4D perfusion CT of prostate cancer for image-guided radiotherapy planning: A proof of concept study.
<h4>Purpose</h4>Advanced forms of prostate cancer (PCa) radiotherapy with either external beam therapy or brachytherapy delivery techniques aim for a focal boost and thus require accurate lesion localization and lesion segmentation for subsequent treatment planning. This study prospectiv...
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doaj-97a6c65301e849c0a264cf1f32cb221e2021-03-04T11:20:23ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-011412e022567310.1371/journal.pone.02256734D perfusion CT of prostate cancer for image-guided radiotherapy planning: A proof of concept study.Lucian BeerStephan H PolanecPascal A T BaltzerGeorg SchatzlDietmar GeorgChristian SchestakAnja DutschkeHarald HerrmannPeter MazalAlexander K BrendelShahrokh F ShariatHelmut RinglThomas H HelbichPaul Apfaltrer<h4>Purpose</h4>Advanced forms of prostate cancer (PCa) radiotherapy with either external beam therapy or brachytherapy delivery techniques aim for a focal boost and thus require accurate lesion localization and lesion segmentation for subsequent treatment planning. This study prospectively evaluated dynamic contrast-enhanced computed tomography (DCE-CT) for the detection of prostate cancer lesions in the peripheral zone (PZ) using qualitative and quantitative image analysis compared to multiparametric magnet resonance imaging (mpMRI) of the prostate.<h4>Methods</h4>With local ethics committee approval, 14 patients (mean age, 67 years; range, 57-78 years; PSA, mean 8.1 ng/ml; range, 3.5-26.0) underwent DCE-CT, as well as mpMRI of the prostate, including standard T2, diffusion-weighted imaging (DWI), and DCE-MRI sequences followed by transrectal in-bore MRI-guided prostate biopsy. Maximum intensity projections (MIP) and DCE-CT perfusion parameters (CTP) were compared between healthy and malignant tissue. Two radiologists independently rated image quality and the tumor lesion delineation quality of PCa using a five-point ordinal scale. MIP and CTP were compared using visual grading characteristics (VGC) and receiver operating characteristics (ROC)/area under the curve (AUC) analysis.<h4>Results</h4>The PCa detection rate ranged between 57 to 79% for the two readers for DCE-CT and was 92% for DCE-MRI. DCE-CT perfusion parameters in PCa tissue in the PZ were significantly different compared to regular prostate tissue and benign lesions. Image quality and lesion visibility were comparable between DCE-CT and DCE-MRI (VGC: AUC 0.612 and 0.651, p>0.05).<h4>Conclusion</h4>Our preliminary results suggest that it is feasible to use DCE-CT for identification and visualization, and subsequent segmentation for focal radiotherapy approaches to PCa.https://doi.org/10.1371/journal.pone.0225673 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Lucian Beer Stephan H Polanec Pascal A T Baltzer Georg Schatzl Dietmar Georg Christian Schestak Anja Dutschke Harald Herrmann Peter Mazal Alexander K Brendel Shahrokh F Shariat Helmut Ringl Thomas H Helbich Paul Apfaltrer |
spellingShingle |
Lucian Beer Stephan H Polanec Pascal A T Baltzer Georg Schatzl Dietmar Georg Christian Schestak Anja Dutschke Harald Herrmann Peter Mazal Alexander K Brendel Shahrokh F Shariat Helmut Ringl Thomas H Helbich Paul Apfaltrer 4D perfusion CT of prostate cancer for image-guided radiotherapy planning: A proof of concept study. PLoS ONE |
author_facet |
Lucian Beer Stephan H Polanec Pascal A T Baltzer Georg Schatzl Dietmar Georg Christian Schestak Anja Dutschke Harald Herrmann Peter Mazal Alexander K Brendel Shahrokh F Shariat Helmut Ringl Thomas H Helbich Paul Apfaltrer |
author_sort |
Lucian Beer |
title |
4D perfusion CT of prostate cancer for image-guided radiotherapy planning: A proof of concept study. |
title_short |
4D perfusion CT of prostate cancer for image-guided radiotherapy planning: A proof of concept study. |
title_full |
4D perfusion CT of prostate cancer for image-guided radiotherapy planning: A proof of concept study. |
title_fullStr |
4D perfusion CT of prostate cancer for image-guided radiotherapy planning: A proof of concept study. |
title_full_unstemmed |
4D perfusion CT of prostate cancer for image-guided radiotherapy planning: A proof of concept study. |
title_sort |
4d perfusion ct of prostate cancer for image-guided radiotherapy planning: a proof of concept study. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2019-01-01 |
description |
<h4>Purpose</h4>Advanced forms of prostate cancer (PCa) radiotherapy with either external beam therapy or brachytherapy delivery techniques aim for a focal boost and thus require accurate lesion localization and lesion segmentation for subsequent treatment planning. This study prospectively evaluated dynamic contrast-enhanced computed tomography (DCE-CT) for the detection of prostate cancer lesions in the peripheral zone (PZ) using qualitative and quantitative image analysis compared to multiparametric magnet resonance imaging (mpMRI) of the prostate.<h4>Methods</h4>With local ethics committee approval, 14 patients (mean age, 67 years; range, 57-78 years; PSA, mean 8.1 ng/ml; range, 3.5-26.0) underwent DCE-CT, as well as mpMRI of the prostate, including standard T2, diffusion-weighted imaging (DWI), and DCE-MRI sequences followed by transrectal in-bore MRI-guided prostate biopsy. Maximum intensity projections (MIP) and DCE-CT perfusion parameters (CTP) were compared between healthy and malignant tissue. Two radiologists independently rated image quality and the tumor lesion delineation quality of PCa using a five-point ordinal scale. MIP and CTP were compared using visual grading characteristics (VGC) and receiver operating characteristics (ROC)/area under the curve (AUC) analysis.<h4>Results</h4>The PCa detection rate ranged between 57 to 79% for the two readers for DCE-CT and was 92% for DCE-MRI. DCE-CT perfusion parameters in PCa tissue in the PZ were significantly different compared to regular prostate tissue and benign lesions. Image quality and lesion visibility were comparable between DCE-CT and DCE-MRI (VGC: AUC 0.612 and 0.651, p>0.05).<h4>Conclusion</h4>Our preliminary results suggest that it is feasible to use DCE-CT for identification and visualization, and subsequent segmentation for focal radiotherapy approaches to PCa. |
url |
https://doi.org/10.1371/journal.pone.0225673 |
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