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Improved dosimetry in prostate brachytherapy using high resolution contrast enhanced magnetic resonance imaging: a feasibility study.

Buch K, Morancy T, Kaplan I, Qureshi MM, Hirsch AE, Rofksy NM, Holupka E, Oismueller R, Hawliczek R, Helbich TH, Bloch BN - J Contemp Brachytherapy (2014)

Bottom Line: Dosimetry data including V100, D90, and D100 was calculated from these contours.Mean V100 values from CT and HR-CEMRI contours were as follows: prostate (98.5% and 96.2%, p = 0.003), urethra (81.0% and 88.7%, p = 0.027), anterior rectal wall (ARW) (8.9% and 2.8%, p < 0.001), left NVB (77.9% and 51.5%, p = 0.002), right NVB (69.2% and 43.1%, p = 0.001), and PB (0.09% and 11.4%, p = 0.005).Significant differences were seen between CT and HR-CEMRI, with volume overestimation of CT derived contours compared to HR-CEMRI.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Boston University Medical Center, Boston, USA.

ABSTRACT

Purpose: To assess detailed dosimetry data for prostate and clinical relevant intra- and peri-prostatic structures including neurovascular bundles (NVB), urethra, and penile bulb (PB) from postbrachytherapy computed tomography (CT) versus high resolution contrast enhanced magnetic resonance imaging (HR-CEMRI).

Material and methods: Eleven postbrachytherapy prostate cancer patients underwent HR-CEMRI and CT imaging. Computed tomography and HR-CEMRI images were randomized and 2 independent expert readers created contours of prostate, intra- and peri-prostatic structures on each CT and HR-CEMRI scan for all 11 patients. Dosimetry data including V100, D90, and D100 was calculated from these contours.

Results: Mean V100 values from CT and HR-CEMRI contours were as follows: prostate (98.5% and 96.2%, p = 0.003), urethra (81.0% and 88.7%, p = 0.027), anterior rectal wall (ARW) (8.9% and 2.8%, p < 0.001), left NVB (77.9% and 51.5%, p = 0.002), right NVB (69.2% and 43.1%, p = 0.001), and PB (0.09% and 11.4%, p = 0.005). Mean D90 (Gy) derived from CT and HR-CEMRI contours were: prostate (167.6 and 150.3, p = 0.012), urethra (81.6 and 109.4, p = 0.041), ARW (2.5 and 0.11, p = 0.003), left NVB (98.2 and 58.6, p = 0.001), right NVB (87.5 and 55.5, p = 0.001), and PB (11.2 and 12.4, p = 0.554).

Conclusions: Findings of this study suggest that HR-CEMRI facilitates accurate and meaningful dosimetric assessment of prostate and clinically relevant structures, which is not possible with CT. Significant differences were seen between CT and HR-CEMRI, with volume overestimation of CT derived contours compared to HR-CEMRI.

No MeSH data available.


Related in: MedlinePlus

Corresponding T2-W, HR-CEMR and CT images of the same location.Please note the superior seed-tissue contrast of the HR-CEMR image: With the prostate gland homogeneously hyperintense (grey) and seeds causing signal voids (black), delineating two displaced seeds (arrows) in proximity to the Denonvillier's fascia/rectal wall, which is not well appreciated on the CT image. T2-weighted image image does not visualize all of the seeds as clearly as the HR-CEMR image
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Figure 0001: Corresponding T2-W, HR-CEMR and CT images of the same location.Please note the superior seed-tissue contrast of the HR-CEMR image: With the prostate gland homogeneously hyperintense (grey) and seeds causing signal voids (black), delineating two displaced seeds (arrows) in proximity to the Denonvillier's fascia/rectal wall, which is not well appreciated on the CT image. T2-weighted image image does not visualize all of the seeds as clearly as the HR-CEMR image

Mentions: Statistically significant differences were noted in V100, V120, and V150 with a greater percentage of prostate volume receiving the prescribed dose in CT-derived contours compared to HR-CEMRI-derived contours, Table 1. Imaging examples are depicted in Figure 1. The mean (± standard deviation) values from CT and HR-CEMRI contours, respectively, were as follows: V100 (98.5 ± 1.5% and 96.2 ± 3.6%, p = 0.003), V120 (96.8 ± 2.7% and 93.7 ± 4.8%, p = 0.002), and V150 (92.6 ± 4.7% and 88.7 ± 6.6%, p = 0.002). Similarly, a higher minimum dose covering 90% and 100% of volume of prostate gland was noted in CT-derived prostate contours, Table 2: D90 (167.6 ± 27.7 and 150.3 ± 35.5, p = 0.012) and D100 (72.1 ± 18.3 and 53.9 ± 20.2, p = 0.006).


Improved dosimetry in prostate brachytherapy using high resolution contrast enhanced magnetic resonance imaging: a feasibility study.

Buch K, Morancy T, Kaplan I, Qureshi MM, Hirsch AE, Rofksy NM, Holupka E, Oismueller R, Hawliczek R, Helbich TH, Bloch BN - J Contemp Brachytherapy (2014)

Corresponding T2-W, HR-CEMR and CT images of the same location.Please note the superior seed-tissue contrast of the HR-CEMR image: With the prostate gland homogeneously hyperintense (grey) and seeds causing signal voids (black), delineating two displaced seeds (arrows) in proximity to the Denonvillier's fascia/rectal wall, which is not well appreciated on the CT image. T2-weighted image image does not visualize all of the seeds as clearly as the HR-CEMR image
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4300354&req=5

Figure 0001: Corresponding T2-W, HR-CEMR and CT images of the same location.Please note the superior seed-tissue contrast of the HR-CEMR image: With the prostate gland homogeneously hyperintense (grey) and seeds causing signal voids (black), delineating two displaced seeds (arrows) in proximity to the Denonvillier's fascia/rectal wall, which is not well appreciated on the CT image. T2-weighted image image does not visualize all of the seeds as clearly as the HR-CEMR image
Mentions: Statistically significant differences were noted in V100, V120, and V150 with a greater percentage of prostate volume receiving the prescribed dose in CT-derived contours compared to HR-CEMRI-derived contours, Table 1. Imaging examples are depicted in Figure 1. The mean (± standard deviation) values from CT and HR-CEMRI contours, respectively, were as follows: V100 (98.5 ± 1.5% and 96.2 ± 3.6%, p = 0.003), V120 (96.8 ± 2.7% and 93.7 ± 4.8%, p = 0.002), and V150 (92.6 ± 4.7% and 88.7 ± 6.6%, p = 0.002). Similarly, a higher minimum dose covering 90% and 100% of volume of prostate gland was noted in CT-derived prostate contours, Table 2: D90 (167.6 ± 27.7 and 150.3 ± 35.5, p = 0.012) and D100 (72.1 ± 18.3 and 53.9 ± 20.2, p = 0.006).

Bottom Line: Dosimetry data including V100, D90, and D100 was calculated from these contours.Mean V100 values from CT and HR-CEMRI contours were as follows: prostate (98.5% and 96.2%, p = 0.003), urethra (81.0% and 88.7%, p = 0.027), anterior rectal wall (ARW) (8.9% and 2.8%, p < 0.001), left NVB (77.9% and 51.5%, p = 0.002), right NVB (69.2% and 43.1%, p = 0.001), and PB (0.09% and 11.4%, p = 0.005).Significant differences were seen between CT and HR-CEMRI, with volume overestimation of CT derived contours compared to HR-CEMRI.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Boston University Medical Center, Boston, USA.

ABSTRACT

Purpose: To assess detailed dosimetry data for prostate and clinical relevant intra- and peri-prostatic structures including neurovascular bundles (NVB), urethra, and penile bulb (PB) from postbrachytherapy computed tomography (CT) versus high resolution contrast enhanced magnetic resonance imaging (HR-CEMRI).

Material and methods: Eleven postbrachytherapy prostate cancer patients underwent HR-CEMRI and CT imaging. Computed tomography and HR-CEMRI images were randomized and 2 independent expert readers created contours of prostate, intra- and peri-prostatic structures on each CT and HR-CEMRI scan for all 11 patients. Dosimetry data including V100, D90, and D100 was calculated from these contours.

Results: Mean V100 values from CT and HR-CEMRI contours were as follows: prostate (98.5% and 96.2%, p = 0.003), urethra (81.0% and 88.7%, p = 0.027), anterior rectal wall (ARW) (8.9% and 2.8%, p < 0.001), left NVB (77.9% and 51.5%, p = 0.002), right NVB (69.2% and 43.1%, p = 0.001), and PB (0.09% and 11.4%, p = 0.005). Mean D90 (Gy) derived from CT and HR-CEMRI contours were: prostate (167.6 and 150.3, p = 0.012), urethra (81.6 and 109.4, p = 0.041), ARW (2.5 and 0.11, p = 0.003), left NVB (98.2 and 58.6, p = 0.001), right NVB (87.5 and 55.5, p = 0.001), and PB (11.2 and 12.4, p = 0.554).

Conclusions: Findings of this study suggest that HR-CEMRI facilitates accurate and meaningful dosimetric assessment of prostate and clinically relevant structures, which is not possible with CT. Significant differences were seen between CT and HR-CEMRI, with volume overestimation of CT derived contours compared to HR-CEMRI.

No MeSH data available.


Related in: MedlinePlus