Abstract
Early identification of PCa patients at risk for biochemical recurrence (BCR) post-therapy will potentially complement definitive therapy with either neo- or adjuvant therapy to improve prognosis. BCR post definitive therapy is often associated with disease progression that might cause a bulge in the prostate gland. In this work we explored if an atlas-based comparison approach reveals shape differences in the prostate capsule as observed on pre-treatment T2-weighted MRI between prostate cancer patients who do (BCR+) and do not (BCR−) have BCR following definitive therapy. A single center IRB approved study included 874 patients. Complete image datasets, clinically localized PCa, availability of Gleason score, data available for post-treatment PSA and follow-up for at least 3 years in patients without BCR were the inclusion criteria to select 77 patients out of the 874 patients. Further controlling for Gleason score, stage, age and to maintain equal number of cases for the BCR+ and BCR− categories, the total number of cases was reduced to 50. Manually segmented prostate capsules were aligned to a BCR− template for statistical comparison between the BCR+ and BCR− groups. Statistically significant shape difference between the two groups was observed towards the lateral and the posterior sides of prostate.
Highlights
About 180,890 new cases of prostate cancer will be diagnosed in USA in 20161
Building on the findings of[6], in this work we sought to explore whether an atlas based comparison approach could help identify shape differences in the prostate capsule as observed on pre-treatment T2 weighted MRI between prostate cancer patients who do (BCR+) and do not (BCR−) have biochemical recurrence (BCR) following definitive therapy
Unlike the work showcased in Rusu et al which revealed that shape differences exist between diseased and a normal prostate, the objective of this study was to spatially localize surface of interest that significantly differs between (BCR+) and (BCR−) patients, while controlling for ECap in the process
Summary
About 180,890 new cases of prostate cancer will be diagnosed in USA in 20161. Over 50% of these patients will be treated with either radical prostactomy or radiation therapy or both[2]. In6, Rusu et al showed via an atlas based approach that the shape of the prostate capsule and the transition zone as observed on a T2w MRI were significantly different between men with and without prostate cancer. Building on the findings of[6], in this work we sought to explore whether an atlas based comparison approach could help identify shape differences in the prostate capsule as observed on pre-treatment T2 weighted MRI between prostate cancer patients who do (BCR+) and do not (BCR−) have BCR following definitive therapy. The difference in the surface of interest information could potentially be used as a bio-marker to differentiate (BCR+) and (BCR−) cohorts in an independent validation set in the future Another crucial difference between our approach and that of Rusu et al is that our framework is completely automatic and a robust GLM based T-test method is used to interrogate shape differences between (BCR+) and (BCR−) cases.
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