Guang Jia PhD, Presenter: Nothing to Disclose

Zarine Ketul Shah MD, Abstract Co-Author: Nothing to Disclose

Steffen Sammet MD, PhD, Abstract Co-Author: Nothing to Disclose

Douglas D. Martin MD, Abstract Co-Author: Nothing to Disclose

Nina A. Mayr MD, Abstract Co-Author: Nothing to Disclose

Michael Vinzenz Knopp MD, PhD, Abstract Co-Author: Nothing to Disclose

William T.C. Yuh MD, MSEE, Abstract Co-Author: Nothing to Disclose

To assess the feasibility of 3T MRI of the prostate in delineating tumor contour and to evaluate the clinical utility of integrating MR into radiation therapy planning in patients with prostate cancer.

12 patients with prostate cancer (63 ± 10 years) scheduled to receive either brachytherapy or external beam therapy, were imaged at 3T (Achieva, Philips) using an 8-channel phased array coil. Median Gleanson’s score was 7 (range 5-10) as measured by TRUS guided biopsy and PSA was 8.3 ng/ml (range 2-43). Diagnostic quality T1w and T2w images were acquired in multiple planes using an optimized clinical protocol. A multi-shot TSE sequence with 10 TEs was performed to measure T2 relaxation. Prostatic perfusion was assessed using a 3D FFE sequence following intravenous contrast injection (Multihance 0.2mg/kg BW). MIPAV (NIH) was used to perform organ segmentation by drawing contours of the prostate, suspected tumor (based on DCE, T2 measurements and diagnostic imaging), transition zone, urethra, neuro-vascular bundle and peri-prostatic tissues. MR images with segmented contours were fused with the diagnostic CT images and loaded onto radiation therapy planning software (Eclipse, Varian Inc.). The clinical utility of the MR data was evaluated using a questionnaire completed by radiation oncologists after the therapy.

17 suspected tumor nodules were detected based on the DCE and T2 measurement data. Three patients had 2 each and 1 patient had 3 suspected regions. The average prostate volume was (44 ± 25) ml, and the suspected tumor volume was (2.0 ± 1.6) ml. Upon assessment of the questionnaire, MR images with contours fused to the CT improved tumor visualization and proved beneficial in radiation therapy planning for all patients.

3T MR without use of an endorectal coil enables pelvic visualization and delineation of prostatic cancer areas to improve the radiation therapy planning.

Improved tumor visualization on MRI when fused with diagnostic CT has the potential to provide valuable clinical information to the radiation oncologist for therapy planning in prostate cancer.

Jia, G, Shah, Z, Sammet, S, Martin, D, Mayr, N, Knopp, M, Yuh, W, Clinical Utility of 3T MRI of Prostate without the Endorectal Coil for Therapy Planning in Radiation Oncology: A Phase I Study.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5009352.html