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A multiobserver study investigating the effectiveness of prostatic multiparametric magnetic resonance imaging to dose escalate corresponding histologic lesions using high-dose-rate brachytherapy.
Smith, Christopher W; Hoover, Douglas; Surry, Kathleen; D'Souza, David; Cool, Derek W; Kassam, Zahra; Bastian-Jordan, Matthew; Gomez, Jose A; Moussa, Madeleine; Chin, Joseph; Pautler, Stephen; Bauman, Glenn S; Ward, Aaron D.
Afiliação
  • Smith CW; Baines Imaging Research Laboratory, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Department of Medical Biophysics, Western University, London, Ontario, Canada; London Regional Cancer Program, London, Ontario, Canada.
  • Hoover D; Lawson Health Research Institute, London, Ontario, Canada; Department of Medical Biophysics, Western University, London, Ontario, Canada; London Regional Cancer Program, London, Ontario, Canada.
  • Surry K; Lawson Health Research Institute, London, Ontario, Canada; Department of Medical Biophysics, Western University, London, Ontario, Canada; London Regional Cancer Program, London, Ontario, Canada.
  • D'Souza D; Lawson Health Research Institute, London, Ontario, Canada; Department of Oncology, Western University, London, Ontario, Canada; London Regional Cancer Program, London, Ontario, Canada.
  • Cool DW; Lawson Health Research Institute, London, Ontario, Canada; Department of Medical Imaging, Western University, London, Ontario, Canada.
  • Kassam Z; Lawson Health Research Institute, London, Ontario, Canada; Department of Medical Imaging, Western University, London, Ontario, Canada.
  • Bastian-Jordan M; Department of Medical Imaging, University of Queensland, Brisbane, Queensland, Australia.
  • Gomez JA; Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada.
  • Moussa M; Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada.
  • Chin J; Department of Surgery, Western University, London, Ontario, Canada; Department of Oncology, Western University, London, Ontario, Canada.
  • Pautler S; Department of Surgery, Western University, London, Ontario, Canada; Department of Oncology, Western University, London, Ontario, Canada.
  • Bauman GS; Department of Medical Biophysics, Western University, London, Ontario, Canada; Department of Oncology, Western University, London, Ontario, Canada; London Regional Cancer Program, London, Ontario, Canada.
  • Ward AD; Baines Imaging Research Laboratory, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Department of Medical Biophysics, Western University, London, Ontario, Canada; Department of Oncology, Western University, London, Ontario, Canada; London Regional Cancer Program,
Brachytherapy ; 20(3): 601-610, 2021.
Article em En | MEDLINE | ID: mdl-33648893
ABSTRACT

PURPOSE:

Using multiparametric MRI data and the pathologic data from radical prostatectomy specimens, we simulated the treatment planning of dose-escalated high-dose-rate brachytherapy (HDR-BT) to the Multiparametric MRI dominant intraprostatic lesion (mpMRI-DIL) to compare the dose potentially delivered to the pathologically confirmed locations of the high-grade component of the cancer. METHODS AND MATERIALS Pathologist-annotated prostatectomy midgland histology sections from 12 patients were registered to preprostatectomy mpMRI scans that were interpreted by four radiologists. To simulate realistic HDR-BT, we registered each observer's mpMRI-DILs and corresponding histology to two transrectal ultrasound images of other HDR-BT patients with a 15-Gy whole-gland prescription. We used clinical inverse planning to escalate the mpMRI-DILs to 20.25 Gy. We compared the dose that the histopathology would have received if treated with standard treatment plans to the dose mpMRI-targeting would have achieved. The histopathology was grouped as high-grade cancer (any Gleason Grade 4 or 5) and low-grade cancer (only Gleason Grade 3).

RESULTS:

212 mpMRI-targeted HDR-BT plans were analyzed. For high-grade histology, the mpMRI-targeted plans achieved significantly higher median [IQR] D98 and D90 values of 18.2 [16.7-19.5] Gy and 19.4 [17.8-20.9] Gy, respectively, in comparison with the standard plans (p = 0.01 and p = 0.003). For low-grade histology, the targeted treatment plans would have resulted in a significantly higher median D90 of 17.0 [16.1-18.4] Gy in comparison with standard plans (p = 0.015); the median D98 was not significantly higher (p = 0.2).

CONCLUSIONS:

In this retrospective pilot study of 12 patients, mpMRI-based dose escalation led to increased dose to high-grade, but not low-grade, cancer. In our data set, different observers and mpMRI sequences had no substantial effect on dose to histologic cancer.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata / Braquiterapia / Imageamento por Ressonância Magnética Multiparamétrica Tipo de estudo: Observational_studies Limite: Humans / Male Idioma: En Revista: Brachytherapy Assunto da revista: RADIOTERAPIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Canadá
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata / Braquiterapia / Imageamento por Ressonância Magnética Multiparamétrica Tipo de estudo: Observational_studies Limite: Humans / Male Idioma: En Revista: Brachytherapy Assunto da revista: RADIOTERAPIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Canadá