Dataset Information

The effect of 5 alpha-reductase inhibitor therapy on prostate cancer detection in the era of multi-parametric magnetic resonance imaging.

ABSTRACT: We aimed to evaluate the effect of 5 alpha-reductase inhibitor (5-ARI) treatment on prostate cancer (PCa) and clinically significant PCa (csPCa) detection in patients undergoing transrectal ultrasound (TRUS)/magnetic resonance imaging (MRI) fusion biopsy in the current era of multi-parametric MRI (mpMRI). We retrospectively reviewed our TRUS/MRI fusion biopsy database (n?=?706). Eighty (11.3%) patients who had used 5-ARI for more than one year at the time of biopsy were stratified as 5-ARI group. Subsequently, we performed comparative analyses of 5-ARI and non-5-ARI groups. csPCa was defined by a Gleason score ?3?+?4 in a single biopsy core. Chi-squared test was used to evaluate the performance of mpMRI in predicting PCa/csPCa between the two groups. Multivariate logistic regression analyses were performed to evaluate the significant variables associated with PCa detection. There were no significant differences in PCa/csPCa detection rates between 5-ARI and non-5-ARI groups (all, P?>?0.05). In multivariate logistic regression analyses for the evaluation of variables associated with csPCa detection, age (odds ratio [OR], 1.062; 95% confidence interval [CI], 1.035-1.090; P?

SUBMITTER: Kim JK

PROVIDER: S-EPMC6882845 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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The effect of 5 alpha-reductase inhibitor therapy on prostate cancer detection in the era of multi-parametric magnetic resonance imaging.

Kim Jung Kwon JK Lee Hak Jong HJ Hwang Sung Il SI Choe Gheeyoung G Kim Hak Ju HJ Hong Sung Kyu SK

Scientific reports 20191128 1

We aimed to evaluate the effect of 5 alpha-reductase inhibitor (5-ARI) treatment on prostate cancer (PCa) and clinically significant PCa (csPCa) detection in patients undergoing transrectal ultrasound (TRUS)/magnetic resonance imaging (MRI) fusion biopsy in the current era of multi-parametric MRI (mpMRI). We retrospectively reviewed our TRUS/MRI fusion biopsy database (n = 706). Eighty (11.3%) patients who had used 5-ARI for more than one year at the time of biopsy were stratified as 5-ARI group ...[more]

PMID: 31780771

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Project description:BackgroundRadiologists currently subjectively examine multi-parametric magnetic resonance imaging (MRI) to detect possible clinically significant lesions using the Prostate Imaging Reporting and Data System (PI-RADS) protocol. The assessment of imaging, however, relies on the experience and judgement of radiologists creating opportunity for inter-reader variability. Quantitative metrics, such as z-score and signal to clutter ratio (SCR), are therefore needed.MethodsMulti-parametric MRI (T1, T2, diffusion, dynamic contrast-enhanced images) were resampled, rescaled, translated, and stitched to form spatially registered multi-parametric cubes for patients undergoing radical prostatectomy. Multi-parametric signatures that characterize prostate tumors were inserted into z-score and SCR. The multispectral covariance matrix was computed for the outlined normal prostate. The z-score from each MRI image was computed and summed. To reduce noise in the covariance matrix, following matrix decomposition, the noisy eigenvectors were removed. Also, regularization and modified regularization was applied to the covariance matrix by minimizing the discrimination score. The filtered and regularized covariance matrices were inserted into the SCR calculation. The z-score and SCR were quantitatively compared to Gleason scores from clinical pathology assessment of the histology of sectioned wholemount prostates.ResultsTwenty-six consecutive patients were enrolled in this retrospective study. Median patient age was 60 years (range, 49 to 75 years), median prostate-specific antigen (PSA) was 5.8 ng/mL (range, 2.3 to 23.7 ng/mL), and median Gleason score was 7 (range, 6 to 9). A linear fit of the summed z-score against Gleason score found a correlation of R=0.48 and a P value of 0.015. A linear fit of the SCR from regularizing covariance matrix against Gleason score found a correlation of R=0.39 and a P value of 0.058. The SCR employing the modified regularizing covariance matrix against Gleason score found a correlation of R=0.52 and a P value of 0.007. A linear fit of the SCR from filtering out 3 and 4 eigenvectors from the covariance matrix against Gleason score found correlations of R=0.50 and 0.44, respectively, and P values of 0.011 and 0.027, respectively.ConclusionsZ-score and SCR using filtered and regularized covariance matrices derived from spatially registered multi-parametric MRI correlates with Gleason score with highly significant P values.

Project description:ObjectiveThe aim of this study was to characterize response to photodynamic therapy (PDT) in a mouse cancer model using a multi-parametric quantitative MRI protocol and to identify MR parameters as potential biomarkers for early assessment of treatment outcome.MethodsCT26.WT colon carcinoma tumors were grown subcutaneously in the hind limb of BALB/c mice. Therapy consisted of intravenous injection of the photosensitizer Bremachlorin, followed by 10 min laser illumination (200 mW/cm2) of the tumor 6 h post injection. MRI at 7 T was performed at baseline, directly after PDT, as well as at 24 h, and 72 h. Tumor relaxation time constants (T1 and T2) and apparent diffusion coefficient (ADC) were quantified at each time point. Additionally, Gd-DOTA dynamic contrast-enhanced (DCE) MRI was performed to estimate transfer constants (Ktrans) and volume fractions of the extravascular extracellular space (ve) using standard Tofts-Kermode tracer kinetic modeling. At the end of the experiment, tumor viability was characterized by histology using NADH-diaphorase staining.ResultsThe therapy induced extensive cell death in the tumor and resulted in significant reduction in tumor growth, as compared to untreated controls. Tumor T1 and T2 relaxation times remained unchanged up to 24 h, but decreased at 72 h after treatment. Tumor ADC values significantly increased at 24 h and 72 h. DCE-MRI derived tracer kinetic parameters displayed an early response to the treatment. Directly after PDT complete vascular shutdown was observed in large parts of the tumors and reduced uptake (decreased Ktrans) in remaining tumor tissue. At 24 h, contrast uptake in most tumors was essentially absent. Out of 5 animals that were monitored for 2 weeks after treatment, 3 had tumor recurrence, in locations that showed strong contrast uptake at 72 h.ConclusionDCE-MRI is an effective tool for visualization of vascular effects directly after PDT. Endogenous contrast parameters T1, T2, and ADC, measured at 24 to 72 h after PDT, are also potential biomarkers for evaluation of therapy outcome.

Project description:BackgroundRadiologists currently subjectively examine multi-parametric magnetic resonance imaging (MP-MRI) to determine prostate tumor aggressiveness using the Prostate Imaging Reporting and Data System scoring system (PI-RADS). Recent studies showed that modified signal to clutter ratio (SCR), tumor volume, and eccentricity (elongation or roundness) of prostate tumors correlated with Gleason score (GS). No previous studies have combined the prostate tumor's shape, SCR, tumor volume, in order to predict potential tumor aggressiveness and GS.MethodsMP-MRI (T1, T2, diffusion, dynamic contrast-enhanced images) were obtained, resized, translated, and stitched to form spatially registered multi-parametric cubes. Multi-parametric signatures that characterize prostate tumors were inserted into a target detection algorithm [adaptive cosine estimator (ACE)]. Pixel-based blobbing, and labeling were applied to the threshold ACE images. Eccentricity calculation used moments of inertia from the blobs. Tumor volume was computed by counting pixels within multi parametric MRI blobs and tumor outlines based on pathologist assessment of whole mount histology. Pathology assessment of GS was performed on whole mount prostatectomy. The covariance matrix and mean of normal tissue background was computed from normal prostate. Using signatures and normal tissue statistics, the z-score, noise corrected SCR [principal component (PC), modified regularization] from each patient was computed. Eccentricity, tumor volume, and SCR were fitted to GS. Analysis of variance assesses the relationship among the variables.ResultsA multivariate analysis generated correlation coefficient (0.60 to 0.784) and P value (0.00741 to <0.0001) from fitting two sets of independent variates, namely, tumor eccentricity (the eccentricity for the largest blob, weighted average for the eccentricity) and SCR (removing 3 PCs, removing 4 PCs, modified regularization, and z-score) to GS. The eccentricity t-statistic exceeded the SCR t-statistic. The three-variable fit to GS using tumor volume (histology, MRI) yielded correlation coefficients ranging from 0.724 to 0.819 (P value <<0.05). Tumor volumes generated from histology yielded higher correlation coefficients than MRI volumes. Adding volume to eccentricity and SCR adds little improvement for fitting GS due to higher correlation coefficients among independent variables and little additional, independent information.ConclusionsCombining prostate tumors eccentricity with SCR relatively highly correlates with GS.

Dataset Information

The effect of 5 alpha-reductase inhibitor therapy on prostate cancer detection in the era of multi-parametric magnetic resonance imaging.

Publications

The effect of 5 alpha-reductase inhibitor therapy on prostate cancer detection in the era of multi-parametric magnetic resonance imaging.

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