| Prostate & Body Cancers |
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Friday 24 April 2009 |
| Room 313A |
10:30-12:30 |
Moderators: |
Anwar R. Padhani and Amita Shukla-Dave |
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10:30 |
782. |
Prostate Cancer Detection:
Multi-Parametric MRI with Diffusion-Weighted Imaging
and Dynamic Contrast Enhanced MRI |
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Deanna Lyn Langer1,2,
Theo H. van der Kwast3, Andrew J. Evans3,
John Trachtenberg4, Brian C. Wilson5,
Masoom A. Haider1,2
1Joint 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 |
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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. |
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10:42 |
783. |
Final Results of IMAPS: An
International Multi-Centre Assessment of Prostate MR
Spectroscopy |
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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
1Radiology (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 |
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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. |
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10:54 |
784. |
Which DCE MRI Parameter
Provides the Best Discrimination Between Prostate
Cancer and Benign Tissue? |
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Louisa Bokacheva1,
Kiran Sheikh1, Henry Rusinek1,
Artem Mikheev1, Danny Kim1,
Xiangtian Kong2, Jonathan Melamed2,
Bachir Taouli1
1Department 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 |
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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. |
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11:06 |
785. |
Apparent Diffusion Coefficient
as a Predictive Biomarker of Prostate Cancer
Progression: Value of Fast and Slow Diffusion
Components |
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Sharon L. Giles1,
Veronica A. Morgan1, Sophie F. Riches2,
Karen Thomas3, Chris Parker4,5,
Nandita M. De Souza1,2
1Clinical 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 |
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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. |
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11:18 |
786. |
Correlation Between
Pretreatment MRI/MRSI Data and Tissue Molecular
Marker Levels for Characterization of Prostate
Cancer and Prediction of Disease Recurrence |
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Amita Shukla-Dave1,
H. Hricak1, N. Ishill1, C. S.
Moskowitz1, M. Drobnjak1, V.
E. Reuter1, K. L. Zakian1, P.
T. Scardino1, C. Cordon-Cardo2
1Memorial Sloan-Kettering Cancer Center, New
York, USA; 2Columbia University, New
York, USA |
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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. |
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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 |
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Maria Triantafyllou1,
Tobias Binser2, Frederic Birkhaeuser3,
Urs E. Studer3, Achim Fleischmann4,
Michael Von Gunten5, Johannes M.
Froehlich6, Peter Vermathen2,
Harriet C. Thoeny7
1Department 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 |
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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. |
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11:42 |
788. |
Correlation Between Lymph Node
Apparent Diffusion Coefficient and Positron Emission
Tomography Standardised Uptake Value in Paediatric
Patients with Lymphoma |
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Shonit Punwani1,
Steve Bandula2, Vineet Prakash2,
Alan Bainbridge2, Enrico De Vita1,
Nicola Stevens2, Stuart Taylor1,
Sharon Hain2, Stephen Daw2,
Ananth Shankar2, Paul Humphries2
1University College London, London, UK; 2University
College London Hospital, London, UK |
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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. |
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11:54 |
789. |
Prediction of Treatment
Response in Follicular and Mantle Cell Lymphomas
Using In Vivo 31P MRS Before
Treatment |
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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
1Radiology, 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 |
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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. |
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12:06 |
790. |
Taurine- A Possible Biomarker
in Urine of Urinary Bladder Cancer by 1H NMR
Spectroscopy: A Pilot Study |
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Abhinav Arun Sonkar1,
Shatakshi Srivastava2, Sudhir Singh1,
Diwakar Dalela3, Satya Narayanan Sankhwar3,
Apul Goel3, Raja Roy2
1Department 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 |
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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. |
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12:18 |
791. |
Characterization and
Evaluation of Metabolic Biomarkers for Human Colon
Adenocarcinomas by 1H HR MAS Spectroscopy |
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May-Britt Tessem1,
Kirsten M. Selnæs2, Wenche Sjursen3,
Gerd Tranø4, Ingrid Gribbestad2,
Eva Hofsli5
1Dept. 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 |
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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. |
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