopsy results. In the first step of the method, all three imaging modalities are registered based on the image coordinates encoded in the DICOM images. In the second step, local statistical features are extracted in each imaging modality to capture intensity, shape, and texture information at every biopsy target. Finally, using support vector machines, supervised learning is conducted with the biopsy results to train a classification system that predicts the pathology of suspicious cancer lesions. The algorithm was tested with a dataset of 54 patients that underwent 164 targeted biopsies (58 positive, 106 negative). The proposed tri-modal MRI algorithm shows significant improvement over a similar approach that utilizes only T2-weighted MRI images (p= 0.048). The areas under the ROC curve for these methods were 0.82 (95% CI: [0.71, 0.93]) and 0.73 (95% CI: [0.55, 0.84]), respectively.

  19. Multiparametric MR imaging of prostate cancer foci: assessing the detectability and localizability of Gleason 7 peripheral zone cancers based on image contrasts

    NASA Astrophysics Data System (ADS)

    Gibson, Eli; Gaed, Mena; Hrinivich, Thomas; Gómez, José A.; Moussa, Madeleine; Romagnoli, Cesare; Mandel, Jonathan; Bastian-Jordan, Matthew; Cool, Derek W.; Ghoul, Suha; Pautler, Stephen E.; Chin, Joseph L.; Crukley, Cathie; Bauman, Glenn S.; Fenster, Aaron; Ward, Aaron D.

    2014-03-01

    Purpose: Multiparametric magnetic resonance imaging (MPMRI) supports detection and staging of prostate cancer, but the image characteristics needed for tumor boundary delineation to support focal therapy have not been widely investigated. We quantified the detectability (image contrast between tumor and non-cancerous contralateral tissue) and the localizability (image contrast between tumor and non-cancerous neighboring tissue) of Gleason score 7 (GS7) peripheral zone (PZ) tumors on MPMRI using tumor contours mapped from histology using accurate 2D-3D registration. Methods: MPMRI [comprising T2-weighted (T2W), dynamic-contrast-enhanced (DCE), apparent diffusion coefficient (ADC) and contrast transfer coefficient images] and post-prostatectomy digitized histology images were acquired for 6 subjects. Histology contouring and grading (approved by a genitourinary pathologist) identified 7 GS7 PZ tumors. Contours were mapped to MPMRI images using semi-automated registration algorithms (combined target registration error: 2 mm). For each focus, three measurements of mean +/- standard deviation of image intensity were taken on each image: tumor tissue (mT+/-sT), non-cancerous PZ tissue < 5 mm from the tumor (mN+/-sN), and non-cancerous contralateral PZ tissue (mC+/-sC). Detectability [D, defined as mT-mC normalized by sT and sC added in quadrature] and localizability [L, defined as mT-mN normalized by sT and sN added in quadrature] were quantified for each focus on each image. Results: T2W images showed the strongest detectability, although detectability |D|>=1 was observed on either ADC or DCE images, or both, for all foci. Localizability on all modalities was variable; however, ADC images showed localizability |L|>=1 for 3 foci. Conclusions: Delineation of GS7 PZ tumors on individual MPMRI images faces challenges; however, images may contain complementary information, suggesting a role for fusion of

  20. Detection of locally radio-recurrent prostate cancer at multiparametric MRI: Can dynamic contrast-enhanced imaging be omitted?

    PubMed

    Alonzo, F; Melodelima, C; Bratan, F; Vitry, T; Crouzet, S; Gelet, A; Rouvière, O

    2016-04-01

    The goal of this study was to assess the added value of dynamic contrast-enhanced (DCE) imaging in detecting locally radio-recurrent prostate cancer using multiparametric magnetic resonance imaging (mpMRI) at 3Tesla (T). We retrospectively analyzed 45 patients with rising prostate-specific antigen level after prostate radiotherapy who underwent mpMRI [T2-weighted (T2w), diffusion-weighted (Dw) and DCE imaging] at 3T before prostate biopsy. Four readers assigned a 5-level Likert score of cancer likelihood in 8 prostate sectors (6 sextants, 2 seminal vesicles) on T2w+Dw and T2w+Dw+DCE images. Biopsy results were used as the standard of reference. T2w+Dw and T2w+Dw+DCE imaging had similar areas under the receiver operating characteristic curves on per-sector (0.87-0.89 vs. 0.87-0.89; P=0.19-0.78) and per-lobe (0.82-0.94 vs. 0.80-0.91; P=0.21-0.84) analysis. Using a Likert score≥2/5 for diagnosis threshold, T2w+Dw+DCE imaging showed non-significantly higher sensitivities on per-sector (0.56-0.72 vs. 0.52-0.73, P=0.34-0.69) and per-lobe (0.80-0.90 vs. 0.73-0.88; P=0.63-0.99) analysis. It also showed non-significantly lower specificities on per-sector (0.74-0.89 vs. 0.82-0.89; P=0.09-0.99) and per-lobe (0.48-0.81 vs. 0.61-0.84; P=0.10-0.99) analysis. Weighted kappa values were respectively 0.57-0.70 and 0.55-0.66 for T2w+Dw and T2w+Dw+DCE imaging at the sector level, and 0.66-0.83 and 0.58-0.85 at the lobe level. The use of DCE MR imaging tends to increase sensitivity and decrease specificity for all readers, but the differences are not significant. Copyright © 2016. Published by Elsevier Masson SAS.

  1. Prostate magnetic resonance imaging: challenges of implementation.

    PubMed

    Loch, Ronald; Fowler, Kathryn; Schmidt, Ryan; Ippolito, Joseph; Siegel, Cary; Narra, Vamsi

    2015-01-01

    Prostate cancer is among the most common causes of cancer and cancer deaths in men. Screening methods and optimal treatments have become controversial in recent years. Prostate magnetic resonance imaging (MRI) is gaining popularity as a tool to assist diagnosis, risk assessment, and staging. However, implementation into clinical practice can be difficult, with many challenges associated with image acquisition, postprocessing, interpretation, reporting, and radiologic-pathologic correlation. Although state-of-the-art technology is available at select sites for targeting tissue biopsy and interpreting multiparametric prostate MRI, many institutions struggle with adapting this new technology into an efficient multidisciplinary model of patient care. This article reviews several of the challenges that radiologists should be aware of when integrating prostate MRI into their clinical practice.

  2. What Is the Negative Predictive Value of Multiparametric Magnetic Resonance Imaging in Excluding Prostate Cancer at Biopsy? A Systematic Review and Meta-analysis from the European Association of Urology Prostate Cancer Guidelines Panel.

    PubMed

    Moldovan, Paul C; Van den Broeck, Thomas; Sylvester, Richard; Marconi, Lorenzo; Bellmunt, Joaquim; van den Bergh, Roderick C N; Bolla, Michel; Briers, Erik; Cumberbatch, Marcus G; Fossati, Nicola; Gross, Tobias; Henry, Ann M; Joniau, Steven; van der Kwast, Theo H; Matveev, Vsevolod B; van der Poel, Henk G; De Santis, Maria; Schoots, Ivo G; Wiegel, Thomas; Yuan, Cathy Yuhong; Cornford, Philip; Mottet, Nicolas; Lam, Thomas B; Rouvière, Olivier

    2017-08-01

    It remains unclear whether patients with a suspicion of prostate cancer (PCa) and negative multiparametric magnetic resonance imaging (mpMRI) can safely obviate prostate biopsy. To systematically review the literature assessing the negative predictive value (NPV) of mpMRI in patients with a suspicion of PCa. The Embase, Medline, and Cochrane databases were searched up to February 2016. Studies reporting prebiopsy mpMRI results using transrectal or transperineal biopsy as a reference standard were included. We further selected for meta-analysis studies with at least 10-core biopsies as the reference standard, mpMRI comprising at least T2-weighted and diffusion-weighted imaging, positive mpMRI defined as a Prostate Imaging Reporting Data System/Likert score of ≥3/5 or ≥4/5, and results reported at patient level for the detection of overall PCa or clinically significant PCa (csPCa) defined as Gleason ≥7 cancer. A total of 48 studies (9613 patients) were eligible for inclusion. At patient level, the median prevalence was 50.4% (interquartile range [IQR], 36.4-57.7%) for overall cancer and 32.9% (IQR, 28.1-37.2%) for csPCa. The median mpMRI NPV was 82.4% (IQR, 69.0-92.4%) for overall cancer and 88.1% (IQR, 85.7-92.3) for csPCa. NPV significantly decreased when cancer prevalence increased, for overall cancer (r=-0.64, p<0.0001) and csPCa (r=-0.75, p=0.032). Eight studies fulfilled the inclusion criteria for meta-analysis. Seven reported results for overall PCa. When the overall PCa prevalence increased from 30% to 60%, the combined NPV estimates decreased from 88% (95% confidence interval [95% CI], 77-99%) to 67% (95% CI, 56-79%) for a cut-off score of 3/5. Only one study selected for meta-analysis reported results for Gleason ≥7 cancers, with a positive biopsy rate of 29.3%. The corresponding NPV for a cut-off score of ≥3/5 was 87.9%. The NPV of mpMRI varied greatly depending on study design, cancer prevalence, and definitions of positive mpMRI and csPCa. As

  3. Vitamin E and Prostate Cancer

    USDA-ARS?s Scientific Manuscript database

    Vitamin E, its metabolites or its analogs, might help prevent prostate cancer initiation or progression. Prostate cancer is the most common non-skin malignancy and the second leading cause of cancer deaths among men in the United States, exceeded only by lung cancer. About 218,890 new cases of prost...

  4. [Grading of prostate cancer].

    PubMed

    Kristiansen, G; Roth, W; Helpap, B

    2016-07-01

    The current grading of prostate cancer is based on the classification system of the International Society of Urological Pathology (ISUP) following a consensus conference in Chicago in 2014. The foundations are based on the frequently modified grading system of Gleason. This article presents a brief description of the development to the current ISUP grading system.

  5. Five-Year Outcomes from 3 Prospective Trials of Image-Guided Proton Therapy for Prostate Cancer

    SciTech Connect

    Mendenhall, Nancy P.; Hoppe, Bradford S.; Nichols, Romaine C.; Mendenhall, William M.; Morris, Christopher G.; Li, Zuofeng; Su, Zhong; Williams, Christopher R.; Costa, Joseph; Henderson, Randal H.

    2014-03-01

    Purpose: To report 5-year clinical outcomes of 3 prospective trials of image-guided proton therapy for prostate cancer. Methods and Materials: A total of 211 prostate cancer patients (89 low-risk, 82 intermediate-risk, and 40 high-risk) were treated in institutional review board-approved trials of 78 cobalt gray equivalent (CGE) in 39 fractions for low-risk disease, 78 to 82 CGE for intermediate-risk disease, and 78 CGE with concomitant docetaxel therapy followed by androgen deprivation therapy for high-risk disease. Toxicities were graded according to Common Terminology Criteria for Adverse Events (CTCAE), version 3.0. Median follow-up was 5.2 years. Results: Five-year rates of biochemical and clinical freedom from disease progression were 99%, 99%, and 76% in low-, intermediate-, and high-risk patients, respectively. Actuarial 5-year rates of late CTCAE, version 3.0 (or version 4.0) grade 3 gastrointestinal and urologic toxicity were 1.0% (0.5%) and 5.4% (1.0%), respectively. Median pretreatment scores and International Prostate Symptom Scores at >4 years posttreatment were 8 and 7, 6 and 6, and 9 and 8, respectively, among the low-, intermediate-, and high-risk patients. There were no significant changes between median pretreatment summary scores and Expanded Prostate Cancer Index Composite scores at >4 years for bowel, urinary irritative and/or obstructive, and urinary continence. Conclusions: Five-year clinical outcomes with image-guided proton therapy included extremely high efficacy, minimal physician-assessed toxicity, and excellent patient-reported outcomes. Further follow-up and a larger patient experience are necessary to confirm these favorable outcomes.

  6. Prostate Cancer: Sextant Localization at MR Imaging and MR Spectroscopic Imaging before Prostatectomy—Results of ACRIN Prospective Multi-institutional Clinicopathologic Study

    PubMed Central

    Weinreb, Jeffrey C.; Blume, Jeffrey D.; Coakley, Fergus V.; Wheeler, Thomas M.; Cormack, Jean B.; Sotto, Christopher K.; Cho, Haesun; Kawashima, Akira; Tempany-Afdhal, Clare M.; Macura, Katarzyna J.; Rosen, Mark; Gerst, Scott R.; Kurhanewicz, John

    2009-01-01

    Purpose: To determine the incremental benefit of combined endorectal magnetic resonance (MR) imaging and MR spectroscopic imaging, as compared with endorectal MR imaging alone, for sextant localization of peripheral zone (PZ) prostate cancer. Materials and Methods: This prospective multicenter study, conducted by the American College of Radiology Imaging Network (ACRIN) from February 2004 to June 2005, was institutional review board approved and HIPAA compliant. Research associates were required to follow consent guidelines approved by the Office for Human Research Protection and established by the institutional review boards. One hundred thirty-four patients with biopsy-proved prostate adenocarcinoma and scheduled to undergo radical prostatectomy were recruited at seven institutions. T1-weighted, T2-weighted, and spectroscopic MR sequences were performed at 1.5 T by using a pelvic phased-array coil in combination with an endorectal coil. Eight readers independently rated the likelihood of the presence of PZ cancer in each sextant by using a five-point scale—first on MR images alone and later on combined MR–MR spectroscopic images. Areas under the receiver operating characteristic curve (AUCs) were calculated with sextant as the unit of analysis. The presence or absence of cancer at centralized histopathologic evaluation of prostate specimens was the reference standard. Reader-specific receiver operating characteristic curves for values obtained with MR imaging alone and with combined MR imaging–MR spectroscopic imaging were developed. The AUCs were estimated by using Mann-Whitney statistics and appropriate 95% confidence intervals. Results: Complete data were available for 110 patients (mean age, 58 years; range, 45–72 years). MR imaging alone and combined MR imaging–MR spectroscopic imaging had similar accuracy in PZ cancer localization (AUC, 0.60 vs 0.58, respectively; P > .05). AUCs for individual readers were 0.57–0.63 for MR imaging alone and 0

  7. In Vivo Imaging of Branched Chain Amino Acid Metabolism in Prostate Cancer

    DTIC Science & Technology

    2012-08-01

    BCAA ) metabolism, which are known to be modified in the tumor-bearing state. For example, recent reports have demonstrated the critical role of BCAAs ...in the proliferation of tumorgenic prostate tissue.5 In particular, many of the features of BCAA metabolism in cancerous tissue are generally...characterized by altered BCAA availability and elevated rates of BCAA oxidation.6 Body In order to determine the ideal animal model for investigating

  8. In Vivo Imaging of Branched Chain Amino Acid Metabolism in Prostate Cancer

    DTIC Science & Technology

    2013-08-01

    Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway...Instruments Molecular Biotools, Oxford, UK). All MR measurements were performed using a custom- built carbon-13 surface coil (∅inner = 28 mm), operating at...Anal Biochem 1996; 238: 65–71. 23. Sobel RE, et al. Cell lines used in prostate cancer research: a compendium of old and new lines. J Urol 2005; 173

  9. Prostate Cancer for the Internist.

    PubMed

    Jaiswal, Shikha; Sarmad, Rehan; Arora, Sumant; Dasaraju, Radhikha; Sarmad, Komal

    2015-10-01

    In the United States, approximately 240,000 men are diagnosed annually with prostate cancer. Although effective treatment options are available for clinically localized cancer, the potential burdensome co-morbidities and attendant healthcare costs from over diagnosis and over treatment have escalated the discussion and controversy regarding appropriate screening, diagnosis, and optimal management of prostate cancer. Although the lifetime risk of developing prostate cancer is approximately 1 in 6 (~16%), the risk of dying from the disease is only ~2%. The discrepancy between the cancer incidence and lethality has led to widespread scrutiny of prostate cancer patient management, particularly for low-grade, low-stage (indolent) disease. The vast majority of men diagnosed with clinically localized prostate cancer are treated with interventional therapies despite studies demonstrating that even without treatment, prostate cancer-specific mortality is low. A MedLine/PubMed search was performed using PICO format (Patient, Intervention, Comparison and Outcome) identifying all relevant articles. No restrictions were used for publication dates. The terms "Prostate Cancer", "Screening", "Mortality", "Morbidity" yielded 307 results. "Diagnosis", "Prognosis" and "Survival" yielded 1504 results. Further filters were applied to narrow down the results using keywords "Prostate cancer screening guidelines 2014", "Beyond PSA", "NCCN Guidelines prostate", "MRI guided Prostate biopsy" yielding 72, 274, 54 and 568 results respectively. Of these, approximately 137 articles were found relevant and were reviewed. References from the reviewed articles were included in the final article.

  10. Co-targeting androgen receptor and DNA for imaging and molecular radiotherapy of prostate cancer: in vitro studies.

    PubMed

    Han, Guang; Kortylewicz, Zbigniew P; Enke, Thomas; Baranowska-Kortylewicz, Janina

    2014-12-01

    The androgen receptor (AR) axis, the key growth and survival pathway in prostate cancer, remains a prime target for drug development. 5-Radioiodo-3'-O-(17β-succinyl-5α-androstan-3-one)-2'-deoxyuridin-5'-yl phosphate (RISAD-P) is the AR-seeking reagent developed for noninvasive assessment of AR and proliferative status, and for molecular radiotherapy of prostate cancer with Auger electron-emitting radionuclides. RISAD-P radiolabeled with 123I, 124I, and 125I were synthesized using a common stannylated precursor. The cellular uptake, subcellular distribution, and radiotoxicity of 123I-, 124I-, and (125) IRISAD-P were measured in LNCaP, DU145, and PC-3 cell lines expressing various levels of AR. The uptake of RISAD-P by prostate cancer cells is proportional to AR levels and independent of the radionuclide. The intracellular accumulation of radioactivity is directly proportional to the extracellular concentration of RISAD-P and the duration of exposure. Initially, RISAD-P is trapped in the cytoplasm. Within 24 hr, radioactivity is associated exclusively with DNA. The RISAD-P radiotoxicity is determined by the radionuclide; however, the cellular responses are directly proportional to the AR expression levels. LNCaP cells expressing high levels of AR are killed at the rate of up to 60% per day after a brief 1 hr RISAD-P treatment. For the first time, the AR expression in PC-3 and DU 145 cells, generally reported as AR-negative, was quantitated by the ultra sensitive RISAD-P-based method. RISAD-P is a theranostic drug, which targets AR. Its subcellular metabolite participates in DNA synthesis. RISAD-P is a promising candidate for imaging of the AR expression and tumor proliferation as well as molecular radiotherapy of prostate cancer. © 2014 Wiley Periodicals, Inc.

  11. Evaluation of Focal Ablation of Magnetic Resonance Imaging Defined Prostate Cancer Using Magnetic Resonance Imaging Controlled Transurethral Ultrasound Therapy with Prostatectomy as the Reference Standard.

    PubMed

    Ramsay, Elizabeth; Mougenot, Charles; Staruch, Robert; Boyes, Aaron; Kazem, Mohammad; Bronskill, Michael; Foster, Harry; Sugar, Linda; Haider, Masoom; Klotz, Laurence; Chopra, Rajiv

    2017-01-01

    We evaluated magnetic resonance imaging controlled transurethral ultrasound therapy as a treatment for magnetic resonance imaging defined focal prostate cancer using subsequent prostatectomy and histology as the reference standard. Five men completed this pilot study, which was approved by the institutional review board. Prior to radical prostatectomy focal tumors identified by magnetic resonance imaging were treated by coagulating targeted subtotal 3-dimensional volumes of prostate tissue using magnetic resonance imaging controlled transurethral focused ultrasound. Treatment was performed with a 3 Tesla clinical magnetic resonance imaging unit combined with modified clinical planning software for high intensity focused ultrasound therapy. After prostatectomy whole mount histological sections parallel to the magnetic resonance imaging treatment planes were used to compare magnetic resonance imaging measurements with thermal damage at the cellular level and, thus, evaluate treatment and target accuracy. Three-dimensional target volumes of 4 to 20 cc and with radii up to 35 mm from the urethra were treated successfully. Mean ± SD temperature control accuracy at the target boundary was -1.6 ± 4.8C and the mean spatial targeting accuracy achieved was -1.5 ± 2.8 mm. Mean treatment accuracy with respect to histology was -0.4 ± 1.7 mm with all index tumors falling inside the histological outer limit of thermal injury. Magnetic resonance imaging guided transurethral ultrasound therapy is capable of generating thermal coagulation and tumor destruction in targeted 3-dimensional angular sectors out to the prostate capsule for prostate glands up to 70 cc in volume. Ultrasound parameters needed to achieve ablation at the prostate capsule were determined, providing a foundation for future studies. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  12. Survival in prostate cancer prevention trial detailed

    Cancer.gov

    In the NCI-sponsored Prostate Cancer Prevention Trial, initial findings from a decade ago showed that the drug finasteride significantly reduced the risk of prostate cancer, but among those who did develop prostate cancer, paradoxically, the drug was asso

  13. Survival in prostate cancer prevention trial detailed

    Cancer.gov

    In the NCI-sponsored Prostate Cancer Prevention Trial, initial findings from a decade ago showed that the drug finasteride significantly reduced the risk of prostate cancer, but among those who did develop prostate cancer, paradoxically, the drug was asso

  14. 11C-Acetate PET/CT Imaging in Localized Prostate Cancer: A study with MRI and Histopathologic Correlation

    PubMed Central

    Mena, Esther; Turkbey, Baris; Mani, Haresh; Adler, Stephen; Valera, Vladimir A.; Bernardo, Marcelino; Shah, Vijay; Pohida, Thomas; McKinney, Yolanda; Kwarteng, Gideon; Daar, Dagane; Lindenberg, Maria L.; Eclarinal, Philip; Wade, Revia; Linehan, W. Marston; Merino, Maria J.; Pinto, Peter A.; Choyke, Peter L.; Kurdziel, Karen A.

    2012-01-01

    This work characterizes the uptake of 11C-Acetate in prostate cancer (PCa), benign prostate hyperplasia (BPH) and normal prostate tissue in comparison with multi-parametric MRI, whole mount histopathology and clinical markers, to evaluate its potential utility for delineating intra-prostatic tumors in a population of patients with localized PCa. METHODS 39 men with presumed localized PCa underwent dynamic/static abdomen-pelvic 11C-Acetate PET/CT for 30-minutes and 3T multi-parametric (MP) MRI prior to prostatectomy. PET/CT images were registered to MRI using pelvic bones for initial rotation-translation, followed by manual adjustments to account for prostate motion and deformation from the MRI endorectal coil. Whole-mount pathology specimens were sectioned using an MRI-based patient specific mold resulting in improved registration between the MRI, PET and pathology. 11C-Acetate PET standardized uptake values were compared with MP-MRI and pathology. RESULTS 11C-Acetate uptake was rapid but reversible, peaking at 3–5 minutes post-injection and reaching a relative plateau at ~10 minutes. The average SUVmax(10–12min) of tumors was significantly higher than that of normal prostate tissue (4.4±2.05, range 1.8–9.2 vs. 2.1±0.94, range 0.7–3.4; p<0.001); however it was not significantly different from benign prostatic hyperplasia (4.8±2.01; range 1.8–8.8). A sector-based comparison with histopathology, including all tumors > 0.5 cm, revealed a sensitivity and specificity of 61.6 % and 80.0 % for 11C-Acetate PET/CT, and 82.3% and 95.1% for MRI, respectively. Considering only tumors >0.9 cm the 11C-Acetate accuracy was comparable to that of MRI. In a small cohort (n=9), 11C-Acetate uptake was independent of fatty acid synthase expression based on immunohistochemistry. CONCLUSION 11C-Acetate PET/CT demonstrates higher uptake in tumor foci than normal prostate tissue; however 11C-Acetate uptake in tumors is similar to BPH nodules. While 11C-Acetate PET/CT is not

  15. GCPII Imaging and Cancer

    PubMed Central

    Foss, C.A.; Mease, R.C.; Cho, S.Y.; Kim, H.J.; Pomper, M.G.

    2014-01-01

    Glutamate carboxypeptidase II (GCPII) in the central nervous system is referred to as the prostate-specific membrane antigen (PSMA) in the periphery. PSMA serves as a target for imaging and treatment of prostate cancer and because of its expression in solid tumor neovasculature has the potential to be used in this regard for other malignancies as well. An overview of GCPII/PSMA in cancer, as well as a discussion of imaging and therapy of prostate cancer using a wide variety of PSMA-targeting agents is provided. PMID:22304713

  16. Cerebellar Metastases From Prostate Cancer on 68Ga-PSMA PET/CT.

    PubMed

    Chan, Mico; Hsiao, Edward; Turner, Jennifer

    2017-03-01

    Ga prostate-specific membrane antigen PET/CT is increasingly used to evaluate extent of disease in prostate carcinoma. Parenchymal brain metastases originating from prostate cancer have highly variable imaging appearance. We present a 77-year-old man with cerebellar metastasis from prostate cancer showing focal uptake on prostate-specific membrane antigen PET/CT.

  17. Multiparametric magnetic resonance imaging findings in men with low-risk prostate cancer followed using active surveillance

    PubMed Central

    Mullins, Jeffrey K.; Bonekamp, David; Landis, Patricia; Begum, Hosne; Partin, Alan W.; Epstein, Jonathan I.; Carter, H. Ballentine; Macura, Katarzyna J.

    2014-01-01

    Objective To assess the performance of multiparametric magnetic resonance imaging (MRI) in identifying pathological-index (path-index) lesions, defined as cancer present in the same prostate sextant in two separate surveillance biopsies, in men followed within an active surveillance (AS) programme for low-risk prostate cancer (CaP) with extended follow-up. Materials and Methods A total of 50 men, representing >215 person-years of follow-up in an AS programme, who were referred for prostate MRI were randomly chosen to have their images