Show simple item record

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.identifier.citationRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2019, 141 pp. 181 - 187
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.format.extent181 - 187
dc.subjectProstatic Neoplasms
dc.subjectDiffusion Magnetic Resonance Imaging
dc.subjectRadiotherapy Dosage
dc.subjectProspective Studies
dc.subjectMiddle Aged
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
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/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.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

Files in this item


This item appears in the following collection(s)

Show simple item record
Except where otherwise noted, this item's license is described as