PD06-08 PROSPECTIVE TRIAL TO EVALUATE A HIGH RESOLUTION DIFFUSION-WEIGHTED MRI IN PROSTATE CANCER PATIENTS

Abstract

You have accessJournal of UrologyImaging/Radiology: Uroradiology II1 Apr 2016PD06-08 PROSPECTIVE TRIAL TO EVALUATE A HIGH RESOLUTION DIFFUSION-WEIGHTED MRI IN PROSTATE CANCER PATIENTS Ali Reza Sharif-Afshar, Christopher Nguyen, Tom Feng, Lucas Payor, Zhaoyang Fan, Rola Saouaf, Debiao Li, and Hyung Kim Ali Reza Sharif-AfsharAli Reza Sharif-Afshar More articles by this author , Christopher NguyenChristopher Nguyen More articles by this author , Tom FengTom Feng More articles by this author , Lucas PayorLucas Payor More articles by this author , Zhaoyang FanZhaoyang Fan More articles by this author , Rola SaouafRola Saouaf More articles by this author , Debiao LiDebiao Li More articles by this author , and Hyung KimHyung Kim More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2628AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prostate cancer active surveillance requires serial biopsies. However, high-resolution prostate imaging may allow for detection of subtle changes in tumor size, potentially decreasing the reliance on biopsies, and help define tumor boundaries during ablation. METHODS Our team developed a novel software that can be loaded on any modern MRI to generate high resolution diffusion-weighted imaging sequences (HR-DWI), which were compared to standard diffusion-weighted imaging sequence (S-DWI) in a prospective pilot trial in active surveillance patients. HR-DWI captures the entire volume of the prostate rather than sections, reducing streaking artifacts and geometric distortions. Multiple shots, rather than single shots, are used to differentiate signal and noise, enhancing resolution. All images were read by two radiologists. The primary outcome was the percent of biopsy-proven zones seen in 17 patients. The trial was powered to detect discordant proportions of 0.04 and 0.40 at one-sided alpha=0.05. RESULTS The resolution was defined using standard phantoms. HR-DWI produced a 5-fold improvement in spatial resolution when compared to S-DWI (Figures). Multiparametric (MP)-MRI incorporating S-DWI was useful for predicting biopsy results (AUC 0.72, Fisher’s exact p<0.001); however, using HR-DWI allowed MP-MRI to be more highly predictive of biopsy results (AUC 0.88, Fisher’s exact p<0.001). AUC for MP-MRI incorporating HR-DWI was significantly larger than MP-MRI incorporating S-DWI (p=0.002). MP-MRI with HR-DWI had a sensitivity of 95.7% and identified tumor in 22 of 23 zones proven to have cancer on biopsy. In contrast, MP-MRI with S-DWI had a sensitivity of 60.9% and only identified 14 of 23 biopsy-positive zones (p=0.004). CONCLUSIONS We developed a novel DWI sequence and evaluated its improved resolution in a clinical setting. This technology has many potential applications and should be evaluated in future clinical trials as a patient management tool. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e177-e178 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Ali Reza Sharif-Afshar More articles by this author Christopher Nguyen More articles by this author Tom Feng More articles by this author Lucas Payor More articles by this author Zhaoyang Fan More articles by this author Rola Saouaf More articles by this author Debiao Li More articles by this author Hyung Kim More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...