Validation of functional imaging with pathology for tumor delineation in the prostate.

INTRODUCTION A study was performed to validate magnetic resonance (MR) based prostate tumor delineations with pathology. MATERIAL AND METHODS Five patients with biopsy proven prostate cancer underwent a T2 weighted (T2w), diffusion weighted MRI (DW-MRI) and dynamic contrast-enhanced MRI (DCE-MRI) scan before prostatectomy. Suspicious regions were delineated based on all available MR information. After prostatectomy whole-mount hematoxylin-eosin stained (H&E) sections were made. Tumor tissue was delineated on the H&E stained sections and compared with the MR based delineations. The registration accuracy between the MR images and H&E stained sections was estimated. RESULTS A tumor coverage of 44-89% was reached by the MR based tumor delineations. The application of a margin of approximately 5mm to the MR based tumor delineations yielded a tumor coverage of 85-100% in all patients. Errors created during the registration procedure were 2-3mm, which cannot completely explain the limited tumor coverage. CONCLUSIONS An accurate tissue processing and registration method was presented (registration error 2-3mm), which enables the validation of MR based tumor delineations with pathology. Reasonable tumor coverage of about 85% and larger was found when applying a margin of approximately 5 mm to the MR based tumor delineations.

[1]  K. Hosseinzadeh,et al.  Endorectal diffusion‐weighted imaging in prostate cancer to differentiate malignant and benign peripheral zone tissue , 2004, Journal of magnetic resonance imaging : JMRI.

[2]  Stefan Klein,et al.  Automatic segmentation of the prostate in 3D MR images by atlas matching using localized mutual information. , 2008, Medical physics.

[3]  M. Knopp,et al.  Estimating kinetic parameters from dynamic contrast‐enhanced t1‐weighted MRI of a diffusable tracer: Standardized quantities and symbols , 1999, Journal of magnetic resonance imaging : JMRI.

[4]  H. Huisman,et al.  Prostate cancer localization with dynamic contrast-enhanced MR imaging and proton MR spectroscopic imaging. , 2006, Radiology.

[5]  Masoom A Haider,et al.  Combined T2-weighted and diffusion-weighted MRI for localization of prostate cancer. , 2007, AJR. American journal of roentgenology.

[6]  Joos V Lebesque,et al.  Dose-response in radiotherapy for localized prostate cancer: results of the Dutch multicenter randomized phase III trial comparing 68 Gy of radiotherapy with 78 Gy. , 2006, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[7]  佐藤 千峰,et al.  Differentiation of noncancerous tissue and cancer lesions by apparent diffusion coefficient values in transition and peripheral zones of the prostate , 2006 .

[8]  Daniel W. Miller,et al.  Comparison of conventional-dose vs high-dose conformal radiation therapy in clinically localized adenocarcinoma of the prostate: a randomized controlled trial. , 2005, JAMA.

[9]  L. Turnbull,et al.  Diffusion Imaging of the Prostate at 3.0 Tesla , 2006, Investigative radiology.

[10]  M Goitein,et al.  Intensity modulated therapy and inhomogeneous dose to the tumor: a note of caution. , 1996, International journal of radiation oncology, biology, physics.

[11]  Vincenzo Valentini,et al.  Analysis of intraprostatic failures in patients treated with hormonal therapy and radiotherapy: implications for conformal therapy planning. , 2002, International journal of radiation oncology, biology, physics.

[12]  J J W Lagendijk,et al.  A novel method for comparing 3D target volume delineations in radiotherapy , 2008, Physics in medicine and biology.

[13]  A. Hemal,et al.  Apparent diffusion coefficient of the prostate in men prior to biopsy: determination of a cut‐off value to predict malignancy of the peripheral zone , 2007, NMR in biomedicine.

[14]  N. Clarke,et al.  Late tissue effects following radiotherapy and neoadjuvant hormone therapy of the prostate measured with quantitative magnetic resonance imaging. , 2008, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[15]  Silvia D. Chang,et al.  Combined diffusion‐weighted and dynamic contrast‐enhanced MRI for prostate cancer diagnosis—Correlation with biopsy and histopathology , 2006, Journal of magnetic resonance imaging : JMRI.

[16]  H. Hricak,et al.  Clinically significant prostate cancer local recurrence after radiation therapy occurs at the site of primary tumor: magnetic resonance imaging and step-section pathology evidence. , 2007, International journal of radiation oncology, biology, physics.

[17]  P. Carroll,et al.  Prostate cancer: localization with three-dimensional proton MR spectroscopic imaging--clinicopathologic study. , 1999, Radiology.

[18]  L Verhey,et al.  Static field intensity modulation to treat a dominant intra-prostatic lesion to 90 Gy compared to seven field 3-dimensional radiotherapy. , 1999, International journal of radiation oncology, biology, physics.

[19]  Gabor Fichtinger,et al.  Simultaneous integrated boost of biopsy proven, MRI defined dominant intra-prostatic lesions to 95 Gray with IMRT: early results of a phase I NCI study , 2007, Radiation oncology.

[20]  Deanna L Langer,et al.  Intermixed normal tissue within prostate cancer: effect on MR imaging measurements of apparent diffusion coefficient and T2--sparse versus dense cancers. , 2008, Radiology.

[21]  Tristan Barrett,et al.  Dynamic contrast-enhanced MRI of prostate cancer at 3 T: a study of pharmacokinetic parameters. , 2007, AJR. American journal of roentgenology.

[22]  Mark Rijpkema,et al.  Combined quantitative dynamic contrast‐enhanced MR imaging and 1H MR spectroscopic imaging of human prostate cancer , 2004, Journal of magnetic resonance imaging : JMRI.

[23]  Takeo Ishigaki,et al.  Prostate cancer detection with 3-T MRI: comparison of diffusion-weighted and T2-weighted imaging. , 2007, European journal of radiology.

[24]  Kenya Murase,et al.  Efficient method for calculating kinetic parameters using T1‐weighted dynamic contrast‐enhanced magnetic resonance imaging , 2004, Magnetic resonance in medicine.

[25]  D. Beyersdorff,et al.  MRI before and after external beam intensity-modulated radiotherapy of patients with prostate cancer: the feasibility of monitoring of radiation-induced tissue changes using a dynamic contrast-enhanced inversion-prepared dual-contrast gradient echo sequence. , 2009, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[26]  Max A. Viergever,et al.  elastix: A Toolbox for Intensity-Based Medical Image Registration , 2010, IEEE Transactions on Medical Imaging.

[27]  Matthias Taupitz,et al.  Evaluation of Normal Prostate Tissue, Chronic Prostatitis, and Prostate Cancer by Quantitative Perfusion Analysis Using a Dynamic Contrast-Enhanced Inversion-Prepared Dual-Contrast Gradient Echo Sequence , 2008, Investigative radiology.

[28]  Geometric accuracy of field alignment in fractionated stereotactic conformal radiotherapy of brain tumors. , 1999, International journal of radiation oncology, biology, physics.

[29]  Tom W J Scheenen,et al.  IMRT boost dose planning on dominant intraprostatic lesions: gold marker-based three-dimensional fusion of CT with dynamic contrast-enhanced and 1H-spectroscopic MRI. , 2006, International journal of radiation oncology, biology, physics.

[30]  C. Lawton.  Update of Dutch Multicenter Dose-Escalation Trial of Radiotherapy for Localized Prostate Cancer , 2009 .

[31]  L. Turnbull,et al.  Diffusion‐weighted imaging of normal and malignant prostate tissue at 3.0T , 2006, Journal of magnetic resonance imaging : JMRI.

[32]  Marco van Vulpen,et al.  Analysis of fiducial marker-based position verification in the external beam radiotherapy of patients with prostate cancer. , 2007, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[33]  U. A. van der Heide,et al.  Difficulties and potential of correlating local recurrences in prostate cancer with the delivered local dose. , 2009, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[34]  Hyunjin Park,et al.  Registration methodology for histological sections and in vivo imaging of human prostate. , 2008, Academic radiology.

[35]  George Starkschall,et al.  Prostate cancer radiation dose response: results of the M.D. Anderson phase III randomized trial , 2003 .