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Author Spotlight: Advancing Prostate Cancer Research Through Improved Tissue Sampling and Biobanking
Published on: November 17, 2023
Voxel Level Radiologic-Pathologic Validation of Restriction Spectrum Imaging Cellularity Index with Gleason Grade in
Ghiam Yamin1, Natalie M Schenker-Ahmed1, Ahmed Shabaik2
1Department of Radiology, University of California San Diego School of Medicine, San Diego, California.
Purpose:
Restriction spectrum imaging (RSI-MRI), an advanced diffusion imaging technique, can potentially circumvent current limitations in tumor conspicuity, in vivo characterization, and location demonstrated by multiparametric magnetic resonance imaging (MP-MRI) techniques in prostate cancer detection. Prior reports show that the quantitative signal derived from RSI-MRI, the cellularity index, is associated with aggressive prostate cancer as measured by Gleason grade (GG). We evaluated the reliability of RSI-MRI to predict variance with GG at the voxel-level within clinically demarcated prostate cancer regions.
Experimental Design:
Ten cases were processed using whole mount sectioning after radical prostatectomy. Regions of tumor were identified by an uropathologist. Stained prostate sections were scanned at high resolution (75 μm/pixel). A grid of tiles corresponding to voxel dimensions was graded using the GG system. RSI-MRI cellularity index was calculated from presurgical prostate MR scans and presented as normalized z-score maps. In total, 2,795 tiles were analyzed and compared with RSI-MRI cellularity.
Results:
RSI-MRI cellularity index was found to distinguish between prostate cancer and benign tumor (t = 25.48, P < 0.00001). Significant differences were also found between benign tissue and prostate cancer classified as low-grade (GG = 3; t = 11.56, P < 0.001) or high-grade (GG ≥ 4; t = 24.03, P < 0.001). Furthermore, RSI-MRI differentiated between low and high-grade prostate cancer (t = 3.23; P = 0.003).
Conclusions:
Building on our previous findings of correlation between GG and the RSI-MRI among whole tumors, our current study reveals a similar correlation at voxel resolution within tumors. Because it can detect variations in tumor grade with voxel-level precision, RSI-MRI may become an option for planning targeted procedures where identifying the area with the most aggressive disease is important. Clin Cancer Res; 22(11); 2668-74. ©2016 AACR.
Insights
Restriction spectrum imaging (RSI-MRI) accurately predicts prostate cancer aggressiveness at the voxel level, distinguishing between low and high-grade tumors. This advanced MRI technique offers precise characterization for targeted treatment planning in prostate cancer.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Prostate cancer detection faces limitations with current multiparametric MRI (MP-MRI).
- Restriction spectrum imaging (RSI-MRI) is an advanced diffusion imaging technique.
- Prior research links RSI-MRI's cellularity index to prostate cancer aggressiveness (Gleason grade).
Purpose of the Study:
- To evaluate the reliability of RSI-MRI in predicting Gleason grade (GG) variations at the voxel level within prostate cancer regions.
- To assess RSI-MRI's potential to overcome current MP-MRI limitations in tumor characterization.
Main Methods:
- Whole mount prostatectomy sections from 10 cases were analyzed.
- High-resolution scanning (75 μm/pixel) and Gleason grading of tissue tiles.
- RSI-MRI cellularity index calculated from pre-surgical MRI scans, presented as normalized z-score maps.
- Comparison of 2,795 analyzed tiles with RSI-MRI cellularity.
Main Results:
- RSI-MRI cellularity index significantly distinguished prostate cancer from benign tissue (P < 0.00001).
- Significant differences were observed between benign tissue and low-grade (P < 0.001) or high-grade (P < 0.001) prostate cancer.
- RSI-MRI successfully differentiated between low and high-grade prostate cancer (P = 0.003).
Conclusions:
- RSI-MRI demonstrates a correlation with Gleason grade at the voxel level within prostate tumors.
- This technique offers voxel-level precision for detecting tumor grade variations.
- RSI-MRI may aid in planning targeted procedures by identifying the most aggressive disease areas.
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