Prospective Evaluation Of The Value Of Dynamic Contrast Enhanced Dce Imaging For Prostate Cancer Detection And Staging With Pathology Correlation

Objective:The main aim is to evaluate the value of dynamic contrast-enhanced (DCE) imaging in multi-parametric prostate MRI (mpMRI) for the detection and staging of prostate cancer in comparison with T2W and DWI images alone in biparametric MRI (bpMRI), in treatment nau00efve patients.Methods:One hundred consecutive patients who underwent a prostate MRI at our institution from June-August 2017, as well as a systematic ultrasound-guided prostate biopsy or prostatectomy, were included. Strictly following the PIRADSv2, the MRI studies were independently interpreted by a body radiologist and a body-imaging fellow on two different occasions 8-10 weeks apart. Initially, with all mpMRI sequences and then without the DCE sequence (bpMRI). The readers were blinded to the clinical information. Ethics approval was obtained.Results/Discussion:One hundred treatment-nau00efve patients were included (median age 64, age range 48-81, mean PSA 10.3). There was excellent intra-observer agreement of the mpMRI versus bpMRI for both readers [Cohenu2019s Kappa (k) 0.88-0.86] and very good inter-observer agreement (k=0.74 for mpMRI and 0.76 for bpMRI). The sensitivity and specificity did not significantly change between the multi-parametric and bi-parametric MRI (Sensitivity 91.7% and 90%, Specificity of 85.5% and 85% for mpMRI and bpMRI, respectively).Conclusion:Prostate MRI without DCE (bpMRI) is of comparable diagnostic accuracy to mpMRI in treatment-nau00efve patients. Performing prostate MRI without DCE (bpMRI) will reduce acquisition time, decrease cost and potentially improve patient safety.

This book covers novel strategies and state of the art approaches for automated non-invasive systems for early prostate cancer diagnosis. Prostate cancer is the most frequently diagnosed malignancy after skin cancer and the second leading cause of cancer related male deaths in the USA after lung cancer. However, early detection of prostate cancer increases chances of patients’ survival. Generally, The CAD systems analyze the prostate images in three steps: (i) prostate segmentation; (ii) Prostate description or feature extraction; and (iii) classification of the prostate status. Explores all of the latest research and developments in state-of-the art imaging of the prostate from world class experts. Contains a comprehensive overview of 2D/3D Shape Modeling for MRI data. Presents a detailed examination of automated segmentation of the prostate in 3D imaging. Examines Computer-Aided-Diagnosis through automated techniques. There will be extensive references at the end of each chapter to enhance further study.

MRI Atlas of Prostate Cancer analyses high-resolution MRI scanning and dynamic contrast-enhanced (DCE) MRI. This combination improves the diagnosis and staging of prostate cancer and may soon replace PSA testing and digital rectal examination. The first two chapters focus on normal anatomy, anatomic variations, benign disease and intraprostatic tumors. The subsequent chapters on MRI of extracapsular disease create a useful atlas of pathologic anatomy. This is the first text of its kind to show color-coded DCE-MRI scans of prostate cancer and to correlate these imaging findings with tumor grading. The chapters on the post-treatment prostate clearly display the increasing incidence of post-therapy recurrences. This book is intended for internists, radiologists, radiotherapists, oncologists, urologists, family practitioners, and general surgeons. Ultrasound, MRI, and radiotherapy technicians will find it extremely useful as a reference guide.

This fully updated and revised new edition provides a comprehensive, state-of-the art review of this field, and will serve as a valuable resource for clinicians, surgeons and researchers with an interest in prostate cancer. The book reviews new data about molecular characteristics of the disease, profiles the new grading system for prostate cancer introduced in 2015, and provides new perspectives about imaging of prostate cancer, as well as the role of targeted biopsies. The text summarizes the role of biomarkers and MRI in patient selection and management and details the world wide results of active surveillance. Specific chapters address communication and ethical issues, QOL outcomes, economic aspects, and psycho-social aspects of surveillance. The role of focal therapy for low risk disease is summarized, and the data supporting preventive interventions during surveillance reviewed. This text will serve as a very useful resource for physicians and researchers dealing with, and interested in this common malignancy, as it provides a concise yet comprehensive summary of the current status of the field that will help guide patient management and stimulate investigative efforts.

In this issue of Radiologic Clinics, guest editors Drs. Nicola Schieda and Andrei Purysko bring their considerable expertise to the topic of Prostate Imaging. Worldwide, prostate cancer is the second most common cancer diagnosed in males, and MRI scans can give doctors a very clear picture of the prostate and nearby areas. In this issue, top experts discuss key topics such as a contemporary approach to prostate imaging and data reporting system score 3 lesions; the expanding role of MRI and use of PRECISE criteria in the active surveillance of prostate cancer; MRI-guided prostate cancer therapies; and more. Contains 12 relevant, practice-oriented topics, including update on optimization of prostate MRI technique and image quality; prostate imaging and data reporting system (PI-RADS) Version 2.1 pitfalls in prostate MRI interpretation; prostate cancer staging with MRI; PSMA PET: pearls and pitfalls; and more. Provides in-depth clinical reviews on prostate imaging, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

Aim and objectives: To assess the correlation between the apparent diffusion coefficient (ADC of the tumor, ADC ratio) and final grade group (GG) after radical prostatectomy (RP), and to determine the threshold values of ADC for detecting clinically significant prostate cancer (PC) with subsequent evaluation in a prospective group.Materials and methods: 118 patients with PC were included in the retrospective group. These patients underwent RP from 2012 to 2017 with preoperative 3 Tesla multiparametric MRI (mpMRT) with contrast enhancement in a single center. After analyzing all the MRI studies, the average values of tumor ADC and benign tissue ADC were calculated using the maps of ADC. The prospective part of the study included 60 patients with completed pre-biopsy mpMRI and subsequent RP from January 2018 to March 2019.Results: Tumor ADC and postoperative GG had a statistically significant negative correlation of moderate strength (Spearmanu2019s correlation coefficient = -0.733, p=0.0001). A similar correlation was found for the ADC ratio with a slightly higher Spearman ratio (p = -0.802, p=0.0001). In the ROC-analysis of potential for discrimination between GG 1 and GG 2, the area under the curve (AUC) was 0.898 (95%, CI 0.835-0.961) for tumor ADC and 0.950 for ADC ratio (95%, CI 0.909-0.992). When used as a criterion for determining GG 1 tumor, ADC values u2265 0.78 shown sensitivity of 78% and specificity of 98%. When using ADC ratio u22650.4501, the sensitivity and specificity were 92 and 93% respectively. The prospective part of the study demonstrated the effectiveness of applying the obtained diffusion coefficient thresholds. When used as a criterion for determining clinically significant prostate cancer (GG > 1), the threshold value of tumor ADC had sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 81%, 61%, 73%, 77 %, and 67% respectively. For the ADC ratio sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 84%, 91%, 87%, 94%, and 78% respectively.Conclusion: ADC of the tumor had a statistically significant negative correlation with the final PC grade group. ADC ratio had a slightly stronger correlation, which is more accurate when separating grade group 1 from grade group 2. In a prospective analysis, the ADC ratio showed a high predictive value. In determining the diffusion coefficients, it is possible to obtain important information about the histopathological aggressiveness of PC. The integration of non-invasive markers in the diagnostic process helps to personalize the patient's treatment plan and avoid unnecessary risks.

This pocket book explains the significant and well-documented impact that PET/CT can have on the management of prostate cancer through the provision of high-quality evidence regarding function and structure. Up-to-date information is supplied on the relevance of PET/CT to diagnosis, treatment planning, and therapy, including the emerging role of PET/CT with PSMA. Readers will also find clear explanation of the relation of the clinical and pathological background to imaging and the value of PET/CT compared with conventional radiological imaging. The book will be an excellent asset for referring clinicians, nuclear medicine/radiology physicians, radiographers/technologists, and nurses who routinely work in nuclear medicine and participate in multidisciplinary meetings. It is published within the Springer series Clinicians’ Guides to Radionuclide Hybrid Imaging, which presents contributions from professionals worldwide who share a common purpose in promoting nuclear medicine as an important imaging specialty for the diagnosis and management of oncological and non-oncological conditions.

This volume provides a broad background of the basic sciences, clinical and therapeutic aspects, and management of uterine cervical cancer. It offers state-of-the-art information on the molecular genetics, biology, and clinical aspects of premalignant lesions of the uterine cervix, and provides a better understanding of the molecular and cellular events that underlie uterine cervical cancer. Uterine Cervical Cancer: Clinical and Therapeutic Perspectives contains extensive, updated information on the promising new developments in the diagnosis and management of uterine cervical cancer. It will serve as an invaluable resource for all clinicians and basic medical scientists caring for women with uterine cervical cancer, including attending surgeons, physicians, clinical fellows, and residents in the disciplines of gynecologic oncology, medical oncology, and surgical oncology.

This pertinently illustrated and well referenced text serves as an up-to-date, attractive book of oncologic imaging for radiologists, oncologists, radiation therapists and others involved in oncologic care. This volume, with chapter contributions from world-renowned experts, provides clinical and research information that underpins accurate interpretation and sensible use of cancer imaging. The book also highlights new developments and advances in oncologic imaging.