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dc.contributor.authorAlexander, EJen_US
dc.contributor.authorMurray, JRen_US
dc.contributor.authorMorgan, VAen_US
dc.contributor.authorGiles, SLen_US
dc.contributor.authorRiches, SFen_US
dc.contributor.authorHazell, Sen_US
dc.contributor.authorThomas, Ken_US
dc.contributor.authorSohaib, SAen_US
dc.contributor.authorThompson, Aen_US
dc.contributor.authorGao, Aen_US
dc.contributor.authorDearnaley, DPen_US
dc.contributor.authorDeSouza, NMen_US
dc.date.accessioned2019-12-05T12:16:15Z
dc.date.issued2019-12
dc.identifier.citationRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2019, 141 pp. 181 - 187
dc.identifier.issn0167-8140
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/3434
dc.identifier.eissn1879-0887
dc.identifier.doi10.1016/j.radonc.2019.07.030
dc.description.abstractBACKGROUND AND PURPOSE:To assess the diagnostic accuracy and inter-observer agreement of T2-weighted (T2W) and diffusion-weighted (DW) magnetic resonance imaging (MRI) for mapping intra-prostatic tumour lesions (IPLs) for the purpose of focal dose-escalation in prostate cancer radiotherapy. MATERIALS AND METHODS:Twenty-six men selected for radical treatment with radiotherapy were recruited prospectively and underwent pre-treatment T2W+DW-MRI and 5 mm spaced transperineal template-guided mapping prostate biopsies (TTMPB). A 'traffic-light' system was used to score both data sets. Radiologically suspicious lesions measuring ≥0.5 cm3 were classified as red; suspicious lesions 0.2-0.5 cm3 or larger lesions equivocal for tumour were classified as amber. The histopathology assessment combined pathological grade and tumour length on biopsy (red = ≥4 mm primary Gleason grade 4/5 or ≥6 mm primary Gleason grade 3). Two radiologists assessed the MRI data and inter-observer agreement was measured with Cohens' Kappa co-efficient. RESULTS:Twenty-five of 26 men had red image-defined IPLs by both readers, 24 had red pathology-defined lesions. There was a good correlation between lesions ≥0.5 cm3 classified "red" on imaging and "red" histopathology in biopsies (Reader 1: r = 0.61, p < 0.0001, Reader 2: r = 0.44, p = 0.03). Diagnostic accuracy for both readers for red image-defined lesions was sensitivity 85-86%, specificity 93-98%, positive predictive value (PPV) 79-92% and negative predictive value (NPV) 96%. Inter-observer agreement was good (Cohen's Kappa 0.61). CONCLUSIONS:MRI is accurate for mapping clinically significant prostate cancer; diffusion-restricted lesions ≥0.5 cm3 can be confidently identified for radiation dose boosting.
dc.formatPrint-Electronic
dc.format.extent181 - 187
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.subjectHumans
dc.subjectProstatic Neoplasms
dc.subjectDiffusion Magnetic Resonance Imaging
dc.subjectRadiotherapy Dosage
dc.subjectProspective Studies
dc.subjectAged
dc.subjectMiddle Aged
dc.subjectMale
dc.subjectRadiotherapy, Intensity-Modulated
dc.subjectImage-Guided Biopsy
dc.titleValidation of T2- and diffusion-weighted magnetic resonance imaging for mapping intra-prostatic tumour prior to focal boost dose-escalation using intensity-modulated radiotherapy (IMRT).
dc.typeJournal Article
dcterms.dateAccepted2019-07-25
rioxxterms.versionofrecord10.1016/j.radonc.2019.07.030
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0
rioxxterms.licenseref.startdate2019-12
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
pubs.notesNo embargo
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams/Clinical Academic Radiotherapy (Dearnaley)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Magnetic Resonance
pubs.publication-statusPublished
pubs.volume141
pubs.embargo.termsNo embargo
icr.researchteamClinical Academic Radiotherapy (Dearnaley)en_US
icr.researchteamMagnetic Resonanceen_US
dc.contributor.icrauthorDearnaley, Daviden
dc.contributor.icrauthordeSouza, Nanditaen
dc.contributor.icrauthorGiles, Sharonen
dc.contributor.icrauthorMurray, Juliaen


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