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  • Magnetic Resonance Imaging
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  • 1
    Language: English
    In: Urology, August 2018, Vol.118, pp.1-2
    Keywords: Medicine
    ISSN: 0090-4295
    E-ISSN: 1527-9995
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  • 2
    Language: English
    In: Urology, June 2017, Vol.104, pp.7-8
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.urology.2017.03.020 Byline: James Johnston, Werner J. Struss, Peter C. Black Article Note: (footnote) Azzouzi A.-R., Vincendeau S., Barret E., et al., on behalf of the PCM301 Study Group. Lancet Oncol 2016;18:181-191.
    Keywords: Medicine
    ISSN: 0090-4295
    E-ISSN: 1527-9995
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  • 3
    Language: English
    In: Radiology, August 2017, Vol.284(2), pp.451-459
    Description: Purpose To assess the feasibility of luminal water imaging, a quantitative T2-based magnetic resonance (MR) imaging technique, for the detection and grading of prostate cancer (PCa). Materials and Methods Eighteen patients with biopsy-proven PCa provided informed consent to be included in this institutional human ethics board-approved prospective study between January 2015 and January 2016. Patients underwent 3.0-T MR imaging shortly before radical prostatectomy. T2 distributions were generated with a regularized non-negative least squares algorithm from multiecho spin-echo MR imaging data. From T2 distributions, maps of seven MR parameters, N, T2, T2, geometric mean T2 (gmT2), luminal water fraction (LWF), A, and A, were generated and compared with digitized images of hematoxylin-eosin-stained whole-mount histologic slices. A paired t test was used to determine significant differences between MR parameters in malignant and nonmalignant tissue. Correlation with Gleason score (GS) was evaluated with the Spearman rank correlation test. Diagnostic accuracy was evaluated by using logistic generalized linear mixed-effect models and receiver operating characteristic (ROC) analysis. Results The average values of four MR parameters (gmT2, A, A, and LWF) were significantly different between malignant and nonmalignant tissue. All MR parameters except for T2 showed significant correlation (P 〈 .05) with GS in the peripheral zone. The highest correlation with GS was obtained for LWF (-0.78 ± 0.11, P 〈 .001). ROC analysis demonstrated high accuracy for tumor detection, with the highest area under the ROC curve obtained for LWF (0.97 in the peripheral zone and 0.98 in the transition zone). Conclusion Results of this pilot study demonstrated the feasibility of luminal water imaging in the detection and grading of PCa. A study with a larger cohort of patients and a broader range of GS is required to further evaluate this new technique in clinical settings. RSNA, 2017.
    Keywords: Adenocarcinoma -- Diagnostic Imaging ; Magnetic Resonance Imaging -- Methods ; Prostatic Neoplasms -- Diagnostic Imaging
    ISSN: 00338419
    E-ISSN: 1527-1315
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  • 4
    Language: English
    In: PLOS ONE, 4/6/2017, Vol.12(4), p.e0174978
    Description: Objectives Radical cystectomy (RC) and pelvic lymph-node dissection (LND) is standard treatment for non-metastatic muscle-invasive urothelial bladder cancer (MIBC). However, loco-regional recurrence (LRR) is a common early event associated with poor prognosis. We evaluate 3-year LRR-free (LRRFS), metastasis-free (MFS) and overall survivals (OS) after adjuvant radiotherapy (RT) for pathological high-risk MIBC. Material and methods We retrospectively reviewed data from patients in 3 institutions. Inclusion criteria were MIBC, histologically-proven urothelial carcinoma treated by RC and adjuvant RT. Patients with conservative surgery were excluded. Outcomes were evaluated by Kaplan-Meier method. Acute toxicities were recorded according to CTCAE V4.0 scale. Results Between 2000 and 2013, 57 patients [median age 66.3 years (45-84)] were included. Post-operative pathological staging was [less than or equal to]pT2, pT3 and pT4 in 16%, 44%, and 39%, respectively. PLND revealed 28% pN0, 26% pN1 and 42% pN2. Median number of lymph-nodes retrieved was 10 (2-33). Forty-eight patients (84%) received platin-based chemotherapy. For RT, clinical target volume 1 (CTV 1) encompassed pelvic lymph nodes for all patients. CTV 1 also included cystectomy bed for 37 patients (65%). CTV 1 median dose was 45 Gy (4-50). A boost of 16 Gy (5-22), corresponding to CTV 2, was administered for 30 patients, depending on pathological features. One third of patients received intensity-modulated RT. With median follow-up of 40.4 months, 8 patients (14%) had LRR. Three-year LRRFS, MFS and OS were 45% (95%CI 30-60), 37% (95%CI 24-51) and 49% (95%CI 33-63), respectively. Five (9%) patients had acute grade [greater than or equal to]3 toxicities (gastro-intestinal, genito-urinary and biological parameters). One patient died with intestinal fistula in a septic context. Conclusions Because of poor prognosis, an effective post-operative standard of care is needed for pathological high-risk MIBC. Adjuvant RT is feasible and may have oncological benefits. Prospective trials evaluating this approach with current RT techniques should be undertaken.
    Keywords: Radiotherapy – Usage ; Bladder Cancer – Care and Treatment;
    ISSN: PLOS ONE
    E-ISSN: 1932-6203
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  • 5
    In: BJU International, December 2010, Vol.106(11), pp.1799-1804
    Description: To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1464-410X.2010.09424.x Keywords: animal model; bioluminescence imaging; MRI; hypoxia; bladder cancer Abstract: OBJECTIVE To assess the correlation in orthotopic bladder xenografts of bioluminescence imaging (BLI) with tumour volume as determined by magnetic resonance imaging (MRI), and to define the potential role of hypoxia and necrosis in the relationship between BLI and tumour volume at autopsy. MATERIALS AND METHODS Orthotopic bladder tumours were established in nude mice with KU7 and 253J B-V cells expressing luciferase. BLI and MRI were performed weekly. Tumour volume was calculated from MR images at each time point. Autopsy was performed 4 weeks after inoculation and 45 min after injection of piminidazole. haematoxylin and eosin staining and immunohistochemical analysis of piminidazole adduct formation were performed on 1-mm step-sections through frozen whole bladder specimens to assess necrosis and hypoxia, respectively. CD31 staining was used to evaluate vascularity. Relative volumes of each specimen containing total tumour, hypoxic tumour and necrotic tumour were quantified. RESULTS The correlation between MRI volume and BLI was weak in KU7 xenografts (R.sup.2 〈 0.1) but strong in 253J B-V (R.sup.2= 0.93 at 4 weeks). KU7 xenografts had vasculature only peripherally and showed extensive hypoxic and necrotic areas. After subtraction of necrotic areas, the correlation of BLI to viable tumour volume improved (R.sup.2= 0.42). CONCLUSION The correlation between tumour BLI and tumour size varies by cell line and is poor in xenografts that rapidly outgrow their vascular supply and develop broad areas of hypoxia and necrosis. However, in these cases BLI does yield information about the amount of viable tumour, and should therefore still be considered as a useful imaging method. Author Affiliation: Departments of(*)Urology, ([dagger])Imaging Physics, and ([double dagger])Cancer Biology, the University of Texas, M.D. Anderson Cancer Center, TX, USA Article History: Accepted for publication 22 December 2009 Article note: Peter C. Black, Department of Urologic Sciences, University of British Columbia, Level 6, 2775 Laurel St., Vancouver, B.C. V5Z 1M9, Canada., e-mail: peter.black@ubc.ca
    Keywords: Animal Model ; Bioluminescence Imaging ; Mri ; Hypoxia ; Bladder Cancer
    ISSN: 1464-4096
    E-ISSN: 1464-410X
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  • 6
    In: PLoS ONE, 2014, Vol.9(9)
    Description: Purpose To investigate the association between Apparent Diffusion Coefficient (ADC) values and cell cycle and proliferative biomarkers (p53, p21, Ki67,) in order to establish its potential role as a noninvasive biomarker for prediction of cell cycle, proliferative activity and biological aggressiveness in bladder cancer. Materials and Methods Patients with bladder cancer who underwent 3,0 Tesla DW-MRI of the bladder before TUR-B or radical cystectomy were eligible for this prospective IRB-approved study. Histological specimen were immunohistochemically stained for the following markers: p53, p21 and ki67. Two board-certified uropathologists reviewed the specimens blinded to DW-MRI results. Histological grade and T-stage were classified according to the WHO 2004 and the 2009 TNM classification, respectively. Nonparametric univariate and multivariate statistics including correlation, logistic regression and ROC analysis were applied. Results Muscle invasive bladder cancer was histologically confirmed in 10 out of 41 patients. All examined tissue biomarkers were significantly correlated with ADC values (p〈0.05, respectively). Based on multivariate analysis, p53 and ADC are both independent prognostic factors for muscle invasiveness of bladder cancer (〉/ = T2). (p = 0.013 and p = 0.018). Conclusion ADC values are associated with cell cycle and proliferative biomarkers and do thereby reflect invasive and proliferative potential in bladder cancer. ADC and p53 are both independent prognostic factors for muscle invasiveness in bladder cancer.
    Keywords: Research Article ; Medicine And Health Sciences
    E-ISSN: 1932-6203
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  • 7
    Language: English
    In: Urologic Oncology: Seminars and Original Investigations, April 2015, Vol.33(4), pp.165.e1-165.e7
    Description: We aimed to determine the performance of multiparametric magnetic resonance imaging (mpMRI) in the detection of prostate cancer (PCa) in patients with prior negative transrectal ultrasound–guided prostate biopsy (TRUS-B) results. Between 2010 and 2013, 2,416 men underwent TRUS-B or an mpMRI or both at Vancouver General Hospital. Among these, 283 men had persistent suspicion of PCa despite prior negative TRUS-B finding. An MRI was obtained in 112, and a lesion (prostate imaging reporting and data system score ≥3) was identified in 88 cases (78%). A subsequent combined MRI-targeted and standard template biopsy was performed in 86 cases. A matching cohort of 86 patients was selected using a one-nearest neighbor method without replacement. The end points were the rate of diagnosis of PCa and significant PCa (sPCa) (Gleason〉6, or〉2 cores, or〉50% of any core). MRI-targeted TRUS-B detected PCa and sPCa in 36 (41.9%) and 30 (34.9%) men when compared with 19 (22.1%) and 14 (16.3%), respectively, men without mpMRI ( = 0.005 for both). In 9 cases (10.4%), MRI-targeted TRUS-B detected sPCa that was missed on standard cores. sPCa was present in 6 cases (6.9%) on standard cores but not the targeted cores. Multivariate analysis revealed that prostate imaging reporting and data system score and prostate-specific antigen density〉0.15 ng/ml were statistically significant predictors of significant cancer detection (odds ratio = 14.93, 〈0.001 and odds ratio = 6.19, = 0.02, respectively). In patients with prior negative TRUS-B finding, MRI-targeted TRUS-B improves the detection rate of all PCa and sPCa.
    Keywords: Prostate ; Prostatic Neoplasms ; Magnetic Resonance Imaging ; Ultrasonography ; Image-Guided Biopsy ; Targeted Biopsy ; Medicine
    ISSN: 1078-1439
    E-ISSN: 1873-2496
    E-ISSN: 15279995
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  • 8
    In: Journal of Magnetic Resonance Imaging, September 2017, Vol.46(3), pp.861-869
    Description: Byline: Shirin Sabouri, Ladan Fazli, Silvia D. Chang, Richard Savdie, Edward C. Jones, S. Larry Goldenberg, Peter C. Black, Piotr Kozlowski Keywords: prostate; prostatic luminal space; MR T.sub.2 mapping Purpose To determine the relationship between parameters measured from luminal water imaging (LWI), a new magnetic resonance imaging (MRI) T.sub.2 mapping technique, and the corresponding tissue composition in prostate. Materials and Methods In all, 17 patients with prostate cancer were examined with a 3D multiecho spin echo sequence at 3T prior to undergoing radical prostatectomy. Maps of seven MR parameters, called N, T.sub.2-short, T.sub.2-long, A.sub.short, A.sub.long, geometric mean T.sub.2 time (gmT.sub.2), and luminal water fraction (LWF), were generated using nonnegative least squares (NNLS) analysis of the T.sub.2 decay curves. MR parametric maps were correlated to digitized whole-mount histology sections. Percentage area of tissue components, including luminal space, nuclei, and cytoplasm plus stroma, was measured on the histology sections by using color-based image segmentation. Spearman's rank correlation test was used to evaluate the correlation between MR parameters and the corresponding tissue components, with particular attention paid to the correlation between LWF and percentage area of luminal space. Results N, T.sub.2-short, A.sub.long, gmT.sub.2, and LWF showed significant correlation (P 〈 0.05) with percentage area of luminal space and stroma plus cytoplasm. T.sub.2-short and gmT.sub.2 also showed significant correlation (P 〈 0.05) with percentage area of nuclei. Overall, the strongest correlation was observed between LWF and luminal space (Spearman's coefficient of rank correlation=0.75, P 〈 0.001). Conclusion Results of this study show that LWF measured with MRI is strongly correlated with the fractional amount of luminal space in prostatic tissue. This result suggests that LWI can potentially be applied for evaluation of prostatic diseases in which the extent of luminal space differs between normal and abnormal tissues. Level of Evidence: 1 Technical Efficacy: Stage 1 J. MAGN. RESON. IMAGING 2017;46:861-869
    Keywords: Prostate ; Prostatic Luminal Space ; Mr T 2 Mapping
    ISSN: 1053-1807
    E-ISSN: 1522-2586
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  • 9
    Language: English
    In: Canadian Urological Association journal = Journal de l'Association des urologues du Canada, August 2018, Vol.12(8), pp.270-275
    Description: The natural history of prostatic lesions identified on multiparametric magnetic resonance imaging (mpMRI) is largely unknown. We aimed to describe changes observed over time on serial MRI. All patients with ≥2 MRI studies between 2008 and 2015 at our institution were identified. MRI progression was defined as an increase in Prostate Imaging Reporting and Data System (PI-RADS; version 2) or size of existing lesions, or the appearance of a new lesion PIRADS ≥4. Patients on active surveillance (AS) were analyzed for correlation of MRI progression to biopsy reclassification. A total of 83 patients (54 on AS and 29 for diagnostic purposes) underwent serial MRI, with a mean interval of 1.9 years between scans. At baseline, 115 lesions (66 index, 49 non-index) were identified. Index lesions were more likely than non-index lesions to increase in size ≥2 mm (36.2 vs. 7.3 %; p=0.002). Overall progression was more likely to be seen among the index cohort (34.8 vs. 7.6%; p〈0.001). New lesions with PI-RADS ≥4 were seen on second imaging in 13 (16.5%) men, and became the index lesion in 29 cases (34.9%). Eighteen men on AS showed evidence of MRI progression (five with new lesions, 13 with progression of a previous lesion). Biopsy reclassification was present in three men (16.7%) with and seven men without MRI progression (19.4%). Overall changes in size and PI-RADS scores of index lesions on MRI were small. New lesions were common, but usually did not alter management.
    Keywords: Magnetic Resonance Imaging;
    ISSN: 1911-6470
    E-ISSN: 19201214
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  • 10
    Language: English
    In: IEEE Transactions on Medical Imaging, December 2015, Vol.34(12), pp.2535-2549
    Description: A common challenge when performing surface-based registration of images is ensuring that the surfaces accurately represent consistent anatomical boundaries. Image segmentation may be difficult in some regions due to either poor contrast, low slice resolution, or tissue ambiguities. To address this, we present a novel non-rigid surface registration method designed to register two partial surfaces, capable of ignoring regions where the anatomical boundary is unclear. Our probabilistic approach incorporates prior geometric information in the form of a statistical shape model (SSM), and physical knowledge in the form of a finite element model (FEM). We validate results in the context of prostate interventions by registering pre-operative magnetic resonance imaging (MRI) to 3D transrectal ultrasound (TRUS). We show that both the geometric and physical priors significantly decrease net target registration error (TRE), leading to TREs of 2.35 ± 0.81 mm and 2.81 ± 0.66 mm when applied to full and partial surfaces, respectively. We investigate robustness in response to errors in segmentation, varying levels of missing data, and adjusting the tunable parameters. Results demonstrate that the proposed surface registration method is an efficient, robust, and effective solution for fusing data from multiple modalities.
    Keywords: Shape ; Finite Element Analysis ; Transforms ; Image Segmentation ; Computational Modeling ; Deformable Models ; Mathematical Model ; Biopsy ; Finite Element Modeling ; Gaussian Mixture Model ; Prostate ; Statistical Shape Model ; Surface Registration ; Medicine ; Engineering
    ISSN: 0278-0062
    E-ISSN: 1558-254X
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