The role of magnetic resonance imaging (MRI) in prostate cancer imaging and staging at 1.5 and 3 Tesla: the Beth Israel Deaconess Medical Center (BIDMC) approach.

Department of Radiology, MRI, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
Cancer biomarkers: section A of Disease markers (Impact Factor: 1.19). 02/2008; 4(4-5):251-62.
Source: PubMed

ABSTRACT Management decisions for patients with prostate cancer present a dilemma for both patients and their clinicians because prostate cancers demonstrate a wide range in biologic activity, with the majority of cases not leading to a prostate cancer related death. Furthermore, the current treatment options have significant side effects, such as incontinence, rectal injury and impotence. Key elements for guiding appropriate treatment include: distinction of organ-confined disease from extracapsular extension (ECE); and determination of tumor volume and tumor grade, none of which have been satisfactorily accomplished in today's pre-treatment paradigm. Magnetic resonance imaging (MRI) has the capability to assess prostate tissue, both functionally and morphologically. MRI as a staging tool has not shown enough consistency or sufficient accuracy for widespread adoption in clinical practice; yet, recent technical developments in MRI have yielded improved results. At our institution we have combined the use of new endorectal 3 Tesla MRI technology, T2-weighted, and high spatial resolution dynamic-contrast enhanced (DCE) MRI to non-invasively assess the prostate with higher signal-to-noise ratio and spatial resolution than previously achieved. This approach allows assessment of prostate-tissue morphology and kinetics, thus providing a non-invasive tool for tumor detection and staging and, consequently, directing biopsy and treatment specifically to diseased areas for a pre-treatment evaluation that can assist in the rational selection of patients for appropriate prostate cancer therapy.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Medical image analysis is more than just algorithms. Visualization of the original image data and processed results, interaction with the data, as well as the data themselves are also important. It has been widely used for demonstrating lesions or their localization in the musculoskeletal system, vascular system, respiratory and alimentary systems. Region of interest (ROI) imaging visualization techniques in computed tomography (CT), which can visualize an ROI image from the CT sequence data set of the ROI, can be used not only for reducing imaging-time but also for potentially increasing clinical analysis accuracy of the particular area images. VC++6.0 with visualization toolkit (VTK) are adopted to reconstruct the 3D images using the 2D CT image sequence in DICOM format. The ROI images visualization by use of the marching cubes (MC) algorithm from the clinical human CT data. The experimental results show that this method is robust, easy to implement and excellent image quality evaluation. Because the proposed method requires minimum visualization data for clinical analysis, it can reduce imaging-time, and has excellent image quality evaluation. These methods can assist doctors to make better and more accurate diagnosis.
  • [Show abstract] [Hide abstract]
    ABSTRACT: There have been significant advancements in the quality and precision of radiation therapy (RT) for prostate cancer over the past two decades. The development and implementation of intensity-modulated radiation therapy has allowed for RT dose-escalation without parallel increases in treatment morbidity. Moreover, integration of androgen deprivation therapy with definitive RT has led to improvements in outcomes for certain subgroups of prostate cancer patients. In this review, we highlight several ongoing and developing technical advances that hold promise for further optimizing RT care, including proton beam therapy, inter- and intra-fractional image-guided dose-delivery, methods for improved target volume definition, and development of techniques for safely performing hypofractionation and stereotactic body radiotherapy. We also discuss the importance of investigating the potential benefit of integrating novel systemic therapies with prostate RT to further improve outcomes for patients with locally advanced prostate cancer.
    Seminars in Oncology 06/2013; 40(3):297-307. DOI:10.1053/j.seminoncol.2013.04.005 · 3.94 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Three-dimensional (3D) prostate image segmentation is useful for cancer diagnosis and therapy guidance, but can be time-consuming to perform manually and involves varying levels of difficulty and interoperator variability within the prostatic base, midgland (MG), and apex. In this study, the authors measured accuracy and interobserver variability in the segmentation of the prostate on T2-weighted endorectal magnetic resonance (MR) imaging within the whole gland (WG), and separately within the apex, midgland, and base regions.
    Medical Physics 11/2014; 41(11):113503. DOI:10.1118/1.4899182 · 3.01 Impact Factor