S&T-13 INFORMING FOCAL THERAPY MARGINS THROUGH MRI-PATHOLOGY CORRELATION (2016)

You have accessJournal of UrologyScience & Technology Posters1 Apr 2016S&T-13 INFORMING FOCAL THERAPY MARGINS THROUGH MRI-PATHOLOGY CORRELATION Alan Priester, Khoshnoodi Pooria, Shellee Ogawa, Jesse Le, James Garritano, Bryan Radosavcev, Daniel Margolis, Robert Reiter, Jiaoti Huang, Warren Grundfest, Shyam Natarajan, and Leonard Marks Alan PriesterAlan Priester More articles by this author , Khoshnoodi PooriaKhoshnoodi Pooria More articles by this author , Shellee OgawaShellee Ogawa More articles by this author , Jesse LeJesse Le More articles by this author , James GarritanoJames Garritano More articles by this author , Bryan RadosavcevBryan Radosavcev More articles by this author , Daniel MargolisDaniel Margolis More articles by this author , Robert ReiterRobert Reiter More articles by this author , Jiaoti HuangJiaoti Huang More articles by this author , Warren GrundfestWarren Grundfest More articles by this author , Shyam NatarajanShyam Natarajan More articles by this author , and Leonard MarksLeonard Marks More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2842AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Multi-parametric MRI (mpMRI) appears to be a robust method for imaging prostate cancer (CaP) and guiding targeted interventions. However, the spatial relationship between MRI-visible regions of interest (ROIs) and areas of known CaP is incompletely understood. We aimed to clarify that relationship and characterize the treatment margins necessary for effective focal therapy. METHODS Prior to radical prostatectomy, 65 men underwent mpMRI, from which a radiologist contoured the prostate capsule and regions suspicious for CaP. A custom mold was then 3D printed from the patient′s MRI and used for precise sectioning of the surgical specimen. This mold facilitated accurate matching of the delineated slides (Fig 1A) with preoperative mpMRI (Fig 1B). All tumors found on pathology were digitally reconstructed in 3D and matched to corresponding MRI targets (n = 71). The geometric features of all surfaces and the maximum distance between each MRI target and matched tumor were determined using custom software. RESULTS Spatial features of ROIs and tumors are summarized in Table 1. The mean volume and longest axis of the prostate capsule corresponded closely with MRI measurements, yet the mean volume of CaP was 2.7 times greater than the ROI predictions. The mean longest axis on MRI was found to be 16.8 mm, whereas the mean longest axis on pathology was 27.5 mm. Due to tumor asymmetry, CaP extended an average of 15 mm beyond the ROI along at least one axis (Fig 1C). Retrospectively, only a minority of these tumor extensions was identifiable on MRI. CONCLUSIONS MRI underestimated CaP volume by a factor of 2.7 (0.9 cc on MRI vs 2.4 cc on pathology). Using MRI targeting alone, effective focal therapy would need to include substantial margins around the ROI (median 15 mm). In practice, this margin could be reduced using tracked biopsy information or better imaging to characterize tumor asymmetry. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e313 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Alan Priester More articles by this author Khoshnoodi Pooria More articles by this author Shellee Ogawa More articles by this author Jesse Le More articles by this author James Garritano More articles by this author Bryan Radosavcev More articles by this author Daniel Margolis More articles by this author Robert Reiter More articles by this author Jiaoti Huang More articles by this author Warren Grundfest More articles by this author Shyam Natarajan More articles by this author Leonard Marks More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...