MR-guided Prostate Biopsy for Planning of Focal Salvage after Radiation Therapy

作者：Cynthia Ménard, Douglas Iupati, Julia Publicover, Jenny Lee, Jessamine Abed, Gerald O’Leary, Anna Simeonov, Warren D. Foltz, Michael Milosevic, Charles Catton, Gerard Morton, Robert Glen Bristow, Andrew Bayley, Eshetu G. Atenafu, Andrew John Evans, David A. Jaffray, Peter W M Chung, Kristy K. Brock, Masoom A. Haider · 发表于：Radiology · 年份：2014 · DOI：10.1148/radiol.14122681 · 被引用次数：45 · 研究领域：Prostate Cancer Diagnosis and Treatment、Prostate Cancer Treatment and Research、Advanced Radiotherapy Techniques

PURPOSE: To determine if the integration of diagnostic magnetic resonance (MR) imaging and MR-guided biopsy would improve target delineation for focal salvage therapy in men with prostate cancer. MATERIALS AND METHODS: Between September 2008 and March 2011, 30 men with biochemical failure after radiation therapy for prostate cancer provided written informed consent and were enrolled in a prospective clinical trial approved by the institutional research ethics board. An integrated diagnostic MR imaging and interventional biopsy procedure was performed with a 1.5-T MR imager by using a prototype table and stereotactic transperineal template. Multiparametric MR imaging (T2-weighted, dynamic contrast material-enhanced, and diffusion-weighted sequences) was followed by targeted biopsy of suspicious regions and systematic sextant sampling. Biopsy needle locations were imaged and registered to diagnostic images. Two observers blinded to clinical data and the results of prior imaging studies delineated tumor boundaries. Area under the receiver operating characteristic curve (Az) was calculated based on generalized linear models by using biopsy as the reference standard to distinguish benign from malignant lesions. RESULTS: Twenty-eight patients were analyzed. Most patients (n = 22) had local recurrence, with 82% (18 of 22) having unifocal disease. When multiparametric volumes from two observers were combined, it increased the apparent overall tumor volume by 30%; however, volumes rem...