Aims and objectives
To evaluate the use of multiparametric prostate MR imaging in dose escalation for intermediate to high grade tumours.
Methods and materials
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20 patients with biopsy proven intermediate to high grade prostatic malignancies were included in the study.
All patients underwent multiparametric MRI with T2,
diffusion,
dynamic contrast enhancement (DCE) and spectroscopy sequences as part of diagnostic work up and for delineation of organ confirmed malignancy.
We performed multi parametric prostate imaging in a 1.5T Philips Achieva MR System,
using a 16 Channel Sense Torso XL phased array coil.
T2-weighted MR imaging is the mainstay of prostate MR...
Results
Planning for external beam radiotherapy with mpMRI can result in dose elevation to the tumors (GTV) with smaller CTV.
Use of MR images reduces the volume of delineated target structures and improves coverage of extracapsular extension and seminal vesicle invasion.
MRI delineation leads to significantly lower urinary frequency and urinary retention toxicity scores.
Conclusion
Using mpMRI would result in better and higher dose delivery to tumours within the prostatic parenchyma while reducing dose to adjacent structures that would result in lesser adverse effects.
The future would be to develop an automated tumour detection and contouring algorithm based on mpMRI.
References
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Chung P,
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Rosenkrantz AV,
Villers A,
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Image guided focal therapy for magnetic resonance imaging visible prostate cancer: defining a 3-dimensional treatment margin based on magnetic resonance imaging
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