Prostate & Body Cancers
Friday 24 April 2009
Room 313A 10:30-12:30


Anwar R. Padhani and Amita Shukla-Dave

10:30 782. Prostate Cancer Detection:  Multi-Parametric MRI with Diffusion-Weighted Imaging and Dynamic Contrast Enhanced MRI
    Deanna Lyn Langer1,2, Theo H. van der Kwast3, Andrew J. Evans3, John Trachtenberg4, Brian C. Wilson5, Masoom A. Haider1,2
Joint Department of Medical Imaging, Princess Margaret Hospital, University Health Network and Mount Sinai Hospital, Toronto, Ontario, Canada; 2Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada; 3Department of Pathology and Laboratory Medicine, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada; 4Department of Surgical Oncology, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada; 5Medical Biophysics, University of Toronto, Ontario Cancer Institute, Toronto, Ontario, Canada
    A logistic regression (LR) model for identifying prostate cancer (PCa) in the peripheral zone (PZ) was developed and compared to single-parameters (ADC, T2, Ktrans, ve). Pathologically-identified regions of PCa and normal PZ tissue from whole mount histology were used during model development. Areas under ROC curves were compared: ADC was the top single-parameter; significantly higher than Ktrans or ve, and higher than T2 (not significant). The LR-model included ADC, T2, and Ktrans and performed significantly better than T2, Ktrans, and ve, and higher than ADC (not significant). This method permits tumor probability mapping, providing a quantitative method to combine modalities.
10:42 783. Final Results of IMAPS: An International Multi-Centre Assessment of Prostate MR Spectroscopy
    Tom WJ Scheenen1, Jurgen J. Fütterer1, Elisabeth Weiland2, Paul van Hecke3, Marc Lemort4, Christian M. Zechmann5, Heinz-Peter Schlemmer6, Dale R. Broome7, Geert M. Villeirs8, Jaoping Lu9, Jelle O. Barentsz1, Stefan O. Roell2, Arend Heerschap1
Radiology (667), Radboud University Nijmegen Medical Center, Nijmegen, Netherlands; 2Siemens Healthcare; 3University Hospital, Katholieke Universiteit Leuven, Belgium; 4the Bordet Institute, Belgium; 5German Cancer Research Center DKFZ, Germany; 6University of Tuebingen, Germany; 7Loma Linda University Medical Centre, USA; 8Ghent University Hospital, Belgium; 9Shanghai Changhai Hospital, China
    IMAPS is a multi-centre study evaluating the use of 3D 1H-spectroscopic imaging of the prostate to detect and localize prostate cancer. 99 patients and were contributed by 8 different institutions. With histopathology of resected prostates as a reference, we evaluated the (choline+creatine)/citrate integral ratio of selected voxels in different anatomical regions and tumor tissue. The (choline+creatine)/citrate ratio is significantly different for the peripheral zone, the central gland and cancer tissue of patients with prostate cancer. Moreover, no significant differences were found in non-cancer tissues for patients from different contributing institutions.
10:54 784. Which DCE MRI Parameter Provides the Best Discrimination Between Prostate Cancer and Benign Tissue?
    Louisa Bokacheva1, Kiran Sheikh1, Henry Rusinek1, Artem Mikheev1, Danny Kim1, Xiangtian Kong2, Jonathan Melamed2, Bachir Taouli1
Department of Radiology, New York University School of Medicine, New York, NY, USA; 2Department of Pathology, New York University Langone Medical Center, New York, NY, USA
    Dynamic contrast-enhanced (DCE) MRI has shown promise for discrimination of prostate cancer from normal prostatic tissue. We compare three published methods of DCE analysis: maximum wash-in rate of contrast, two-compartment Tofts model, and distributed parameters model (adiabatic approximation to tissue homogeneity, AATH model), and assess their ability to distinguish prostate cancer from noncancerous tissue.
11:06 785. Apparent Diffusion Coefficient as a Predictive Biomarker of Prostate Cancer Progression: Value of Fast and Slow Diffusion Components
    Sharon L. Giles1, Veronica A. Morgan1, Sophie F. Riches2, Karen Thomas3, Chris Parker4,5, Nandita M. De Souza1,2
Clinical Magnetic Resonance Unit, Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK; 2Clinical Magnetic Resonance Unit, Institute of Cancer Research, Sutton, Surrey, UK; 3Clinical Research & Development, Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK; 4Academic Urology, Institute of Cancer Research, Sutton, Surrey, UK; 5Academic Urology, Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
    This study investigates ADC as a predictive biomarker in prostate cancer progression. Mean ADC measurements of tumor in 81 patients on active surveillance were calculated for all b values (ADCoverall), and with only low b values (0-300, ADCfast) and high b values (300-800, ADCslow). ADCs in those whose repeat biopsies were upgraded vs. stable at follow-up were compared. Cox’s regression was used to predict likelihood of progression to radical treatment. Both ADC components were significantly lower in those that were histologically upgraded at repeat biopsy. True diffusion, ADCslow, was a significant predictor of progression to radical treatment.
11:18 786. Correlation Between Pretreatment MRI/MRSI Data and Tissue Molecular Marker Levels for Characterization of Prostate Cancer and Prediction of Disease Recurrence
    Amita Shukla-Dave1, H. Hricak1, N. Ishill1, C. S. Moskowitz1, M. Drobnjak1, V. E. Reuter1, K. L. Zakian1, P. T. Scardino1, C. Cordon-Cardo2
Memorial Sloan-Kettering Cancer Center, New York, USA; 2Columbia University, New York, USA
    Accurate pretreatment distinction between low-risk prostate cancer (PCa) and more advanced disease remains challenging. Better characterization of insignificant PCa and prediction of which cancers may recur after initial treatment are needed. Our study assessed whether MRI/MRSI data and molecular marker levels correlate with pathologically insignificant PCa and can predict disease recurrence. Eighty-nine patients underwent MRI/MRSI before radical prostatectomy. Immunohistochemistry assays for Ki-67, phoshpo-Akt and Androgen Receptor were performed on the surgical specimens. MRI/MRSI findings and molecular marker levels correlated with pathologically insignificant PCa and were significant predictors of recurrence. These results suggest that pretreatment MRI/MRSI findings and molecular marker analyses of biopsy samples could favorably impact treatment selection.
11:30 787. Diffusion-Weighted MRI to Detect Pelvic Lymph Node Metastases in Patients with Bladder or Prostate Cancer: Comparison with Histopathology as Gold Standard
    Maria Triantafyllou1, Tobias Binser2, Frederic Birkhaeuser3, Urs E. Studer3, Achim Fleischmann4, Michael Von Gunten5, Johannes M. Froehlich6, Peter Vermathen2, Harriet C. Thoeny7
Department of Diagnostic,  Interventional and Pediatric Radiology, Inselspital Bern, Bern, Switzerland; 2Department of Clinical Research, Inselspital, Bern, Switzerland; 3Department of Urology, Inselspital, Bern, Switzerland; 4Department of Pathology, Inselpital, Bern, Switzerland; 5Department of pathology, Inselspital, Bern, Switzerland; 6Guerbet, Switzerland; 7Department of Diagnostic,  Interventional and Pediatric Radiology, Inselspital, Bern, Switzerland
    The hypothesis that a decreased ADC value in lymph nodes of patients suffering from prostate or bladder cancer might indicate metastatic involvement was studied in a prospective controlled clinical study including forty patients. Hyperintense structures on b 1000 images were correlated with the morphological images to check whether these were lymph nodes. In case of an ADC value beyond 90 x 10-5 mm”/sec these were classified as metastatic, while lymph nodes between 90 and 100 were ambigous. Overall a sensitivity of 80%, a specificity of 79%, a positive-predictive value of 57% and a negative predictive value of 92% resulted.
11:42 788. Correlation Between Lymph Node Apparent Diffusion Coefficient and Positron Emission Tomography Standardised Uptake Value in Paediatric Patients with Lymphoma
    Shonit Punwani1, Steve Bandula2, Vineet Prakash2, Alan Bainbridge2, Enrico De Vita1, Nicola Stevens2, Stuart Taylor1, Sharon Hain2, Stephen Daw2, Ananth Shankar2, Paul Humphries2
University College London, London, UK; 2University College London Hospital, London, UK
    Fluorodeoxyglucose Positron emission tomography (FDG-PET) produces images reflecting the metabolic activity of tumour tissue but imparts a significant radiation dose to the patient. Apparent diffusion coefficient (ADC) is known to be related to cellular density. In theory cellular density should be related to metabolic activity and as such ADC values could provide a potential non-ionising surrogate measure of 'functional' activity. This study aims to evaluate this relationship for lymph nodes in paediatric and adolescent patients diagnosed with lymphoma prior to treatment.
11:54 789. Prediction of Treatment Response in Follicular and Mantle Cell Lymphomas Using In Vivo 31P MRS Before Treatment
    Fernando Arias-Mendoza1, Geoffrey Payne2, Kristen Zakian3, Marion Stubbs4, Hamed Mojahed1, Amita Shukla-Dave3, Nicholas R. Maisey2, David Cunningham2, Harish Poptani5, Mitchell R. Smith6, Owen A. O'Connor7, Jazmine Zain7, Steven J. Shuster8, Andrew D. Zelenetz9, George A. Follows10, John Raemaekers11, Marius MacKenzie11, Martin O. Leach2, Jason A. Koutcher3, John R. Griffiths4, Arend Heerschap12, Jerry D. Glickson5, Truman R. Brown1
Radiology, Columbia University, New York, NY, USA; 2Radiology, Royal Marsden Hospital, London, UK; 3Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA; 4Radiology, Cambridge University, Cambridge, UK; 5Radiology, University of Pennsylvania, Philadelphia, PA, USA; 6Clinical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA; 7Clinical Oncology, Columbia University, New York, NY, USA; 8Clinical Oncology, University of Pennsylvania, Philadelphia, PA, USA; 9Clinical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA; 10Clinical Oncology, Addenbroke's Hospital, Cambridge, UK; 11Clinical Oncology, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands; 12Radiology, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands
    In this work, we studied less frequent histological subtypes of non Hodgkin's lymphomas (mainly follicular and mantle cell lymphomas) to test the utility of the [Etn P + Cho P]/NTP ratio in predicting treatment failure and drug-free survival in these patients.Our results show that even though there is more overlap between the complete and not complete response groups in NHL types studied here, the prediction of treatment response and disease-free survival by [Etn P + Cho P]/NTP determined by 31P-MRS is still applicable to these more infrequent forms of NHL.
12:06 790. Taurine- A Possible Biomarker in Urine of Urinary Bladder Cancer by 1H NMR Spectroscopy: A Pilot Study
    Abhinav Arun Sonkar1, Shatakshi Srivastava2, Sudhir Singh1, Diwakar Dalela3, Satya Narayanan Sankhwar3, Apul Goel3, Raja Roy2
Department of Surgery, CSM Medical University, Lucknow, Uttar Pradesh, India; 2Centre of Biomedical Magnetic Resonance, Sanjay Gandhi Post Graduate Institute, Lucknow, Uttar Pradesh, India; 3Department of Urology, CSM Medical University, Lucknow, Uttar Pradesh, India
    The increase in rate of urinary bladder cancer has aroused the need for development of better treatment strategies and consequently, improved diagnostic techniques. The biomarker study of non-invasive body fluid as urine may provide, firstly, a better insight for metabolic processes occuring in pathological state and secondly, improved diagnosis. The altered concentrations of small metabolites viz.taurine, citrate and phenylalanine may provide a diagnostic measure for bladder cancer. Techniques like cytology apart from being invasive suffer from lower sensitivity. Therefore, 1H NMR spectroscopy has been employed for gathering information present in urine of bladder cancer patients, in form of small metabolites.
12:18 791. Characterization and Evaluation of Metabolic Biomarkers for Human Colon Adenocarcinomas by 1H HR MAS Spectroscopy
    May-Britt Tessem1, Kirsten M. Selnæs2, Wenche Sjursen3, Gerd Tranø4, Ingrid Gribbestad2, Eva Hofsli5
Dept. of Circulation and medical imaging, Norwegian University of Science and Technology (NTNU)  , Trondheim, Norway; 2Dept. of Circulation and medical imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; 3Laboratory Medicine Children’s and Women’s Health, NTNU, Trondheim, Norway; 4Dept. of Surgery, Hamar Hospital, Hamar, Norway; 5Dept. of Oncology, St. Olavs University Hospital, Trondheim, Norway
    Colon cancer is one of the most frequent cancers worldwide, and screening for biomarkers to reveal its biochemical mechanisms could improve tumor characterization. A long echo HR-MAS CPMG sequence was used to characterize metabolic profiles of human colon cancer tissue. Marked differences were found between healthy and cancer tissue, and between healthy and adenomas. There was minimal overlap between the individual metabolic profiles, and marked changes were seen in levels of taurine, inositols, choline-containing compounds and lactate. These metabolic changes are important biomarkers for colon cancer, and could be used to improve clinical diagnosis and characterisation of colon cancer.