ISMRM 23rd Annual Meeting & Exhibition • 30 May - 05 June 2015 • Toronto, Ontario, Canada

Scientific Session • Cancer: Prostate Cancer

Friday 5 June 2015

Room 801 A/B

08:00 - 10:00


Ruth Lim, M.D., Elizabeth M. Hecht, M.D.

08:00   Introduction
Hedvig Hricak
08:12 1043.   
Diagnostic potential of simultaneous 18F-FACBC PET/MRI in high risk prostate cancer patients
Kirsten Margrete Selnæs1,2, Mattijs Elschot1, Brage Krüger-Stokke1,3, Øystein Størkersen4, Dag Linthoe Halvorsen5, Elise Sandsmark1, May-Britt Tessem1,2, Sverre Langørgen3, Eirik Kjøbli5, Anders Angelsen1, Frode Willoch6,7, Helena Bertilsson5,8, Siver Andreas Moestue1,2, and Tone Frost Bathen1,2
1Department of Sirculation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway, 2St. Olavs University Hospital, Trondheim, Norway, 3Clinic of Radiology and Nuclear Medicine, St. Olavs University Hospital, Trondheim, Norway, 4Clinic of Laboratory Medicine, St. Olavs University Hospital, Trondheim, Norway, 5Clinic of Surgery, St. Olavs University Hospital, Trondheim, Norway, 6Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway, 7Aleris Cancer Center, Oslo, Norway, 8Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway

The leucine amino acid analog 1-amino-3-fluorine 18-fluorocyclobutane-1-carboxylic acid (18F-FACBC) has shown promising results in assessment of primary and metastatic prostate cancer. In the present study a protocol for simultaneous 18F-FACBC PET and multiparametric MR was established and evaluated with respect to the diagnostic potential (N-stage and grade) in high risk prostate cancer patients. The preliminary results show that there is high tracer uptake in regions corresponding to tumor within the gland, however, areas of BPH has also been observed to have high uptake. Histopathologically verified lymph node metastasis also show high uptake of tracer.

08:24 1044.   Hypoxia modification during prostate radiotherapy: an evaluation of changes in the tumour microenvironment using multi-parametric MRI (mpMRI)
N Jane Taylor1, Kent Yip2, Juliette Valentine2, J James Stirling1, Ian C Simcock1, David J Collins3, James A d'Arcy3, Uma Patel2, Andrew Gogbashian1, Peter Hoskin2, Anwar R Padhani1, and Roberto Alonzi2
1Paul Strickland Scanner Centre, Mount Vernon Hospital, London, United Kingdom, 2Marie Curie Research Wing, Mount Vernon Cancer Centre, London, United Kingdom, 3Cancer Research-UK-EPSRC Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom

Hypoxia correction improves survival in patients treated with radiotherapy (RT) for some cancers. Previous studies have shown the existence of hypoxia in untreated prostate cancer (PCa) and hypoxia resolution following carbogen breathing. Androgen deprivation therapy (ADT) is normally given prior to RT. ADT is anti-angiogenic and causes tumour vascular disruption. It is not known whether the use of carbogen gas will still be effective in correcting hypoxia post ADT. This study has assessed this during hypoxia-modified RT.

08:36 1045.   
Gradient Echo Signal Decays in Healthy and Cancerous Prostate at 3T Require a Gaussian Augmentation of the Mono-Exponential (GAME) Model - permission withheld
Pelin Aksit Ciris1,2, Robert V. Mulkern2,3, Mukund Balasubramanian2,3, Ravi T. Seethamraju4, Janice Fairhurst1, Junichi Tokuda1,2, Jonathan Scalera1,2, Tobias Penzkofer1,2, Fiona Fennessy2,5, Ferenc A. Jolesz1,2, Clare M. Tempany-Afdhal1,2, Ehud Schmidt1,2, and Kemal Tuncali1,2
1Brigham and Women's Hospital, Boston, MA, United States, 2Harvard Medical School, Boston, MA, United States, 3Boston Children's Hospital, Boston, MA, United States, 4Siemens Healthcare, Boston, MA, United States, 5Dana-Farber Cancer Institute, MA, United States

Hypoxia is prevalent in prostate cancer, and may indicate cancer aggressiveness. Oxygenation, among many other factors, can influence gradient-echo signal decay in the prostate, appropriate characterization of which is essential for any potential quantitative use. A standard Mono-Exponential (ME) decay model has shown promise at 1.5T, however, we report that proper signal characterization requires a Gaussian Augmentation of the Mono-Exponential (GAME) decay model at 3T. GAME characterized signal decays better than or equivalent to ME everywhere in the prostate. This increases the potential for determining correlates of the fit parameters with biomarkers, such as of oxygenation status.

08:48 1046.   Utility of T2 histogram analysis in active surveillance of prostate cancer
Harsh K Agarwal1,2, Sandeep Sankineni2, Marcelino Bernardo2,3, Bradford Wood2, Peter Pinto2, Peter L Choyke2, and Baris Turkbey2
1Philips Research NA, Briarcliff Manor, New York, United States, 2National Institutes of Health, Bethesda, MD, United States, 3Frederic National Laboratory for Cancer Research, Leidos Biomedical Research Inc., Frederick, MD, United States

): Low mortality rate of indolent prostate cancer is motivating patients to choose active survelliance. However there are limited number of quantitative tools to monitor the patients on active survelliance with imaging. T2 contrast in prostate MRI has a potential to monitor the patient on active surveliance. This is study we have shown that Quantitative T2 histogram analysis can be potentially utilized as an efficient, and quick visual method of determining status of active surveillance with high negative predictive value for low-risk prostate cancer patients.

09:00 1047.   
Support Vector Neural Networks versus Logistic Regression MR based diagnostic model for classification of transition zone prostate cancer - permission withheld
Nikolaos Dikaios1,2, Jokha Alkalbani2, Alex Kirkham3, Clare Allen3, Hashim Ahmed4, Mark Emberton4, Alex Freeman5, Steve Halligan2, Stuart Taylor2, David Atkinson2, and Shonit Punwani2
1Medical Physics, UCL, London, Greater London, United Kingdom, 2Centre of Medical Imaging, UCL, Greater London, United Kingdom, 3Radiology, UCL, Greater London, United Kingdom, 4Urology, UCL, Greater London, United Kingdom, 5Histopathology, UCL, Greater London, United Kingdom

Multi-parametric MRI (mp-MRI) facilitates identification of transition zone cancers, yet its overall diagnostic accuracy is likely lower in this part of the prostate compared with the peripheral zone. Benign hyperplastic nodules within the transition zone likely make the localisation of cancer difficult. Logistic regression (LR) models1 for classifying transition zone (TZ) prostate cancer (PCa) on mp-MRI were previously derived and validated. Here we explore whether the application of support vector machine (SVM) neural network (SVNN) algorithms can improve classification accuracy. The proposed SVNN algorithm is trained on 70 patients and temporally validated on a second independent cohort of 85 patients.

09:12 1048.   Unsupervised multi-characterstic framework for DW-MRI prostate cancer localization
Raisa Z Freidlin1, Harsh K Agarwal2, Sandeep Sankineni3, Anna M Brown3, Marcelino Bernardo3,4, Peter A Pinto3, Bradford J Wood3, Deborah E Citrin3, Peter L Choyke3, and Baris Turkbey3
1NIH/CIT, Bethesda, Maryland, United States, 2Philips Research, New York, United States, 3NIH/NCI, Maryland, United States, 4Leidos, Maryland, United States

Existing studies using diffusion MRI models for prostate cancer (PCa) detection have not used an unsupervised approach. Our proof-of-concept study introduces a novel unsupervised multi-characteristic framework for localizing PCa. Our framework calculates voxel-based parameters from the IVIM and kurtosis models and identifies “tumor” and “tumor suspicious” voxels using patient-specific thresholds. Ten patients with moderate-high clinicopathological risk for PCa underwent 3T prostate MRI and subsequent biopsy. The index lesion was identified in all patients (100% patient-based detection rate). Of the 25 framework-identified lesions, 14 were true positives (56% lesion-based detection rate). This novel framework shows promise for identifying index PCa lesions.

09:24 1049.   Correlation between MRI-derived Quantitative Biomarkers and Circulating Tumor Cells in Prostate Cancer
Radka Stoyanova1, Sakhi Abraham1, Adrian Breto1, Zheng Ao2, Anthony Williams2, Jorge Torres-Munoz2, Ram Datar2, Richard Cote2, Yosef Zeidan1, Adrian Ishkanian1, Matthew Abramowitz1, and Alan Pollack1
1Radiation Oncology, University of Miami, Miami, Florida, United States, 2Pathology, University of Miami, Miami, Florida, United States

Circulating tumor cells (CTC) are rare malignant cells found in the peripheral blood of patients with a wide range of solid tumors. In this study we investigated the correlation of CTC counts with the prostate tumor volume, tissue perfusion and diffusion properties, estimated from multiparametric (MP)-MRI. These imaging biomarkers were related to CTC counts in patients enrolled in a contemporary randomized clinical trial for definitive radiotherapy of prostate cancer. This is, to our knowledge, the first study comparing CTC counts with in vivo measurements of tumor volume, perfusion and diffusion.

09:36 1050.   
Assessment of Prostate Cancer Aggressiveness with Hyperpolarized Dual-Agent 3D Dynamic Imaging of Metabolism and Perfusion
Hsin-Yu Chen1,2, Peder E.Z. Larson1,2, Robert A. Bok2, Cornelius von Morze2, Romelyn Delos Santos2, Renuka Sriram2, Justin Delos Santos2, John Kurhanewicz1,2, and Daniel B. Vigneron1,2
1Graduate Program in Bioengineering, UCSF and UC Berkeley, San Francisco, California, United States, 2Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, United States

A major challenge in the clinical management of prostate cancer is the differentiation of aggressive cancer from indolent disease. We developed a novel protocol using dynamic 3D compressed sensing EPSI to quantitatively assess aggressive prostate cancer on transgenic mouse model of prostate cancer (TRAMP) using dual agent hyperpolarized [C13]-pyruvate & [C13]-urea for simultaneous metabolic and perfusion MR. The dynamic HP [C13] results demonstrated significantly (P<.001) higher rates of lactate production and lower perfusion (P<.003) in high grade tumors versus low grade.

09:48 1051.   Robust 3D 1H MRSI of the prostate without endorectal coil at 3T
Nassim Tayari1, Isabell K. Steinseifer1, Cai Xia Fu2, Elisabeth Weiland3, Jack J.A. van Asten1, Tom W.J. Scheenen4, Marnix C Maas1, and Arend Heerschap1
1Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, Netherlands, 2Siemens Shenzhen Magnetic Resonance Ltd., China, 3Siemens Healthcare, Erlangen, Germany, 4Department of Radiology and Nuclear Medicine, Radboud university medical center, Nijmegen, Netherlands

The use of an endorectal coil (ERC) in MR of the prostate is time consuming and uncomfortable for patients. In this work we demonstrate that robust 1H MRSI of the prostate can be performed without ERC by a semi-LASER sequence with GOIA-WURST(16,4) refocusing pulses. This sequence has an excellent performance as reflected by high citrate signals and minor lipid contamination. Furthermore, acquisition times can be shortened to 5 min (TR = 630 ms), which is clinically valuable. For the detection of the choline signal, a TR of about 900 ms is more favorable, to avoid too much signal saturation.