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Permanent prostate brachytherapy pubic arch evaluation with diagnostic magnetic resonance imaging
Geoffrey V Martin1, Thomas J Pugh2, Usama Mahmood1
1Division of Radiation Oncology, Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
Brachytherapy
|March 13, 2017
Summary
Staging MRI can effectively evaluate pubic arch interference (PAI) for prostate cancer brachytherapy, offering similar predictability to CT scans. This may eliminate the need for additional CT imaging before treatment.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Pubic arch interference (PAI) can limit brachytherapy for prostate cancer.
- MRI is increasingly used for prostate cancer staging, potentially replacing CT and TRUS.
Purpose of the Study:
- To assess if staging MRI can evaluate PAI.
- To compare MRI's PAI evaluation with CT and transrectal ultrasound (TRUS).
Main Methods:
- Pelvic MRI, CT, and TRUS simulations were performed on 41 patients.
- Prostate gland contours from MRI and CT were superimposed on the pubic arch.
- TRUS determined the presence of PAI, and MRI/CT predictions were compared.
Main Results:
- 48% of patients showed PAI on TRUS.
- MRI and CT showed average overlaps of 2.0mm and 2.9mm, respectively (R=0.783, p<0.001).
- Both MRI and CT were equally predictive of PAI (AUC=0.75).
Conclusions:
- Diagnostic MRI can assess PAI before brachytherapy.
- MRI offers similar PAI predictability to CT.
- Staging MRI may reduce the need for pre-brachytherapy CT scans.
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