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Sample records for prostate volume estimation

  1. Prostate-specific antigen as an estimator of prostate volume in the management of patients with symptomatic benign prostatic hyperplasia

    NARCIS (Netherlands)

    Mochtar, CA; Kiemeney, LALM; van Riemsdijk, MM; Barnett, GS; Laguna, MP; Debruyne, FMJ; de la Rosette, JJMCH

    2003-01-01

    Objectives: To assess the ability of serum prostate specific antigen (PSA) to estimate prostate volume (PV) to aid in the management of patients with benign prostatic hyperplasia (BPH). Methods: From 1989 to 2002, data were collected from 2264 patients complaining of lower urinary tract symptoms

  2. Estimation of clinically significant prostate volumes by digital rectal examination: a comparative prospective study.

    LENUS (Irish Health Repository)

    Ahmad, Sarfraz

    2011-12-01

    Reliable quantification of prostate volume is important to correctly select patients with benign prostatic hyperplasia (BPH) most likely to benefit from medical therapy [e.g. 5 alpha-reductase inhibitors (5-ARIs)] and in selecting appropriate surgical approach. We aim to determine the reliability of digital rectal examination (DRE) in estimation of prostate volume which may be helpful in patient selection for 5-ARIs therapy.

  3. Standardized assessment to enhance the diagnostic value of prostate volume; Part II: Correlation with prostate-specific antigen levels

    NARCIS (Netherlands)

    Aarnink, R. G.; de la Rosette, J. J.; Huynen, A. L.; Giesen, R. J.; Debruyne, F. M.; Wijkstra, H.

    1996-01-01

    Standardized estimations of prostate volumes are used for interpretation of prostate specific antigen (PSA) levels. In 243 patients with clinically benign diagnosis, automated and reference prostate volumes and transition zone volumes are correlated to PSA levels. Besides, growth curves of PSA level

  4. Prostate health index (PHI) and prostate-specific antigen (PSA) predictive models for prostate cancer in the Chinese population and the role of digital rectal examination-estimated prostate volume.

    Science.gov (United States)

    Chiu, Peter K F; Roobol, Monique J; Teoh, Jeremy Y; Lee, Wai-Man; Yip, Siu-Ying; Hou, See-Ming; Bangma, Chris H; Ng, Chi-Fai

    2016-10-01

    To investigate PSA- and PHI (prostate health index)-based models for prediction of prostate cancer (PCa) and the feasibility of using DRE-estimated prostate volume (DRE-PV) in the models. This study included 569 Chinese men with PSA 4-10 ng/mL and non-suspicious DRE with transrectal ultrasound (TRUS) 10-core prostate biopsies performed between April 2008 and July 2015. DRE-PV was estimated using 3 pre-defined classes: 25, 40, or 60 ml. The performance of PSA-based and PHI-based predictive models including age, DRE-PV, and TRUS prostate volume (TRUS-PV) was analyzed using logistic regression and area under the receiver operating curves (AUC), in both the whole cohort and the screening age group of 55-75. PCa and high-grade PCa (HGPCa) was diagnosed in 10.9 % (62/569) and 2.8 % (16/569) men, respectively. The performance of DRE-PV-based models was similar to TRUS-PV-based models. In the age group 55-75, the AUCs for PCa of PSA alone, PSA with DRE-PV and age, PHI alone, PHI with DRE-PV and age, and PHI with TRUS-PV and age were 0.54, 0.71, 0.76, 0.78, and 0.78, respectively. The corresponding AUCs for HGPCa were higher (0.60, 0.70, 0.85, 0.83, and 0.83). At 10 and 20 % risk threshold for PCa, 38.4 and 55.4 % biopsies could be avoided in the PHI-based model, respectively. PHI had better performance over PSA-based models and could reduce unnecessary biopsies. A DRE-assessed PV can replace TRUS-assessed PV in multivariate prediction models to facilitate clinical use.

  5. Age and prostate volume are risk factors for transient urinary incontinence after transurethral enucleation with bipolar for benign prostatic hyperplasia.

    Science.gov (United States)

    Hirasawa, Yosuke; Kato, Yuji; Fujita, Kiichiro

    2018-01-01

    To investigate the predictive factors for transient urinary incontinence after transurethral enucleation with bipolar. We retrospectively analyzed the data of 584 patients who underwent transurethral enucleation with bipolar between December 2011 and September 2016 operated by a single surgeon. Urinary incontinence after transurethral enucleation with bipolar was defined as involuntary leakage of urine that required the use of pads. It was evaluated at 1 week, and 1, 3, 6, 12 and 24 months after transurethral enucleation with bipolar. We defined transient urinary incontinence as urinary incontinence persisting up to 1 month after transurethral enucleation with bipolar. Based on independent risk factors identified by a multivariate stepwise logistic regression analysis, a nomogram to predict transient urinary incontinence was developed. Of the 584 patients, 17.3%, 13.5%, 3.1%, 0.41%, and 0% patients had urinary incontinence at 1 week, 1, 3, 6 and 12 months after transurethral enucleation with bipolar, respectively. The mean (±standard error) age was 69.6 ± 0.26 years, estimated prostate volume was 54.7 ± 0.91 cm 3 , operative time was 58.0 ± 1.1 min and the prostate specimen weight was 30.6 ± 0.69 g. On univariate analysis, age, prostate volume estimated by transrectal ultrasonography, prostate-specific antigen, prostate specimen weight, operative time, prostate specimen weight/prostate volume and prostate specimen weight/operative time were significant predictive factors for transient urinary incontinence after transurethral enucleation with bipolar. On multivariate analysis, age (hazard ratio 1.07, P-value = 0.0034) and prostate volume (hazard ratio 1.03, P-value bipolar. Age and prostate volume estimated by transrectal ultrasonography seem to represent significant independent risk factors for transient urinary incontinence after transurethral enucleation with bipolar. This should be well discussed with the patient before surgery. © 2017 The Japanese

  6. Prostate-specific antigen lowering effect of metabolic syndrome is influenced by prostate volume.

    Science.gov (United States)

    Choi, Woo Suk; Heo, Nam Ju; Paick, Jae-Seung; Son, Hwancheol

    2016-04-01

    To investigate the influence of metabolic syndrome on prostate-specific antigen levels by considering prostate volume and plasma volume. We retrospectively analyzed 4111 men who underwent routine check-ups including prostate-specific antigen and transrectal ultrasonography. The definition of metabolic syndrome was based on the modified Adult Treatment Panel III criteria. Prostate-specific antigen mass density (prostate-specific antigen × plasma volume / prostate volume) was calculated for adjusting plasma volume and prostate volume. We compared prostate-specific antigen and prostate-specific antigen mass density levels of participants with metabolic syndrome (metabolic syndrome group, n = 1242) and without metabolic syndrome (non-prostate-specific antigen metabolic syndrome group, n = 2869). To evaluate the impact of metabolic syndrome on prostate-specific antigen, linear regression analysis for the natural logarithm of prostate-specific antigen was used. Patients in the metabolic syndrome group had significantly older age (P prostate volume (P prostate-specific antigen (non-metabolic syndrome group vs metabolic syndrome group; 1.22 ± 0.91 vs 1.15 ± 0.76 ng/mL, P = 0.006). Prostate-specific antigen mass density in the metabolic syndrome group was still significantly lower than that in the metabolic syndrome group (0.124 ± 0.084 vs 0.115 ± 0.071 μg/mL, P = 0.001). After adjusting for age, prostate volume and plasma volume using linear regression model, the presence of metabolic syndrome was a significant independent factor for lower prostate-specific antigen (prostate-specific antigen decrease by 4.1%, P = 0.046). Prostate-specific antigen levels in patients with metabolic syndrome seem to be lower, and this finding might be affected by the prostate volume. © 2016 The Japanese Urological Association.

  7. Conformal irradiation of the prostate: estimating long-term rectal bleeding risk using dose-volume histograms

    International Nuclear Information System (INIS)

    Hartford, Alan C.; Niemierko, Andrzej; Adams, Judith A.; Urie, Marcia M.; Shipley, William U.

    1996-01-01

    Purpose: Dose-volume histograms (DVHs) may be very useful tools for estimating probability of normal tissue complications (NTCP), but there is not yet an agreed upon method for their analysis. This study introduces a statistical method of aggregating and analyzing primary data from DVHs and associated outcomes. It explores the dose-volume relationship for NTCP of the rectum, using long-term data on rectal wall bleeding following prostatic irradiation. Methods and Materials: Previously published data were reviewed and updated on 41 patients with Stages T3 and T4 prostatic carcinoma treated with photons followed by perineal proton boost, including dose-volume histograms (DVHs) of each patient's anterior rectal wall and data on the occurrence of postirradiation rectal bleeding (minimum FU > 4 years). Logistic regression was used to test whether some individual combination of dose and volume irradiated might best separate the DVHs into categories of high or low risk for rectal bleeding. Further analysis explored whether a group of such dose-volume combinations might be superior in predicting complication risk. These results were compared with results of the 'critical volume model', a mathematical model based on assumptions of underlying radiobiological interactions. Results: Ten of the 128 tested dose-volume combinations proved to be 'statistically significant combinations' (SSCs) distinguishing between bleeders (14 out of 41) and nonbleeders (27 out of 41), ranging contiguously between 60 CGE (Cobalt Gray Equivalent) to 70% of the anterior rectal wall and 75 CGE to 30%. Calculated odds ratios for each SSC were not significantly different across the individual SSCs; however, analysis combining SSCs allowed segregation of DVHs into three risk groups: low, moderate, and high. Estimates of probabilities of normal tissue complications (NTCPs) based on these risk groups correlated strongly with observed data (p = 0.003) and with biomathematical model-generated NTCPs

  8. Prostate-Specific Antigen Mass and Free Prostate-Specific Antigen Mass for Predicting the Prostate Volume of Korean Men With Biopsy-Proven Benign Prostatic Hyperplasia

    OpenAIRE

    Park, Tae Yong; Chae, Ji Yun; Kim, Jong Wook; Kim, Jin Wook; Oh, Mi Mi; Yoon, Cheol Yong; Moon, Du Geon

    2013-01-01

    Purpose It has been reported that prostate-specific antigen (PSA) correlates with prostate volume. Recently, some studies have reported that PSA mass (PSA adjusted for plasma volume) is more accurate than PSA at predicting prostate volume. In this study, we analyzed the accuracy of PSA and the related parameters of PSA mass, free PSA (fPSA), and fPSA mass in predicting prostate volume. Materials and Methods We retrospectively investigated 658 patients who underwent prostate biopsy from 2006 t...

  9. SU-F-T-40: Can CBCT Images Be Used for Volume Studies of Prostate Seed Implants for Boost Treatment?

    Energy Technology Data Exchange (ETDEWEB)

    Xu, H; Lee, S; Diwanji, T; Amin, P; Krudys, K; Guerrero, M [University of Maryland School of Medicine, Baltimore, MD (United States)

    2016-06-15

    Purpose: In our clinic, the planning CT is used for definitive and boost low-dose-rate (LDR) brachytherapy treatments to determine the ultrasound volume in the operating room (OR) at the time of the implant. While the CT overestimation of OR volume is known, a larger estimation discrepancy has been observed for boost treatments. A possible reason is the prostate size reduction during EBRT for boost patients. Since cone-beam CT (CBCT) is often used as routine imaging guidance of EBRT, this prostate volume change may be captured. This study investigates if CBCT taken during EBRT includes the volume change information and therefore beats CT in estimating the prostate OR volumes. Methods: 9 prostate patients treated with EBRT (45Gy in 1.8Gy per fractions to the whole pelvis) and I-125 seed implants (108Gy) were involved in this study. During EBRT, CBCT image guidance was performed on a weekly basis. For each patient, the prostate volumes on the first and the last available CBCT images were manually contoured by a physician. These volumes were then compared to each other and with the contoured volumes from the planning CT and from the ultrasound images in the OR. Results: The first and the last CBCT images did not show significant prostate volume change. Their average +/− standard deviation of prostate volumes were 24.4cc+/−14.6cc and 29.9cc+/−16.1cc, respectively (T-test p=0.68). The ratio of the OR volume to the last CBCT (0.71+/−0.21) was not significantly different from the ratio of OR volumes to the planning CT (0.61+/−0.13) (p=0.25). Conclusion: In this study, CBCT does not show significant prostate volume changes during EBRT. CBCT and CT volumes are quite consistent and no improvement of volume estimation using CBCT is observed. The advantage of CBCT as a replacement of CT for volume study of boost LDR brachytherapy is limited.

  10. Prostate specific cancer volume: a significant prognostic factor in prostate cancer patients at intermediate risk of failing radiotherapy

    International Nuclear Information System (INIS)

    Lankford, S.P.; Pollack, A.; Zagars, G.K.

    1996-01-01

    Purpose: Although the pretreatment serum prostate specific antigen level (PSAL) is the single most significant predictor of local and biochemical control in prostate cancer patients treated with radiotherapy, it is relatively insensitive for patients with a PSAL in the intermediate range (4-20 ng/ml). PSA density (PSAD) has been shown to be slightly more predictive of outcome than PSAL for this intermediate risk group; however, this improvement is small and of little use clinically. PSA cancer volume (PSACV) is an estimate of cancer volume based on PSA that was recently described by D'Amico and Propert (IJROBP 32:232, 1995) as providing significant and independent prognostic information in addition to PSAL. We report here a detailed comparison between this new prognostic factor, PSAL, and PSAD. Methods and Materials: The records of 356 patients treated with definitive external beam radiotherapy for regionally localized (T1-4, Nx, M0) adenocarcinoma of the prostate were reviewed. Each patient had a PSAL, biopsy Gleason score, and pretreatment prostate volume by transrectal ultrasonography. The median PSAL was 9.3 ng/ml and 66% had Gleason scores in the 2-6 range. The median radiation dose was 66.0 Gy and the median follow-up for those living was 27 months. PSACV is a calculated parameter that takes into account PSAL (total PSA), ultrasonographic prostate volume (estimate of PSA from benign epithelium), and Gleason grade (estimate of PSA per tumor volume). The median PSACV was 1.43 cc. Biochemical failure was defined as increases in two consecutive follow-up PSA levels, one increase by a factor > 1.5, or an absolute increase of > 1 ng/ml. Local failure was defined as a cancer-positive prostate biopsy, usually undertaken because of evidence of biochemical failure. Results: The distributions of PSACV and PSAL were similar and, when normalized by log-transformation, were highly correlated (p 4 cc, as compared to those with a PSACV ≤ 0.5 cc, was over 30%. Conclusion

  11. Does Core Length Taken per cc of Prostate Volume in Prostate Biopsy Affect the Diagnosis of Prostate Cancer?

    Science.gov (United States)

    Deliktas, Hasan; Sahin, Hayrettin; Cetinkaya, Mehmet; Dere, Yelda; Erdogan, Omer; Baldemir, Ercan

    2016-08-01

    The aim of this study was to determine the minimal core length to be taken per cc of prostate volume for an effective prostate biopsy. A retrospective analysis was performed on the records of 379 patients who underwent a first prostate biopsy with 12 to 16 cores under transrectal ultrasound guidance between September 2012 and April 2015. For each patient, the core length per cc of the prostate and the percentage of sampled prostate volume were calculated, and these values were compared between the patients with and without prostate cancer. A total of 348 patients were included in the study. Cancer was determined in 26.4% of patients. The mean core length taken per cc of prostate and the percentage of sampled prostate volume were determined to be 3.40 ± 0.15 mm/cc (0.26%; range, 0.08-0.63 cc) in patients with cancer and 2.75 ± 0.08 mm/cc (0.20%; range, 0.04-0.66 cc) in patients without cancer (P = .000 and P = .000), respectively. Core length taken per cc of prostate of > 3.31 mm/cc was found to be related to an increase in the rates of prostate cancer diagnosis (odds ratio, 2.84; 95% confidence interval, 1.68-4.78). The rate of cancer determination for core length taken per cc of prostate of  3.31 mm/cc, 41.1%. Core length taken per cc of prostate and the percentage of sampled prostate volume are important morphometric parameters in the determination of prostate cancer. The results of study suggest a core length per cc of the prostate of > 3.31 mm/cc as a cutoff value for quality assurance. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Evaluation of magnetic resonance imaging-based prostate-specific antigen density of the prostate in the diagnosis of prostate cancer

    International Nuclear Information System (INIS)

    Hoshii, Tatsuhiko; Nishiyama, Tsutomu; Toyabe, Shinichi; Akazawa, Kohei; Komatsu, Shuichi; Kaneko, Masaaki; Hara, Noboru; Takahashi, Kota

    2007-01-01

    We evaluated prostate-specific antigen (PSA) density of the prostatic volume (PSAD) estimated using transrectal ultrasonography (TRUS; TRUS-based PSAD), magnetic resonance imaging (MRI; MRI-based PSAD), and PSA density of the transition zone (TZ) volume (PSATZD) estimated using MRI (MRI-based PSATZD) in the diagnosis of prostate cancer (PCa). One hundred and twenty patients, who were suspected to have PCa based on PSA, ranged between 4.1 and 20.0 ng/mL were enrolled in this study. The prostatic volume estimated using TRUS was smaller than the volume estimated using MRI by 11.4% in the patients with PSA levels ranging 4.1-20.0 ng/mL, 7.2% in those 4.1-10.0 ng/mL, and 15.7% in those 10.1-20.0 ng/mL, respectively. PSA levels were correlated with the prostatic volume estimated using TRUS and MRI, and TZ volume estimated using MRI in the patients without PCa; however, the level was not correlated with them in the patients with PCa. The area under the receiver operating characteristic curve of MRI-based PSAD was higher than that of TRUS-based PSAD; however, there was no statistical difference. Stepwise logistic regression analysis for the prediction of PCa by using PSA-related parameters confirmed that MRI-based PSATZD was the most significant predictor in patients with PSA levels in the range of 4.1-20.0 ng/mL (P<0.001), the range of 4.1-10.0 ng/mL (P=0.002), and the range of 10.1-20.0 ng/mL (P<0.001), respectively. The prostatic volume estimated using TRUS was smaller than the volume estimated using MRI. MRI-based PSATZD is the most significant predictor in the four parameters. (author)

  13. Formula-derived prostate volume determination

    NARCIS (Netherlands)

    Aarnink, R. G.; de la Rosette, J. J.; Debruyne, F. M.; Wijkstra, H.

    1996-01-01

    OBJECTIVES: Despite disadvantages such as time-consuming and tedious to the user, planimetric volumetry is considered to be the most accurate method for prostate volume determination. This study investigates the possibilities of formula-derived volume determination and reveals the best alternative

  14. Lesion volume predicts prostate cancer risk and aggressiveness: validation of its value alone and matched with prostate imaging reporting and data system score.

    Science.gov (United States)

    Martorana, Eugenio; Pirola, Giacomo Maria; Scialpi, Michele; Micali, Salvatore; Iseppi, Andrea; Bonetti, Luca Reggiani; Kaleci, Shaniko; Torricelli, Pietro; Bianchi, Giampaolo

    2017-07-01

    To demonstrate the association between magnetic resonance imaging (MRI) estimated lesion volume (LV), prostate cancer detection and tumour clinical significance, evaluating this variable alone and matched with Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) score. We retrospectively analysed 157 consecutive patients, with at least one prior negative systematic prostatic biopsy, who underwent transperineal prostate MRI/ultrasonography fusion-targeted biopsy between January 2014 and February 2016. Suspicious lesions were delineated using a 'region of interest' and the system calculated prostate volume and LV. Patients were divided in groups considering LV (≤0.5, 0.5-1, ≥1 mL) and PI-RADS score (1-5). We considered clinically significant prostate cancer as all cancers with a Gleason score of ≥3 + 4 as suggested by PI-RADS v2. A direct comparison between MRI estimated LV (MRI LV) and histological tumour volume (HTV) was done in 23 patients who underwent radical prostatectomy during the study period. Differences between MRI LV and HTV were assessed using the paired sample t-test. MRI LV and HTV concordance was verified using a Bland-Altman plot. The chi-squared test and logistic and ordinal regression models were used to evaluate difference in frequencies. The MRI LV and PI-RADS score were associated both with prostate cancer detection (both P prostate cancer detection (P Prostate cancer detection was 1.4-times higher for LVs of 0.5-1 mL and 1.8-times higher for LVs of ≥1 mL; significant prostate cancer detection was 2.6-times for LVs of 0.5-1 mL and 4-times for LVs of ≥1 mL. There was a positive correlation between MRI LV and HTV (r = 0.9876, P prostate cancer detection and with tumour clinical significance. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

  15. Determination of prostate gland volume by transrectal ultrasound

    DEFF Research Database (Denmark)

    Myschetzky, P S; Suburu, R E; Kelly, B S

    1991-01-01

    Seventy six patients underwent transrectal ultrasound examination of the prostate prior to radical prostatectomy. All radical specimens were weighed and measured when freshly excised. Corresponding measurements calculated using transrectal ultrasound dimensions were retrospectively compared with ...... was shown. A modified prolate ellipse formula, using the factor of 0.70, appears to be a more reliable means of estimating gland volume with transrectal ultrasound than the original formula [Width x Height x Length) x 0.523)....

  16. Toxicity Profile With a Large Prostate Volume After External Beam Radiotherapy for Localized Prostate Cancer

    International Nuclear Information System (INIS)

    Pinkawa, Michael; Fischedick, Karin; Asadpour, Branka; Gagel, Bernd; Piroth, Marc D.; Nussen, Sandra; Eble, Michael J.

    2008-01-01

    Purpose: To assess the impact of prostate volume on health-related quality of life (HRQOL) before and at different intervals after radiotherapy for prostate cancer. Methods and Materials: A group of 204 patients was surveyed prospectively before (Time A), at the last day (Time B), 2 months after (Time C), and 16 months (median) after (Time D) radiotherapy, with a validated questionnaire (Expanded Prostate Cancer Index Composite). The group was divided into subgroups with a small (11-43 cm 3 ) and a large (44-151 cm 3 ) prostate volume. Results: Patients with large prostates presented with lower urinary bother scores (median 79 vs. 89; p = 0.01) before treatment. Urinary function/bother scores for patients with large prostates decreased significantly compared to patients with small prostates due to irritative/obstructive symptoms only at Time B (pain with urination more than once daily in 48% vs. 18%; p 3 vs. 47 cm 3 ; p < 0.01). Conclusions: Patients with a large prostate volume have a great risk of irritative/obstructive symptoms (particularly dysuria) in the acute radiotherapy phase. These symptoms recover rapidly and do not influence long-term HRQOL

  17. Strategies to evaluate the impact of rectal volume on prostate motion during three-dimensional conformal radiotherapy for prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Poli, Ana Paula Diniz Fortuna, E-mail: anapaulafortuna@yahoo.com.br [Universidade Estadual de Campinas (CAISM/UNICAMP), Campinas, SP (Brazil). Centro de Atencao Integrada a Saude da Mulher. Divisao de Radioterapia; Dias, Rodrigo Souza; Giordani, Adelmo Jose; Segreto, Helena Regina Comodo; Segreto, Roberto Araujo [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Medicina. Divisao de Radioterapia

    2016-01-15

    Objective: To evaluate the rectal volume influence on prostate motion during three-dimensional conformal radiotherapy (3D-CRT) for prostate cancer. Materials and Methods: Fifty-one patients with prostate cancer underwent a series of three computed tomography scans including an initial planning scan and two subsequent scans during 3D-CRT. The organs of interest were outlined. The prostate contour was compared with the initial CT images considering the anterior, posterior, superior, inferior and lateral edges of the organ. Variations in the anterior limits and volume of the rectum were assessed and correlated with prostate motion in the anteroposterior direction. Results: The maximum range of prostate motion was observed in the superoinferior direction, followed by the anteroposterior direction. A significant correlation was observed between prostate motion and rectal volume variation (p = 0.037). A baseline rectal volume superior to 70 cm{sup 3} had a significant influence on the prostate motion in the anteroposterior direction (p = 0.045). Conclusion: The present study showed a significant interfraction motion of the prostate during 3D-CRT with greatest variations in the superoinferior and anteroposterior directions, and that a large rectal volume influences the prostate motion with a cutoff value of 70 cm{sup 3}. Therefore, the treatment of patients with a rectal volume > 70 cm{sup 3} should be re-planned with appropriate rectal preparation. Keywords: Rectal volume; Prostate cancer; Three-dimensional conformal radiotherapy. (author)

  18. Prostate volume measurement by TRUS using heights obtained by transaxial and midsagittal scaning: comparison with specimen volume following radical prostatectomy

    International Nuclear Information System (INIS)

    Park, Bung Bin; Kim, Jae Kyun; Choi, Sung Hoon; Noh, Han Na; Ji, Eun Kyung; Cho, Kyoung Sik

    2000-01-01

    The purpose of this study was to determine, when measuring prostate volume by TRUS, whether height is more accurately determined by transaxial or midsagittal scanning. Sixteen patients who between March 1995 and March 1998 underwent both preoperative TRUS and radical prostatectomy for prostate cancer were included in this study. Using prolate ellipse volume calculation (height x length x width x π/6), TRUS prostate volume was determined, and was compared with the measured volume of the specimen. Prostate volume measured by TRUS, regardless of whether height was determined transaxially or midsagittally, correlated closely with real specimen volume. When height was measured in one of these planes, a paired t test revealed no significant difference between TRUS prostate volume and real specimen volume (p = .411 and p = .740, respectively), nor were there significant differences between the findings of transaxial and midsagittal scanning (p = .570). A paired sample test, however, indicated that TRUS prostate volumes determined transaxially showed a higher correlation coefficient (0.833) and a lower standard deviation (9.04) than those determined midsagittally (0.714 and 11.48, respectively). Prostate volume measured by TRUS closely correlates with real prostate volume. Furthermore, we suggest that when measuring prostate volume in this way, height is more accurately determined by transaxial than by midsagittal scanning

  19. Strategies to evaluate the impact of rectal volume on prostate motion during three-dimensional conformal radiotherapy for prostate cancer

    Directory of Open Access Journals (Sweden)

    Ana Paula Diniz Fortuna Poli

    2016-02-01

    Full Text Available Abstract Objective: To evaluate the rectal volume influence on prostate motion during three-dimensional conformal radiotherapy (3D-CRT for prostate cancer. Materials and Methods: Fifty-one patients with prostate cancer underwent a series of three computed tomography scans including an initial planning scan and two subsequent scans during 3D-CRT. The organs of interest were outlined. The prostate contour was compared with the initial CT images considering the anterior, posterior, superior, inferior and lateral edges of the organ. Variations in the anterior limits and volume of the rectum were assessed and correlated with prostate motion in the anteroposterior direction. Results: The maximum range of prostate motion was observed in the superoinferior direction, followed by the anteroposterior direction. A significant correlation was observed between prostate motion and rectal volume variation ( p = 0.037. A baseline rectal volume superior to 70 cm3 had a significant influence on the prostate motion in the anteroposterior direction ( p = 0.045. Conclusion: The present study showed a significant interfraction motion of the prostate during 3D-CRT with greatest variations in the superoinferior and anteroposterior directions, and that a large rectal volume influences the prostate motion with a cutoff value of 70 cm3. Therefore, the treatment of patients with a rectal volume > 70 cm3 should be re-planned with appropriate rectal preparation.

  20. Relationship of age, prostate-specific antigen, and prostate volume in Indonesian men with benign prostatic hyperplasia.

    Science.gov (United States)

    Putra, Ida Bagus O W; Hamid, Agus R A H; Mochtar, Chaidir A; Umbas, Rainy

    2016-06-01

    To investigate the relationship between age, prostate specific antigen (PSA), and prostate volume (PV) in Indonesian men with histologically proven benign prostatic hyperplasia. Data were generated from our BPH database from June 1994 until December 2013. Subjects were men with a minimum age of 40 years with chief complaint of LUTS or urinary retention, diagnosed with BPH. All patients underwent TRUS-guided prostate biopsy. Patients with PSA level >10 ng/mL were excluded from the study to exclude the possibility of occult prostate cancer. PV was measured with TRUS. Appropriate statistical tests were employed for data analysis. In all, 1638 patients were enrolled in our study. There was a statistically significant difference in PSA (P = 0.03) and PV (P Prostate volume was significantly correlated with PSA. Even though the results were weaker, these results are consistent with results in other sets of population. The results vary between different countries and thus, ethnicities. Indonesia is a populous a sociocultural and ethnically diverse country. Therefore, aside from PSA, age, and PV, when investigating men with BPH, ethnicity may also need to be taken into account.

  1. Prostate specific antigen in a community-based sample of men without prostate cancer: Correlations with prostate volume, age, body mass index, and symptoms of prostatism

    NARCIS (Netherlands)

    J.L.H.R. Bosch (Ruud); W.C.J. Hop (Wim); C.H. Bangma (Chris); W.J. Kirkels (Wim); F.H. Schröder (Fritz)

    1995-01-01

    textabstractThe correlation between both prostate specific antigen levels (PSA) and prostate specific antigen density (PSAD) and age, prostate volume parameters, body mass index, and the International Prostate Symptom Score (IPSS) were studied in a community‐based population. A sample of 502 men

  2. The dependence of prostate postimplant dosimetric quality on CT volume determination

    International Nuclear Information System (INIS)

    Merrick, Gregory S.; Butler, Wayne M.; Dorsey, Anthony T.; Lief, Jonathan H.

    1999-01-01

    Purpose: The postoperative evaluation of permanent prostate brachytherapy requires a subjective determination of the implant volume. This work investigates the magnitude of the effect that various methods of treatment volume delineation have on dosimetric quality parameters for a treatment planning philosophy that defines a target volume as the prostate with a periprostatic margin. Methods and Materials: Eight consecutive prostate brachytherapy patients with a prescribed dose of 145 Gy from 125 I as monotherapy comprised the study population. The prostate ultrasound volume was enlarged to a planning volume by an average factor of 1.8 to encompass probable extracapsular extension in the periprostatic region. For this cohort, the mean pretreatment parameters were 30.3 cm 3 ultrasound volume, 51.8 cm 3 planning volume, 131 seeds per patient, and 42.9 mCi total activity. On CT study sets obtained less than 2 hours postoperatively, target volumes were drawn using three methods: prostate plus a periprostatic margin, prostate only which excluded the puborectalis muscles, the periprostatic fat and the periprostatic venous plexus, and the preplanning ultrasound magnified to conform to the magnification factor of the postimplant CT scan. Three sets of 5 dosimetric quality parameters corresponding to the different volumetric approaches were calculated: V100, V150, and V200 which are the fractions of the target volume covered by 100, 150, and 200% of the prescribed dose, and D90 and D100, which are the minimal doses covering 90 and 100% of the target volume. Results: The postoperative CT volume utilizing the prostate plus margin technique was comparable to the initial planning volume (mean 55.5 cm 3 vs. 51.8 cm 3 , respectively) whereas those determined via superimposing the preplan ultrasound resulted in volumes nearly identical to the initial ultrasound evaluation (mean 32.4 cm 3 vs. 30.3 cm 3 ). The prostate only approach resulted in volumes approximately 25% larger than

  3. Influence of volumes of prostate, rectum, and bladder on treatment planning CT on interfraction prostate shifts during ultrasound image-guided IMRT

    International Nuclear Information System (INIS)

    Reddy, Nandanuri M. S.; Nori, Dattatreyudu; Sartin, William; Maiorano, Samuel; Modena, Jennifer; Mazur, Andrej; Osian, Adrian; Sood, Brijmohan; Ravi, Akkamma; Sampath, Seshadri; Lange, Christopher S.

    2009-01-01

    Purpose: The purpose of this study was to analyze the relationship between prostate, bladder, and rectum volumes on treatment planning CT day and prostate shifts in the XYZ directions on treatment days. Methods: Prostate, seminal vesicles, bladder, and rectum were contoured on CT images obtained in supine position. Intensity modulated radiation therapy plans was prepared. Contours were exported to BAT-ultrasound imaging system. Patients were positioned on the couch using skin marks. An ultrasound probe was used to obtain ultrasound images of prostate, bladder, and rectum, which were aligned with CT images. Couch shifts in the XYZ directions as recommended by BAT system were made and recorded. 4698 couch shifts for 42 patients were analyzed to study the correlations between interfraction prostate shifts vs bladder, rectum, and prostate volumes on planning CT. Results: Mean and range of volumes (cc): Bladder: 179 (42-582), rectum: 108 (28-223), and prostate: 55 (21-154). Mean systematic prostate shifts were (cm, ±SD) right and left lateral: -0.047±0.16 (-0.361-0.251), anterior and posterior: 0.14±0.3 (-0.466-0.669), and superior and inferior: 0.19±0.26 (-0.342-0.633). Bladder volume was not correlated with lateral, anterior/posterior, and superior/inferior prostate shifts (P>0.2). Rectal volume was correlated with anterior/posterior (P 0.2). The smaller the rectal volume or cross sectional area, the larger was the prostate shift anteriorly and vice versa (P 0.2). The smaller the prostate volume, the larger was prostate shift superiorly and vice versa (P<0.05). Conclusions: Prostate and rectal volumes, but not bladder volumes, on treatment planning CT influenced prostate position on treatment fractions. Daily image-guided adoptive radiotherapy would be required for patients with distended or empty rectum on planning CT to reduce rectal toxicity in the case of empty rectum and to minimize geometric miss of prostate.

  4. Variation of clinical target volume definition in three-dimensional conformal radiation therapy for prostate cancer

    International Nuclear Information System (INIS)

    Valicenti, Richard K.; Sweet, John W.; Hauck, Walter W.; Hudes, Richard S.; Lee, Tony; Dicker, Adam P.; Waterman, Frank M.; Anne, Pramila R.; Corn, Benjamin W.; Galvin, James M.

    1999-01-01

    Purpose: Currently, three-dimensional conformal radiation therapy (3D-CRT) planning relies on the interpretation of computed tomography (CT) axial images for defining the clinical target volume (CTV). This study investigates the variation among multiple observers to define the CTV used in 3D-CRT for prostate cancer. Methods and Materials: Seven observers independently delineated the CTVs (prostate ± seminal vesicles [SV]) from the CT simulation data of 10 prostate cancer patients undergoing 3D-CRT. Six patients underwent CT simulation without the use of contrast material and serve as a control group. The other 4 had urethral and bladder opacification with contrast medium. To determine interobserver variation, we evaluated the derived volume, the maximum dimensions, and the isocenter for each examination of CTV. We assessed the reliability in the CTVs among the observers by correlating the variation for each class of measurements. This was estimated by intraclass correlation coefficient (ICC), with 1.00 defining absolute correlation. Results: For the prostate volumes, the ICC was 0.80 (95% confidence interval [CI]: 0.56-0.96). This changed to 0.92 (95% CI: 0.75-0.99) with the use of contrast material. Similarly, the maximal prostatic dimensions were reliable and improved. There was poor agreement in defining the SV. For this structure, the ICC never exceeded 0.28. The reliability of the isocenter was excellent, with the ICC exceeding 0.83 and 0.90 for the prostate ± SV, respectively. Conclusions: In 3D-CRT for prostate cancer, there was excellent agreement among multiple observers to define the prostate target volume but poor agreement to define the SV. The use of urethral and bladder contrast improved the reliability of localizing the prostate. For all CTVs, the isocenter was very reliable and should be used to compare the variation in 3D dosimetry among multiple observers

  5. Comparison of MRI pulse sequences in defining prostate volume after permanent implantation

    International Nuclear Information System (INIS)

    McLaughlin, P.W.; Narayana, V.; Drake, D.G.; Miller, B.M.; Marsh, L.; Chan, J.; Gonda, R.; Winfield, R.J.; Roberson, P.L.

    2002-01-01

    Purpose: To determine the relative value of three MRI pulse sequences in defining the prostate volume after permanent implantation. Methods and Materials: A total of 45 patients who received a permanent 125 I implant were studied. Two weeks after implantation, an axial CT scan (2 mm thickness) and T 1 -weighted, T 1 -weighted fat saturation, and T 2 -weighted axial MRI (3-mm) studies were obtained. The prostate volumes were compared with the initial ultrasound planning volumes, and subsequently the CT, T 1 -weighted, and T 1 -weighted fat saturation MRI volumes were compared with the T 2 -weighted volumes. Discrepancies in volume were evaluated by visual inspection of the registered axial images and the registration of axial volumes on the sagittal T 2 -weighted volumes. In a limited set of patients, pre- and postimplant CT and T 2 -weighted MRI studies were available for comparison to determine whether prostate volume changes after implant were dependent on the imaging modality. Results: T 1 -weighted and T 1 -weighted fat saturation MRI and CT prostate volumes were consistently larger than the T 2 -weighted MRI prostate volumes, with a volume on average 1.33 (SD 0.24) times the T 2 -weighted volume. This discrepancy was due to the superiority of T 2 -weighted MRI for prostate definition at the following critical interfaces: membranous urethra, apex, and anterior base-bladder and posterior base-seminal vesicle interfaces. The differences in prostate definition in the anterior base region suggest that the commonly reported underdose may be due to overestimation of the prostate in this region by CT. The consistent difference in volumes suggests that the degree of swelling observed after implantation is in part a function of the imaging modality. In patients with pre- and postimplant CT and T 2 -weighted MRI images, swelling on the T 2 -weighted images was 1.1 times baseline and on CT was 1.3 times baseline, confirming the imaging modality dependence of prostate

  6. The Impact of Pretreatment Prostate Volume on Severe Acute Genitourinary Toxicity in Prostate Cancer Patients Treated With Intensity-Modulated Radiation Therapy

    International Nuclear Information System (INIS)

    Aizer, Ayal A.; Anderson, Nicole S.; Oh, Steven C.; Yu, James B.; McKeon, Anne M.; Decker, Roy H.; Peschel, Richard E.

    2011-01-01

    Purpose: To assess the impact of pretreatment prostate volume on the development of severe acute genitourinary toxicity in patients undergoing intensity-modulated radiation therapy (IMRT) for prostate cancer. Methods and Materials: Between 2004 and 2007, a consecutive sample of 214 patients who underwent IMRT (75.6 Gy) for prostate cancer at two referral centers was analyzed. Prostate volumes were obtained from computed tomography scans taken during treatment simulation. Genitourinary toxicity was defined using the National Cancer Institute Common Terminology Criteria for Adverse Events Version 3.0 guidelines. Acute toxicity was defined as any toxicity originating within 90 days of the completion of radiation therapy. Patients were characterized as having a small or large prostate depending on whether their prostate volume was less than or greater than 50 cm 3 , respectively. Genitourinary toxicity was compared in these groups using the chi-square or Fisher's exact test, as appropriate. Bivariate and multivariate logistic regression analysis was performed to further assess the impact of prostate volume on severe (Grade 3) acute genitourinary toxicity. Results: Patients with large prostates (>50 cm 3 ) had a higher rate of acute Grade 3 genitourinary toxicity (p = .02). Prostate volume was predictive of the likelihood of developing acute Grade 3 genitourinary toxicity on bivariate (p = .004) and multivariate (p = .006) logistic regression. Every 27.0 cm 3 increase in prostate volume doubled the likelihood of acute Grade 3 genitourinary toxicity. Conclusions: Patients with larger prostates are at higher risk for the development of severe acute genitourinary toxicity when treated with IMRT for prostate cancer.

  7. The effect of androgen deprivation on the early changes in prostate volume following transperineal ultrasound guided interstitial therapy for localized carcinoma of the prostate

    Energy Technology Data Exchange (ETDEWEB)

    Whittington, Richard; Broderick, Gregory A; Arger, Peter; Malkowicz, S Bruce; Epperson, Robert D; Arjomandy, Bijan; Kassaee, Alireza

    1999-07-15

    Purpose: To determine the change in volume of the prostate as a result of neoadjuvant androgen deprivation prior to prostate implant and in the early postimplant period following transperineal ultrasound guided palladium-103 brachytherapy for early-stage prostate cancer. Methods and Materials: Sixty-nine men received 3 to 6 months of androgen deprivation therapy followed by treatment planning ultrasound followed 4 to 8 weeks later by palladium-103 implant of the prostate. All patients had clinical and radiographic stage T1c-T2b adenocarcinoma of the prostate. A second ultrasound study was carried out 11 to 13 days following the implant to determine the change in volume of the prostate as a result of the implant. The prehormonal and preimplant volumes were compared to the postimplant volume to determine the effect of hormones and brachytherapy on prostate volume. Results: The median decrease in prostate volume as a result of androgen deprivation was 33% among the 54 patients with prostate volume determinations prior to hormonal therapy. The reduction in volume was greatest in the quartile of men with the largest initial gland volume (59%) and least in the quartile of men with smallest glands (10%). The median reduction in prostate volume between the treatment planning ultrasound and the follow-up study after implant was 3%, but 23 (33%) patients had an increase in prostate volume, including 16 (23%) who had an increase in volume >20%; 11 of these patients (16%) had an increase in volume >30%. The time course of development and resolution of this edema is not known. The severity of the edema was not related to initial or preimplant prostate volume or duration of hormonal therapy. Conclusions: Prostate edema may significantly affect the dose delivered to the prostate following transperineal ultrasound guided brachytherapy. The effect on the actual delivered dose will be greater when shorter lived isotopes are used. It remains to be observed whether this edema will

  8. Proper Measurement of the Prostate Volume by Transrectal Ultrasound: Experimental Study about the Prostate with Focal Intravesical Protrusion of the Enlarged Central Gland

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Sung Kyoung; Kim, Hyoung Jung; Lim, Joo Won; Lee, Dong Ho; Ko, Young Tae [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    2008-06-15

    To evaluate the proper volume measurement of prostate with focal intravesical protrusion of enlarged central gland by comparison between methods using craniocaudal length from top of protruded central gland and from prostate base near bladder neck to prostate apex. We made 20 prostate models with focal intravesical protrusion (volume range: 20{approx}50 mL, height of protrusion: about 1 cm) using devil's tongue jelly. Two radiologists measured volume of models 3 times by two kinds of methods using craniocaudal length from top of protruded central gland (method 1) and from prostate base near bladder neck (method 2) by transrectal ultrasound. The accuracy of volume measurement of models was evaluated statistically by comparing their average volume to true volume. Intra- and interobserver agreement was also evaluated. Average true volume of models was 31.05 mL. Each average volume using method 1 by two observers was 37.07 mL and 38.56 mL. Each average volume using method 2 was 30.69 mL and 31.55 mL. Volume measurement using method 2 was approximated to true volume of prostate statistically (p = .654, .823). There was no significant inter- and intra-observer variation in both methods. To measure the accurate volume of prostate with focal intravesical protrusion of enlarged central gland, its craniocaudal length should be measured from prostate base near bladder neck

  9. Dosimetric impact of prostate volume change between CT-based HDR brachytherapy fractions

    International Nuclear Information System (INIS)

    Kim, Yongbok; Hsu, I-C.; Lessard, Etienne; Vujic, Jasmina; Pouliot, Jean

    2004-01-01

    Purpose: The objective is to evaluate the prostate volume change and its dosimetric consequences after the insertion of catheters for high-dose-rate brachytherapy. Methods and Materials: For 13 consecutive patients, a spiral CT scan was acquired before each of the 2 fractions, separated on average by 20 hours. The coordinates of the catheters were obtained on 3 axial CT slices corresponding to apex, mid portion, and base portion of the prostate. A mathematical expansion model was used to evaluate the change of prostate volumes between the 2 fractions. It is based on the difference in the cube of the average distance between the centroid and catheter positions. The variation of implant dose-volume histograms between fractions was computed for plans produced by either inverse planning based on simulated annealing or geometric optimization. Results: The average magnitude of either increase or reduction in prostate volume was 7.8% (range, 2-17%). This volume change corresponds to an average prostate radius change of only 2.5% (range, 0.7-5.4%). For 5 patients, the prostate volume increased on average by 9% (range, 2-17%), whereas a reduction was observed for 8 patients by an average of 7% (range, 2-13%). More variation was observed at the prostate base than at mid or apex gland. The comparison of implant dose-volume histograms showed a small reduction of V100 receiving the prescription dose, with an average of 3.5% (range, 0.5-12%) and 2.2% (range, 1-6%) for inverse planning based on our simulated annealing and geometric optimization plans, respectively. Conclusion: Small volume change was observed between treatment fractions. This translates into small changes in dose delivered to the prostate volume

  10. Prostate cancer volume adds significantly to prostate-specific antigen in the prediction of early biochemical failure after external beam radiation therapy

    International Nuclear Information System (INIS)

    D'Amico, Anthony V.; Propert, Kathleen J.

    1996-01-01

    Purpose: A new clinical pretreatment quantity that closely approximates the true prostate cancer volume is defined. Methods and Materials: The cancer-specific prostate-specific antigen (PSA), PSA density, prostate cancer volume (V Ca ), and the volume fraction of the gland involved with carcinoma (V Ca fx) were calculated for 227 prostate cancer patients managed definitively with external beam radiation therapy. 1. PSA density PSA/ultrasound prostate gland volume 2. Cancer-specific PSA = PSA - [PSA from benign epithelial tissue] 3. V Ca = Cancer-specific PSA/[PSA in serum per cm 3 of cancer] 4. V Ca fx = V Ca /ultrasound prostate gland volume A Cox multiple regression analysis was used to test whether any of these-clinical pretreatment parameters added significantly to PSA in predicting early postradiation PSA failure. Results: The prostate cancer volume (p = 0.039) and the volume fraction of the gland involved by carcinoma (p = 0.035) significantly added to the PSA in predicting postradiation PSA failure. Conversely, the PSA density and the cancer-specific PSA did not add significantly (p > 0.05) to PSA in predicting postradiation PSA failure. The 20-month actuarial PSA failure-free rates for patients with calculated tumor volumes of ≤0.5 cm 3 , 0.5-4.0 cm 3 , and >4.0 cm 3 were 92, 80, and 47%, respectively (p = 0.00004). Conclusion: The volume of prostate cancer (V Ca ) and the resulting volume fraction of cancer both added significantly to PSA in their ability to predict for early postradiation PSA failure. These new parameters may be used to select patients in prospective randomized trials that examine the efficacy of combining radiation and androgen ablative therapy in patients with clinically localized disease, who are at high risk for early postradiation PSA failure

  11. Some aspects of the relation between the volume of prostate carcinoma and its interstitial BT volume

    International Nuclear Information System (INIS)

    Zivanovic, A; Babic, J; Erak, M.; Dabic, K.; Donat, D.; Kuzmanovic, Z.; Savic, D.

    1996-01-01

    It is a fact that the volume achieved by the interstitial procedure during the brachy treatment of prostate carcinoma is several times smaller than the one we get in, so called, external beam therapy. Furthermore, interstitial brachytherapy offers the possibility to apply large dose into the small volume. However, both dose and volume are at the same time the factors that limit the therapy and the main technical offenders in case of therapy failure. We tried, through a strong individual approach, to compare the volume obtained mathematically and the volume obtained by planning (TPS). By means of clinical examinations and CT scans we conceived a prostate as half of the volume of ellipsoid under one condition only: the magnification of the prostate has to be a symmetrical one. Finally, we applied the following formula: V prostate=(1(2)) ellipsoid=2.09·a/2·e/2·b where a=(1(2)) of sagittal diameter b=prostate height (from apex to base) c=(1(2)) of transversal diameter Each volume obtained in the this way has been taken into account during the application of interstitial needles which in their own way and in accordance to a routine planning, form an active therapeutic interstitial volume. The obtained data showed differences between these two types of volumes. From the statistical point of view, mathematically obtained volume of CV was 16.6% while interstitial volume was 14.9%. T-test was 3.9. On average, mathematical volume is lower and this balance is a desirable one because it means a smaller possibility for potential positive biopsy as a result of a 'rest' tumour. If on the other hand, positive biopsy is a result of the 'rest' tumour and our interpretation has been a contradictory one, precious time with disappointing results will be lost. At the end we achieved: a) double checked control of the embraced volumes, b) stronger fulcrum for the next step: dose-fraction balance

  12. Prostate position variability and dose-volume histograms in radiotherapy for prostate cancer with full and empty bladder

    International Nuclear Information System (INIS)

    Pinkawa, Michael; Asadpour, Branka; Gagel, Bernd; Piroth, Marc D.; Holy, Richard; Eble, Michael J.

    2006-01-01

    Purpose: To evaluate prostate position variability and dose-volume histograms in prostate radiotherapy with full bladder (FB) and empty bladder (EB). Methods and Materials: Thirty patients underwent planning computed tomography scans in a supine position with FB and EB before and after 4 and 8 weeks of radiation therapy. The scans were matched by alignment of pelvic bones. Displacements of the prostate/seminal vesicle organ borders and center of mass were determined. Treatment plans (FB vs. EB) were compared. Results: Compared with the primary scan, FB volume varied more than EB volume (standard deviation, 106 cm 3 vs. 47 cm 3 ), but the prostate/seminal vesicle center of mass position variability was the same (>3 mm deviation in right-left, anterior-posterior, and superior-inferior directions in 0, 41%, and 33%, respectively, with FB vs. 0, 44%, and 33% with EB). The bladder volume treated with 90% of the prescription dose was significantly larger with EB (39% ± 14% vs. 22% ± 10%; p < 0.01). Bowel loops received ≥90% of prescription dose in 37% (3% with FB; p < 0.01). Conclusion: Despite the larger variability of bladder filling, prostate position stability was the same with FB compared with EB. An increased amount of bladder volume in the high-dose region and a higher dose to bowel loops result from treatment plans with EB

  13. Evaluation of dose-volume histograms after prostate seed implantation. 4-year experience

    International Nuclear Information System (INIS)

    Hoinkis, C.; Lehmann, D.; Winkler, C.; Herrmann, T.; Hakenberg, O.W.; Wirth, M.P.

    2004-01-01

    Background and purpose: permanent interstitial brachytherapy by seed implantation is a treatment alternative for low-volume low-risk prostate cancer and a complex interdisciplinary treatment with a learning curve. Dose-volume histograms are used to assess postimplant quality. The authors evaluated their learning curve based on dose-volume histograms and analyzed factors influencing implantation quality. Patients and methods: since 1999, 38 patients with a minimum follow-up of 6 months were treated at the authors' institution with seed implantation using palladium-103 or iodine-125, initially using the preplan method and later real-time planning. Postimplant CT was performed after 4 weeks. The dose-volume indices D90, V100, V150, the D max of pre- and postplans, and the size and position of the volume receiving the prescribed dose (high-dose volume) of the postplans were evaluated. In six patients, postplan imaging both by CT and MRI was used and prostate volumes were compared with preimplant transrectal ultrasound volumes. The first five patients were treated under external supervision. Results: patients were divided into three consecutive groups for analysis of the learning curve (group 1: n = 5 patients treated under external supervision; group 2: n = 13 patients; group 3: n = 20 patients). D90 post for the three groups were 79.3%, 74.2%, and 99.9%, the V100 post were 78.6%, 73.5%, and 88.2%, respectively. The relationship between high-dose volume and prostate volume showed a similar increase as the D90, while the relationship between high-dose volume lying outside the prostate and prostate volume remained constant. The ratio between prostate volumes from transrectal ultrasound and CT imaging decreased with increasing D90 post , while the preplanning D90 and V100 remained constant. The different isotopes used, the method of planning, and the implanted activity per prostate volume did not influence results. Conclusion: a learning curve characterized by an increase

  14. Prostate volume did not affect voiding function improvements in diode laser enucleation of the prostate.

    Science.gov (United States)

    Yang, Stephen Shei-Dei; Hsieh, Cheng-Hsing; Chiang, I-Ni; Lin, Chia-Da; Chang, Shang-Jen

    2013-03-01

    We compared safety and surgical outcomes in patients with different prostate sizes treated with diode laser enucleation of the prostate. From 2008 to 2012 consecutive patients with benign prostatic obstruction undergoing diode laser prostate enucleation at our institution were enrolled for analysis. A single surgeon performed diode laser prostate enucleation with an end firing, continuous wave diode laser (980 nm). Based on preoperative prostate volume on transrectal ultrasound, patients were stratified into 2 groups, including group 1-65 with less than 60 ml and group 2-55 with 60 ml or greater. Baseline and perioperative characteristics, and postoperative surgical outcomes were compared between the 2 groups. A total of 120 men with a mean ± SD age of 70.2 ± 9.0 years were enrolled for analysis. Compared with group 1 patients, those in group 2 had larger mean total prostate volume (85.0 ± 24.6 vs 40.9 ± 10.8 ml), longer mean operative time (117.7 ± 48.2 vs 60.7 ± 25.0 minutes), higher mean retrieved prostate weight (37.3 ± 16.1 vs 12.5 ± 7.3 gm) and a higher mean tissue retrieval ratio (74.4% ± 22.2% vs 58.8% ± 23.2%, p laser energy, voiding function improvements and surgical complication rates of diode laser prostate enucleation were comparable in patients with a larger vs smaller prostate. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  15. The relationship between prostate volume and prostate-specific antigen variability: data from the Baltimore Longitudinal Study of Aging and the Johns Hopkins Active Surveillance Program.

    Science.gov (United States)

    Nichols, John H; Loeb, Stacy; Metter, E Jeffrey; Ferrucci, Luigi; Carter, H Ballentine

    2012-05-01

    Study Type--Prognostic (cohort). Level of Evidence 2b. What's known on the subject? And what does the study add? Previous studies have attempted to characterize the normal biological variability in PSA among men without prostate cancer. These reports suggest that PSA variability is unrelated to age, but there are conflicting data on its association with the baseline PSA level. There are limited published data regarding the effects of prostate volume on PSA variability. A prior study assessing whether prostate volume changes would confound the use of PSA velocity in clinical practice reported that prostate volume changes were not significantly related to PSA changes. This study did not directly address the effect of baseline prostate volume on serial PSA variability. The objective of the current study was to further examine the relationship between prostate volume and PSA variability. Our hypothesis was that larger baseline prostate volume would be associated with increased PSA variability in men without known prostate cancer and in those with suspected small-volume disease. The results of the study suggest that baseline PSA, not prostate volume, is the primary driver of PSA variability in these populations. • To clarify the relationship between serial prostate-specific antigen (PSA) variability and prostate volume in both cancer-free participants from the Baltimore Longitudinal Study of Aging (BLSA) and patients with low-risk prostate cancer from the Johns Hopkins Active Surveillance Program (AS). • In all, 287 men from the BLSA and 131 patients from the AS were included in the analysis, all with at least two PSA measurements and concurrent prostate volume measurements. • PSA variability was calculated in ng/mL per year, and a linear mixed-effects model was used to determine the relative effects of prostate volume, baseline PSA and age on PSA change over time. • In a model with prostate volume, age and baseline PSA, there was no significant relationship

  16. National Trends in Prostate Biopsy and Radical Prostatectomy Volumes Following the US Preventive Services Task Force Guidelines Against Prostate-Specific Antigen Screening.

    Science.gov (United States)

    Halpern, Joshua A; Shoag, Jonathan E; Artis, Amanda S; Ballman, Karla V; Sedrakyan, Art; Hershman, Dawn L; Wright, Jason D; Shih, Ya Chen Tina; Hu, Jim C

    2017-02-01

    Studies demonstrate that use of prostate-specific antigen screening decreased significantly following the US Preventive Services Task Force (USPSTF) recommendation against prostate-specific antigen screening in 2012. To determine downstream effects on practice patterns in prostate cancer diagnosis and treatment following the 2012 USPSTF recommendation. Procedural volumes of certifying and recertifying urologists from 2009 through 2016 were evaluated for variation in prostate biopsy and radical prostatectomy (RP) volume. Trends were confirmed using the New York Statewide Planning and Research Cooperative System and Nationwide Inpatient Sample. The study included a representative sample of urologists across practice settings and nationally representative sample of all RP discharges. We obtained operative case logs from the American Board of Urology and identified urologists performing at least 1 prostate biopsy (n = 5173) or RP (n = 3748), respectively. The 2012 USPSTF recommendation against routine population-wide prostate-specific antigen screening. Change in median biopsy and RP volume per urologist and national procedural volume. Following the USPSTF recommendation, median biopsy volume per urologist decreased from 29 to 21 (interquartile range [IQR}, 12-34; P prostate biopsy and RP volumes decreased significantly. A panoramic vantage point is needed to evaluate the long-term consequences of the 2012 USPSTF recommendation.

  17. The longitudinal effect of ejaculation on seminal vesicle fluid volume and whole-prostate ADC as measured on prostate MRI

    Energy Technology Data Exchange (ETDEWEB)

    Barrett, Tristan; Gallagher, Ferdia A. [Addenbrooke' s Hospital and University of Cambridge, Department of Radiology, Cambridge (United Kingdom); Addenbrooke' s Hospital and University of Cambridge, CamPARI Clinic, Cambridge (United Kingdom); Tanner, James; Gill, Andrew B.; Slough, Rhys A. [Addenbrooke' s Hospital and University of Cambridge, Department of Radiology, Cambridge (United Kingdom); Wason, James [University of Cambridge, MRC Biostatistics Unit, Cambridge (United Kingdom)

    2017-12-15

    To prospectively investigate the longitudinal effect of ejaculatory abstinence on MRI-measured seminal vesicle (SV) volume and whole-prostate ADC over consecutive days. 15 healthy male volunteers (mean 35.9 years, range 27-53) underwent 3-T MRI at baseline and 1, 2 and 3 days post-ejaculation. Prostate and SV volumes were derived by volume segmentation and whole-gland apparent diffusion coefficient (ADC) values calculated. A mixed-effects linear regression compared ADC values and prostate/seminal vesicle volumes in each volunteer between studies in a pairwise manner. All subjects completed the four MRIs. Mean prostate volume was 22.45 cm{sup 3} (range 13.04-31.21 cm{sup 3}), with no change between the four studies (p = 0.89-0.99). 13/15 subjects showed SV volume reduction from baseline to day 1, with group-mean decreasing from 6.45 to 4.80 cm{sup 3} (-25.6%, p < 0.001), and a significant reduction from baseline to day 2 (-18.1%, p = 0.002). There was a significant volume increase from both day 1 (+21.3%, p = 0.006) and day 2 (+10.2%, p = 0.022) to day 3 post-ejaculation. There was a significant reduction in ADC from 1.105 at baseline to 1.056 x 10{sup -3} mm{sup 2}/s at day 1 (mean -4.3%, p = 0.009). The longitudinal effect of ejaculation on SV volume was demonstrated. Significant reductions in SV volume and whole-gland ADC were observed post-ejaculation, supporting a 3-day period of abstinence before prostate MRI. (orig.)

  18. Prostate-specific antigen cancer volume: a significant prognostic factor in prostate cancer patients at intermediate risk of failing radiotherapy

    International Nuclear Information System (INIS)

    Lankford, Scott P.; Pollack, Alan; Zagars, Gunar K.

    1997-01-01

    Purpose: Although the pretreatment serum prostate-specific antigen level (PSAL) is the single-most significant predictor of local and biochemical control in prostate cancer patients treated with radiotherapy, it is relatively insensitive for patients with a PSAL in the intermediate range (4-20 ng/ml). PSA density (PSAD) has been shown to be slightly more predictive of outcome than PSAL for this intermediate risk group; however, this improvement is small and of little use clinically. PSA cancer volume (PSACV), an estimate of cancer volume based on PSA, has recently been described and has been purported to be more significant t than PSAL in predicting early biochemical failure after radiotherapy. We report a detailed comparison between this new prognostic factor, PSAL, and PSAD. Methods and Materials: The records of 356 patients treated with definitive external beam radiotherapy for regionally localized (T1-4,Nx,M0) adenocarcinoma of the prostate were reviewed. Each patient had a PSAL, biopsy Gleason score, and pretreatment prostate volume by transrectal ultrasonography. The median PSAL was 9.3 ng/ml and 66% had Gleason scores in the 2-6 range. The median radiation dose was 66.0 Gy and the median follow-up for those living was 27 months. PSACV was calculated using a formula which takes into account PSAL, pretreatment prostate ultrasound volume, and Gleason score. The median PSACV was 1.43 cc. Biochemical failure was defined as increases in two consecutive follow-up PSA levels, one increase by a factor > 1.5, or an absolute increase of > 1 ng/ml. Local failure was defined as a cancer-positive prostate biopsy, obtained for evidence of tumor progression. Results: The distributions of PSACV and PSAL were similar and, when normalized by log transformation, were highly correlated (p < 0.0001, linear regression). There was a statistically significant relationship between PSACV and several potential prognostic factors including PSAL, PSAD, stage, Gleason score, and

  19. Value of prostate specific antigen and prostatic volume ratio (PSA/V) as the selection criterion for US-guided prostatic biopsy

    International Nuclear Information System (INIS)

    Veneziano, S.; Paulica, P.; Querze', R.; Viglietta, G.; Trenta, A.

    1991-01-01

    US-guided biopsy was performed in 94 patients with suspected lesions at transerectal US. Histology demonstrated carcinoma in 43 cases, benign hyperplasia in 44, and prostatis in 7. In all cases the prostate specific antigen (PSA) was calculated, by means of US, together with prostatic volume (v). PSA was related to the corresponding gland volume, which resulted in PSA/V ratio. Our study showed PSA/V ration to have higher sensitivity and specificity than absolulute PSA value in the diagnosis of prostatic carcinoma. The authors believe prostate US-guided biopsy to be: a) necessary when the suspected area has PSA/V ratio >0.15, and especially when PSA/V >0.30; b) not indicated when echo-structural alterations are associated with PSA/V <0.15, because they are most frequently due to benign lesions. The combined use of PSA/V ratio and US is therefore suggested to select the patients in whom biopsy is to be performed

  20. Rectal toxicity after intensity modulated radiotherapy for prostate cancer: Which rectal dose volume constraints should we use?

    International Nuclear Information System (INIS)

    Fonteyne, Valérie; Ost, Piet; Vanpachtenbeke, Frank; Colman, Roos; Sadeghi, Simin; Villeirs, Geert; Decaestecker, Karel; De Meerleer, Gert

    2014-01-01

    Background: To define rectal dose volume constraints (DVC) to prevent ⩾grade2 late rectal toxicity (LRT) after intensity modulated radiotherapy (IMRT) for prostate cancer (PC). Material and methods: Six hundred thirty-seven PC patients were treated with primary (prostate median dose: 78 Gy) or postoperative (prostatic bed median dose: 74 Gy (adjuvant)–76 Gy (salvage)) IMRT while restricting the rectal dose to 76 Gy, 72 Gy and 74 Gy respectively. The impact of patient characteristics and rectal volume parameters on ⩾grade2 LRT was determined. DVC were defined to estimate the 5% and 10% risk of developing ⩾grade2 LRT. Results: The 5-year probability of being free from ⩾grade2 LRT, non-rectal blood loss and persisting symptoms is 88.8% (95% CI: 85.8–91.1%), 93.4% (95% CI: 91.0–95.1%) and 94.3% (95% CI: 92.0–95.9%) respectively. There was no correlation with patient characteristics. All volume parameters, except rectal volume receiving ⩾70 Gy (R70), were significantly correlated with ⩾grade2 LRT. To avoid 10% and 5% risk of ⩾grade2 LRT following DVC were derived: R40, R50, R60 and R65 <64–35%, 52–22%, 38–14% and 5% respectively. Conclusion: Applying existing rectal volume constraints resulted in a 5-year estimated risk of developing late ⩾grade2 LRT of 11.2%. New rectal DVC for primary and postoperative IMRT planning of PC patients are proposed. A prospective evaluation is needed

  1. Comparison of doses according to change of bladder volume in treatment of prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Kyung Tae [Dept. of Radiologic Technology, Dongnam Health University, Suwon (Korea, Republic of); Min, Jung Whan [Dept. of Radiological Technology, Shingu University, Seongnam (Korea, Republic of)

    2017-09-15

    In the case of radiation therapy for prostate cancer, a balloon infused with a certain amount of air through the anus is used to reduce rectal dose. Because of the reason, radiation therapy for prostate cancer has acquired CBCT for daily image induction. In order to maintain the anatomical structure most similar to the first CT taken before treatment, it is pretreated, but it can not be said to be perfectly consistent. In two actual treatment regimens, the volume of the bladder was measured as 45.82 cc and 63.43 cc, and the equivalent diameter was 4.4 cm and 4.9 cm. As a result of this study, the mean volume of the bladder was estimated to be 56.2 cc, 105.6 cc by 20 CBCT. The mean dose of CBCT was 1.74% and the mean Bladder mean dose was 96.67%. In case B, PTV mean dose was 4.31%, Bladder mean Dose was estimated to be 97.35%. The changes in the volume of the bladder resulted in changes in the dose of PTV and bladder. The correlation coefficient of bladder dose according to the change of bladder volume showed linearity of mean dose R2= -0.94. The correlation coefficient of the PTV dose according to the volume change of the bladder showed linearity of mean dose R2= 0.04. It was found that the dose change of PTV was larger than that of bladder according to the change of bladder volume.

  2. Whole Prostate Volume and Shape Changes with the Use of an Inflatable and Flexible Endorectal Coil

    International Nuclear Information System (INIS)

    Osman, M.; Shebel, H.; Sankineni, S.; Bernardo, M.L.; Daar, D.; Choyke, P.L.; Turkbey, B.; Agarwal, H.K.; Osman, M.; Shebel, H.; Bernardo, M.L.; Wood, P.J.; Pinto, P.A.; Agarwal, H.K.

    2014-01-01

    To determine to what extent an inflatable endorectal coil (ERC) affects whole prostate (WP) volume and shape during prostate MRI. Materials and Methods. 79 consecutive patients underwent T2W MRI at 3T first with a 6-channel surface coil and then with the combination of a 16-channel surface coil and ERC in the same imaging session. WP volume was assessed by manually contouring the prostate in each T2W axial slice. PSA density was also calculated. The maximum anterior-posterior (AP), left-right (LR), and cranio caudal (CC) prostate dimensions were measured. Changes in WP prostate volume, PSA density, and prostate dimensions were then evaluated. Results. In 79 patients, use of an ERC yielded no significant change in whole prostate volume (0.6 ± 5.7 %, Ρ=0.270) and PSA density (-0.2 ±5.6%,Ρ=0.768 ). However, use of an ERC significantly decreased the AP dimension of the prostate by -8.6 ±7.8%(Ρ<0.001), increased LR dimension by 4.5 ± 5.8 %(Ρ<0.001), and increased the CC dimension by 8.8 ±6.9 %( Ρ<0.001). Conclusion. Use of an ERC in prostate MRI results in the shape deformation of the prostate gland with no significant change in the volume of the prostate measured on T2W MRI. Therefore, WP volumes calculated on ERC MRI can be reliably used in clinical work flow.

  3. A new model consists of intravesical prostatic protrusion, prostate volume and serum prostatic-specific antigen in the evaluation of prostate cancer.

    Science.gov (United States)

    Xu, Ding; Yu, Yongjiang; Zhu, Yunkai; Huang, Tao; Chen, Yaqing; Qi, Jun

    2014-04-01

    The Prostate-specific antigen (PSA) level is largely used to diagnose prostate cancer (PCa) in last decades. However, its specificity is low in patients with a PSA level ranging from 4.0 to 10.0 ng/ml. This study aims to define the correlation between intravesical prostatic protrusion (IPP) and PSA and to establish a new model to predict PCa. A total of 339 patients order than 45 years examined between October 2010 and June 2012 were enrolled. Eligible patients were recommended for transrectal ultrasonography (TRUS)-guided prostate biopsies after measuring total prostate volume (TPV), tranzisional zone volume (TZV) and IPP. The levels of total PSA (tPSA), free PSA (fPSA) were analyzed by using Hybritech calibrated Access tPSA and fPSA assays. A new mathematical model, named IPP removed PCa predicting score (IRPPS), consists of tPSA, TZV and IPP was established. The predictive accuracy of IRPPS, PSA density (PSAD), %PSA and tPSA were compared using receiver-operator characteristic (ROC) analysis. Eighty-six patients had PSA levels of 4.0-10.0 ng/ml. Twenty of them were diagnosed as PCa. Using ROC curves, the areas under the curve for IRPPS, PSAD and %PSA and tPSA were 0.786, 0.768 and 0.664 and 0.585, respectively. We suggested IPP grade had a significant relationship with serum tPSA levels. The predictive accuracy of IRPPS was higher than the other 3 indictors.

  4. Is the Ellipsoid Formula the New Standard for 3-Tesla MRI Prostate Volume Calculation without Endorectal Coil?

    Science.gov (United States)

    Haas, Matthias; Günzel, Karsten; Miller, Kurt; Hamm, Bernd; Cash, Hannes; Asbach, Patrick

    2017-01-01

    Prostate volume in multiparametric MRI (mpMRI) is of clinical importance. For 3-Tesla mpMRI without endorectal coil, there is no distinctive standard for volume calculation. We tested the accuracy of the ellipsoid formula with planimetric volume measurements as reference and investigated the correlation of gland volume and cancer detection rate on MRI/ultrasound (MRI/US) fusion-guided biopsy. One hundred forty-three patients with findings on 3-Tesla mpMRI suspicious of cancer and subsequent MRI/US fusion-guided targeted biopsy and additional systematic biopsy were analyzed. T2-weighted images were used for measuring the prostate diameters and for planimetric volume measurement by a segmentation software. Planimetric and calculated prostate volumes were compared with clinical data. The median prostate volume was 48.1 ml (interquartile range (IQR) 36.9-62.1 ml). Volume calculated by the ellipsoid formula showed a strong concordance with planimetric volume, with a tendency to underestimate prostate volume (median volume 43.1 ml (IQR 31.2-58.8 ml); r = 0.903, p Tesla mpMRI without endorectal coil. It allows a fast, valid volume calculation in prostate MRI datasets. © 2016 S. Karger AG, Basel.

  5. Prostate cancer: Doses and volumes of radiotherapy

    International Nuclear Information System (INIS)

    Hennequin, C.; Rivera, S.; Quero, L.; Latorzeff, I.

    2010-01-01

    Radiotherapy is nowadays a major therapeutic option in prostate cancer. Technological improvements allowed dose escalation without increasing late toxicity. Some randomized trials have shown that dose escalation decreases the biochemical failure rate, without any benefit in survival with the present follow-up. However, some studies indicate that the distant metastases rate is also decreased. Most of these studies have been done without hormonal treatment, and the role of dose escalation in case of long-term androgen deprivation is unknown. The target volume encompassed the whole gland: however, complete or partial focal treatment of the prostate can be done with sophisticated IMRT technique and must be evaluated. Proximal part of the seminal vesicles must be included in the target volumes. The role of nodal irradiation is another debate, but it could be logically proposed for the unfavourable group. (authors)

  6. Probiotics for Rectal Volume Variation During Radiation Therapy for Prostate Cancer

    International Nuclear Information System (INIS)

    Ki, Yongkan; Kim, Wontaek; Nam, Jiho; Kim, Donghyun; Lee, Juhye; Park, Dahl; Jeon, Hosang; Ha, Honggu; Kim, Taenam; Kim, Dongwon

    2013-01-01

    Purpose: To investigate the effect of the probiotic Lactobacillus acidophilus on the percentage volume change of the rectum (PVC R ), a crucial factor of prostate movement. Methods and Materials: Prostate cancer patients managed with tomotherapy as a radical treatment were enrolled in the study to take a probiotic capsule containing 1.0 × 10 8 colony-forming units of L acidophilus or a placebo capsule twice daily. Radiation therapy was performed at a dose of 78 Gy in 39 fractions. The PVC R , defined as the difference in rectal volume between the planning computed tomographic (CT) and daily megavoltage CT images, was analyzed. Results: Forty patients were randomized into 2 groups. The L acidophilus group showed significantly lower median rectal volume and median PVC R values than the placebo group. L acidophilus showed a significant reduction effect on the PVC R (P R . Conclusions: L acidophilus was useful in reducing the PVC R , which is the most important determining factor of prostate position, during radiation therapy for prostate cancer

  7. The influence of isotope and prostate volume on urinary morbidity after prostate brachytherapy

    International Nuclear Information System (INIS)

    Niehaus, Angela; Merrick, Gregory S.; Butler, Wayne M.; Wallner, Kent E.; Allen, Zachariah A.; Galbreath, Robert W.; Adamovich, Edward

    2006-01-01

    Purpose: To evaluate the influence of isotope and prostate size on International Prostate Symptom Score (IPSS) normalization, catheter dependency, and the need for surgical intervention secondary to bladder outlet obstruction after prostate brachytherapy. Methods and Materials: Between January 1998 and June 2003, 976 consecutive patients underwent brachytherapy for clinical stage T1b-T3a (2002 American Joint Committee on Cancer) prostate cancer. Seven hundred eighty-nine (80.8%) were implanted with 103 Pd and 187 (19.2%) with 125 I. The median follow-up was 41.2 months. Patients were stratified into size cohorts ≤25 cm 3 , 25.1-35 cm 3 , 35.1-45 cm 3 , and >45 cm 3 . Four hundred eighteen patients (42.8%) received androgen deprivation therapy (ADT). Four hundred eighty-six patients (49.7%) received supplemental external-beam radiation therapy (XRT). In all patients, an alpha blocker was initiated before implantation and continued at least until the IPSS returned to baseline. IPSS resolution was defined as a return to within one point of baseline. The median number of IPSS determinations per patient was 21. Clinical, treatment, and dosimetric parameters evaluated included patient age, pretreatment PSA, Gleason score, clinical T stage, percent positive biopsies, preimplant IPSS, ultrasound volume, planning volume, isotope, V 100/150/20 , D 9 , urethral dose (average and maximum), supplemental XRT, ADT, and the duration of ADT (≤6 months vs. >6 months). Catheter dependency and the need for postsurgical intervention were also evaluated. Results: For both isotopes and all prostate size cohorts, IPSS peaked 1 month after implantation and returned to baseline at a mean of 1.9 months. Stratification of prostate size cohorts by isotope demonstrated no significant differences in prolonged catheter dependency (≥5 days), IPSS resolution, or postimplant surgical intervention. In Cox regression analysis, IPSS normalization was best predicted by preimplant IPSS, XRT, and

  8. Serum prostate-specific antigen as a predictor of prostate volume in the community: the Krimpen study.

    NARCIS (Netherlands)

    Bohnen, A.M.; Groeneveld, F.P.; Bosch, J.L.H.R.

    2007-01-01

    OBJECTIVES: Serum prostate-specific antigen (PSA) is considered a proxy for prostate volume (PV). This study investigates which range of PSA values has the best utility in the determination of PV (4. Low PSA ranges (0-2 and 2.1-4.0) discriminate better for a PV of 30 cc (eg, in men with a PSA range

  9. Dosimetric Coverage of the Prostate, Normal Tissue Sparing, and Acute Toxicity with High-Dose-Rate Brachytherapy for Large Prostate Volumes

    Directory of Open Access Journals (Sweden)

    George Yang

    2015-06-01

    Full Text Available ABSTRACTPurposeTo evaluate dosimetric coverage of the prostate, normal tissue sparing, and acute toxicity with HDR brachytherapy for large prostate volumes.Materials and MethodsOne hundred and two prostate cancer patients with prostate volumes >50 mL (range: 5-29 mL were treated with high-dose-rate (HDR brachytherapy ± intensity modulated radiation therapy (IMRT to 4,500 cGy in 25 daily fractions between 2009 and 2013. HDR brachytherapy monotherapy doses consisted of two 1,350-1,400 cGy fractions separated by 2-3 weeks, and HDR brachytherapy boost doses consisted of two 950-1,150 cGy fractions separated by 4 weeks. Twelve of 32 (38% unfavorable intermediate risk, high risk, and very high risk patients received androgen deprivation therapy. Acute toxicity was graded according to the Common Terminology Criteria for Adverse Events (CTCAE version 4.ResultsMedian follow-up was 14 months. Dosimetric goals were achieved in over 90% of cases. Three of 102 (3% patients developed Grade 2 acute proctitis. No variables were significantly associated with Grade 2 acute proctitis. Seventeen of 102 (17% patients developed Grade 2 acute urinary retention. American Urological Association (AUA symptom score was the only variable significantly associated with Grade 2 acute urinary retention (p=0.04. There was no ≥ Grade 3 acute toxicity.ConclusionsDosimetric coverage of the prostate and normal tissue sparing were adequate in patients with prostate volumes >50 mL. Higher pre-treatment AUA symptom scores increased the relative risk of Grade 2 acute urinary retention. However, the overall incidence of acute toxicity was acceptable in patients with large prostate volumes.

  10. Dosimetric coverage of the prostate, normal tissue sparing, and acute toxicity with high-dose-rate brachytherapy for large prostate volumes

    Energy Technology Data Exchange (ETDEWEB)

    Yang, George; Strom, Tobin J.; Shrinath, Kushagra; Mellon, Eric A.; Fernandez, Daniel C.; Biagioli, Matthew C. [Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (United States); Wilder, Richard B., E-mail: mcbiagioli@yahoo.com [Cancer Treatment Centers of America, Newnan, GA (United States)

    2015-05-15

    Purpose: to evaluate dosimetric coverage of the prostate, normal tissue sparing, and acute toxicity with HDR brachytherapy for large prostate volumes. Materials and methods: one hundred and two prostate cancer patients with prostate volumes >50 mL (range: 5-29 mL) were treated with high-dose-rate (HDR) brachytherapy ± intensity modulated radiation therapy (IMRT) to 4,500 cGy in 25 daily fractions between 2009 and 2013. HDR brachytherapy monotherapy doses consisted of two 1,350-1,400 cGy fractions separated by 2-3 weeks, and HDR brachytherapy boost doses consisted of two 950-1,150 cGy fractions separated by 4 weeks. Twelve of 32 (38%) unfavorable intermediate risk, high risk, and very high risk patients received androgen deprivation therapy. Acute toxicity was graded according to the Common Terminology Criteria for Adverse Events (CTCAE) version 4. Results: median follow-up was 14 months. Dosimetric goals were achieved in over 90% of cases. Three of 102 (3%) patients developed Grade 2 acute proctitis. No variables were significantly associated with Grade 2 acute proctitis. Seventeen of 102 (17%) patients developed Grade 2 acute urinary retention. American Urological Association (AUA) symptom score was the only variable significantly associated with Grade 2 acute urinary retention (p-0.04). There was no ≥ Grade 3 acute toxicity. Conclusions: dosimetric coverage of the prostate and normal tissue sparing were adequate in patients with prostate volumes >50 mL. Higher pre-treatment AUA symptom scores increased the relative risk of Grade 2 acute urinary retention. However, the overall incidence of acute toxicity was acceptable in patients with large prostate volumes. (author)

  11. An interactive tool for CT volume rendering and sagittal plane-picking of the prostate for radiotherapy treatment planning

    International Nuclear Information System (INIS)

    Jani, Ashesh B.; Pelizzari, Charles A.; Chen, George T.Y.; Grzezcszuk, Robert P.; Vijayakumar, Srinivasan

    1997-01-01

    Objective: Accurate and precise target volume and critical structure definition is a basic necessity in radiotherapy. The prostate, particularly the apex (an important potential site of recurrence in prostate cancer patients), is a challenging structure to define using any modality, including conventional axial CT. Invasive or expensive techniques, such as retrograde urethrography or MRI, could be avoided if localization of the prostate were possible using information already available on the planning CT. Our primary objective was to build a software tool to determine whether volume rendering and sagittal plane-picking, which are CT-based, noninvasive visualization techniques, were of utility in radiotherapy treatment planning for the prostate. Methods: Using AVS (Application Visualization System) on a Silicon Graphics Indigo 2 High Impact workstation, we have developed a tool that enables the clinician to efficiently navigate a CT volume and to use volume rendering and sagittal plane-picking to better define structures at any anatomic site. We applied the tool to the specific example of the prostate to compare the two visualization techniques with the current standard of axial CT. The prostate was defined on 80-slice CT scans (scanning thickness 4mm, pixel size 2mm x 2mm) of prostate cancer patients using axial CT images, volume-rendered CT images, and sagittal plane-picked images. Results: The navigation of the prostate using the different visualization techniques qualitatively demonstrated that the sagittal plane-picked images, and even more so the volume-rendered images, revealed the prostate (particularly the lower border) better in relationship to the surrounding regional anatomy (bladder, rectum, pelvis, and penile structures) than did the axial images. A quantitative comparison of the target volumes obtained by navigating using the different visualization techniques demonstrated that, when compared to the prostate volume defined on axial CT, a larger volume

  12. Prostate and seminal vesicle volume based consideration of prostate cancer patients for treatment with 3D-conformal or intensity-modulated radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Reddy, Nandanuri M. S.; Nori, Dattatreyudu; Chang, Hyesook; Lange, Christopher S.; Ravi, Akkamma [Department of Radiation Oncology, New York Hospital Queens, Flushing, New York 11355 (United States); Department of Radiation Oncology, State University of New York Downstate Medical Center, Brooklyn, New York 11203 (United States); Department of Radiation Oncology, New York Hospital Queens, Flushing, New York 11355 (United States)

    2010-07-15

    Purpose: The purpose of this article was to determine the suitability of the prostate and seminal vesicle volumes as factors to consider patients for treatment with image-guided 3D-conformal radiation therapy (3D-CRT) or intensity-modulated radiation therapy (IMRT), using common dosimetry parameters as comparison tools. Methods: Dosimetry of 3D and IMRT plans for 48 patients was compared. Volumes of prostate, SV, rectum, and bladder, and prescriptions were the same for both plans. For both 3D and IMRT plans, expansion margins to prostate+SV (CTV) and prostate were 0.5 cm posterior and superior and 1 cm in other dimensions to create PTV and CDPTV, respectively. Six-field 3D plans were prepared retrospectively. For 3D plans, an additional 0.5 cm margin was added to PTV and CDPTV. Prescription for both 3D and IMRT plans was the same: 45 Gy to CTV followed by a 36 Gy boost to prostate. Dosimetry parameters common to 3D and IMRT plans were used for comparison: Mean doses to prostate, CDPTV, SV, rectum, bladder, and femurs; percent volume of rectum and bladder receiving 30 (V30), 50 (V50), and 70 Gy (V70), dose to 30% of rectum and bladder, minimum and maximum point dose to CDPTV, and prescription dose covering 95% of CDPTV (D95). Results: When the data for all patients were combined, mean dose to prostate and CDPTV was higher with 3D than IMRT plans (P<0.01). Mean D95 to CDPTV was the same for 3D and IMRT plans (P>0.2). On average, among all cases, the minimum point dose was less for 3D-CRT plans and the maximum point dose was greater for 3D-CRT than for IMRT (P<0.01). Mean dose to 30% rectum with 3D and IMRT plans was comparable (P>0.1). V30 was less (P<0.01), V50 was the same (P>0.2), and V70 was more (P<0.01) for rectum with 3D than IMRT plans. Mean dose to bladder was less with 3D than IMRT plans (P<0.01). V30 for bladder with 3D plans was less than that of IMRT plans (P<0.01). V50 and V70 for 3D plans were the same for 3D and IMRT plans (P>0.2). Mean dose to femurs

  13. Probiotics for Rectal Volume Variation During Radiation Therapy for Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ki, Yongkan [Department of Radiation Oncology, Pusan National University School of Medicine, Busan (Korea, Republic of); Kim, Wontaek, E-mail: rokwt@hanmail.net [Department of Radiation Oncology, Pusan National University School of Medicine, Busan (Korea, Republic of); Nam, Jiho; Kim, Donghyun; Lee, Juhye; Park, Dahl; Jeon, Hosang [Department of Radiation Oncology, Pusan National University School of Medicine, Busan (Korea, Republic of); Ha, Honggu; Kim, Taenam [Department of Urology, Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan (Korea, Republic of); Kim, Dongwon [Department of Radiation Oncology, Pusan National University School of Medicine, Busan (Korea, Republic of)

    2013-11-15

    Purpose: To investigate the effect of the probiotic Lactobacillus acidophilus on the percentage volume change of the rectum (PVC{sub R}), a crucial factor of prostate movement. Methods and Materials: Prostate cancer patients managed with tomotherapy as a radical treatment were enrolled in the study to take a probiotic capsule containing 1.0 × 10{sup 8} colony-forming units of L acidophilus or a placebo capsule twice daily. Radiation therapy was performed at a dose of 78 Gy in 39 fractions. The PVC{sub R}, defined as the difference in rectal volume between the planning computed tomographic (CT) and daily megavoltage CT images, was analyzed. Results: Forty patients were randomized into 2 groups. The L acidophilus group showed significantly lower median rectal volume and median PVC{sub R} values than the placebo group. L acidophilus showed a significant reduction effect on the PVC{sub R} (P<.001). However, the radiation therapy fraction number did not significantly influence the PVC{sub R}. Conclusions: L acidophilus was useful in reducing the PVC{sub R}, which is the most important determining factor of prostate position, during radiation therapy for prostate cancer.

  14. Ratio of prostate specific antigen to the outer gland volume of prostrate as a predictor for prostate cancer.

    Science.gov (United States)

    Zhang, Hai-Min; Yan, Yang; Wang, Fang; Gu, Wen-Yu; Hu, Guang-Hui; Zheng, Jun-Hua

    2014-01-01

    As a definite diagnosis of prostate cancer, puncture biopsy of the prostate is invasive method. The aim of this study was to evaluate the value of OPSAD (the ratio of PSA to the outer gland volume of prostate) as a non-invasive screening and diagnosis method for prostate cancer in a select population. The diagnosis data of 490 subjects undergoing ultrasound-guided biopsy of the prostate were retrospectively analyzed. This included 133 patients with prostate cancer, and 357 patients with benign prostate hyperplasia (BPH). The OPSAD was significantly greater in patients with prostate cancer (1.87 ± 1.26 ng/ml(2)) than those with BPH (0.44 ± 0.21 ng/ml(2)) (P prostate cancer. In the different groups divided according to the Gleason score of prostate cancer, OPSAD is elevated with the rise of the Gleason score. OPSAD may be used as a new indicator for the diagnosis and prognosis of prostate cancer, and it can reduce the use of unnecessary puncture biopsy of the prostate.

  15. Combined sabal and urtica extract compared with finasteride in men with benign prostatic hyperplasia: analysis of prostate volume and therapeutic outcome.

    Science.gov (United States)

    Sökeland, J

    2000-09-01

    To test the hypothesis that in patients with benign prostatic hyperplasia (BPH), the outcome of drug therapy with finasteride may be predictable from the baseline prostate volume and that positive clinical effects might be expected only in patients with prostate volumes of > 40 mL, using a subgroup analysis of results from a previously reported clinical trial of finasteride and phytotherapy. A subgroup of 431 patients was analysed from a randomized, multicentre, double-blind clinical trial involving 543 patients with the early stages of BPH. Patients received a fixed combination of extracts of saw palmetto fruit (Serenoa repens) and nettle root (Urtica dioica) (PRO 160/120) or the synthetic 5alpha-reductase inhibitor finasteride. The patients assessed had valid ultrasonographic measurements and baseline prostate volumes of either 40 mL. All 516 patients were included in the safety analysis. The results of the original trial showed equivalent efficacy for both treatments. The mean (SD) maximum urinary flow (the main outcome variable) increased (from baseline values) after 24 weeks by 1.9 (5.6) mL/s with PRO 160/120 and by 2.4 (6.3) mL/s with finasteride. There were no statistically significant group differences (P = 0.52). The subgroups with small prostates ( 40 mL were similar, at 2.3 (6.1) and 2. 2 (5.3) mL/s, respectively. There were improvements in the International Prostate Symptom Score in both treatment groups, with no statistically significant differences. The subgroup analysis showed slightly better results for voiding symptoms in the patients with prostates of > 40 mL, but there were also improvements in the subgroup with smaller prostates. The safety analysis showed that more patients in the finasteride group reported adverse events and also there were more adverse events in this group than in patients treated with PRO 160/120. The present analysis showed that the efficacy of both PRO 160/120 and finasteride was equivalent and unrelated to prostate volume

  16. Genetic Determinants of Metabolism and Benign Prostate Enlargement: Associations with Prostate Volume.

    Directory of Open Access Journals (Sweden)

    Ayush Giri

    Full Text Available Prostate enlargement leading to clinical benign prostatic hyperplasia (BPH is associated with metabolic dysregulation and obesity. The genetic basis of this association is unclear. Our objective was to evaluate whether single nucleotide polymorphisms (SNPs previously associated with metabolic disorders are also associated with prostate volume (PV. Participants included 876 men referred for prostate biopsy and found to be prostate cancer free. PV was measured by transrectal ultrasound. Samples were genotyped using the Illumina Cardio-MetaboChip platform. Multivariable adjusted linear regression models were used to evaluate SNPs (additive coding in relation to natural-log transformed (log PV. We compared SNP-PV results from biopsy-negative men to 442 men with low-grade prostate cancer with similar levels of obesity and PV. Beta-coefficients from the discovery and replication samples were then aggregated with fixed effects inverse variance weighted meta-analysis. SNP rs11736129 (near the pseudo-gene LOC100131429 was significantly associated with log-PV (beta: 0.16, p-value 1.16x10(-8 after adjusting for multiple testing. Other noteworthy SNPs that were nominally associated (p-value < 1x10(-4 with log-PV included rs9583484 (intronic SNP in COL4A2, rs10146527 (intronic SNP in NRXN3, rs9909466 (SNP near RPL32P31, and rs2241606 (synonymous SNP in SLC12A7. We found several SNPs in metabolic loci associated with PV. Further studies are needed to confirm our results and elucidate the mechanism between these genetic loci, PV, and clinical BPH.

  17. Prostate cancer mortality in screen and clinically detected prostate cancer : Estimating the screening benefit

    NARCIS (Netherlands)

    van Leeuwen, Pim J.; Connolly, David; Gavin, Anna; Roobol, Monique J.; Black, Amanda; Bangma, Chris H.; Schroder, Fritz H.

    Background: To estimate the benefits of prostate-specific antigen (PSA) screening on prostate cancer (Pca) metastasis and Pca-specific mortality, we compared two populations with a well-defined difference in intensity of screening. Methods: Between 1997 and 1999, a total of 11,970 men, aged 55-74

  18. Prostate and seminal vesicle volume based consideration of prostate cancer patients for treatment with 3D-conformal or intensity-modulated radiation therapy

    International Nuclear Information System (INIS)

    Reddy, Nandanuri M. S.; Nori, Dattatreyudu; Chang, Hyesook; Lange, Christopher S.; Ravi, Akkamma

    2010-01-01

    Purpose: The purpose of this article was to determine the suitability of the prostate and seminal vesicle volumes as factors to consider patients for treatment with image-guided 3D-conformal radiation therapy (3D-CRT) or intensity-modulated radiation therapy (IMRT), using common dosimetry parameters as comparison tools. Methods: Dosimetry of 3D and IMRT plans for 48 patients was compared. Volumes of prostate, SV, rectum, and bladder, and prescriptions were the same for both plans. For both 3D and IMRT plans, expansion margins to prostate+SV (CTV) and prostate were 0.5 cm posterior and superior and 1 cm in other dimensions to create PTV and CDPTV, respectively. Six-field 3D plans were prepared retrospectively. For 3D plans, an additional 0.5 cm margin was added to PTV and CDPTV. Prescription for both 3D and IMRT plans was the same: 45 Gy to CTV followed by a 36 Gy boost to prostate. Dosimetry parameters common to 3D and IMRT plans were used for comparison: Mean doses to prostate, CDPTV, SV, rectum, bladder, and femurs; percent volume of rectum and bladder receiving 30 (V30), 50 (V50), and 70 Gy (V70), dose to 30% of rectum and bladder, minimum and maximum point dose to CDPTV, and prescription dose covering 95% of CDPTV (D95). Results: When the data for all patients were combined, mean dose to prostate and CDPTV was higher with 3D than IMRT plans (P 0.2). On average, among all cases, the minimum point dose was less for 3D-CRT plans and the maximum point dose was greater for 3D-CRT than for IMRT (P 0.1). V30 was less (P 0.2), and V70 was more (P 0.2). Mean dose to femurs was more with 3D than IMRT plans (P 3 (39/48), respectively (P 3 , respectively, would be suitable for 3D-CRT. Patients with prostate and prostate+SV volumes >65 and 85 cm 3 , respectively, might get benefit from IMRT.

  19. Evaluation of the effect of prostate volume change on tumor control probability in LDR brachytherapy.

    Science.gov (United States)

    Knaup, Courtney; Mavroidis, Panayiotis; Stathakis, Sotirios; Smith, Mark; Swanson, Gregory; Papanikolaou, Niko

    2011-09-01

    This study evaluates low dose-rate brachytherapy (LDR) prostate plans to determine the biological effect of dose degradation due to prostate volume changes. In this study, 39 patients were evaluated. Pre-implant prostate volume was determined using ultrasound. These images were used with the treatment planning system (Nucletron Spot Pro 3.1(®)) to create treatment plans using (103)Pd seeds. Following the implant, patients were imaged using CT for post-implant dosimetry. From the pre and post-implant DVHs, the biologically equivalent dose and the tumor control probability (TCP) were determined using the biologically effective uniform dose. The model used RBE = 1.75 and α/β = 2 Gy. The prostate volume changed between pre and post implant image sets ranged from -8% to 110%. TCP and the mean dose were reduced up to 21% and 56%, respectively. TCP is observed to decrease as the mean dose decreases to the prostate. The post-implant tumor dose was generally observed to decrease, compared to the planned dose. A critical uniform dose of 130 Gy was established. Below this dose, TCP begins to fall-off. It was also determined that patients with a small prostates were more likely to suffer TCP decrease. The biological effect of post operative prostate growth due to operative trauma in LDR was evaluated using the concept. The post-implant dose was lower than the planned dose due to an increase of prostate volume post-implant. A critical uniform dose of 130 Gy was determined, below which TCP begun to decline.

  20. Does prostate brachytherapy treat the seminal vesicles? A dose-volume histogram analysis of seminal vesicles in patients undergoing combined PD-103 prostate implantation and external beam irradiation

    International Nuclear Information System (INIS)

    Stock, Richard G.; Lo, Yeh-Chi; Gaildon, Mohamoud; Stone, Nelson N.

    1999-01-01

    Purpose: Combined brachytherapy of the prostate and external beam irradiation (EBRT) of the prostate and seminal vesicles (SV) is becoming a popular treatment for high-risk prostate cancer. Dose-volume histogram (DVH) analysis of the SV in patients undergoing this treatment was performed to determine the dose distribution to the SV and the adequacy of this treatment in patients with potential SV involvement. Methods and Materials: Twenty-five consecutive patients were treated with a Pd-103 implant of the prostate alone and 45 Gy of EBRT to the prostate and SV. Attempts were not made to implant the SV but seeds were routinely placed at the junction of the prostate and SV. All patients underwent CT-based post implant dosimetric analysis 1 month after implantation. As part of this analysis, DVH were generated for the prostate and total SV volume (SVT). In addition, the SV was divided into 6-mm-thick volumes identified as SV1, SV2, SV3, SV4, and SV5 starting from the junction of the prostate and SV and extending distally. DVH were also generated for these structures. Delivered dose was defined as the D90 (dose delivered to 90% of the organ on DVH). Results: The median volumes in cc of the prostate, SVT, SV1, SV2, SV3, SV4, and SV5 were 34.33, 9.75, 2.7, 3.48, 2.92, 3.18, and 1.96 respectively. The SVT contained from 0-9 seeds (median 2). There was little dose delivered to the SVT and SV volumes from the implanted prostate. The median D90 values for the prostate, SVT, SV1, SV2, SV3, SV4, and SV5 were 8615 cGy, 675 cGy, 3100 cGy, 1329 cGy, 553 cGy, 246 cGy, and 67 cGy, respectively. The dose delivered to the prostate covered small percentages of SV. The percents of SV volumes covered by the prostate D90 were 11, 35, 3.3, 0, 0, and 0 for SVT, SV1, SV2, SV3, SV4, and SV5, respectively. Conclusions: DVH analysis of the SV reveals that dose generated from an implanted prostate contributes little to the SV. Those patients at high risk for SV involvement may be under treated

  1. Prognostic role of prostate-specific antigen and prostate volume for the risk of invasive therapy in patients with benign prostatic hyperplasia initially managed with alpha(1)-blockers and watchful waiting

    NARCIS (Netherlands)

    Mochtar, C. A.; Kiemeney, L. A. L. M.; Laguna, M. P.; van Riemsdijk, M. M.; Barnett, G. S.; Debruyne, F. M. J.; de la Rosette, J. J. M. C. H.

    2005-01-01

    Objectives. To investigate the prognostic role of prostate-specific antigen (PSA) level and prostate volume (PV) for the need for benign prostatic hyperplasia (BPH)-related invasive therapy among patients initially treated with an alpha(1)-blocker or watchful waiting (WW) in real-life clinical

  2. Daily Prostate Volume and Position Monitoring Using Implanted Gold Markers and On-Board Imaging during Radiotherapy

    Directory of Open Access Journals (Sweden)

    Linda Kašaová

    2011-01-01

    Full Text Available Purpose: This study aimed to evaluate prostate volume changes and prostate motions during radiotherapy. Methods: In 2010, twenty-five patients were treated for prostate cancer by external beam radiotherapy with implanted fiducial markers. Coordinates of three gold markers on kilovoltage images were calculated daily. Volume changes in target structure were observed through changes in intermarker distances. Differences in patient position between laser-tattoo alignment and gold marker localization were evaluated. Intrafraction motion was assessed by measuring marker displacement on kilovoltage images acquired before and after fraction delivery. Results: Prostate shrinkage was observed in 60% of patients. The average shrinkage was 7% of the prostate’s initial volume. Corrections after laser-tattoo alignment remained mostly below 1 cm. The difference between marker centroid position on the actual images and the planning images was 2 ± 1 mm on average. The extension of intrafraction movements was 7.6 ± 0.2 mm on average. Conclusions: In our retrospective study, the possibility for prostate volume changes during radiotherapy was revealed. Intrafraction movements turned out to be the limiting factor in safety margin reduction.

  3. SU-E-J-135: An Investigation of Ultrasound Imaging for 3D Intra-Fraction Prostate Motion Estimation

    Energy Technology Data Exchange (ETDEWEB)

    O' Shea, T; Harris, E; Bamber, J [Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, Greater London (United Kingdom); Evans, P [Centre for Vision, Speech and Signal Processing, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford (United Kingdom)

    2014-06-01

    Purpose: This study investigates the use of a mechanically swept 3D ultrasound (US) probe to estimate intra-fraction motion of the prostate during radiation therapy using an US phantom and simulated transperineal imaging. Methods: A 3D motion platform was used to translate an US speckle phantom while simulating transperineal US imaging. Motion patterns for five representative types of prostate motion, generated from patient data previously acquired with a Calypso system, were using to move the phantom in 3D. The phantom was also implanted with fiducial markers and subsequently tracked using the CyberKnife kV x-ray system for comparison. A normalised cross correlation block matching algorithm was used to track speckle patterns in 3D and 2D US data. Motion estimation results were compared with known phantom translations. Results: Transperineal 3D US could track superior-inferior (axial) and anterior-posterior (lateral) motion to better than 0.8 mm root-mean-square error (RMSE) at a volume rate of 1.7 Hz (comparable with kV x-ray tracking RMSE). Motion estimation accuracy was poorest along the US probe's swept axis (right-left; RL; RMSE < 4.2 mm) but simple regularisation methods could be used to improve RMSE (< 2 mm). 2D US was found to be feasible for slowly varying motion (RMSE < 0.5 mm). 3D US could also allow accurate radiation beam gating with displacement thresholds of 2 mm and 5 mm exhibiting a RMSE of less than 0.5 mm. Conclusion: 2D and 3D US speckle tracking is feasible for prostate motion estimation during radiation delivery. Since RL prostate motion is small in magnitude and frequency, 2D or a hybrid (2D/3D) US imaging approach which also accounts for potential prostate rotations could be used. Regularisation methods could be used to ensure the accuracy of tracking data, making US a feasible approach for gating or tracking in standard or hypo-fractionated prostate treatments.

  4. Evaluation of the effect of prostate volume change on tumor control probability in LDR brachytherapy

    Directory of Open Access Journals (Sweden)

    Courtney Knaup

    2011-09-01

    Full Text Available Purpose: This study evaluates low dose-rate brachytherapy (LDR prostate plans to determine the biological effectof dose degradation due to prostate volume changes. Material and methods: In this study, 39 patients were evaluated. Pre-implant prostate volume was determinedusing ultrasound. These images were used with the treatment planning system (Nucletron Spot Pro 3.1® to create treatmentplans using 103Pd seeds. Following the implant, patients were imaged using CT for post-implant dosimetry. Fromthe pre and post-implant DVHs, the biologically equivalent dose and the tumor control probability (TCP were determinedusing the biologically effective uniform dose. The model used RBE = 1.75 and α/β = 2 Gy. Results: The prostate volume changed between pre and post implant image sets ranged from –8% to 110%. TCP andthe mean dose were reduced up to 21% and 56%, respectively. TCP is observed to decrease as the mean dose decreasesto the prostate. The post-implant tumor dose was generally observed to decrease, compared to the planned dose.A critical uniform dose of 130 Gy was established. Below this dose, TCP begins to fall-off. It was also determined thatpatients with a small prostates were more likely to suffer TCP decrease. Conclusions: The biological effect of post operative prostate growth due to operative trauma in LDR was evaluatedusing the concept. The post-implant dose was lower than the planned dose due to an increase of prostate volumepost-implant. A critical uniform dose of 130 Gy was determined, below which TCP begun to decline.

  5. Age and total and free prostate-specific antigen levels for predicting prostate volume in patients with benign prostatic hyperplasia.

    Science.gov (United States)

    Coban, Soner; Doluoglu, Omer Gokhan; Keles, Ibrahim; Demirci, Hakan; Turkoglu, Ali Riza; Guzelsoy, Muhammet; Karalar, Mustafa; Demirbas, Murat

    2016-06-01

    To investigate the predictive values of free prostate-specific antigen (fPSA), total PSA (tPSA) and age on the prostate volume. The data of 2148 patients with lower urinary tract symptoms were analyzed retrospectively. The patients who had transrectal ultrasonography guided 10 core biopsies owing to the findings obtained on digital rectal examination and presence of high PSA levels (PSA = 2.5-10 ng/dl), and proven to have BPH histopathologically were included in the study. Age, tPSA, fPSA and the prostate volumes (PV) of the patients were noted. One thousand patients that fulfilled the inclusion criteria were included in the study. The PV of the patients were significantly correlated with age, tPSA and fPSA (p < 0.001 and r = 0.307, p < 0.001 and r = 0.382, p < 0.001 and r = 0.296, respectively). On linear regression model, fPSA was found as a stronger predictive for PV (AUC = 0.75, p < 0.001) when compared to age (AUC = 0.64, p < 0.001), and tPSA (AUC = 0.69, p = 0.013). Although tPSA is an important prognostic factor for predicting PV, the predictive value of fPSA is higher. PV can easily be predicted by using age, and serum tPSA and fPSA levels.

  6. Testosterone and dihydrotestosterone levels in the transition zone correlate with prostate volume.

    Science.gov (United States)

    Pejčić, Tomislav; Tosti, Tomislav; Tešić, Živoslav; Milković, Borivoj; Dragičević, Dejan; Kozomara, Milutin; Čekerevac, Milica; Džamić, Zoran

    2017-07-01

    There is still no consensus regarding intraprostatic androgen levels and the accumulation of androgens in the hyperplastic prostatic tissue. The current opinion is that intraprostatic dihydrotestosterone (DHT) concentrations are maintained but not elevated in benign prostatic hyperplasia (BPH), while there is no similar data concerning intraprostatic testosterone (T). Tissue T (tT) and tissue DHT (tDHT) concentration were determined in 93 patients scheduled for initial prostate biopsy. The criteria for biopsy were abnormal DRE and/or PSA > 4 ng/mL. Total prostate volume (TPV) was determined by transrectal ultrasound (TRUS). During TRUS- guided prostate biopsy, 10-12 samples were collected from the peripheral zone (PZ) and two additional samples were collected from the transition zone (TZ). The samples from the TZ were immediately frozen in liquid nitrogen at -70°C, and transported for tissue androgen determination, using liquid chromatography mass spectrometry (LC-MS). Pathological analysis revealed that prostate cancer (PCa) was present in 45 and absent in 48 patients. In the whole group, there were 42 men with small prostate (TPV prostate (TPV ≥ 31 mL). The overall average tT level was 0.79 ± 0.66 ng/g, while the average tDHT level was 10.27 ± 7.15 ng/g. There were no differences in tT and tDHT level in prostates with and without PCa. However, tT and tDHT levels were significantly higher in larger, than in smaller prostates (tT: 1.05 ± 0.75 and 0.46 ± 0.29 ng/g, and tDHT: 15.0 ± 6.09 and 4.51 ± 2.75 ng/g, respectively). There were strong correlations between tT and TPV (r = 0.71), and tDHT and TPV (r = 0.74). The present study confirmed that both T and DHT accumulated in the stroma of enlarged prostates; the degree of accumulation correlated with prostate volume. © 2017 Wiley Periodicals, Inc.

  7. Prognostic Factors for Hormone Sensitive Metastatic Prostate Cancer: Impact of Disease Volume

    Science.gov (United States)

    Alhanafy, Alshimaa Mahmoud; Zanaty, Fouad; Ibrahem, Reda; Omar, Suzan

    2018-04-27

    Background and Aim: The optimal management of metastatic hormone-sensitive prostate cancer has been controversial in recent years with introduction of upfront chemohormonal treatment based on results of several Western studies. This changing landscape has renewed interest in the concept “disease volume”, the focus of the present study is the Egyptian patients. Methods: Patients with hormone sensitive metastatic prostate cancer presenting at Menoufia University Hospital, Egypt, during the period from June 2013 to May 2016, were enrolled. All received hormonal treatment. Radiologic images were evaluated and patients were stratified according to their disease volume into high or low, other clinical and pathological data that could affect survival also being collected and analyzed. Results: A total of 128 patients were included, with a median age of 70 years (53.9% ≥70). About 46% had co-morbidities, 62% having high volume disease. During the median follow up period of 28 months about half of the patients progressed and one third received chemotherapy. On univariate analysis, disease volume, performance status (PS), prostate specific antigen level (PSA) and presence of pain at presentation were identified as factors influencing overall survival. Multivariate analysis revealed the independent predictor factors for survival to be PS, PSA and disease volume. The median overall survival with 27 months was high volume versus 49 with low volume disease (hazard ratio 2.1; 95% CI 1.2 - 4.4; P=0.02). Median progression free survival was 19 months in the high volume, as compared with 48 months in the low volume disease patients (hazard ratio, 2.44; 95% CI, 1.42 – 7.4; P=0.009). Conclusions: Disease volume is a reliable predictor of survival which should be incorporated with other important factors as; patient performance status and comorbidities in treatment decision-making. Creative Commons Attribution License

  8. Value of prostate specific antigen and prostatic volume ratio (PSA/V) as the selection criterion for US-guided prostatic biopsy. Importanza del rapporto tra antigene prostatico specifico e volume prostatico nella selezione dei pazienti da sottoporre a biopsia ecoguidata della prostata

    Energy Technology Data Exchange (ETDEWEB)

    Veneziano, S; Paulica, P; Querze' , R; Viglietta, G; Trenta, A [Ospedale Melpighi, Bologna (Italy). Serv. di Radiologia

    1991-01-01

    US-guided biopsy was performed in 94 patients with suspected lesions at transerectal US. Histology demonstrated carcinoma in 43 cases, benign hyperplasia in 44, and prostatis in 7. In all cases the prostate specific antigen (PSA) was calculated, by means of US, together with prostatic volume (v). PSA was related to the corresponding gland volume, which resulted in PSA/V ratio. Our study showed PSA/V ration to have higher sensitivity and specificity than absolulute PSA value in the diagnosis of prostatic carcinoma. The authors believe prostate US-guided biopsy to be: a) necessary when the suspected area has PSA/V ratio >0.15, and especially when PSA/V >0.30; b) not indicated when echo-structural alterations are associated with PSA/V <0.15, because they are most frequently due to benign lesions. The combined use of PSA/V ratio and US is therefore suggested to select the patients in whom biopsy is to be performed. 20 refs.

  9. Changes in Treatment Volume of Hormonally Treated and Untreated Cancerous Prostate and its Impact on Rectal Dose

    International Nuclear Information System (INIS)

    Lilleby, Wolfgang; Dale, Einar; Olsen, Dag R.; Gude, Unn; Fossaa, Sophie D.

    2003-01-01

    Late chronic side effects of the rectum constitute one of the principal limiting factors for curative radiation therapy in patients with prostate cancer. The purpose of the study was to determine the impact of immediate androgen deprivation (IAD) prior to conformal radiotherapy on rectal volume exposed to high doses, as compared with a deferred treatment strategy (DAD). Twenty-five patients (13 in the IAD group and 12 in the DAD group) with bulky tumours of the prostate, T3pN1-2M0 from the prospective EORTC trial 30846 were analysed. Three-dimensional conformal radiation treatment plans (3D CRT) using a 4-field box technique were generated based on the digitized computed tomographic or magnetic resonance findings acquired during the first 9 months after inclusion in the EORTC trial. Dose-volume histograms (DVHs) were calculated for the prostate and rectum. In the DAD group, there was no obvious alteration in the mean size of the prostate or other evaluated structures. In the IAD patients, a statistically significant reduction of approximately 40% of the gross tumour volume (GTV) was reached after a 6 months' course of hormonal treatment (p<0.001). High-dose rectal volume was correlated with the volume changes of the GTV (p<0.001). Mean rectal volume receiving 95% or more of the target dose was significantly reduced by 20%. Our study confirms the effect of downsizing of locally advanced prostate tumours following AD treatment and demonstrates the interdependence of the high-dose rectal volume with the volume changes of the GTV. However, the mean beneficial sparing of rectal volume was outweighed in some patients by considerable inter-patient variations

  10. Prostate cancer

    International Nuclear Information System (INIS)

    Bey, P.; Beckendorf, V.; Stines, J.

    2001-01-01

    Radiation therapy of prostate carcinoma with a curative intent implies to treat the whole prostate at high dose (at least 66 Gy). According to clinical stage, PSA level, Gleason's score, the clinical target volume may include seminal vesicles and less often pelvic lymph nodes. Microscopic extra-capsular extension is found in 15 to 60% of T1-T2 operated on, specially in apex tumors. On contrary, cancers developing from the transitional zone may stay limited to the prostate even with a big volume and with a high PSA level. Zonal anatomy of the prostate identifies internal prostate, including the transitional zone (5% of the prostate in young people). External prostate includes central and peripheral zones. The inferior limit of the prostate is not lower than the inferior border of the pubic symphysis. Clinical and radiological examination: ultrasonography, nuclear magnetic resonance (NMR), CT-scan identify prognostic factors as tumor volume, capsule effraction, seminal vesicles invasion and lymph node extension. The identification of the clinical target volume is now done mainly by CT-Scan which identifies prostate and seminal vesicles. NMR could be helpful to identify more precisely prostate apex. The definition of margins around the clinical target volume has to take in account daily reproducibility and organ motion and of course the maximum tolerable dose for organs at risk. (authors)

  11. The roles of prostate-specific antigen (PSA) density, prostate volume, and their zone-adjusted derivatives in predicting prostate cancer in patients with PSA less than 20.0 ng/mL.

    Science.gov (United States)

    Shen, P; Zhao, J; Sun, G; Chen, N; Zhang, X; Gui, H; Yang, Y; Liu, J; Shu, K; Wang, Z; Zeng, H

    2017-05-01

    The aim of this study was to develop nomograms for predicting prostate cancer and its zonal location using prostate-specific antigen density, prostate volume, and their zone-adjusted derivatives. A total of 928 consecutive patients with prostate-specific antigen (PSA) less than 20.0 ng/mL, who underwent transrectal ultrasound-guided transperineal 12-core prostate biopsy at West China Hospital between 2011 and 2014, were retrospectively enrolled. The patients were randomly split into training cohort (70%, n = 650) and validation cohort (30%, n = 278). Predicting models and the associated nomograms were built using the training cohort, while the validations of the models were conducted using the validation cohort. Univariate and multivariate logistic regression was performed. Then, new nomograms were generated based on multivariate regression coefficients. The discrimination power and calibration of these nomograms were validated using the area under the ROC curve (AUC) and the calibration curve. The potential clinical effects of these models were also tested using decision curve analysis. In total, 285 (30.7%) patients were diagnosed with prostate cancer. Among them, 131 (14.1%) and 269 (29.0%) had transition zone prostate cancer and peripheral zone prostate cancer. Each of zone-adjusted derivatives-based nomogram had an AUC more than 0.75. All nomograms had higher calibration and much better net benefit than the scenarios in predicting patients with or without different zones prostate cancer. Prostate-specific antigen density, prostate volume, and their zone-adjusted derivatives have important roles in detecting prostate cancer and its zonal location for patients with PSA 2.5-20.0 ng/mL. To the best of our knowledge, this is the first nomogram using these parameters to predict outcomes of 12-core prostate biopsy. These instruments can help clinicians to increase the accuracy of prostate cancer screening and to avoid unnecessary prostate biopsy. © 2017

  12. SU-F-T-378: Evaluation of Dose-Volume Variability and Parameters Between Prostate IMRT and VMAT Plans

    Energy Technology Data Exchange (ETDEWEB)

    Chow, J [Princess Margaret Cancer Centre, Toronto, ON (Canada); Jiang, R [Grand River Regional Cancer Centre, Kitchener, ON (Canada); Kiciak, A [University of Waterloo, Waterloo, ON (Canada)

    2016-06-15

    Purpose: This study compared the rectal dose-volume consistency, equivalent uniform dose (EUD) and normal tissue complication probability (NTCP) in prostate intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT). Methods: For forty prostate IMRT and fifty VMAT patients treated using the same dose prescription (78 Gy/39 fraction) and dose-volume criteria in inverse planning optimization, the rectal EUD and NTCP were calculated for each patient. The rectal dose-volume consistency, showing the variability of dose-volume histogram (DVH) among patients, was defined and calculated based on the deviation between the mean and corresponding rectal DVH. Results: From both the prostate IMRT and VMAT plans, the rectal EUD and NTCP were found decreasing with the rectal volume. The decrease rates for the IMRT plans (EUD = 0.47 × 10{sup −3} Gy cm{sup −3} and NTCP = 3.94 × 10{sup −2} % cm{sup −3}) were higher than those for the VMAT (EUD = 0.28 × 10{sup −3} Gy cm{sup −3} and NTCP = 2.61 × 10{sup −2} % cm{sup −3}). In addition, the dependences of the rectal EUD and NTCP on the dose-volume consistency were found very similar between the prostate IMRT and VMAT plans. This shows that both delivery techniques have similar variations of the rectal EUD and NTCP on the dose-volume consistency. Conclusion: Dependences of the dose-volume consistency on the rectal EUD and NTCP were compared between the prostate IMRT and VMAT plans. It is concluded that both rectal EUD and NTCP decreased with an increase of the rectal volume. The variation rates of the rectal EUD and NTCP on the rectal volume were higher for the IMRT plans than VMAT. However, variations of the rectal dose-volume consistency on the rectal EUD and NTCP were found not significant for both delivery techniques.

  13. Robotic Assisted Simple Prostatectomy versus Holmium Laser Enucleation of the Prostate for Lower Urinary Tract Symptoms in Patients with Large Volume Prostate: A Comparative Analysis from a High Volume Center.

    Science.gov (United States)

    Umari, Paolo; Fossati, Nicola; Gandaglia, Giorgio; Pokorny, Morgan; De Groote, Ruben; Geurts, Nicolas; Goossens, Marijn; Schatterman, Peter; De Naeyer, Geert; Mottrie, Alexandre

    2017-04-01

    We report a comparative analysis of robotic assisted simple prostatectomy vs holmium laser enucleation of the prostate in patients who had benign prostatic hyperplasia with a large volume prostate (greater than 100 ml). A total of 81 patients underwent robotic assisted simple prostatectomy and 45 underwent holmium laser enucleation of the prostate in a 7-year period. Patients were preoperatively assessed with transrectal ultrasound and uroflowmetry. Functional parameters were assessed postoperatively during followup. Perioperative outcomes included operative time, postoperative hemoglobin, catheterization time and hospitalization. Complications were reported according to the Clavien-Dindo classification. Compared to the holmium laser enucleation group, patients treated with prostatectomy were significantly younger (median age 69 vs 74 years, p = 0.032) and less healthy (Charlson comorbidity index 2 or greater in 62% vs 29%, p = 0.0003), and had a lower rate of suprapubic catheterization (23% vs 42%, p = 0.028) and a higher preoperative I-PSS (International Prostate Symptom Score) (25 vs 21, p = 0.049). Both groups showed an improvement in the maximum flow rate (15 vs 11 ml per second, p = 0.7), and a significant reduction in post-void residual urine (-73 vs -100 ml, p = 0.4) and I-PSS (-20 vs -18, p = 0.8). Median operative time (105 vs 105 minutes, p = 0.9) and postoperative hemoglobin (13.2 vs 13.8 gm/dl, p = 0.08) were similar for robotic assisted prostatectomy and holmium laser enucleation, respectively. Median catheterization time (3 vs 2 days, p = 0.005) and median hospitalization (4 vs 2 days, p = 0.0001) were slightly shorter in the holmium laser group. Complication rates were similar with no Clavien grade greater than 3 in either group. Our results from a single center suggest comparable outcomes for robotic assisted simple prostatectomy and holmium laser enucleation of the prostate in patients with a large volume prostate. These findings require

  14. Understanding PSA and its derivatives in prediction of tumor volume: Addressing health disparities in prostate cancer risk stratification.

    Science.gov (United States)

    Chinea, Felix M; Lyapichev, Kirill; Epstein, Jonathan I; Kwon, Deukwoo; Smith, Paul Taylor; Pollack, Alan; Cote, Richard J; Kryvenko, Oleksandr N

    2017-03-28

    To address health disparities in risk stratification of U.S. Hispanic/Latino men by characterizing influences of prostate weight, body mass index, and race/ethnicity on the correlation of PSA derivatives with Gleason score 6 (Grade Group 1) tumor volume in a diverse cohort. Using published PSA density and PSA mass density cutoff values, men with higher body mass indices and prostate weights were less likely to have a tumor volume PSA derivatives when predicting for tumor volume. In receiver operator characteristic analysis, area under the curve values for all PSA derivatives varied across race/ethnicity with lower optimal cutoff values for Hispanic/Latino (PSA=2.79, PSA density=0.06, PSA mass=0.37, PSA mass density=0.011) and Non-Hispanic Black (PSA=3.75, PSA density=0.07, PSA mass=0.46, PSA mass density=0.008) compared to Non-Hispanic White men (PSA=4.20, PSA density=0.11 PSA mass=0.53, PSA mass density=0.014). We retrospectively analyzed 589 patients with low-risk prostate cancer at radical prostatectomy. Pre-operative PSA, patient height, body weight, and prostate weight were used to calculate all PSA derivatives. Receiver operating characteristic curves were constructed for each PSA derivative per racial/ethnic group to establish optimal cutoff values predicting for tumor volume ≥0.5 cm3. Increasing prostate weight and body mass index negatively influence PSA derivatives for predicting tumor volume. PSA derivatives' ability to predict tumor volume varies significantly across race/ethnicity. Hispanic/Latino and Non-Hispanic Black men have lower optimal cutoff values for all PSA derivatives, which may impact risk assessment for prostate cancer.

  15. Evidence-based estimate of appropriate radiotherapy utilization rate for prostate cancer

    International Nuclear Information System (INIS)

    Foroudi, Farshad; Tyldesley, Scott; Barbera, Lisa; Huang, Jenny; Mackillop, William J.

    2003-01-01

    Purpose: Current estimates of the proportion of cancer patients who will require radiotherapy (RT) are based almost entirely on expert opinion. The objective of this study was to use an evidence-based approach to estimate the proportion of incident cases of prostate cancer that should receive RT at any point in the evolution of the illness. Methods and Materials: A systematic review of the literature was undertaken to identify indications for RT for prostate cancer and to ascertain the level of evidence that supported each indication. An epidemiologic approach was then used to estimate the incidence of each indication for RT in a typical North American population of prostate cancer patients. The effect of sampling error on the estimated appropriate rate of RT was calculated mathematically, and the effect of systematic error using alternative sources of information was estimated by sensitivity analysis. Results: It was estimated that 61.2% ±5.6% of prostate cancer cases develop one or more indications for RT at some point in the course of the illness. The plausible range for this rate was 57.3%-69.8% on sensitivity analysis. Of all prostate cancer patients, 32.2%±3.8% should receive RT in their initial treatment and 29.0% ± 4.1% later for recurrence or progression. The proportion of cases that ever require RT is risk grouping dependent; 43.9%±2.2% in low-risk disease, 68.7%± .5% in intermediate-risk disease; and 79.0% ± 3.8% in high-risk locoregional disease. For metastatic disease, the predicted rate was 66.4%±0.3%. Conclusion: This method provides a rational starting point for the long-term planning of radiation services and for the audit of access to RT at the population level. By completing such evaluations in major cancer sites, it will be possible to estimate the appropriate RT rate for the cancer population as a whole

  16. The relationship between the bladder volume and optimal treatment planning in definitive radiotherapy for localized prostate cancer

    International Nuclear Information System (INIS)

    Nakamura, Naoki; Sekiguchi, Kenji; Akahane, Keiko; Shikama, Naoto; Takahashi, Osamu; Hama, Yukihiro; Nakagawa, Keiichi

    2012-01-01

    Background and purpose: There is no current consensus regarding the optimal bladder volumes in definitive radiotherapy for localized prostate cancer. The aim of this study was to clarify the relationship between the bladder volume and optimal treatment planning in radiotherapy for localized prostate cancer. Material and methods: Two hundred and forty-three patients underwent definitive radiotherapy with helical tomotherapy for intermediate- and high-risk localized prostate cancer. The prescribed dose defined as 95 % of the planning target volume (PTV) receiving 100 % of the prescription dose was 76 Gy in 38 fractions. The clinical target volume (CTV) was defined as the prostate with a 5-mm margin and 2 cm of the proximal seminal vesicle. The PTV was defined as the CTV with a 5-mm margin. Treatment plans were optimized to satisfy the dose constraints defined by in-house protocols for PTV and organs at risk (rectum wall, bladder wall, sigmoid colon and small intestine). If all dose constraints were satisfied, the plan was defined as an optimal plan (OP). Results: An OP was achieved with 203 patients (84%). Mean bladder volume (± 1 SD) was 266 ml (± 130 ml) among those with an OP and 214 ml (±130 ml) among those without an OP (p = 0.02). Logistic regression analysis also showed that bladder volumes below 150 ml decreased the possibility of achieving an OP. However, the percentage of patients with an OP showed a plateau effect at bladder volumes above 150 ml. Conclusions. Bladder volume is a significant factor affecting OP rates. However, our results suggest that bladder volumes exceeding 150 ml may not help meet planning dose constraints

  17. Sequential evaluation of prostate edema after permanent seed prostate brachytherapy using CT-MRI fusion

    International Nuclear Information System (INIS)

    Taussky, Daniel; Austen, Lyn; Toi, Ants; Yeung, Ivan; Williams, Theresa; Pearson, Shannon; McLean, Michael; Pond, Gregory; Crook, Juanita

    2005-01-01

    Purpose: To analyze the extent and time course of prostate edema and its effect on dosimetry after permanent seed prostate brachytherapy. Methods and Materials: Twenty patients scheduled for permanent seed 125 I prostate brachytherapy agreed to a prospective study on postimplant edema. Implants were preplanned using transrectal ultrasonography. Postimplant dosimetry was calculated using computed tomography-magnetic resonance imaging (CT-MRI) fusion on the day of the implant (Day 1) and Days 8 and 30. The prostate was contoured on MRI, and the seeds were located on CT. Factors investigated for an influence on edema were the number of seeds and needles, preimplant prostate volume, transitional zone index (transition zone volume divided by prostate volume), age, and prostate-specific antigen level. Prostate dosimetry was evaluated by the percentage of the prostate volume receiving 100% of the prescribed dose (V 100 ) and percentage of prescribed dose received by 90% of the prostate volume (D 90 ). Results: Prostate edema was maximal on Day 1, with the median prostate volume 31% greater than preimplant transrectal ultrasound volume (range, 0.93-1.72; p 100 on Day 1 was 93.6% (range, 86.0-98.2%) and was 96.3% (range, 85.7-99.5%) on Day 30 (p = 0.079). Patients with a Day 1 V 100 >93% were less affected by edema resolution, showing a median increase in V 100 of 0.67% on Day 30 compared with 2.77% for patients with a V 100 100 >93%)

  18. Original article The Relationship Between Prostate Volume, Prostate ...

    African Journals Online (AJOL)

    mn

    ), prostate specific antigen. (PSA) and age in a cohort of Saudi men from the Urology Department, King Abdul Aziz University. Hospital, Jeddah, Saudi Arabia. Methods: Medical records of 447 Saudi men aged 20-89 years with benign prostatic ...

  19. 3D prostate TRUS segmentation using globally optimized volume-preserving prior.

    Science.gov (United States)

    Qiu, Wu; Rajchl, Martin; Guo, Fumin; Sun, Yue; Ukwatta, Eranga; Fenster, Aaron; Yuan, Jing

    2014-01-01

    An efficient and accurate segmentation of 3D transrectal ultrasound (TRUS) images plays an important role in the planning and treatment of the practical 3D TRUS guided prostate biopsy. However, a meaningful segmentation of 3D TRUS images tends to suffer from US speckles, shadowing and missing edges etc, which make it a challenging task to delineate the correct prostate boundaries. In this paper, we propose a novel convex optimization based approach to extracting the prostate surface from the given 3D TRUS image, while preserving a new global volume-size prior. We, especially, study the proposed combinatorial optimization problem by convex relaxation and introduce its dual continuous max-flow formulation with the new bounded flow conservation constraint, which results in an efficient numerical solver implemented on GPUs. Experimental results using 12 patient 3D TRUS images show that the proposed approach while preserving the volume-size prior yielded a mean DSC of 89.5% +/- 2.4%, a MAD of 1.4 +/- 0.6 mm, a MAXD of 5.2 +/- 3.2 mm, and a VD of 7.5% +/- 6.2% in - 1 minute, deomonstrating the advantages of both accuracy and efficiency. In addition, the low standard deviation of the segmentation accuracy shows a good reliability of the proposed approach.

  20. The Effect of Pro-Qura Case Volume on Post-Implant Prostate Dosimetry

    International Nuclear Information System (INIS)

    Merrick, Gregory S.; Lief, Jonathan H.; Grimm, Peter; Sylvester, John; Butler, Wayne M.; Allen, Zachariah A.

    2011-01-01

    Purpose: To evaluate the effect of prostate brachytherapy case volume on postimplant dosimetric quality in Pro-Qura proctored programs. Methods and Materials: From August 1999 to December 2008, the computed tomography datasets for 6,600 prostate implants performed by 129 brachytherapists were submitted to Pro-Qura for dosimetric analysis. Brachytherapists were divided into three roughly equal-sized terciles based on total case volume. Postimplant computed tomography scans were obtained at a median of 30 days. Excellent target coverage was defined by a V100 ≥90% and D90 ≥100% minimum prescribed peripheral dose. To determine if the number of excellent implants improved with increasing case numbers, each brachytherapist’s series of implants was bisected into early and late experience by a moveable critical point. Results: For the entire cohort, the mean V100 and D90 were 89.2% and 102.8%, respectively, with 47.7% of the implants scored as excellent. Brachytherapists in the highest-case tercile had a significantly greater fraction of excellent target coverage (57.9%) than did those in the two lower terciles (39.5% and 45.7%, p = 0.015). Twenty-one (25.6%) of the 82 brachytherapists with sufficient case volume for dosimetric improvement analyses demonstrated quality improvement over time. Although there was no significant difference between prostate volume and seed strength, the number of seeds used was significantly greater in adequate implants. Conclusions: The highest-volume brachytherapists were most likely to obtain excellent target coverage. We are encouraged that in general practice, nearly 48% of all implants were scored excellent. It is conceivable that with greater expert third-party involvement, an even greater percentage of cases with excellent target coverage will become reality.

  1. The Effect of Pro-Qura Case Volume on Post-Implant Prostate Dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Merrick, Gregory S., E-mail: gmerrick@urologicresearchinstitute.org [Schiffler Cancer Center Wheeling Jesuit University, Wheeling, WV (United States); Lief, Jonathan H. [Schiffler Cancer Center Wheeling Jesuit University, Wheeling, WV (United States); Grimm, Peter [Prostate Cancer Treatment Center, Seattle, WA (United States); Sylvester, John [Lakewood Ranch Oncology, Bradenton, FL (United States); Butler, Wayne M.; Allen, Zachariah A. [Schiffler Cancer Center Wheeling Jesuit University, Wheeling, WV (United States)

    2011-12-01

    Purpose: To evaluate the effect of prostate brachytherapy case volume on postimplant dosimetric quality in Pro-Qura proctored programs. Methods and Materials: From August 1999 to December 2008, the computed tomography datasets for 6,600 prostate implants performed by 129 brachytherapists were submitted to Pro-Qura for dosimetric analysis. Brachytherapists were divided into three roughly equal-sized terciles based on total case volume. Postimplant computed tomography scans were obtained at a median of 30 days. Excellent target coverage was defined by a V100 {>=}90% and D90 {>=}100% minimum prescribed peripheral dose. To determine if the number of excellent implants improved with increasing case numbers, each brachytherapist's series of implants was bisected into early and late experience by a moveable critical point. Results: For the entire cohort, the mean V100 and D90 were 89.2% and 102.8%, respectively, with 47.7% of the implants scored as excellent. Brachytherapists in the highest-case tercile had a significantly greater fraction of excellent target coverage (57.9%) than did those in the two lower terciles (39.5% and 45.7%, p = 0.015). Twenty-one (25.6%) of the 82 brachytherapists with sufficient case volume for dosimetric improvement analyses demonstrated quality improvement over time. Although there was no significant difference between prostate volume and seed strength, the number of seeds used was significantly greater in adequate implants. Conclusions: The highest-volume brachytherapists were most likely to obtain excellent target coverage. We are encouraged that in general practice, nearly 48% of all implants were scored excellent. It is conceivable that with greater expert third-party involvement, an even greater percentage of cases with excellent target coverage will become reality.

  2. Can prostatic arterial embolisation (PAE) reduce the volume of the peripheral zone? MRI evaluation of zonal anatomy and infarction after PAE

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Yen-Ting [Assistance Publique Hopitaux de Paris. Hopital Europeen Georges-Pompidou, Vascular and Oncological Interventional Radiology, Paris (France); Department of Radiology, Taichung Veterans General Hospital, Taichung City (China); Amouyal, Gregory; Pereira, Helena; Del Giudice, Costantino; Dean, Carole [Assistance Publique Hopitaux de Paris. Hopital Europeen Georges-Pompidou, Vascular and Oncological Interventional Radiology, Paris (France); Correas, Jean-Michel [Assistance Publique Hopitaux de Paris. Hopital Europeen Georges-Pompidou, Vascular and Oncological Interventional Radiology, Paris (France); Hopital Necker, Radiology Department, Paris (France); Pellerin, Olivier; Sapoval, Marc [Assistance Publique Hopitaux de Paris. Hopital Europeen Georges-Pompidou, Vascular and Oncological Interventional Radiology, Paris (France); Inserm (Institut national de la sante et de la recherche medicale) U970, Paris (France); Universite Paris Descartes, Paris (France); Thiounn, Nicolas [Assistance Publique Hopitaux de Paris, Hopital Europeen Georges-Pompidou, Urology, Paris (France)

    2016-10-15

    To assess the impact of prostatic arterial embolisation (PAE) on various prostate gland anatomical zones. We retrospectively reviewed paired MRI scans obtained before and after PAE for 25 patients and evaluated changes in volumes of the median lobe (ML), central gland (CG), peripheral zone (PZ) and whole prostate gland (WPV) following PAE. We used manual segmentation to calculate volume on axial view T2-weighted images for ML, CG and WPV. We calculated PZ volume by subtracting CG volume from WPV. Enhanced phase on dynamic contrasted-enhanced MRI was used to evaluate the infarction areas after PAE. Clinical results of International Prostate Symptom Score and International Index of Erectile Function questionnaires and the urodynamic study were evaluated before and after PAE. Significant reductions in volume were observed after PAE for ML (26.2 % decrease), CG (18.8 %), PZ (16.4 %) and WPV (19.1 %; p < 0.001 for all these volumes). Patients with clinical failure had smaller volume reductions for WPV, ML and CG (all p < 0.05). Patients with significant CG infarction after PAE displayed larger WPV, ML and CG volume reductions (all p < 0.01). PAE can significantly decrease WPV, ML, CG and PZ volumes, and poor clinical outcomes are associated with smaller volume reductions. (orig.)

  3. Prostate Brachytherapy Case Volumes by Academic and Nonacademic Practices: Implications for Future Residency Training

    International Nuclear Information System (INIS)

    Orio, Peter F.; Nguyen, Paul L.; Buzurovic, Ivan; Cail, Daniel W.; Chen, Yu-Wei

    2016-01-01

    Purpose: The use of prostate brachytherapy has continued to decline in the United States. We examined the national practice patterns of both academic and nonacademic practices performing prostate brachytherapy by case volume per year to further characterize the decline and postulate the effect this trend might have on training the next generation of residents. Methods and Materials: Men diagnosed with prostate cancer who had undergone radiation therapy in 2004 to 2012 were identified. The annual brachytherapy case volume at each facility was determined and further categorized into ≤12 cases per year (ie, an average of ≤1 cases per month), 13 to 52 cases per year, and ≥53 cases per year (ie, an average of ≥1 cases per week) in academic practices versus nonacademic practices. Results: In 2004 to 2012, academic practices performing an average of ≤1 brachytherapy cases per month increased from 56.4% to 73.7%. In nonacademic practices, this percentage increased from 60.2% to 77.4% (P<.0001 for both). Practices performing an average of ≥1 cases per week decreased among both academic practices (from 6.7% to 1.5%) and nonacademic practices (from 4.5% to 2.7%). Conclusions: Both academic and nonacademic radiation oncology practices have demonstrated a significant reduction in the use of prostate brachytherapy from 2004 to 2012. With the case volume continuing to decline, it is unclear whether we are prepared to train the next generation of residents in this critical modality.

  4. Dutasteride reduces prostate size and prostate specific antigen in older hypogonadal men with benign prostatic hyperplasia undergoing testosterone replacement therapy.

    Science.gov (United States)

    Page, Stephanie T; Hirano, Lianne; Gilchriest, Janet; Dighe, Manjiri; Amory, John K; Marck, Brett T; Matsumoto, Alvin M

    2011-07-01

    Benign prostatic hyperplasia and hypogonadism are common disorders in aging men. There is concern that androgen replacement in older men may increase prostate size and symptoms of benign prostatic hyperplasia. We examined whether combining dutasteride, which inhibits testosterone to dihydrotestosterone conversion, with testosterone treatment in older hypogonadal men with benign prostatic hyperplasia reduces androgenic stimulation of the prostate compared to testosterone alone. We conducted a double-blind, placebo controlled trial of 53 men 51 to 82 years old with symptomatic benign prostatic hyperplasia, prostate volume 30 cc or greater and serum total testosterone less than 280 ng/dl (less than 9.7 nmol/l). Subjects were randomized to daily transdermal 1% T gel plus oral placebo or dutasteride for 6 months. Testosterone dosing was adjusted to a serum testosterone of 500 to 1,000 ng/dl. The primary outcomes were prostate volume measured by magnetic resonance imaging, serum prostate specific antigen and androgen levels. A total of 46 subjects completed all procedures. Serum testosterone increased similarly into the mid-normal range in both groups. Serum dihydrotestosterone increased in the testosterone only but decreased in the testosterone plus dutasteride group. In the testosterone plus dutasteride group prostate volume and prostate specific antigen (mean ± SEM) decreased 12% ± 2.5% and 35% ± 5%, respectively, compared to the testosterone only group in which prostate volume and prostate specific antigen increased 7.5% ± 3.3% and 19% ± 7% (p = 0.03 and p = 0.008), respectively, after 6 months of treatment. Prostate symptom scores improved in both groups. Combined treatment with testosterone plus dutasteride reduces prostate volume and prostate specific antigen compared to testosterone only. Coadministration of a 5α-reductase inhibitor with testosterone appears to spare the prostate from androgenic stimulation during testosterone replacement in older

  5. Role of choline PET/CT in guiding target volume delineation for irradiation of prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Schwarzenboeck, S.M.; Kurth, J. [University Medical Centre Rostock, Department of Nuclear Medicine, Rostock (Germany); Gocke, C.; Kuhnt, T.; Hildebrandt, G. [University Medical Centre Rostock, Department of Radiotherapy, Rostock (Germany); Krause, B.J. [University Medical Centre Rostock, Department of Nuclear Medicine, Rostock (Germany); Universitaet Rostock, Department of Nuclear Medicine, Universitaetsmedizin Rostock, Rostock (Germany)

    2013-07-15

    Choline PET/CT has shown limitations for the detection of primary prostate cancer and nodal metastatic disease, mainly due to limited sensitivity and specificity. Conversely in the restaging of prostate cancer recurrence, choline PET/CT is a promising imaging modality for the detection of local regional and nodal recurrence with an impact on therapy management. This review highlights current literature on choline PET/CT for radiation treatment planning in primary and recurrent prostate cancer. Due to limited sensitivity and specificity in differentiating between benign and malignant prostatic tissues in primary prostate cancer, there is little enthusiasm for target volume delineation based on choline PET/CT. Irradiation planning for the treatment of single lymph node metastases on the basis of choline PET/CT is controversial due to its limited lesion-based sensitivity in primary nodal staging. In high-risk prostate cancer, choline PET/CT might diagnose lymph node metastases, which potentially can be included in the conventional irradiation field. Prior to radiation treatment of recurrent prostate cancer, choline PET/CT may prove useful for patient stratification by excluding distant disease which would require systemic therapy. In patients with local recurrence, choline PET/CT can be used to delineate local sites of recurrence within the prostatic resection bed allowing a boost to PET-positive sites. In patients with lymph node metastases outside the prostatic fossa and regional metastatic lymph nodes, choline PET/CT might influence radiation treatment planning by enabling extension of the target volume to lymphatic drainage sites with or without a boost to PET-positive lymph nodes. Further clinical randomized trials are required to assess treatment outcomes following choline-based biological radiation treatment planning in comparison with conventional radiation treatment planning. (orig.)

  6. Changes in Prostate Shape and Volume and Their Implications for Radiotherapy After Introduction of Endorectal Balloon as Determined by MRI at 3T

    International Nuclear Information System (INIS)

    Heijmink, Stijn W.T.P.J.; Scheenen, Tom W.J.; Lin, Emile N.J.T. van; Visser, Andries G.; Kiemeney, Lambertus A.L.M.; Witjes, J. Alfred; Barentsz, Jelle O.

    2009-01-01

    Purpose: To determine the changes in prostate shape and volume after the introduction of an endorectal coil (ERC) by means of magnetic resonance imaging (MRI) at 3T. Methods and materials: A total of 44 consecutive patients with biopsy-proven prostate cancer underwent separate MRI examinations at 3T with a body array coil and subsequently with an ERC inflated with 50 mL of fluid. Prospectively, two experienced readers independently evaluated all data sets in random order. The maximal anteroposterior, right-to-left, and craniocaudal prostate diameters, as well as the total prostate and peripheral zone and central gland volumes were measured before and after ERC introduction. The changes in prostate shape and volume were analyzed using Wilcoxon's test for paired samples. Results: The introduction of the ERC significantly changed the prostate shape in all three directions, with mean changes in the anteroposterior, right-to-left, and craniocaudal diameters of 15.7% (5.5 mm), 7.7% (3.5 mm), and 6.3% (2.2 mm), respectively. The mean total prostate, peripheral zone, and central gland volume decreased significantly after ERC introduction by 17.9% (8.3 cm 3 ), 21.6% (4.8 cm 3 ), and 14.2% (3.4 cm 3 ), respectively. Conclusion: ERC introduction as observed by 3T MRI changed the prostate shape and volume significantly. The mean anteroposterior diameter was reduced by nearly one-sixth of its original diameter, and the mean total prostate volume was decreased by approximately 18%. This could cause difficulties and should be considered when using ERC-based MRI for MRI-computed tomography fusion and radiotherapy planning.

  7. Standardization of prostate brachytherapy treatment plans

    International Nuclear Information System (INIS)

    Ove, Roger; Wallner, Kent; Badiozamani, Kas; Korjsseon, Tammy; Sutlief, Steven

    2001-01-01

    Purpose: Whereas custom-designed plans are the norm for prostate brachytherapy, the relationship between linear prostate dimensions and volume calls into question the routine need for customized treatment planning. With the goal of streamlining the treatment-planning process, we have compared the treatment margins (TMs) achieved with one standard plan applied to patients with a wide range of prostate volumes. Methods and Materials: Preimplant transrectal ultrasound (TRUS) images of 50 unselected University of Washington patients with T1-T2 cancer and a prostate volume between 20 cc and 50 cc were studied. Patients were arbitrarily grouped into categories of 20-30 cc, 30-40 cc, and 40-50 cc. A standard 19-needle plan was devised for patients in the 30- to 40-cc range, using an arbitrary minimum margin of 5 mm around the gross tumor volume (GTV), making use of inverse planning technology to achieve 100% coverage of the target volume with accentuation of dose at the periphery and sparing of the central region. The idealized plan was applied to each patient's TRUS study. The distances (TMs) between the prostatic edge (GTV) and treated volume (TV) were determined perpendicular to the prostatic margin. Results: Averaged over the entire patient group, the ratio of thickness to width was 1.4, whereas the ratio of length to width was 1.3. These values were fairly constant over the range of volumes, emphasizing that the prostate retains its general shape as volume increases. The idealized standard plan was overlaid on the ultrasound images of the 17 patients in the 30- to 40-cc group and the V100, the percentage of target volume receiving 100% or more of the prescription dose, was 98% or greater for 15 of the 17 patients. The lateral and posterior TMs fell within a narrow range, most being within 2 mm of the idealized 5-mm TM. To estimate whether a 10-cc volume-interval stratification was reasonable, the standard plan generated from the 30- to 40-cc prostate model was

  8. [Estimating minimum period of time to perform prostate MRI after prostate biopsy: Clinical and histological bleeding risk factors; from a prospective study].

    Science.gov (United States)

    Sarradin, M; Lepiney, C; Celhay, O; Delpech, P O; Charles, T; Pillot, P; Bernardeau, S; Tasu, J P; Irani, J

    2018-02-01

    A minimum delay of 4 to 6 weeks between biopsy and multiparametric prostatic MRI (mpMRI) is admitted due to post-biopsy hemorrhage that can impact MRI reading without strong scientific evidence. The objective of the study was to evaluate the best period between prostate biopsy and 3Tesla mpMRI and searching for predictive factors of intraprostatic blood. A prostate biopsy followed by a 4-week prostate MRI (MRIp M1) was performed. In case of hemorrhage, MRI was rescheduled at 8 and 12 weeks (M2/M3). We analyzed the persistant bleeding to identify risk factors: anticoagulant/antiaggregant, post-biopsy side effects, histological criteria. In this prospective, single-center study, we included 40 patients followed for suspected prostate cancer between December 2014 and March 2016. At the MRIpM1, blood was found for 97.5 % of the patients. The rates were 90.9 % and 88.9 % respectively at the M2 and M3 mpMRI. Compared to initial blood volume on MRIpM1, a significant decrease in blood volume was observed between M1 and M2 (55 %; P=0.0091). We showed a 75 % decrease between M1 and M3 (P=0.0003). Low urinary tract symptoms (LUTS) suggesting urinary infection at 4 weeks were significantly correlated with blood volume on MRIpM1 (P=0.0063). The blood volume was higher in case of unconformity between biopsy and mpMRI results for detection of significant tumors (11.3 vs. 2.3; P=0.0051). A minimum of 8-week biopsy and mpMRI period would limit post-biopsy hemorrhage, predicted by LUTS suggesting urinary infection. A delay of 12 weeks would be optimal without delaying the management of the patient. 4. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  9. Sexual steroids in serum and prostatic tissue of human non-cancerous prostate (STERPROSER trial).

    Science.gov (United States)

    Neuzillet, Yann; Raynaud, Jean-Pierre; Radulescu, Camélia; Fiet, Jean; Giton, Franck; Dreyfus, Jean-François; Ghoneim, Tarek P; Lebret, Thierry; Botto, Henry

    2017-11-01

    The specific involvement of the sex steroids in the growth of the prostatic tissue remains unclear. Sex steroid concentrations in plasma and in fresh surgical samples of benign central prostate were correlated to prostate volume. Monocentric prospective study performed between September 2014 and January 2017. Age, obesity parameters, and both serum and intraprostatic concentrations of sex steroids were collected complying with the latest Endocrine Society guidelines and the steroids assessed by GC/MS. Statistical calculations were adjusted for age and body mass index (BMI). Thirty-two patients, equally divided between normal- and high-volume prostate groups, were included in the analysis. High-volume prostate patients were older, heavier and had higher BMI. Comparison adjusted for age and BMI showed higher DHT concentrations in high-volume prostate. Both normal- and high-volume prostate tissues concentrate sex steroids in a similar way. Comparison of enzymatic activity surrogate marker ratios within tissue highlighted similar TT/E1 and TT/E2 ratios, and higher DHT/E1 ratio and lower DHT/PSA ratio in the high-volume prostates. STERPROSER trial provides evidence for higher DHT concentration in highvolume prostates, that could reflect either higher 5-alpha reductase expression or lower expression of downstream metabolizing enzymes such as 3a-hydoxysteroid dehydrogenase. © 2017 Wiley Periodicals, Inc.

  10. A randomized trial comparing bladder volume consistency during fractionated prostate radiation therapy

    LENUS (Irish Health Repository)

    Mullaney, L.

    2014-01-10

    Organ motion is a contributory factor to the variation in location of the prostate and organs at risk during a course of fractionated prostate radiation therapy (RT). A prospective randomized controlled trial was designed with the primary endpoint to provide evidence-based bladder-filling instructions to achieve a consistent bladder volume (BV) and thus reduce the bladder-related organ motion. The secondary endpoints were to assess the incidence of acute and late genitourinary (GU) and gastrointestinal (GI) toxicity for patients and patients’ satisfaction with the bladder-filling instructions.

  11. 18F-fluorocholine PET-guided target volume delineation techniques for partial prostate re-irradiation in local recurrent prostate cancer

    International Nuclear Information System (INIS)

    Wang Hui; Vees, Hansjoerg; Miralbell, Raymond; Wissmeyer, Michael; Steiner, Charles; Ratib, Osman; Senthamizhchelvan, Srinivasan; Zaidi, Habib

    2009-01-01

    Background and purpose: We evaluate the contribution of 18 F-choline PET/CT in the delineation of gross tumour volume (GTV) in local recurrent prostate cancer after initial irradiation using various PET image segmentation techniques. Materials and methods: Seventeen patients with local-only recurrent prostate cancer (median = 5.7 years) after initial irradiation were included in the study. Rebiopsies were performed in 10 patients that confirmed the local recurrence. Following injection of 300 MBq of 18 F-fluorocholine, dynamic PET frames (3 min each) were reconstructed from the list-mode acquisition. Five PET image segmentation techniques were used to delineate the 18 F-choline-based GTVs. These included manual delineation of contours (GTV man ) by two teams consisting of a radiation oncologist and a nuclear medicine physician each, a fixed threshold of 40% and 50% of the maximum signal intensity (GTV 40% and GTV 50% ), signal-to-background ratio-based adaptive thresholding (GTV SBR ), and a region growing (GTV RG ) algorithm. Geographic mismatches between the GTVs were also assessed using overlap analysis. Results: Inter-observer variability for manual delineation of GTVs was high but not statistically significant (p = 0.459). In addition, the volumes and shapes of GTVs delineated using semi-automated techniques were significantly higher than those of GTVs defined manually. Conclusions: Semi-automated segmentation techniques for 18 F-choline PET-guided GTV delineation resulted in substantially higher GTVs compared to manual delineation and might replace the latter for determination of recurrent prostate cancer for partial prostate re-irradiation. The selection of the most appropriate segmentation algorithm still needs to be determined.

  12. 18F-fluorocholine PET-guided target volume delineation techniques for partial prostate re-irradiation in local recurrent prostate cancer.

    Science.gov (United States)

    Wang, Hui; Vees, Hansjörg; Miralbell, Raymond; Wissmeyer, Michael; Steiner, Charles; Ratib, Osman; Senthamizhchelvan, Srinivasan; Zaidi, Habib

    2009-11-01

    We evaluate the contribution of (18)F-choline PET/CT in the delineation of gross tumour volume (GTV) in local recurrent prostate cancer after initial irradiation using various PET image segmentation techniques. Seventeen patients with local-only recurrent prostate cancer (median=5.7 years) after initial irradiation were included in the study. Rebiopsies were performed in 10 patients that confirmed the local recurrence. Following injection of 300 MBq of (18)F-fluorocholine, dynamic PET frames (3 min each) were reconstructed from the list-mode acquisition. Five PET image segmentation techniques were used to delineate the (18)F-choline-based GTVs. These included manual delineation of contours (GTV(man)) by two teams consisting of a radiation oncologist and a nuclear medicine physician each, a fixed threshold of 40% and 50% of the maximum signal intensity (GTV(40%) and GTV(50%)), signal-to-background ratio-based adaptive thresholding (GTV(SBR)), and a region growing (GTV(RG)) algorithm. Geographic mismatches between the GTVs were also assessed using overlap analysis. Inter-observer variability for manual delineation of GTVs was high but not statistically significant (p=0.459). In addition, the volumes and shapes of GTVs delineated using semi-automated techniques were significantly higher than those of GTVs defined manually. Semi-automated segmentation techniques for (18)F-choline PET-guided GTV delineation resulted in substantially higher GTVs compared to manual delineation and might replace the latter for determination of recurrent prostate cancer for partial prostate re-irradiation. The selection of the most appropriate segmentation algorithm still needs to be determined.

  13. Stereotactic ultrasound for target volume definition in a patient with prostate cancer and bilateral total hip replacement.

    Science.gov (United States)

    Boda-Heggemann, Judit; Haneder, Stefan; Ehmann, Michael; Sihono, Dwi Seno Kuncoro; Wertz, Hansjörg; Mai, Sabine; Kegel, Stefan; Heitmann, Sigrun; von Swietochowski, Sandra; Lohr, Frank; Wenz, Frederik

    2015-01-01

    Target-volume definition for prostate cancer in patients with bilateral metal total hip replacements (THRs) is a challenge because of metal artifacts in the planning computed tomography (CT) scans. Magnetic resonance imaging (MRI) can be used for matching and prostate delineation; however, at a spatial and temporal distance from the planning CT, identical rectal and vesical filling is difficult to achieve. In addition, MRI may also be impaired by metal artifacts, even resulting in spatial image distortion. Here, we present a method to define prostate target volumes based on ultrasound images acquired during CT simulation and online-matched to the CT data set directly at the planning CT. A 78-year-old patient with cT2cNxM0 prostate cancer with bilateral metal THRs was referred to external beam radiation therapy. T2-weighted MRI was performed on the day of the planning CT with preparation according to a protocol for reproducible bladder and rectal filling. The planning CT was obtained with the immediate acquisition of a 3-dimensional ultrasound data set with a dedicated stereotactic ultrasound system for online intermodality image matching referenced to the isocenter by ceiling-mounted infrared cameras. MRI (offline) and ultrasound images (online) were thus both matched to the CT images for planning. Daily image guided radiation therapy (IGRT) was performed with transabdominal ultrasound and compared with cone beam CT. Because of variations in bladder and rectal filling and metal-induced image distortion in MRI, soft-tissue-based matching of the MRI to CT was not sufficient for unequivocal prostate target definition. Ultrasound-based images could be matched, and prostate, seminal vesicles, and target volumes were reliably defined. Daily IGRT could be successfully completed with transabdominal ultrasound with good accordance between cone beam CT and ultrasound. For prostate cancer patients with bilateral THRs causing artifacts in planning CTs, ultrasound referenced to

  14. Urinary engrailed-2 (EN2) levels predict tumour volume in men undergoing radical prostatectomy for prostate cancer

    DEFF Research Database (Denmark)

    Pandha, Hardev; Sørensen, Karina Dalsgaard; Ørntoft, Torben Falck

    2012-01-01

    ELISA test and is not dependent on other parameters, even PSA, unlike all the other current biomarkers under evaluation. To date, no marker correlates with the amount of cancer present - the present study shows this positive correlation with EN2 in men undergoing prostatectomy. The potential utility...... in men who had undergone radical prostatectomy (RP) for prostate cancer. To date, prostate-specific antigen (PSA) levels have not reliably predicted prostate cancer volume. Reliable volume indicator biomarker(s) may aid management decisions, e.g. active treatment vs active surveillance. PATIENTS......: In all, 88 of the whole cohort of 125 men (70%) were positive for EN2 in their urine (>42.5 µg/L); 38/58 (65%) men where cancer volume data was available. There was no statistical relationship between urinary EN2 levels and serum PSA levels. PSA levels did not correlate with tumour stage, combined...

  15. Anatomic Boundaries of the Clinical Target Volume (Prostate Bed) After Radical Prostatectomy

    International Nuclear Information System (INIS)

    Wiltshire, Kirsty L.; Brock, Kristy K.; Haider, Masoom A.; Zwahlen, Daniel; Kong, Vickie; Chan, Elisa; Moseley, Joanne; Bayley, Andrew; Catton, Charles; Chung, Peter W.M.; Gospodarowicz, Mary; Milosevic, Michael; Kneebone, Andrew; Warde, Padraig; Menard, Cynthia

    2007-01-01

    Purpose: We sought to derive and validate an interdisciplinary consensus definition for the anatomic boundaries of the postoperative clinical target volume (CTV, prostate bed). Methods and Materials: Thirty one patients who had planned for radiotherapy after radical prostatectomy were enrolled and underwent computed tomography and magnetic resonance imaging (MRI) simulation prior to radiotherapy. Through an iterative process of consultation and discussion, an interdisciplinary consensus definition was derived based on a review of published data, patterns of local failure, surgical practice, and radiologic anatomy. In validation, we analyzed the distribution of surgical clips in reference to the consensus CTV and measured spatial uncertainties in delineating the CTV and vesicourethral anastomosis. Clinical radiotherapy plans were retrospectively evaluated against the consensus CTV (prostate bed). Results: Anatomic boundaries of the consensus CTV (prostate bed) are described. Surgical clips (n = 339) were well distributed throughout the CTV. The vesicourethral anastomosis was accurately localized using central sagittal computed tomography reconstruction, with a mean ± standard deviation uncertainty of 1.8 ± 2.5 mm. Delineation uncertainties were small for both MRI and computed tomography (mean reproducibility, 0-3.8 mm; standard deviation, 1.0-2.3); they were most pronounced in the anteroposterior and superoinferior dimensions and at the superior/posterior-most aspect of the CTV. Retrospectively, the mean ± standard deviation CTV (prostate bed) percentage of volume receiving 100% of prescribed dose was only 77% ± 26%. Conclusions: We propose anatomic boundaries for the CTV (prostate bed) and present evidence supporting its validity. In the absence of gross recurrence, the role of MRI in delineating the CTV remains to be confirmed. The CTV is larger than historically practiced at our institution and should be encompassed by a microscopic tumoricidal dose

  16. Prostatic edema in 125I permanent prostate implants: Dynamical dosimetry taking volume changes into account

    International Nuclear Information System (INIS)

    Leclerc, Ghyslain; Lavallee, Marie-Claude; Roy, Rene; Vigneault, Eric; Beaulieu, Luc

    2006-01-01

    The purpose of this study is to determine the impact of edema on the dose delivered to the target volume. An evaluation of the edema characteristics was first made, and then a dynamical dosimetry algorithm was developed and used to compare its results to a standard clinical (static) dosimetry. Source positions and prostate contours extracted from 66 clinical cases on images taken at different points in time (planning, implant day, post-implant evaluation) were used, via the mean interseed distance, to characterize edema [initial increase (Δr 0 ), half-life (τ)]. An algorithm was developed to take into account the edema by summing a time series of dose-volume histograms (DVHs) with a weight based on the fraction of the dose delivered during the time interval considered. The algorithm was then used to evaluate the impact of edema on the dosimetry of permanent implants by comparing its results to those of a standard clinical dosimetry. The volumetric study yielded results as follows: the initial prostate volume increase was found to be 1.58 (ranging from 1.15 to 2.48) and the edema half-life, approximately 30 days (range: 3 to 170 days). The dosimetric differences in D 90 observed between the dynamic dosimetry and the clinical one for a single case were up to 15 Gy and depended on the edema half-life and the initial volume increase. The average edema half-life, 30 days, is about 3 times longer than the previously reported 9 days. Dosimetric differences up to 10% of the prescription dose are observed, which can lead to differences in the quality assertion of an implant. The study of individual patient edema resorption with time might be necessary to extract meaningful clinical correlation or biological parameters in permanent implants

  17. Natural history of benign prostatic hyperplasia: Appropriate case definition and estimation of its prevalence in the community

    OpenAIRE

    Bosch, Ruud; Hop, Wim; Kirkels, Wim; Schröder, Fritz

    1995-01-01

    textabstractThere is no consensus about a case definition of benign prostatic hyperplasia (BPH). In the present study, BPH prevalence rates were determined using various case definitions based on a combination of clinical parameters used to describe the properties of BPH: symptoms of prostatism, prostate volume increase, and bladder outflow obstruction. The aim of this study—in a community-based population of 502 men (55–74 years of age) without prostate cancer—was to determine the relative i...

  18. Computed tomographic studies on prostate and bladder diseases

    International Nuclear Information System (INIS)

    Ono, Shuta

    1980-01-01

    The computed tomography (CT) has been performed in 6 cases of normal prostate, 4 cases of prostatitis, 6 cases of early stage of benign prostatic hyperplasia, 21 cases of late stage of benign prostatic hyperplasia, 27 cases of prostatic carcinoma, and the pneumo-CT scan with the gas-filled bladder has been performed in 10 cases of bladder carcinomas. The CT gave an excellent visualization of form of the prostate and pelvic anatomic relationships. A significant difference of EMI unit has been observed between benign prostatic hyperplasia (EMI unit: 14.6+-4.4) and prostatic carcinoma (EMI unit: 24.7+-4.4). The volume of prostate has been estimated from the following formula as an ellipsoid, π/6 A x B x C (A) maximum transverse diameter in the CT (B) anteroposterior diameter in the CT (C) length of the prostatic urethra in the urethrogram. A highly significant correlation has been recognized between the postoperative weight of the prostatic in eighteen cases and the prostatic weight estimated from this method. A new method of the pneumo-CT with the gas-filled bladder has been presented and evaluated. Direct visualization of the extent of tumor adjacent soft tissue structure is possible. It is considered that this method also has an advantage to be able to evaluate the effect of anti-cancer drug therapy. (author)

  19. Is it possible to predict low-volume and insignificant prostate cancer by core needle biopsies?

    DEFF Research Database (Denmark)

    Berg, Kasper Drimer; Toft, Birgitte Grønkaer; Røder, Martin Andreas

    2013-01-01

    M: tumour ≤5% of total prostate volume and prostate-specific antigen (PSA) ≤10 ng/mL. In all definitions, Gleason score (GS) was ≤6 and the tumour was organ confined. Biopsies alone performed poorly as a predictor of unifocal and unilateral cancer in the prostatectomy specimens with positive predictive......In an attempt to minimize overtreatment of localized prostate cancer (PCa) active surveillance (AS) and minor invasive procedures have received increased attention. We investigated the accuracy of pre-operative findings in defining insignificant disease and distinguishing between unilateral.......9% and 12.0%, respectively, for identifying InsigM, InsigW and InsigE in the prostate specimen. Conclusively, routine prostate biopsies cannot predict unifocal and unilateral PCa, and must be regarded insufficient to select patients for focal therapy. Although candidates for AS may be identified using...

  20. Prostate CT segmentation method based on nonrigid registration in ultrasound-guided CT-based HDR prostate brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Xiaofeng, E-mail: xyang43@emory.edu; Rossi, Peter; Ogunleye, Tomi; Marcus, David M.; Jani, Ashesh B.; Curran, Walter J.; Liu, Tian [Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia 30322 (United States); Mao, Hui [Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia 30322 (United States)

    2014-11-01

    Purpose: The technological advances in real-time ultrasound image guidance for high-dose-rate (HDR) prostate brachytherapy have placed this treatment modality at the forefront of innovation in cancer radiotherapy. Prostate HDR treatment often involves placing the HDR catheters (needles) into the prostate gland under the transrectal ultrasound (TRUS) guidance, then generating a radiation treatment plan based on CT prostate images, and subsequently delivering high dose of radiation through these catheters. The main challenge for this HDR procedure is to accurately segment the prostate volume in the CT images for the radiation treatment planning. In this study, the authors propose a novel approach that integrates the prostate volume from 3D TRUS images into the treatment planning CT images to provide an accurate prostate delineation for prostate HDR treatment. Methods: The authors’ approach requires acquisition of 3D TRUS prostate images in the operating room right after the HDR catheters are inserted, which takes 1–3 min. These TRUS images are used to create prostate contours. The HDR catheters are reconstructed from the intraoperative TRUS and postoperative CT images, and subsequently used as landmarks for the TRUS–CT image fusion. After TRUS–CT fusion, the TRUS-based prostate volume is deformed to the CT images for treatment planning. This method was first validated with a prostate-phantom study. In addition, a pilot study of ten patients undergoing HDR prostate brachytherapy was conducted to test its clinical feasibility. The accuracy of their approach was assessed through the locations of three implanted fiducial (gold) markers, as well as T2-weighted MR prostate images of patients. Results: For the phantom study, the target registration error (TRE) of gold-markers was 0.41 ± 0.11 mm. For the ten patients, the TRE of gold markers was 1.18 ± 0.26 mm; the prostate volume difference between the authors’ approach and the MRI-based volume was 7.28% ± 0

  1. Prostate CT segmentation method based on nonrigid registration in ultrasound-guided CT-based HDR prostate brachytherapy

    Science.gov (United States)

    Yang, Xiaofeng; Rossi, Peter; Ogunleye, Tomi; Marcus, David M.; Jani, Ashesh B.; Mao, Hui; Curran, Walter J.; Liu, Tian

    2014-01-01

    Purpose: The technological advances in real-time ultrasound image guidance for high-dose-rate (HDR) prostate brachytherapy have placed this treatment modality at the forefront of innovation in cancer radiotherapy. Prostate HDR treatment often involves placing the HDR catheters (needles) into the prostate gland under the transrectal ultrasound (TRUS) guidance, then generating a radiation treatment plan based on CT prostate images, and subsequently delivering high dose of radiation through these catheters. The main challenge for this HDR procedure is to accurately segment the prostate volume in the CT images for the radiation treatment planning. In this study, the authors propose a novel approach that integrates the prostate volume from 3D TRUS images into the treatment planning CT images to provide an accurate prostate delineation for prostate HDR treatment. Methods: The authors’ approach requires acquisition of 3D TRUS prostate images in the operating room right after the HDR catheters are inserted, which takes 1–3 min. These TRUS images are used to create prostate contours. The HDR catheters are reconstructed from the intraoperative TRUS and postoperative CT images, and subsequently used as landmarks for the TRUS–CT image fusion. After TRUS–CT fusion, the TRUS-based prostate volume is deformed to the CT images for treatment planning. This method was first validated with a prostate-phantom study. In addition, a pilot study of ten patients undergoing HDR prostate brachytherapy was conducted to test its clinical feasibility. The accuracy of their approach was assessed through the locations of three implanted fiducial (gold) markers, as well as T2-weighted MR prostate images of patients. Results: For the phantom study, the target registration error (TRE) of gold-markers was 0.41 ± 0.11 mm. For the ten patients, the TRE of gold markers was 1.18 ± 0.26 mm; the prostate volume difference between the authors’ approach and the MRI-based volume was 7.28% ± 0

  2. cExternal beam radiation results in minimal changes in post void residual urine volumes during the treatment of clinically localized prostate cancer

    International Nuclear Information System (INIS)

    Orio, Peter F III; Merrick, Gregory S; Allen, Zachariah A; Butler, Wayne M; Wallner, Kent E; Kurko, Brian S; Galbreath, Robert W

    2009-01-01

    To evaluate the impact of external beam radiation therapy (XRT) on weekly ultrasound determined post-void residual (PVR) urine volumes in patients with prostate cancer. 125 patients received XRT for clinically localized prostate cancer. XRT was delivered to the prostate only (n = 66) or if the risk of lymph node involvement was greater than 10% to the whole pelvis followed by a prostate boost (n = 59). All patients were irradiated in the prone position in a custom hip-fix mobilization device with an empty bladder and rectum. PVR was obtained at baseline and weekly. Multiple clinical and treatment parameters were evaluated as predictors for weekly PVR changes. The mean patient age was 73.9 years with a mean pre-treatment prostate volume of 53.3 cc, a mean IPSS of 11.3 and a mean baseline PVR of 57.6 cc. During treatment, PVR decreased from baseline in both cohorts with the absolute difference within the limits of accuracy of the bladder scanner. Alpha-blockers did not predict for a lower PVR during treatment. There was no significant difference in mean PVR urine volumes or differences from baseline in either the prostate only or pelvic radiation groups (p = 0.664 and p = 0.458, respectively). Patients with a larger baseline PVR (>40 cc) had a greater reduction in PVR, although the greatest reduction was seen between weeks one and three. Patients with a small PVR (<40 cc) had no demonstrable change throughout treatment. Prostate XRT results in clinically insignificant changes in weekly PVR volumes, suggesting that radiation induced bladder irritation does not substantially influence bladder residual urine volumes

  3. cExternal beam radiation results in minimal changes in post void residual urine volumes during the treatment of clinically localized prostate cancer

    Directory of Open Access Journals (Sweden)

    Wallner Kent E

    2009-07-01

    Full Text Available Abstract Background To evaluate the impact of external beam radiation therapy (XRT on weekly ultrasound determined post-void residual (PVR urine volumes in patients with prostate cancer. Methods 125 patients received XRT for clinically localized prostate cancer. XRT was delivered to the prostate only (n = 66 or if the risk of lymph node involvement was greater than 10% to the whole pelvis followed by a prostate boost (n = 59. All patients were irradiated in the prone position in a custom hip-fix mobilization device with an empty bladder and rectum. PVR was obtained at baseline and weekly. Multiple clinical and treatment parameters were evaluated as predictors for weekly PVR changes. Results The mean patient age was 73.9 years with a mean pre-treatment prostate volume of 53.3 cc, a mean IPSS of 11.3 and a mean baseline PVR of 57.6 cc. During treatment, PVR decreased from baseline in both cohorts with the absolute difference within the limits of accuracy of the bladder scanner. Alpha-blockers did not predict for a lower PVR during treatment. There was no significant difference in mean PVR urine volumes or differences from baseline in either the prostate only or pelvic radiation groups (p = 0.664 and p = 0.458, respectively. Patients with a larger baseline PVR (>40 cc had a greater reduction in PVR, although the greatest reduction was seen between weeks one and three. Patients with a small PVR ( Conclusion Prostate XRT results in clinically insignificant changes in weekly PVR volumes, suggesting that radiation induced bladder irritation does not substantially influence bladder residual urine volumes.

  4. Quantifying Uncertainty in Soil Volume Estimates

    International Nuclear Information System (INIS)

    Roos, A.D.; Hays, D.C.; Johnson, R.L.; Durham, L.A.; Winters, M.

    2009-01-01

    Proper planning and design for remediating contaminated environmental media require an adequate understanding of the types of contaminants and the lateral and vertical extent of contamination. In the case of contaminated soils, this generally takes the form of volume estimates that are prepared as part of a Feasibility Study for Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) sites and/or as part of the remedial design. These estimates are typically single values representing what is believed to be the most likely volume of contaminated soil present at the site. These single-value estimates, however, do not convey the level of confidence associated with the estimates. Unfortunately, the experience has been that pre-remediation soil volume estimates often significantly underestimate the actual volume of contaminated soils that are encountered during the course of remediation. This underestimation has significant implications, both technically (e.g., inappropriate remedial designs) and programmatically (e.g., establishing technically defensible budget and schedule baselines). Argonne National Laboratory (Argonne) has developed a joint Bayesian/geostatistical methodology for estimating contaminated soil volumes based on sampling results, that also provides upper and lower probabilistic bounds on those volumes. This paper evaluates the performance of this method in a retrospective study that compares volume estimates derived using this technique with actual excavated soil volumes for select Formerly Utilized Sites Remedial Action Program (FUSRAP) Maywood properties that have completed remedial action by the U.S. Army Corps of Engineers (USACE) New York District. (authors)

  5. Inter- and Intra-Observer Variability in Prostate Definition With Tissue Harmonic and Brightness Mode Imaging

    International Nuclear Information System (INIS)

    Sandhu, Gurpreet Kaur; Dunscombe, Peter; Meyer, Tyler; Pavamani, Simon; Khan, Rao

    2012-01-01

    Purpose: The objective of this study was to compare the relative utility of tissue harmonic (H) and brightness (B) transrectal ultrasound (TRUS) images of the prostate by studying interobserver and intraobserver variation in prostate delineation. Methods and Materials: Ten patients with early-stage disease were randomly selected. TRUS images of prostates were acquired using B and H modes. The prostates on all images were contoured by an experienced radiation oncologist (RO) and five equally trained observers. The observers were blinded to information regarding patient and imaging mode. The volumes of prostate glands and areas of midgland slices were calculated. Volumes contoured were compared among the observers and between observer group and RO. Contours on one patient were repeated five times by four observers to evaluate the intraobserver variability. Results: A one-sample Student t-test showed the volumes outlined by five observers are in agreement (p > 0.05) with the RO. Paired Student t-test showed prostate volumes (p = 0.008) and midgland areas (p = 0.006) with H mode were significantly smaller than that with B mode. Two-factor analysis of variances showed significant interobserver variability (p < 0.001) in prostate volumes and areas. Inter- and intraobserver consistency was quantified as the standard deviation of mean volumes and areas, and concordance indices. It was found that for small glands (≤35 cc) H mode provided greater interobserver consistency; however, for large glands (≥35 cc), B mode provided more consistent estimates. Conclusions: H mode provided superior inter- and intraobserver agreement in prostate volume definition for small to medium prostates. In large glands, H mode does not exhibit any additional advantage. Although harmonic imaging has not proven advantageous for all cases, its utilization seems to be judicious for small prostates.

  6. 5α-Reductase inhibitor is less effective in men with small prostate volume and low serum prostatic specific antigen level.

    Science.gov (United States)

    Lin, Victor C; Liao, Chun-Hou; Wang, Chung-Cheng; Kuo, Hann-Chorng

    2015-09-01

    Large total prostate volumes (TPVs) or high serum prostate-specific antigen (PSA) levels indicate high-risk clinical progression of benign prostatic hyperplasia. This prospective study investigated the treatment outcome of combined 5α-reductase inhibitor and α-blocker in patients with and without large TPVs or high PSA levels. Men aged ≥ 45 years with International Prostate Symptom scores (IPSS) ≥ 8, TPV ≥ 20 mL, and maximum flow rate ≤ 15 mL/s received a combination therapy (dutasteride plus doxaben) for 2 years. Patients with baseline PSA ≥ 4 ng/mL underwent prostatic biopsy for excluding malignancy. The changes in the parameters from baseline to 24 months after combination therapy were compared in those with and without TPV ≥ 40 mL or PSA levels ≥ 1.5 ng/mL. A total of 285 patients (mean age 72 ± 9 years) completed the study. Combination therapy resulted in significant continuous improvement in IPSS, quality of life index, maximum flow rate, and postvoid residual (all p < 0.0001) regardless of baseline TPV or PSA levels. However, only patients with baseline TPV ≥ 40 mL had significant improvements in IPSS-storage subscore, voided volume, reduction in TPV, transitional zone index, and PSA levels. In addition, patients with baseline TPV < 40 mL and PSA < 1.5 ng/mL had neither a reduction in TPV nor a decrease in serum PSA level. A high TPV indicates more outlet resistance, whereas elevated serum PSA level reflects glandular proliferation. Thus, patients with TPV<40 mL and low PSA levels has less benefit from 5α-reductase inhibitor therapy. The therapeutic effect of combined treatment may arise mainly from the α-blocker in these patients. Copyright © 2013. Published by Elsevier B.V.

  7. Larger men have larger prostates: Detection bias in epidemiologic studies of obesity and prostate cancer risk.

    Science.gov (United States)

    Rundle, Andrew; Wang, Yun; Sadasivan, Sudha; Chitale, Dhananjay A; Gupta, Nilesh S; Tang, Deliang; Rybicki, Benjamin A

    2017-06-01

    Obesity is associated with risk of aggressive prostate cancer (PCa), but not with over-all PCa risk. However, obese men have larger prostates which may lower biopsy accuracy and cause a systematic bias toward the null in epidemiologic studies of over-all risk. Within a cohort of 6692 men followed-up after a biopsy or transurethral resection of the prostate (TURP) with benign findings, a nested case-control study was conducted of 495 prostate cancer cases and controls matched on age, race, follow-up duration, biopsy versus TURP, and procedure date. Data on body mass index and prostate volume at the time of the initial procedure were abstracted from medical records. Prior to consideration of differences in prostate volume, overweight (OR = 1.41; 95%CI 1.01, 1.97), and obese status (OR = 1.59; 95%CI 1.09, 2.33) at the time of the original benign biopsy or TURP were associated with PCa incidence during follow-up. Prostate volume did not significantly moderate the association between body-size and PCa, however it did act as an inverse confounder; adjustment for prostate volume increased the effect size for overweight by 22% (adjusted OR = 1.52; 95%CI 1.08, 2.14) and for obese status by 23% (adjusted OR = 1.77; 95%CI 1.20, 2.62). Larger prostate volume at the time of the original benign biopsy or TURP was inversely associated with PCa incidence during follow-up (OR = 0.92 per 10 cc difference in volume; 95%CI 0.88, 0.97). In analyses that stratified case-control pairs by tumor aggressiveness of the case, prostate volume acted as an inverse confounder in analyses of non-aggressive PCa but not in analyses of aggressive PCa. In studies of obesity and PCa, differences in prostate volume cause a bias toward the null, particularly in analyses of non-aggressive PCa. A pervasive underestimation of the association between obesity and overall PCa risk may exist in the literature. © 2017 Wiley Periodicals, Inc.

  8. CONTAMINATED SOIL VOLUME ESTIMATE TRACKING METHODOLOGY

    International Nuclear Information System (INIS)

    Durham, L.A.; Johnson, R.L.; Rieman, C.; Kenna, T.; Pilon, R.

    2003-01-01

    The U.S. Army Corps of Engineers (USACE) is conducting a cleanup of radiologically contaminated properties under the Formerly Utilized Sites Remedial Action Program (FUSRAP). The largest cost element for most of the FUSRAP sites is the transportation and disposal of contaminated soil. Project managers and engineers need an estimate of the volume of contaminated soil to determine project costs and schedule. Once excavation activities begin and additional remedial action data are collected, the actual quantity of contaminated soil often deviates from the original estimate, resulting in cost and schedule impacts to the project. The project costs and schedule need to be frequently updated by tracking the actual quantities of excavated soil and contaminated soil remaining during the life of a remedial action project. A soil volume estimate tracking methodology was developed to provide a mechanism for project managers and engineers to create better project controls of costs and schedule. For the FUSRAP Linde site, an estimate of the initial volume of in situ soil above the specified cleanup guidelines was calculated on the basis of discrete soil sample data and other relevant data using indicator geostatistical techniques combined with Bayesian analysis. During the remedial action, updated volume estimates of remaining in situ soils requiring excavation were calculated on a periodic basis. In addition to taking into account the volume of soil that had been excavated, the updated volume estimates incorporated both new gamma walkover surveys and discrete sample data collected as part of the remedial action. A civil survey company provided periodic estimates of actual in situ excavated soil volumes. By using the results from the civil survey of actual in situ volumes excavated and the updated estimate of the remaining volume of contaminated soil requiring excavation, the USACE Buffalo District was able to forecast and update project costs and schedule. The soil volume

  9. Dosimetric impact of the variation of the prostate volume and shape between pretreatment planning and treatment procedure

    International Nuclear Information System (INIS)

    Beaulieu, Luc; Aubin, Sylviane; Taschereau, Richard; Pouliot, Jean; Vigneault, Eric

    2002-01-01

    Purpose: The goal of this study is to evaluate the dosimetric impact on a pretreatment planning of prostatic volume and shape variations occurring between the moment of the volume study (preplanning) and just before a transperineal permanent seed implant procedure. Such variations could be an obvious source of misplacement of the seeds relative to the prostate gland and organs at risk. Other sources of dosimetric uncertainties, such as misplacement due to the procedure itself or edema, are eliminated by looking at these variations before the implant procedure. Methods and Materials: For 35 clinical cases, prostate contours were taken at preplanning time as well as in the operating room (OR) minutes before the procedure. Comparison of shape and volume between the two sets was made. The impact on V100 was evaluated by placing the seeds in their planned positions in the new volume (clinical situation) and also by performing a new plan with the second set of contours to simulate an intraoperative approach. Results: The volume taken in the OR remained unchanged compared to the pretreatment planning volume in only 37% of the cases. While on average the dose coverage loss from pretreatment planning due to a combination of variations of volume and shape was small at 5.7%, a V100 degradation of up to 20.9% was observed in extreme cases. Even in cases in which no changes in volume were observed, changes in shape occurred and strongly affected implant dosimetry. Conclusions: Variations of volume and shape between pretreatment planning and the implant procedure can have a strong impact on the dosimetry if the planning and the implant procedure are not performed on the same day. This is an argument in favor of performing implant dosimetry in the OR

  10. Inter-slice bidirectional registration-based segmentation of the prostate gland in MR and CT image sequences

    Energy Technology Data Exchange (ETDEWEB)

    Khalvati, Farzad, E-mail: farzad.khalvati@uwaterloo.ca; Tizhoosh, Hamid R. [Department of Systems Design Engineering, University of Waterloo, Waterloo, Ontario N2L 3G1 (Canada); Salmanpour, Aryan; Rahnamayan, Shahryar [Department of Engineering and Applied Science, University of Ontario Institute of Technology, Oshawa, Ontario L1H 7K4 (Canada); Rodrigues, George [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario N6C 2R6, Canada and Department of Epidemiology/Biostatistics, University of Western Ontario, London, Ontario N6A 3K7 (Canada)

    2013-12-15

    Purpose: Accurate segmentation and volume estimation of the prostate gland in magnetic resonance (MR) and computed tomography (CT) images are necessary steps in diagnosis, treatment, and monitoring of prostate cancer. This paper presents an algorithm for the prostate gland volume estimation based on the semiautomated segmentation of individual slices in T2-weighted MR and CT image sequences. Methods: The proposedInter-Slice Bidirectional Registration-based Segmentation (iBRS) algorithm relies on interslice image registration of volume data to segment the prostate gland without the use of an anatomical atlas. It requires the user to mark only three slices in a given volume dataset, i.e., the first, middle, and last slices. Next, the proposed algorithm uses a registration algorithm to autosegment the remaining slices. We conducted comprehensive experiments to measure the performance of the proposed algorithm using three registration methods (i.e., rigid, affine, and nonrigid techniques). Results: The results with the proposed technique were compared with manual marking using prostate MR and CT images from 117 patients. Manual marking was performed by an expert user for all 117 patients. The median accuracies for individual slices measured using the Dice similarity coefficient (DSC) were 92% and 91% for MR and CT images, respectively. The iBRS algorithm was also evaluated regarding user variability, which confirmed that the algorithm was robust to interuser variability when marking the prostate gland. Conclusions: The proposed algorithm exploits the interslice data redundancy of the images in a volume dataset of MR and CT images and eliminates the need for an atlas, minimizing the computational cost while producing highly accurate results which are robust to interuser variability.

  11. Inter-slice bidirectional registration-based segmentation of the prostate gland in MR and CT image sequences

    International Nuclear Information System (INIS)

    Khalvati, Farzad; Tizhoosh, Hamid R.; Salmanpour, Aryan; Rahnamayan, Shahryar; Rodrigues, George

    2013-01-01

    Purpose: Accurate segmentation and volume estimation of the prostate gland in magnetic resonance (MR) and computed tomography (CT) images are necessary steps in diagnosis, treatment, and monitoring of prostate cancer. This paper presents an algorithm for the prostate gland volume estimation based on the semiautomated segmentation of individual slices in T2-weighted MR and CT image sequences. Methods: The proposedInter-Slice Bidirectional Registration-based Segmentation (iBRS) algorithm relies on interslice image registration of volume data to segment the prostate gland without the use of an anatomical atlas. It requires the user to mark only three slices in a given volume dataset, i.e., the first, middle, and last slices. Next, the proposed algorithm uses a registration algorithm to autosegment the remaining slices. We conducted comprehensive experiments to measure the performance of the proposed algorithm using three registration methods (i.e., rigid, affine, and nonrigid techniques). Results: The results with the proposed technique were compared with manual marking using prostate MR and CT images from 117 patients. Manual marking was performed by an expert user for all 117 patients. The median accuracies for individual slices measured using the Dice similarity coefficient (DSC) were 92% and 91% for MR and CT images, respectively. The iBRS algorithm was also evaluated regarding user variability, which confirmed that the algorithm was robust to interuser variability when marking the prostate gland. Conclusions: The proposed algorithm exploits the interslice data redundancy of the images in a volume dataset of MR and CT images and eliminates the need for an atlas, minimizing the computational cost while producing highly accurate results which are robust to interuser variability

  12. Multi-atlas-based automatic 3D segmentation for prostate brachytherapy in transrectal ultrasound images

    Science.gov (United States)

    Nouranian, Saman; Mahdavi, S. Sara; Spadinger, Ingrid; Morris, William J.; Salcudean, S. E.; Abolmaesumi, P.

    2013-03-01

    One of the commonly used treatment methods for early-stage prostate cancer is brachytherapy. The standard of care for planning this procedure is segmentation of contours from transrectal ultrasound (TRUS) images, which closely follow the prostate boundary. This process is currently performed either manually or using semi-automatic techniques. This paper introduces a fully automatic segmentation algorithm which uses a priori knowledge of contours in a reference data set of TRUS volumes. A non-parametric deformable registration method is employed to transform the atlas prostate contours to a target image coordinates. All atlas images are sorted based on their registration results and the highest ranked registration results are selected for decision fusion. A Simultaneous Truth and Performance Level Estimation algorithm is utilized to fuse labels from registered atlases and produce a segmented target volume. In this experiment, 50 patient TRUS volumes are obtained and a leave-one-out study on TRUS volumes is reported. We also compare our results with a state-of-the-art semi-automatic prostate segmentation method that has been clinically used for planning prostate brachytherapy procedures and we show comparable accuracy and precision within clinically acceptable runtime.

  13. Standard surgical treatment for benign prostatic hyperplasia is safe for patients over 75 years: analysis of 100 cases from a high-volume urologic center

    Directory of Open Access Journals (Sweden)

    Rafael Marmiroli

    2012-12-01

    Full Text Available OBJECTIVES: In this study, we aimed to determine the complications of standard surgical treatments among patients over 75 years in a high-volume urologic center. METHODS: We analyzed 100 consecutive patients older than 75 years who had undergone transurethral prostatic resection of the prostate or open prostatectomy for treatment of benign prostatic hyperplasia from January 2008 to March 2010. We analyzed patient age, prostate volume, prostate-specific antigen level, international prostatic symptom score, quality of life score, urinary retention, co-morbidities, surgical technique and satisfaction with treatment. RESULTS: Median age was 79 years. Forty-eight patients had undergone transurethral prostatic resection of the prostate, and 52 had undergone open prostatectomy. The median International Prostatic Symptom Score was 20, the median prostate volume was 83 g, 51% were using an indwelling bladder catheter, and the median prostatespecific antigen level was 5.0 ng/ml. The most common comorbidities were hypertension, diabetes and coronary disease. After a median follow-up period of 17 months, most patients were satisfied. Complications were present in 20% of cases. The most common urological complication was urethral stenosis, followed by bladder neck sclerosis, urinary fistula, late macroscopic hematuria and persistent urinary incontinence. The most common clinical complication was myocardial infarction, followed by acute renal failure requiring dialysis. Incidental carcinoma of the prostate was present in 6% of cases. One case had urothelial bladder cancer. CONCLUSIONS: Standard surgical treatments for benign prostatic hyperplasia are safe and satisfactory among the elderly. Complications are infrequent, and urethral stenosis is the most common. No clinical variable is associated with the occurrence of complications.

  14. Estimating Preferences for Treatments in Patients With Localized Prostate Cancer

    International Nuclear Information System (INIS)

    Ávila, Mónica; Becerra, Virginia; Guedea, Ferran; Suárez, José Francisco; Fernandez, Pablo; Macías, Víctor; Mariño, Alfonso

    2015-01-01

    Purpose: Studies of patients' preferences for localized prostate cancer treatments have assessed radical prostatectomy and external radiation therapy, but none of them has evaluated brachytherapy. The aim of our study was to assess the preferences and willingness to pay of patients with localized prostate cancer who had been treated with radical prostatectomy, external radiation therapy, or brachytherapy, and their related urinary, sexual, and bowel side effects. Methods and Materials: This was an observational, prospective cohort study with follow-up until 5 years after treatment. A total of 704 patients with low or intermediate risk localized prostate cancer were consecutively recruited from 2003 to 2005. The estimation of preferences was conducted using time trade-off, standard gamble, and willingness-to-pay methods. Side effects were measured with the Expanded Prostate Index Composite (EPIC), a prostate cancer-specific questionnaire. Tobit models were constructed to assess the impact of treatment and side effects on patients' preferences. Propensity score was applied to adjust for treatment selection bias. Results: Of the 580 patients reporting preferences, 165 were treated with radical prostatectomy, 152 with external radiation therapy, and 263 with brachytherapy. Both time trade-off and standard gamble results indicated that the preferences of patients treated with brachytherapy were 0.06 utilities higher than those treated with radical prostatectomy (P=.01). Similarly, willingness-to-pay responses showed a difference of €57/month (P=.004) between these 2 treatments. Severe urinary incontinence presented an independent impact on the preferences elicited (P<.05), whereas no significant differences were found by bowel and sexual side effects. Conclusions: Our findings indicate that urinary incontinence is the side effect with the highest impact on preferences and that brachytherapy and external radiation therapy are more valued than radical

  15. Estimating Preferences for Treatments in Patients With Localized Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ávila, Mónica [Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona (Spain); CIBER en Epidemiología y Salud Pública (CIBERESP) (Spain); Universitat Pompeu Fabra, Barcelona (Spain); Becerra, Virginia [Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona (Spain); Guedea, Ferran [Servicio de Oncología Radioterápica, Institut Català d' Oncologia, L' Hospitalet de Llobregat (Spain); Suárez, José Francisco [Servicio de Urología, Hospital Universitari de Bellvitge, L' Hospitalet de Llobregat (Spain); Fernandez, Pablo [Servicio de Oncología Radioterápica, Instituto Oncológico de Guipúzcoa, San Sebastián (Spain); Macías, Víctor [Servicio de Oncología Radioterápica, Hospital Clínico Universitario de Salamanca, Salamanca (Spain); Servicio de Oncología Radioterápica, Institut Oncologic del Valles-Hospital General de Catalunya, Sant Cugat del Vallès (Spain); Mariño, Alfonso [Servicio de Oncología Radioterápica, Centro Oncológico de Galicia, A Coruña (Spain); and others

    2015-02-01

    Purpose: Studies of patients' preferences for localized prostate cancer treatments have assessed radical prostatectomy and external radiation therapy, but none of them has evaluated brachytherapy. The aim of our study was to assess the preferences and willingness to pay of patients with localized prostate cancer who had been treated with radical prostatectomy, external radiation therapy, or brachytherapy, and their related urinary, sexual, and bowel side effects. Methods and Materials: This was an observational, prospective cohort study with follow-up until 5 years after treatment. A total of 704 patients with low or intermediate risk localized prostate cancer were consecutively recruited from 2003 to 2005. The estimation of preferences was conducted using time trade-off, standard gamble, and willingness-to-pay methods. Side effects were measured with the Expanded Prostate Index Composite (EPIC), a prostate cancer-specific questionnaire. Tobit models were constructed to assess the impact of treatment and side effects on patients' preferences. Propensity score was applied to adjust for treatment selection bias. Results: Of the 580 patients reporting preferences, 165 were treated with radical prostatectomy, 152 with external radiation therapy, and 263 with brachytherapy. Both time trade-off and standard gamble results indicated that the preferences of patients treated with brachytherapy were 0.06 utilities higher than those treated with radical prostatectomy (P=.01). Similarly, willingness-to-pay responses showed a difference of €57/month (P=.004) between these 2 treatments. Severe urinary incontinence presented an independent impact on the preferences elicited (P<.05), whereas no significant differences were found by bowel and sexual side effects. Conclusions: Our findings indicate that urinary incontinence is the side effect with the highest impact on preferences and that brachytherapy and external radiation therapy are more valued than radical

  16. A critical evaluation of the planning target volume for 3-d conformal radiotherapy of prostate cancer

    International Nuclear Information System (INIS)

    Tinger, Alfred; Michalski, Jeff M.; Cheng, Abel; Low, Daniel A.; Zhu, Ron; Bosch, Walter R.; Purdy, James A.; Perez, Carlos A.

    1996-01-01

    Purpose: The goal was to determine an adequate planning target volume (PTV) margin for three-dimensional conformal radiotherapy (3D CRT) of prostate cancer. The uncertainty in the internal positions of the prostate and seminal vesicles and the uncertainty in the treatment set-ups for a single group of patients was measured. Methods: Weekly computed tomography (CT) scans of the pelvis (n=38) and daily electronic portal images (n=1225) were reviewed for six patients who received seven-field 3D CRT for prostate cancer. The weekly CT scans were registered in three dimensions to the original treatment planning CT scan using commercially available software. This registration permitted measurement of the motion in the center-of-volume (COV) of the prostate and seminal vesicles throughout the course of therapy. The daily portal images (PI) were registered to the corresponding simulation films to measure the set-up displacement for each of the seven fields. The field displacements were then entered into a matrix program which calculated the isocenter displacement by a least squares method. The uncertainty in the internal positions of the prostate and seminal vesicles (standard deviation of the motions) was added to the uncertainty in the set-up (standard deviation of the isocenter displacements) in quadrature to arrive at a total uncertainty. Positive directions were defined in the left, anterior, and superior directions. A discussion of an adequate PTV was based on these results. Results: The mean magnitude of motion for the COV of the prostate ± the standard deviation was 0 ± 1 mm in the left-right (LR) direction, 0.5 ± 2.8 mm in the anterior-posterior (AP) direction, and 0.5 ± 3.5 mm in the superior-inferior (SI) direction. The mean magnitude of motion for the COV of the seminal vesicles ± the standard deviation was -0.3 ± 1.5 mm in the LR, 0.6 ± 4.1 mm in the AP, and 0.7 ± 2.3 mm in the SI directions, respectively. For all patients the mean isocenter

  17. Associations between volume changes and spatial dose metrics for the urinary bladder during local versus pelvic irradiation for prostate cancer.

    Science.gov (United States)

    Casares-Magaz, Oscar; Moiseenko, Vitali; Hopper, Austin; Pettersson, Niclas Johan; Thor, Maria; Knopp, Rick; Deasy, Joseph O; Muren, Ludvig Paul; Einck, John

    2017-06-01

    Inter-fractional variation in urinary bladder volumes during the course of radiotherapy (RT) for prostate cancer causes deviations between planned and delivered doses. This study compared planned versus daily cone-beam CT (CBCT)-based spatial bladder dose distributions, for prostate cancer patients receiving local prostate treatment (local treatment) versus prostate including pelvic lymph node irradiation (pelvic treatment). Twenty-seven patients (N = 15 local treatment; N = 12 pelvic treatment) were treated using daily image-guided RT (1.8 Gy@43-45 fx), adhering to a full bladder/empty rectum protocol. For each patient, 9-10 CBCTs were registered to the planning CT, using the clinically applied translations. The urinary bladder was manually segmented on each CBCT, 3 mm inner shells were generated, and semi and quadrant sectors were created using axial/coronal cuts. Planned and delivered DVH metrics were compared across patients and between the two groups of treatment (t-test, p bladder volume variations and the dose-volume histograms (DVH) of the bladder and its sectors were evaluated (Spearman's rank correlation coefficient, r s ). Bladder volumes varied considerably during RT (coefficient of variation: 16-58%). The population-averaged planned and delivered DVH metrics were not significantly different at any dose level. Larger treatment bladder volumes resulted in increased absolute volume of the posterior/inferior bladder sector receiving intermediate-high doses, in both groups. The superior bladder sector received less dose with larger bladder volumes for local treatments (r s  ± SD: -0.47 ± 0.32), but larger doses for pelvic treatments (r s  ± SD: 0.74 ± 0.24). Substantial bladder volume changes during the treatment course occurred even though patients were treated under a full bladder/daily image-guided protocol. Larger bladder volumes resulted in less bladder wall spared at the posterior-inferior sector, regardless the

  18. Inter- and intra-observer variability in prostate definition with tissue harmonic and brightness mode imaging.

    Science.gov (United States)

    Sandhu, Gurpreet Kaur; Dunscombe, Peter; Meyer, Tyler; Pavamani, Simon; Khan, Rao

    2012-01-01

    The objective of this study was to compare the relative utility of tissue harmonic (H) and brightness (B) transrectal ultrasound (TRUS) images of the prostate by studying interobserver and intraobserver variation in prostate delineation. Ten patients with early-stage disease were randomly selected. TRUS images of prostates were acquired using B and H modes. The prostates on all images were contoured by an experienced radiation oncologist (RO) and five equally trained observers. The observers were blinded to information regarding patient and imaging mode. The volumes of prostate glands and areas of midgland slices were calculated. Volumes contoured were compared among the observers and between observer group and RO. Contours on one patient were repeated five times by four observers to evaluate the intraobserver variability. A one-sample Student t-test showed the volumes outlined by five observers are in agreement (p > 0.05) with the RO. Paired Student t-test showed prostate volumes (p = 0.008) and midgland areas (p = 0.006) with H mode were significantly smaller than that with B mode. Two-factor analysis of variances showed significant interobserver variability (p standard deviation of mean volumes and areas, and concordance indices. It was found that for small glands (≤35 cc) H mode provided greater interobserver consistency; however, for large glands (≥35 cc), B mode provided more consistent estimates. H mode provided superior inter- and intraobserver agreement in prostate volume definition for small to medium prostates. In large glands, H mode does not exhibit any additional advantage. Although harmonic imaging has not proven advantageous for all cases, its utilization seems to be judicious for small prostates. Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.

  19. Utilization of cone-beam CT for offline evaluation of target volume coverage during prostate image-guided radiotherapy based on bony anatomy alignment.

    Science.gov (United States)

    Paluska, Petr; Hanus, Josef; Sefrova, Jana; Rouskova, Lucie; Grepl, Jakub; Jansa, Jan; Kasaova, Linda; Hodek, Miroslav; Zouhar, Milan; Vosmik, Milan; Petera, Jiri

    2012-01-01

    To assess target volume coverage during prostate image-guided radiotherapy based on bony anatomy alignment and to assess possibility of safety margin reduction. Implementation of IGRT should influence safety margins. Utilization of cone-beam CT provides current 3D anatomic information directly in irradiation position. Such information enables reconstruction of the actual dose distribution. Seventeen prostate patients were treated with daily bony anatomy image-guidance. Cone-beam CT (CBCT) scans were acquired once a week immediately after bony anatomy alignment. After the prostate, seminal vesicles, rectum and bladder were contoured, the delivered dose distribution was reconstructed. Target dose coverage was evaluated by the proportion of the CTV encompassed by the 95% isodose. Original plans employed a 1 cm safety margin. Alternative plans assuming a smaller 7 mm margin between CTV and PTV were evaluated in the same way. Rectal and bladder volumes were compared with the initial ones. Rectal and bladder volumes irradiated with doses higher than 75 Gy, 70 Gy, 60 Gy, 50 Gy and 40 Gy were analyzed. In 12% of reconstructed plans the prostate coverage was not sufficient. The prostate underdosage was observed in 5 patients. Coverage of seminal vesicles was not satisfactory in 3% of plans. Most of the target underdosage corresponded to excessive rectal or bladder filling. Evaluation of alternative plans assuming a smaller 7 mm margin revealed 22% and 11% of plans where prostate and seminal vesicles coverage, respectively, was compromised. These were distributed over 8 and 7 patients, respectively. Sufficient dose coverage of target volumes was not achieved for all patients. Reducing of safety margin is not acceptable. Initial rectal and bladder volumes cannot be considered representative for subsequent treatment.

  20. Late rectal toxicity: dose-volume effects of conformal radiotherapy for prostate cancer

    International Nuclear Information System (INIS)

    Huang, Eugene H.; Pollack, Alan; Levy, Larry; Starkschall, George; Lei Dong; Rosen, Isaac; Kuban, Deborah A.

    2002-01-01

    Purpose: To identify dosimetric, anatomic, and clinical factors that correlate with late rectal toxicity after three-dimensional conformal radiotherapy (3D-CRT) for prostate cancer. Methods and Materials: We retrospectively analyzed the dose-volume histograms and clinical records of 163 Stage T1b-T3c prostate cancer patients treated between 1992 and 1999 with 3D-CRT, to a total isocenter dose of 74-78 Gy at The University of Texas M. D. Anderson Cancer Center. The median follow-up was 62 months (range 24-102). All late rectal complications were scored using modified Radiation Therapy Oncology Group and Late Effects Normal Tissue Task Force criteria. The 6-year toxicity rate was assessed using Kaplan-Meier analysis and the log-rank test. A univariate proportional hazards regression model was used to test the correlation between Grade 2 or higher toxicity and the dosimetric, anatomic, and clinical factors. In a multivariate regression model, clinical factors were added to the dosimetric and anatomic variables to determine whether they significantly altered the risk of developing late toxicity. Results: At 6 years, the rate of developing Grade 2 or higher late rectal toxicity was 25%. A significant volume effect was observed at rectal doses of 60, 70, 75.6, and 78 Gy, and the risk of developing rectal complications increased exponentially as greater volumes were irradiated. Although the percentage of rectal volume treated correlated significantly with the incidence of rectal complications at all dose levels (p 3 of the rectum. Of the clinical variables tested, only a history of hemorrhoids correlated with rectal toxicity (p=0.003). Multivariate analysis showed that the addition of hemorrhoids increased the risk of toxicity for each dosimetric variable found to be significant on univariate analysis (p<0.05 for all comparisons). Conclusion: Dose-volume histogram analyses clearly indicated a volume effect on the probability of developing late rectal complications

  1. Target volume definition in conformal radiotherapy for prostate cancer: quality assurance in the MRC RT-01 trial

    International Nuclear Information System (INIS)

    Seddon, B.S.; Wilson, J.; Khoo, V.; Dearnaley, D.; Bidmead, M.

    2000-01-01

    Prior to randomization of patients into the UK Medical Research Council multicentre randomized trial (RT-01) of conformal radiotherapy (CFRT) in prostate cancer, clinicians at participating centres were required to complete a quality assurance (QA) clinical planning exercise to enable an investigation of inter-observer variability in gross target volume (GTV) and normal structure outlining. Thirteen participating centres and two investigators completed the clinical planning exercise of three practice planning cases. Clinicians were asked to draw outlines of the GTV, rectum and bladder on hard-copy computerized tomography (CT) films of the pelvis, which were transferred onto the Cadplan computer planning system by a single investigator. Centre, inferior and superior CT levels of GTV, rectum and bladder were noted, and volume calculations performed. Planning target volumes (PTV) were generated using automatic volume expansion of GTVs by a 1 cm margin. Anterior, right and left lateral beam eye views (BEV) of the PTVs were generated. Using a common central point, the BEV PTVs were superimposed for each beam direction of each case. Radial PTV variation was investigated by measurement of a novel parameter, termed the radial line measurement variation (RLMV). GTV central slice and length were defined with reasonable consistency. The RLMV analysis showed that the main part of the prostate gland, bladder and inferior rectum were outlined with good consistency among clinicians. However, the outlining of the prostatic apex, superior aspect of the prostate projecting into the bladder, seminal vesicles, the base of seminal vesicles and superior rectum were more variable. This exercise has demonstrated adequate consistency of GTV definition. The RLMV method of analysis indicates particular regions of clinician uncertainty. Appropriate feedback has been given to all participating clinicians, and the final RT-01 trial protocol has been modified to accommodate these findings

  2. Estimation of the incidence of late bladder and rectum complications after high-dose (70-78 Gy) conformal radiotherapy for prostate cancer, using dose-volume histograms

    International Nuclear Information System (INIS)

    Boersma, Liesbeth J.; Brink, Mandy van den; Bruce, Allison M.; Shouman, Tarek; Gras, Luuk; Velde, Annet te; Lebesque, Joos V.

    1998-01-01

    Purpose: To investigate whether Dose-Volume Histogram (DVH) parameters can be used to identify risk groups for developing late gastrointestinal (GI) and genitourinary (GU) complications after conformal radiotherapy for prostate cancer. Methods and Materials: DVH parameters were analyzed for 130 patients with localized prostate cancer, treated with conformal radiotherapy in a dose-escalating protocol (70-78 Gy, 2 Gy per fraction). The incidence of late (>6 months) GI and GU complications was classified using the RTOG/EORTC and the SOMA/LENT scoring system. In addition, GI complications were divided in nonsevere and severe (requiring one or more laser treatments or blood transfusions) rectal bleeding. The median follow-up time was 24 months. We investigated whether rectal and bladder wall volumes, irradiated to various dose levels, correlated with the observed actuarial incidences of GI and GU complications, using volume as a continuous variable. Subsequently, for each dose level in the DVH, the rectal wall volumes were dichotomized using different volumes as cutoff levels. The impact of the total radiation dose, and the maximum radiation dose in the rectal and bladder wall was analyzed as well. Results: The actuarial incidence at 2 years for GI complications ≥Grade II was 14% (RTOG/EORTC) or 20% (SOMA/LENT); for GU complications ≥Grade III 8% (RTOG/EORTC) or 21% (SOMA/LENT). Neither for GI complications ≥Grade II (RTOG/EORTC or SOMA/LENT), nor for GU complications ≥Grade III (RTOG/EORTC or SOMA/LENT), was a significant correlation found between any of the DVH parameters and the actuarial incidence of complications. For severe rectal bleeding (actuarial incidence at 2 years 3%), four consecutive volume cutoff levels were found, which significantly discriminated between high and low risk. A trend was observed that a total radiation dose ≥ 74 Gy (or a maximum radiation dose in the rectal wall >75 Gy) resulted in a higher incidence of severe rectal bleeding (p

  3. Urinary prostate-specific antigen: predictor of benign prostatic hyperplasia progression?

    Science.gov (United States)

    Pejcic, Tomislav P; Tulic, Cane Dz; Lalic, Natasa V; Glisic, Biljana D; Ignjatovic, Svetlana D; Markovic, Biljana B; Hadzi-Djokic, Jovan B

    2013-04-01

    Urinary prostate-specific antigen (uPSA) can be used as additional parameter of benign prostatic hyperplasia (BPH) progression. From January 2001 to December 2011, uPSA was determined in 265 patients with benign prostate. Based on total prostate volume (TPV), the patients with benign prostate were divided in two groups: TPV specificity of 0.83 and sensitivity of 0.67. The level of uPSA reflects prostatic hormonal activity and correlates with TPV, PSA and age. UPSA level ≥ 150 ng/mL can be used as additional predictive parameter of BPH progression.

  4. Tissue concentrations of prostate-specific antigen in prostatic carcinoma and benign prostatic hyperplasia.

    Science.gov (United States)

    Pretlow, T G; Pretlow, T P; Yang, B; Kaetzel, C S; Delmoro, C M; Kamis, S M; Bodner, D R; Kursh, E; Resnick, M I; Bradley, E L

    1991-11-11

    Prostate-specific antigen (PSA), as measured in peripheral blood, is currently the most widely used marker for the assessment of tumor burden in the longitudinal study of patients with carcinoma of the prostate (PCA). Studies from other laboratories have led to the conclusion that a given volume of PCA causes a much higher level of PSA in the peripheral circulation of patients than a similar volume of prostate without carcinoma. We have evaluated PSA in the resected tissues immunohistochemically and in extracts of PCA and of prostates resected because of benign prostatic hyperplasia (BPH) with an enzyme-linked immunosorbent assay. Immunohistochemical results were less quantitative than but consistent with the results of the ELISA of tissue extracts. Immunohistochemically, there was considerable heterogeneity in the expression of PSA by both PCA and BPH both within and among prostatic tissues from different patients. While the levels of expression of PSA in these tissues overlap broadly, PSA is expressed at a lower level in PCA than in BPH when PSA is expressed as a function of wet weight of tissue (p = 0.0095), wet weight of tissue/% epithelium (p less than 0.0001), protein extracted from the tissue (p = 0.0039), or protein extracted/% epithelium (p less than 0.0001).

  5. Image Guidance Based on Prostate Position for Prostate Cancer Proton Therapy

    International Nuclear Information System (INIS)

    Vargas, Carlos; Wagner, Marcus; Indelicato, Daniel; Fryer, Amber; Horne, David; Chellini, Angela; McKenzie, Craig; Lawlor, Paula; Mahajan, Chaitali; Li Zuofeng; Lin Liyong; Keole, Sameer

    2008-01-01

    Purpose: To determine the target coverage for proton therapy with and without image guidance and daily prebeam reorientation. Methods and Materials: A total of 207 prostate positions were analyzed for 9 prostate cancer patients treated using our low-risk prostate proton therapy protocol (University of Florida Proton Therapy Institute 001). The planning target volume was defined as the prostate plus a 5-mm axial and 8-mm superoinferior extension. The prostate was repositioned using 5- and 10-mm shifts (anteriorly, inferiorly, posteriorly, and superiorly) and for Points A-D using a combination of 10-mm multidimensional movements (anteriorly or inferiorly; posteriorly or superiorly; and left or right). The beams were then realigned using the new prostate position. The prescription dose was 78 Gray equivalent (GE) to 95% of the planning target volume. Results: For small movements in the anterior, inferior, and posterior directions within the planning target volume (≤5 mm), treatment realignment demonstrated small, but significant, improvements in the clinical target volume (CTV) coverage to the prescribed dose (78 GE). The anterior and posterior shifts also significantly increased the minimal CTV dose (Δ +1.59 GE). For prostate 10-mm movements in the inferior, posterior, and superior directions, the beam realignment produced larger and significant improvements for both the CTV V 78 (Δ +6.4%) and the CTV minimal dose (Δ +8.22 GE). For the compounded 10-mm multidimensional shifts, realignment significantly improved the CTV V 78 (Δ +11.8%) and CTV minimal dose (Δ +23.6 GE). After realignment, the CTV minimal dose was >76.6 GE (>98%) for all points (A-D). Conclusion: Proton beam realignment after target shift will enhance CTV coverage for different prostate positions

  6. A prospective three-dimensional analysis about the impact of differences in the clinical target volume in prostate cancer irradiation on normal-tissue exposure. A potential for increasing the benefit/risk ratio

    International Nuclear Information System (INIS)

    Hille, A.; Toews, N.; Schmidberger, H.; Hess, C.F.

    2005-01-01

    Background and purpose: rectal toxicity following external-beam irradiation of prostate cancer correlates with the exposed percentage of rectal volume. Recently, it has been recommended to reduce the volume of the seminal vesicles that should be included in the clinical target volume (CTV). The purpose of this study was to quantitatively assess the impact of this CTV reduction on the expected rectal and bladder dose sparing. Patients and methods: 14 patients with localized prostate cancer undergoing external-beam radiotherapy were investigated. The prostate, the prostate + entire seminal vesicles, or the prostate + proximal seminal vesicles were delineated as CTV. Treatment plans were generated and compared concerning rectum and bladder dose-volume histograms (DVHs). Results: the exposure of rectum and bladder volume was significantly lower in case of irradiation of the prostate only compared to inclusion of the proximal or entire seminal vesicles into the CTV. The reduction of the CTV from prostate + entire seminal vesicles to prostate + proximal seminal vesicles led to a significant reduction of the rectal and bladder dose exposure. Conclusion: reduction of the CTV to the prostate only, or to the prostate + proximal seminal vesicles led to significant rectal and bladder dose sparing compared to irradiation of the prostate + entire seminal vesicles. In patients with a higher risk for seminal vesicles involvement, irradiation of the prostate + proximal seminal vesicles should be preferred. In case of a need for irradiation of the entire seminal vesicles, patients should be informed about a higher risk for chronic rectal toxicity and, possibly, for bladder complications. (orig.)

  7. Association Between Treatment at a High-Volume Facility and Improved Survival for Radiation-Treated Men With High-Risk Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Yu-Wei [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Mahal, Brandon A. [Department of Medicine, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Harvard Medical School, Boston, Massachusetts (United States); Muralidhar, Vinayak [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Harvard Medical School, Boston, Massachusetts (United States); Nezolosky, Michelle [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Beard, Clair J. [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Harvard Medical School, Boston, Massachusetts (United States); Den, Robert B. [Department of Radiation Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Feng, Felix Y. [Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Hoffman, Karen E. [Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Martin, Neil E.; Orio, Peter F. [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Harvard Medical School, Boston, Massachusetts (United States); Nguyen, Paul L., E-mail: pnguyen@LROC.harvard.edu [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Harvard Medical School, Boston, Massachusetts (United States)

    2016-03-15

    Purpose: Although the association between higher hospital volume and improved outcomes has been well-documented in surgery, there is little data about whether this effect exists for radiation-treated patients. We investigated whether treatment at a radiation facility that treats a high volume of prostate cancer patients is associated with improved survival for men with high-risk prostate cancer. Methods and Materials: We used the National Cancer Database (NCDB) to identity patients diagnosed with prostate cancer from 2004 to 2006. The radiation case volume (RCV) of each hospital was based on its number of radiation-treated prostate cancer patients. We used propensity-score based analysis to compare the overall survival (OS) of high-risk prostate cancer patients in high versus low RCV hospitals. Primary endpoint is overall survival. Covariates adjusted for were tumor characteristics, sociodemographic factors, radiation type, and use of androgen deprivation therapy (ADT). Results: A total of 19,565 radiation-treated high-risk patients were identified. Median follow-up was 81.0 months (range: 1-108 months). When RCV was coded as a continuous variable, each increment of 100 radiation-managed patients was associated with improved OS (adjusted hazard ratio [AHR]: 0.97; 95% confidence interval [CI]: 0.95-0.98; P<.0001) after adjusting for known confounders. For illustrative purposes, when RCV was dichotomized at the 80th percentile (43 patients/year), high RCV was associated with improved OS (7-year overall survival 76% vs 74%, log-rank test P=.0005; AHR: 0.91, 95% CI: 0.86-0.96, P=.0005). This association remained significant when RCV was dichotomized at 75th (37 patients/year), 90th (60 patients/year), and 95th (84 patients/year) percentiles but not the 50th (19 patients/year). Conclusions: Our results suggest that treatment at centers with higher prostate cancer radiation case volume is associated with improved OS for radiation-treated men with high-risk prostate

  8. Excess cases of prostate cancer and estimated overdiagnosis associated with PSA testing in East Anglia

    Science.gov (United States)

    Pashayan, N; Powles, J; Brown, C; Duffy, S W

    2006-01-01

    This study aimed to estimate the extent of ‘overdiagnosis' of prostate cancer attributable to prostate-specific antigen (PSA) testing in the Cambridge area between 1996 and 2002. Overdiagnosis was defined conceptually as detection of prostate cancer through PSA testing that otherwise would not have been diagnosed within the patient's lifetime. Records of PSA tests in Addenbrookes Hospital were linked to prostate cancer registrations by NHS number. Differences in prostate cancer registration rates between those receiving and not receiving prediagnosis PSA tests were calculated. The proportion of men aged 40 years or over with a prediagnosis PSA test increased from 1.4 to 5.2% from 1996 to 2002. The rate of diagnosis of prostate cancer was 45% higher (rate ratios (RR)=1.45, 95% confidence intervals (CI) 1.02–2.07) in men with a history of prediagnosis PSA testing. Assuming average lead times of 5 to 10 years, 40–64% of the PSA-detected cases were estimated to be overdiagnosed. In East Anglia, from 1996 to 2000, a 1.6% excess of cases was associated with PSA testing (around a quarter of the 5.3% excess incidence cases observed in East Anglia from 1996 to 2000). Further quantification of the overdiagnosis will result from continued surveillance and from linkage of incidence to testing in other hospitals. PMID:16832417

  9. Alterations in the regulatory volume decrease (RVD) and swelling-activated Cl- current associated with neuroendocrine differentiation of prostate cancer epithelial cells.

    NARCIS (Netherlands)

    Lemonnier, L.; Lazarenko, R.; Shuba, Y.; Thebault, S.C.; Roudbaraki, M.; Lepage, G.; Prevarskaya, N.; Skryma, R.

    2005-01-01

    Neuroendocrine (NE) differentiation of prostate epithelial/basal cells is a hallmark of advanced, androgen-independent prostate cancer, for which there is no successful therapy. Here we report for the first time on alterations in regulatory volume decrease (RVD) and its key determinant,

  10. A phantom production by using 3-dimensional printer and In-vivo dosimetry for a prostate cancer patient

    International Nuclear Information System (INIS)

    Seo, Jung Nam; Na, Jong Eok; Bae, Sun Myung; Jung, Dong Min; Yoon, In Ha; Bae, Jae Bum; Kwack, Jung Won; Baek, Geum Mun

    2015-01-01

    The purpose of this study is to evaluate the usefulness of a 3D printed phantom for in-vivo dosimetry of a prostate cancer patient. The phantom is produced to equally describe prostate and rectum based on a 3D volume contour of an actual prostate cancer patient who is treated in Asan Medical Center by using a 3D printer (3D EDISON+, Lokit, Korea). CT(Computed tomography) images of phantom are acquired by computed tomography (Lightspeed CT, GE, USA). By using treatment planning system (Eclipse version 10.0, Varian, USA), treatment planning is established after volume of a prostate cancer patient is compared with volume of the phantom. MOSFET(Metal OXIDE Silicon Field Effect Transistor) is estimated to identify precision and is located in 4 measuring points (bladder, prostate, rectal anterior wall and rectal posterior wall) to analyzed treatment planning and measured value. Prostate volume and rectum volume of prostate cancer patient represent 30.61 cc and 51.19 cc respectively. In case of a phantom, prostate volume and rectum volume represent 31.12 cc and 53.52 cc respectively. A variation of volume between a prostate cancer patient and a phantom is less than 3%. Precision of MOSFET represents less than 3%. It indicates linearity and correlation coefficient indicates from 0.99 - 1.00 depending on dose variation. Each accuracy of bladder, prostate, rectal anterior wall and rectal posterior wall represent 1.4%, 2.6%, 3.7% and 1.5% respectively. In- vivo dosimetry represents entirely less than 5% considering precision of MOSFET. By using a 3D printer, possibility of phantom production based on prostate is verified precision within 3%. effectiveness of In-vivo dosimetry is confirmed from a phantom which is produced by a 3D printer. In-vivo dosimetry is evaluated entirely less than 5% considering precision of MOSFET. Therefore, This study is confirmed the usefulness of a 3D printed phantom for in-vivo dosimetry of a prostate cancer patient. It is necessary to additional

  11. A phantom production by using 3-dimensional printer and In-vivo dosimetry for a prostate cancer patient

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Jung Nam; Na, Jong Eok; Bae, Sun Myung; Jung, Dong Min; Yoon, In Ha; Bae, Jae Bum; Kwack, Jung Won; Baek, Geum Mun [Dept. of Radiation Oncology, ASAN Medical Center, Seoul (Korea, Republic of)

    2015-06-15

    The purpose of this study is to evaluate the usefulness of a 3D printed phantom for in-vivo dosimetry of a prostate cancer patient. The phantom is produced to equally describe prostate and rectum based on a 3D volume contour of an actual prostate cancer patient who is treated in Asan Medical Center by using a 3D printer (3D EDISON+, Lokit, Korea). CT(Computed tomography) images of phantom are acquired by computed tomography (Lightspeed CT, GE, USA). By using treatment planning system (Eclipse version 10.0, Varian, USA), treatment planning is established after volume of a prostate cancer patient is compared with volume of the phantom. MOSFET(Metal OXIDE Silicon Field Effect Transistor) is estimated to identify precision and is located in 4 measuring points (bladder, prostate, rectal anterior wall and rectal posterior wall) to analyzed treatment planning and measured value. Prostate volume and rectum volume of prostate cancer patient represent 30.61 cc and 51.19 cc respectively. In case of a phantom, prostate volume and rectum volume represent 31.12 cc and 53.52 cc respectively. A variation of volume between a prostate cancer patient and a phantom is less than 3%. Precision of MOSFET represents less than 3%. It indicates linearity and correlation coefficient indicates from 0.99 - 1.00 depending on dose variation. Each accuracy of bladder, prostate, rectal anterior wall and rectal posterior wall represent 1.4%, 2.6%, 3.7% and 1.5% respectively. In- vivo dosimetry represents entirely less than 5% considering precision of MOSFET. By using a 3D printer, possibility of phantom production based on prostate is verified precision within 3%. effectiveness of In-vivo dosimetry is confirmed from a phantom which is produced by a 3D printer. In-vivo dosimetry is evaluated entirely less than 5% considering precision of MOSFET. Therefore, This study is confirmed the usefulness of a 3D printed phantom for in-vivo dosimetry of a prostate cancer patient. It is necessary to additional

  12. Estimating the Need for Radiotherapy for Patients With Prostate, Breast, and Lung Cancers: Verification of Model Estimates of Need With Radiotherapy Utilization Data From British Columbia

    International Nuclear Information System (INIS)

    Tyldesley, Scott; Delaney, Geoff; Foroudi, Farshad; Barbera, Lisa; Kerba, Marc; Mackillop, William

    2011-01-01

    Purpose: Estimates of the need for radiotherapy (RT) using different methods (criterion based benchmarking [CBB] and the Canadian [C-EBEST] and Australian [A-EBEST] epidemiologically based estimates) exist for various cancer sites. We compared these model estimates to actual RT rates for lung, breast, and prostate cancers in British Columbia (BC). Methods and Materials: All cases of lung, breast, and prostate cancers in BC from 1997 to 2004 and all patients receiving RT within 1 year (RT 1Y ) and within 5 years (RT 5Y ) of diagnosis were identified. The RT 1Y and RT 5Y proportions in health regions with a cancer center for the most recent year were then calculated. RT rates were compared with CBB and EBEST estimates of RT needs. Variation was assessed by time and region. Results: The RT 1Y in regions with a cancer center for lung, breast, and prostate cancers were 51%, 58%, and 33% compared with 45%, 57%, and 32% for C-EBEST and 41%, 61%, and 37% for CBB models. The RT 5Y rates in regions with a cancer center for lung, breast, and prostate cancers were 59%, 61%, and 40% compared with 61%, 66%, and 61% for C-EBEST and 75%, 83%, and 60% for A-EBEST models. The RT 1Y rates increased for breast and prostate cancers. Conclusions: C-EBEST and CBB model estimates are closer to the actual RT rates than the A-EBEST estimates. Application of these model estimates by health care decision makers should be undertaken with an understanding of the methods used and the assumptions on which they were based.

  13. SU-F-T-42: MRI and TRUS Image Fusion as a Mode of Generating More Accurate Prostate Contours

    Energy Technology Data Exchange (ETDEWEB)

    Petronek, M; Purysko, A; Balik, S; Ciezki, J; Klein, E; Wilkinson, D [Cleveland Clinic Foundation, Cleveland, OH (United States)

    2016-06-15

    Purpose: Transrectal Ultrasound (TRUS) imaging is utilized intra-operatively for LDR permanent prostate seed implant treatment planning. Prostate contouring with TRUS can be challenging at the apex and base. This study attempts to improve accuracy of prostate contouring with MRI-TRUS fusion to prevent over- or under-estimation of the prostate volume. Methods: 14 patients with previous MRI guided prostate biopsy and undergone an LDR permanent prostate seed implant have been selected. The prostate was contoured on the MRI images (1 mm slice thickness) by a radiologist. The prostate was also contoured on TRUS images (5 mm slice thickness) during LDR procedure by a urologist. MRI and TRUS images were rigidly fused manually and the prostate contours from MRI and TRUS were compared using Dice similarity coefficient, percentage volume difference and length, height and width differences. Results: The prostate volume was overestimated by 8 ± 18% (range: 34% to −25%) in TRUS images compared to MRI. The mean Dice was 0.77 ± 0.09 (range: 0.53 to 0.88). The mean difference (TRUS-MRI) in the prostate width was 0 ± 4 mm (range: −11 to 5 mm), height was −3 ± 6 mm (range: −13 to 6 mm) and length was 6 ± 6 (range: −10 to 16 mm). Prostate was overestimated with TRUS imaging at the base for 6 cases (mean: 8 ± 4 mm and range: 5 to 14 mm), at the apex for 6 cases (mean: 11 ± 3 mm and range: 5 to 15 mm) and 1 case was underestimated at both base and apex by 4 mm. Conclusion: Use of intra-operative TRUS and MRI image fusion can help to improve the accuracy of prostate contouring by accurately accounting for prostate over- or under-estimations, especially at the base and apex. The mean amount of discrepancy is within a range that is significant for LDR sources.

  14. SU-F-T-42: MRI and TRUS Image Fusion as a Mode of Generating More Accurate Prostate Contours

    International Nuclear Information System (INIS)

    Petronek, M; Purysko, A; Balik, S; Ciezki, J; Klein, E; Wilkinson, D

    2016-01-01

    Purpose: Transrectal Ultrasound (TRUS) imaging is utilized intra-operatively for LDR permanent prostate seed implant treatment planning. Prostate contouring with TRUS can be challenging at the apex and base. This study attempts to improve accuracy of prostate contouring with MRI-TRUS fusion to prevent over- or under-estimation of the prostate volume. Methods: 14 patients with previous MRI guided prostate biopsy and undergone an LDR permanent prostate seed implant have been selected. The prostate was contoured on the MRI images (1 mm slice thickness) by a radiologist. The prostate was also contoured on TRUS images (5 mm slice thickness) during LDR procedure by a urologist. MRI and TRUS images were rigidly fused manually and the prostate contours from MRI and TRUS were compared using Dice similarity coefficient, percentage volume difference and length, height and width differences. Results: The prostate volume was overestimated by 8 ± 18% (range: 34% to −25%) in TRUS images compared to MRI. The mean Dice was 0.77 ± 0.09 (range: 0.53 to 0.88). The mean difference (TRUS-MRI) in the prostate width was 0 ± 4 mm (range: −11 to 5 mm), height was −3 ± 6 mm (range: −13 to 6 mm) and length was 6 ± 6 (range: −10 to 16 mm). Prostate was overestimated with TRUS imaging at the base for 6 cases (mean: 8 ± 4 mm and range: 5 to 14 mm), at the apex for 6 cases (mean: 11 ± 3 mm and range: 5 to 15 mm) and 1 case was underestimated at both base and apex by 4 mm. Conclusion: Use of intra-operative TRUS and MRI image fusion can help to improve the accuracy of prostate contouring by accurately accounting for prostate over- or under-estimations, especially at the base and apex. The mean amount of discrepancy is within a range that is significant for LDR sources.

  15. Planimetric volumetry of the prostate: how accurate is it?

    NARCIS (Netherlands)

    Aarnink, R. G.; Giesen, R. J.; de la Rosette, J. J.; Huynen, A. L.; Debruyne, F. M.; Wijkstra, H.

    1995-01-01

    Planimetric volumetry is used in clinical practice when accurate volume determination of the prostate is needed. The prostate volume is determined by discretization of the 3D prostate shape. The are of the prostate is calculated in consecutive ultrasonographic cross-sections. This area is multiplied

  16. Neoadjuvant androgen deprivation and prostate gland shrinkage during conformal radiotherapy

    International Nuclear Information System (INIS)

    Sanguineti, Giuseppe; Marcenaro, Michela; Franzone, Paola; Foppiano, Franca; Vitale, Vito

    2003-01-01

    Purpose: The shrinking effect of 3-month neoadjuvant androgen deprivation (NAD) on preradiotherapy prostate gland volume is well documented. However, recently, it has been shown that the cancerous prostate gland keeps shrinking up to 12 months after NAD start. Thus, if such a reduction is not taken into account, a larger than planned portion of the surrounding normal tissues might shift in the high-dose region during conformal radiotherapy (3DCRT) course. The present study was undertaken to quantify this issue. Materials and Methods: Prostate gland volume reduction between planning CT (plCT) and the last week of 3DCRT (tmtCT) was prospectively assessed in 33 consecutive patients with localized prostate carcinoma. The median time interval between plCT and tmtCT was 2.5 months (2.1-2.7 months). A single observer was asked to draw on each slice prostate gland volume as appropriate. The observer was 'blind' to the timing of CT (plCT vs. tmtCT). In order to estimate intra-observer variability, prostate gland delineation was repeated twice for each data set. Mean prostate gland change, plCT and tmtCT cumulative dose volume histogram (DVH) calculations for the rectum were analyzed for each patient. Results were correlated to AD status and its duration before plCT. Means were compared by non-parametric rank tests. Results: Based on an internal protocol, 14 patients (42%) did not receive AD, while 19 patients (58%) had undergone neoadjuvant and concomitant AD. The median duration of AD before plCT ranged from 0.2 to 6 months (median: 2.9 months). Although individual data were highly variable, compared to plCT volume, mean prostate gland volume change at the end of 3DCRT was similar for patients receiving (-7.3%) or not (-7%) androgen deprivation (P=0.77). However, within the group of patients treated with hormones, patients starting AD within 3 months from plCT had a significantly larger reduction in prostate volume (-14.2%) than patients with longer NAD duration (-1.1%, P

  17. The Stockholm-3 (STHLM3) Model can Improve Prostate Cancer Diagnostics in Men Aged 50-69 yr Compared with Current Prostate Cancer Testing.

    Science.gov (United States)

    Eklund, Martin; Nordström, Tobias; Aly, Markus; Adolfsson, Jan; Wiklund, Peter; Brandberg, Yvonne; Thompson, James; Wiklund, Fredrik; Lindberg, Johan; Presti, Joseph C; StLezin, Mark; Clements, Mark; Egevad, Lars; Grönberg, Henrik

    2016-11-23

    Prostate cancer screening is associated with low specificity, unnecessary biopsies, and overdiagnosis. We have previously shown that the Stockholm-3 model (S3M) can reduce biopsies compared with using prostate-specific antigen (PSA) ≥3ng/ml as an indication for biopsy. Urologists in today's current prostate cancer testing (CPT) have access to numerous variables in addition to PSA (eg, age, ethnicity, family history, free PSA, PSA velocity, digital rectal examination, and prostate volume) to support biopsy decisions. We estimated the number of prostate cancers diagnosed and prostate biopsies performed if S3M replaced CPT in Stockholm, Sweden, by comparing biopsy results in 56 282 men who underwent PSA testing according to CPT in Stockholm in 2011 with the 47 688 men enrolled in the STHLM3 validation cohort 2012-2015. With the same sensitivity as CPT to diagnose Gleason score ≥7 prostate cancer, S3M was estimated to reduce the number of men biopsied by 53% (95% confidence interval [CI]: 41-65%), avoid 76% (95% CI: 67-81%) of negative biopsies, and reduce Gleason score 6 cancers by 23% (95% CI: 6-40%). S3M has the potential to improve prostate cancer diagnostics by better selecting men with high risk of GS ≥7 prostate cancer. We modeled the effect the Stockholm-3 model would have on prostate cancer diagnostics if it replaced current clinical practice. We found that Stockholm-3 model may substantially reduce the number of biopsies, while maintaining the same sensitivity to diagnose clinically significant prostate cancer. Copyright © 2016. Published by Elsevier B.V.

  18. Prostate Zonal Volumetry as a Predictor of Clinical Outcomes for Prostate Artery Embolization

    Energy Technology Data Exchange (ETDEWEB)

    Assis, André Moreira de, E-mail: andre.assis@criep.com.br, E-mail: andre.maa@gmail.com; Maciel, Macello Sampaio, E-mail: macielmjs@gmail.com; Moreira, Airton Mota, E-mail: airton.mota@criep.com.br; Paula Rodrigues, Vanessa Cristina de, E-mail: vanessapaular@yahoo.com.br [University of Sao Paulo Medical School, Vascular and Interventional Radiology Unit, Radiology Institute (Brazil); Antunes, Alberto Azoubel, E-mail: antunesuro@uol.com.br; Srougi, Miguel, E-mail: srougi@uol.com.br [University of Sao Paulo Medical School, Urology Department (Brazil); Cerri, Giovanni Guido, E-mail: giovanni-cerri@uol.com.br [University of Sao Paulo Medical School, Radiology Institute (Brazil); Carnevale, Francisco Cesar, E-mail: francisco.carnevale@criep.com.br [University of Sao Paulo Medical School, Vascular and Interventional Radiology Unit, Radiology Institute (Brazil)

    2017-02-15

    PurposeTo determine prostate baseline zonal volumetry and correlate these findings with clinical outcomes for patients who underwent prostate artery embolization (PAE) for lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH).Materials and MethodsThis is a retrospective study that included patients treated by PAE from 2010 to 2014. Baseline and 6-month follow-up evaluations included prostate MRI with whole prostate (WP) and central gland (CG) volume measurements—as well as prostate zonal volumetry index (ZVi) calculation, defined as the CG/WP volumes relation—the International Prostate Symptom Score (IPSS), and the Quality of life (QoL) index. Baseline WP, CG, and ZVi were statistical compared to IPSS and QoL values at 6 months.ResultsA total of 93 consecutive patients were included, with mean age of 63.4 years (range, 51–86). Clinical failure, defined as IPSS > 7 or QoL > 2, was seen in four cases (4.3%). Mean reductions in prostate volumes after PAE were of 30.6% and 31.2% for WP and CG, respectively (p < 0.0001). Clinical parameters had mean decrease from 21 to 3.3 points for IPSS, and from 4.7 to 1.2 points for QoL (p < 0.0001). Baseline WP, CG, and ZVi correlated to the degree of clinical improvement (p < 0.05 for all). The baseline ZVi cut-off calculated for better clinical outcomes was > 0.45, with 85% sensitivity and 75% specificity.ConclusionsBaseline CG and WP volumes as well as ZVi presented strong correlation with clinical outcomes in patients undergoing PAE, and its assessment should be considered in pre-treatment evaluation whenever possible. Both patients and medical team should be aware of the possibility of less favorable outcomes when ZVi < 0.45.

  19. Prostate Zonal Volumetry as a Predictor of Clinical Outcomes for Prostate Artery Embolization

    International Nuclear Information System (INIS)

    Assis, André Moreira de; Maciel, Macello Sampaio; Moreira, Airton Mota; Paula Rodrigues, Vanessa Cristina de; Antunes, Alberto Azoubel; Srougi, Miguel; Cerri, Giovanni Guido; Carnevale, Francisco Cesar

    2017-01-01

    PurposeTo determine prostate baseline zonal volumetry and correlate these findings with clinical outcomes for patients who underwent prostate artery embolization (PAE) for lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH).Materials and MethodsThis is a retrospective study that included patients treated by PAE from 2010 to 2014. Baseline and 6-month follow-up evaluations included prostate MRI with whole prostate (WP) and central gland (CG) volume measurements—as well as prostate zonal volumetry index (ZVi) calculation, defined as the CG/WP volumes relation—the International Prostate Symptom Score (IPSS), and the Quality of life (QoL) index. Baseline WP, CG, and ZVi were statistical compared to IPSS and QoL values at 6 months.ResultsA total of 93 consecutive patients were included, with mean age of 63.4 years (range, 51–86). Clinical failure, defined as IPSS > 7 or QoL > 2, was seen in four cases (4.3%). Mean reductions in prostate volumes after PAE were of 30.6% and 31.2% for WP and CG, respectively (p < 0.0001). Clinical parameters had mean decrease from 21 to 3.3 points for IPSS, and from 4.7 to 1.2 points for QoL (p < 0.0001). Baseline WP, CG, and ZVi correlated to the degree of clinical improvement (p < 0.05 for all). The baseline ZVi cut-off calculated for better clinical outcomes was > 0.45, with 85% sensitivity and 75% specificity.ConclusionsBaseline CG and WP volumes as well as ZVi presented strong correlation with clinical outcomes in patients undergoing PAE, and its assessment should be considered in pre-treatment evaluation whenever possible. Both patients and medical team should be aware of the possibility of less favorable outcomes when ZVi < 0.45.

  20. Organ volume estimation using SPECT

    CERN Document Server

    Zaidi, H

    1996-01-01

    Knowledge of in vivo thyroid volume has both diagnostic and therapeutic importance and could lead to a more precise quantification of absolute activity contained in the thyroid gland. In order to improve single-photon emission computed tomography (SPECT) quantitation, attenuation correction was performed according to Chang's algorithm. The dual-window method was used for scatter subtraction. We used a Monte Carlo simulation of the SPECT system to accurately determine the scatter multiplier factor k. Volume estimation using SPECT was performed by summing up the volume elements (voxels) lying within the contour of the object, determined by a fixed threshold and the gray level histogram (GLH) method. Thyroid phantom and patient studies were performed and the influence of 1) fixed thresholding, 2) automatic thresholding, 3) attenuation, 4) scatter, and 5) reconstruction filter were investigated. This study shows that accurate volume estimation of the thyroid gland is feasible when accurate corrections are perform...

  1. Impact of Body Mass Index, Age, Prostate Volume, and Genetic Polymorphisms on Prostate-specific Antigen Levels in a Control Population.

    Science.gov (United States)

    Cornu, Jean-Nicolas; Cancel-Tassin, Geraldine; Cox, David G; Roupret, Morgan; Koutlidis, Nicolas; Bigot, Pierre; Valeri, Antoine; Ondet, Valerie; Gaffory, Cécile; Fournier, Georges; Azzouzi, Abdel-Rahmene; Cormier, Luc; Cussenot, Olivier

    2016-07-01

    Prostate-specific antigen (PSA) is still the cornerstone of prostate cancer (PCa) screening and diagnosis in both research and current clinical practice. Inaccuracy of PSA is partly due to the influence of a number of genetic, clinical, and biological factors modifying PSA blood levels. In the present study, we detailed the respective influence of each factor among age, body mass index (BMI), prostate volume, and five single-nucleotide polymorphisms-rs10788160 (10q26), rs10993994 (10q11), rs11067228 (12q24), rs17632542 (19q13.33), and rs2928679 (8p21)-on PSA values in a cohort of 1374 men without PCa. Our results show that genetic factors, when risk variants are combined, influence PSA levels with an effect size similar to that of BMI. Taken together, the respective correlations of clinical parameters and genetic parameters would make it possible to correct and adjust PSA values more effectively in each individual. These results establish the basis to understand and implement a more personalised approach for the interpretation of PSA blood levels in the context of PCa screening and diagnosis. Prostate-specific antigen (PSA) values in an individual may vary according to genetic predisposition. The effect size of this variation can be significant, comparable with those resulting from clinical characteristics. Personalised PSA testing should take this into account. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  2. Androgen deprivation therapy for volume reduction, lower urinary tract symptom relief and quality of life improvement in patients with prostate cancer

    DEFF Research Database (Denmark)

    Axcrona, Karol; Aaltomaa, Sirpa; da Silva, Carlos Martins

    2012-01-01

    Study Type--Therapy (RCT) Level of Evidence 1b. What's known on the subject? and What does the study add? Androgen deprivation therapy (ADT) is commonly used as a primary treatment for patients with prostate cancer (PCa) who are not eligible for radical treatment options. ADT is also used...... in patients with PCa as neo-adjuvant hormone therapy to reduce prostate volume and down-stage the disease before radiotherapy with curative intent. The present study showed that ADT with the gonadotropin hormone-releasing hormone (GhRH) antagonist degarelix is non-inferior to combined treatment with the LHRH...... agonist goserelin and bicalutamide in terms of reducing prostate volume during the treatment period of 3 months. Degarelix treatment evokes, however, significantly better relief of lower urinary tract symptoms in patients having moderate and severe voiding problems....

  3. Significance of prostatic weight in prostatism

    DEFF Research Database (Denmark)

    Jensen, K M; Bruskewitz, R C; Iversen, P

    1983-01-01

    In addition to routine evaluation, 68 patients with prostatism underwent blinded urodynamic testing prior to transurethral prostatectomy and were reexamined symptomatologically and urodynamically at 3 and 12 months after surgery to determine if prostatic weight could predict postoperative outcome....... Resected prostatic weight correlated with estimated weight at cystoscopy and with obstructive symptoms, but not with urodynamic variables of infravesical obstruction. Patients with small prostates improved symptomatologically to the same degree as patients with larger glands, although they did not improve...... to the same degree urodynamically. Prostatic weight, therefore, could not be used to predict the outcome of transurethral surgery....

  4. MRI-based preplanning in low-dose-rate prostate brachytherapy

    International Nuclear Information System (INIS)

    Tanaka, Osamu; Hayashi, Shinya; Matsuo, Masayuki; Nakano, Masahiro; Kubota, Yasuaki; Maeda, Sunaho; Ohtakara, Kazuhiro; Deguchi, Takashi; Hoshi, Hiroaki

    2008-01-01

    Purpose: To compare the dosimetric results between MRI-based and TRUS-based preplanning in permanent prostate brachytherapy, and to estimate the accuracy of MRI-based preplanning by comparing with CT/MRI fusion-based postimplant dosimetry. Methods and materials: Twenty-one patients were entered in this prospective study with written informed consent. MRI-based and TRUS-based preplanning were performed. The seed and needle locations were identical according to MRI-based and TRUS-based preplanning. MRI-based and TRUS-based preplanning were compared using DVH-related parameters. Following brachytherapy, the accuracy of the MRI-based preplanning was evaluated by comparing it with CT/MRI fusion-based postimplant dosimetry. Results: Mean MRI-based prostate volume was slightly underestimated (0.73 cc in mean volume) in comparison to TRUS-based volume. There were no significant differences in the mean DVH-related parameters except with rectal V 100 (cc) between TRUS-based and MRI-based preplanning. Mean rectal V 100 (cc) was 0.74 cc in TRUS-based and 0.29 cc in MRI-based preplanning, respectively, and the values demonstrated a statistical difference. There was no statistical difference in mean rectal V 150 (cc), and rectal V 100 (cc) between MRI-based preplanning and CT/MRI fusion-based postimplant dosimetry. Conclusion: Prostate volume estimation and DVH-related parameters in MRI-based preplanning were almost identical to TRUS-based preplanning. From the results of CT/MRI fusion-based postimplant dosimetry, MRI-based preplanning was therefore found to be a reliable and useful modality, as well as being helpful for TRUS-based preplanning. MRI-based preplanning can more accurately predict postimplant rectal dose than TRUS-based preplanning

  5. Influence of daily setup measurements and corrections on the estimated delivered dose during IMRT treatment of prostate cancer patients

    International Nuclear Information System (INIS)

    Haaren, Paul M.A. van; Bel, Arjan; Hofman, Pieter; Vulpen, Marco van; Kotte, Alexis N.T.J.; Heide, Uulke A. van der

    2009-01-01

    Purpose: To evaluate the impact of marker-based position verification, using daily imaging and an off-line correction protocol, by calculating the delivered dose to prostate, rectum and bladder. Methods: Prostate cancer patients (n = 217) were treated with IMRT, receiving 35 daily fractions. Plans with five beams were optimized taking target coverage (CTV, boost) and organs-at-risk (rectum and bladder) into account. PTV margins were 8 mm. Prostate position was verified daily using implanted fiducial gold markers by imaging the first segment of all the five beams on an EPID. Setup deviations were corrected off-line using an adapted shrinking-action-level protocol. The estimated delivered dose, including daily organ movements, was calculated using a version of PLATO's dose engine, enabling batch processing of large numbers of patients. The dose was calculated ± inclusion of setup corrections, and was evaluated relative to the original static plan. The marker-based measurements were considered representative for all organs. Results: Daily organ movements would result in an underdosage of 2-3 Gy to CTV and boost volume relative to the original plan, which was prevented by daily setup corrections. The dose to rectum and bladder was on average unchanged, but a large spread was introduced by organ movements, which was reduced by including setup corrections. Conclusions: Without position verification and setup corrections, margins of 8mm would be insufficient to account for position uncertainties during IMRT of prostate cancer. With the daily off-line correction protocol, the remaining variations are accommodated adequately

  6. Magnetic Resonance Imaging Provides Added Value to the Prostate Cancer Prevention Trial Risk Calculator for Patients With Estimated Risk of High-grade Prostate Cancer Less Than or Equal to 10.

    Science.gov (United States)

    Kim, Eric H; Weaver, John K; Shetty, Anup S; Vetter, Joel M; Andriole, Gerald L; Strope, Seth A

    2017-04-01

    To determine the added value of prostate magnetic resonance imaging (MRI) to the Prostate Cancer Prevention Trial risk calculator. Between January 2012 and December 2015, 339 patients underwent prostate MRI prior to biopsy at our institution. MRI was considered positive if there was at least 1 Prostate Imaging Reporting and Data System 4 or 5 MRI suspicious region. Logistic regression was used to develop 2 models: biopsy outcome as a function of the (1) Prostate Cancer Prevention Trial risk calculator alone and (2) combined with MRI findings. When including all patients, the Prostate Cancer Prevention Trial with and without MRI models performed similarly (area under the curve [AUC] = 0.74 and 0.78, P = .06). When restricting the cohort to patients with estimated risk of high-grade (Gleason ≥7) prostate cancer ≤10%, the model with MRI outperformed the Prostate Cancer Prevention Trial alone model (AUC = 0.69 and 0.60, P = .01). Within this cohort of patients, there was no significant difference in discrimination between models for those with previous negative biopsy (AUC = 0.61 vs 0.63, P = .76), whereas there was a significant improvement in discrimination with the MRI model for biopsy-naïve patients (AUC = 0.72 vs 0.60, P = .01). The use of prostate MRI in addition to the Prostate Cancer Prevention Trial risk calculator provides a significant improvement in clinical risk discrimination for patients with estimated risk of high-grade (Gleason ≥7) prostate cancer ≤10%. Prebiopsy prostate MRI should be strongly considered for these patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Timing of computed tomography-based postimplant assessment following permanent transperineal prostate brachytherapy

    International Nuclear Information System (INIS)

    Prestidge, Bradley R.; Bice, William S.; Kiefer, Eric J.; Prete, James J.

    1998-01-01

    Purpose: To establish the rate of resolution of prostatic edema following transperineal interstitial permanent prostate brachytherapy, and to determine the results and impact of timing of the postimplant assessment on the dose-volume relationship. Methods and Materials: A series of 19 consecutive patients with early-stage adenocarcinoma of the prostate receiving transperineal interstitial permanent prostate brachytherapy, were enrolled in this study. Twelve received 125 I and seven received 103 Pd. Postoperative assessment included a computed tomographic (CT) scan on postoperative days 1, 8, 30, 90, and 180. On each occasion, CT scans were performed on a GE helical unit at 3-mm abutting slices, 15-cm field of view. Prostate volumes were outlined on CT scans by a single clinician. Following digitization of the volumes and radioactive sources, volumes and dose-volume histograms were calculated. The prostate volume encompassed by the 80% and 100% reference isodose volumes was calculated. Results: Preimplant transrectal ultrasound determined volumes varied from 17.5 to 38.6 cc (median 27.9 cc). Prostate volumes previously defined on 40 randomly selected postimplant CT scans were compared in a blinded fashion to a second CT-derived volume and ranged from -32% to +24%. The Pearson correlation coefficient for prostate CT volume reproducibility was 0.77 (p < 0.03). CT scan-determined volume performed on postoperative day 1 was an average of 41.4% greater than the volume determined by preimplant ultrasound. Significant decreases in average volume were seen during the first month postoperatively. Average volume decreased 14% from day 1 to day 8, 10% from day 8 to day 30, 3% from day 30 to day 90, and 2% thereafter. Coverage of the prostate volume by the 80% isodose volume increased from 85.6% on postoperative day 1 to 92.2% on postoperative day 180. The corresponding increase in the 100% reference dose coverage of the prostate volume ranged from 73.1% to 83.3% between

  8. Factors Affecting the Improvement of the Initial Peak Urinary Flow Rate after Transurethral Resection of the Prostate or Photoselective Vaporization of the Prostate for Treating Benign Prostatic Hyperplasia

    Directory of Open Access Journals (Sweden)

    Hwa Sub Choi

    2011-03-01

    Full Text Available Purpose We evaluated the factors that affect the improvement of the initial peak flow rate after transurethral resection of the prostate (TURP or photoselective vaporization of the prostate (PVP for benign prostatic hyperplasia (BPH patients by using noninvasive tools. Methods One hundred and twenty seven BPH patients who had undergone TURP or PVP between January 2005 and May 2009 were evaluated. They were divided into 2 groups: the postoperative initial peak urinary flow rate (Qmax was less than 10 mL/sec (Group 1; n=37, TURP=11, PVP=26 and more than 10 mL/sec (Group 2; n=90, TURP=41, PVP=49. We confirmed the patients' preoperative check lists. The check list were the international prostate symptom score (IPSS, the quality of life score, a past history of acute urinary retention (AUR, body mass index and/or pyuria, the serum prostate-specific antigen (PSA level and the prostate volume, the prostate transitional zone volume and prostatic calcification. The initial Qmax was measured at the outpatient clinic one week after discharge. Results The improvement rate was not significant difference between the TURP group (78.8% and the PVP group (65.3%. The efficacy parameters were the IPSS-storage symptom score, the prostate volume, the PSA level and a past history of AUR. The IPSS-storage symptom scores of Group 1 (12.3±3.3 was higher than those of Group 2 (10.5±1.7. The prostate volume of Group 2 (42.3±16.6 g was bigger than that of Group 1 (36.6±7.8 g. The PSA level of Group 2 (3.8±2.6 ng/mL was higher than that of Group 1 (2.6±2.6 ng/mL. A past history of AUR in Group 1 (35.1% was more prevalent than that of Group 2 (15.6%. Conclusions The non-invasive factors affecting the initial Qmax after TURP or PVP were the IPSS-storage symptom score, the prostate volume and a past history of AUR. Accordingly, in patients who have a higher IPSS-storage symptom score, a smaller prostate volume and a history of AUR, there might be a detrimental effect on

  9. 3D-segmentation of the 18F-choline PET signal for target volume definition in radiation therapy of the prostate.

    Science.gov (United States)

    Ciernik, I Frank; Brown, Derek W; Schmid, Daniel; Hany, Thomas; Egli, Peter; Davis, J Bernard

    2007-02-01

    Volumetric assessment of PET signals becomes increasingly relevant for radiotherapy (RT) planning. Here, we investigate the utility of 18F-choline PET signals to serve as a structure for semi-automatic segmentation for forward treatment planning of prostate cancer. 18F-choline PET and CT scans of ten patients with histologically proven prostate cancer without extracapsular growth were acquired using a combined PET/CT scanner. Target volumes were manually delineated on CT images using standard software. Volumes were also obtained from 18F-choline PET images using an asymmetrical segmentation algorithm. PTVs were derived from CT 18F-choline PET based clinical target volumes (CTVs) by automatic expansion and comparative planning was performed. As a read-out for dose given to non-target structures, dose to the rectal wall was assessed. Planning target volumes (PTVs) derived from CT and 18F-choline PET yielded comparable results. Optimal matching of CT and 18F-choline PET derived volumes in the lateral and cranial-caudal directions was obtained using a background-subtracted signal thresholds of 23.0+/-2.6%. In antero-posterior direction, where adaptation compensating for rectal signal overflow was required, optimal matching was achieved with a threshold of 49.5+/-4.6%. 3D-conformal planning with CT or 18F-choline PET resulted in comparable doses to the rectal wall. Choline PET signals of the prostate provide adequate spatial information amendable to standardized asymmetrical region growing algorithms for PET-based target volume definition for external beam RT.

  10. Defining the implant treatment volume for patients with low risk prostate cancer: does the anterior base need to be treated?

    International Nuclear Information System (INIS)

    D'Amico, Anthony V.; Davis, Ann; Vargas, Sara O.; Renshaw, Andrew A.; Jiroutek, Michael; Richie, Jerome P.

    1999-01-01

    Purpose: An increased incidence of acute urinary retention has been reported after interstitial prostate radiation therapy when the anterior base of the prostate gland receives 100% of the prescription dose. The frequency of prostate cancer in this location as a function of the pre-treatment prostate specific antigen (PSA), biopsy Gleason score, and 1992 American Joint Commission on Cancer Staging (AJCC) was determined. Methods and Materials: One hundred four men treated at the Brigham and Women's Hospital with radical prostatectomy for clinically localized prostate cancer between 1995-1996 comprised the study population. Prostatectomy specimens were whole mounted and the location of each tumor foci enumerated. Results: Of 269 foci of prostate cancer found in 39 low-risk prostate cancer patients (PSA 1c,2a ), a single focus (0.37%) was noted in the anterior base. Conversely, 20/355 (5.6%) and 18/251 (7.2%) tumor foci were noted in the anterior base in 43 patients with intermediate risk and 24 patients with high-risk disease, respectively. Conclusions: A new definition of the treatment volume excluding the anterior base for low-risk prostate cancer patients may be justified

  11. Correlation of ultrasound estimated placental volume and umbilical cord blood volume in term pregnancy.

    Science.gov (United States)

    Pannopnut, Papinwit; Kitporntheranunt, Maethaphan; Paritakul, Panwara; Kongsomboon, Kittipong

    2015-01-01

    To investigate the correlation between ultrasound measured placental volume and collected umbilical cord blood (UCB) volume in term pregnancy. An observational cross-sectional study of term singleton pregnant women in the labor ward at Maha Chakri Sirindhorn Medical Center was conducted. Placental thickness, height, and width were measured using two-dimensional (2D) ultrasound and calculated for placental volume using the volumetric mathematic model. After the delivery of the baby, UCB was collected and measured for its volume immediately. Then, birth weight, placental weight, and the actual placental volume were analyzed. The Pearson's correlation was used to determine the correlation between each two variables. A total of 35 pregnant women were eligible for the study. The mean and standard deviation of estimated placental volume and actual placental volume were 534±180 mL and 575±118 mL, respectively. The median UCB volume was 140 mL (range 98-220 mL). The UCB volume did not have a statistically significant correlation with the estimated placental volume (correlation coefficient 0.15; p=0.37). However, the UCB volume was significantly correlated with the actual placental volume (correlation coefficient 0.62; pcorrelation coefficient 0.38; p=0.02). The estimated placental volume by 2D ultrasound was not significantly correlated with the UCB volume. Further studies to establish the correlation between the UCB volume and the estimated placental volume using other types of placental imaging may be needed.

  12. Prostate size and adverse pathologic features in men undergoing radical prostatectomy.

    Science.gov (United States)

    Hong, Sung Kyu; Poon, Bing Ying; Sjoberg, Daniel D; Scardino, Peter T; Eastham, James A

    2014-07-01

    To investigate the relationship between prostate volume measured from preoperative imaging and adverse pathologic features at the time of radical prostatectomy and evaluate the potential effect of clinical stage on such relationship. In 1756 men who underwent preoperative magnetic resonance imaging and radical prostatectomy from 2000 to 2010, we examined associations of magnetic resonance imaging-measured prostate volume with pathologic outcomes using univariate logistic regression and with postoperative biochemical recurrence using Cox proportional hazards models. We also analyzed the effects of clinical stage on the relationship between prostate volume and adverse pathologic features via interaction analyses. In univariate analyses, smaller prostate volume was significantly associated with high pathologic Gleason score (P.05). The association between prostate volume and recurrence was significant in a multivariable analysis adjusting for postoperative variables (P=.031) but missed statistical significance in the preoperative model (P=.053). Addition of prostate volume did not change C-Indices (0.78 and 0.83) of either model. Although prostate size did not enhance the prediction of recurrence, it is associated with aggressiveness of prostate cancer. There is no evidence that this association differs depending on clinical stage. Prospective studies are warranted assessing the effect of initial method of detection on the relationship between volume and outcome. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Effect of serum testosterone and percent tumor volume on extra-prostatic extension and biochemical recurrence after laparoscopic radical prostatectomy

    Directory of Open Access Journals (Sweden)

    Eu Chang Hwang

    2016-01-01

    Full Text Available Several studies have revealed that the preoperative serum testosterone and percent tumor volume (PTV predict extra-prostatic extension (EPE and biochemical recurrence (BCR after radical prostatectomy. This study investigated the prognostic significance of serum testosterone and PTV in relation to EPE and BCR after laparoscopic radical prostatectomy (LRP. We reviewed 520 patients who underwent LRP between 2004 and 2012. PTV was determined as the sum of all visually estimated tumor foci in every section. BCR was defined as two consecutive increases in the postoperative prostate-specific antigen (PSA >0.2 ng ml−1 . The threshold for serum total testosterone was 3.0 ng ml−1 . Multivariate logistic regression was used to define the effect of variables on the risk of EPE and BCR. A low serum testosterone (<3.0 ng ml−1 was associated with a high serum PSA, Gleason score, positive core percentage of the prostate biopsy, PTV, and all pathological variables. On multivariate analysis, similar to previous studies, the serum PSA, biopsy positive core percentage, Gleason score, and pathological variables predicted EPE and BCR. In addition, low serum testosterone (<3.0 ng ml−1 , adjusted OR, 8.52; 95% CI, 5.04-14.4, P= 0.001 predicted EPE and PTV (adjusted OR, 1.02; 95% CI, 1.01-1.05, P= 0.046 predicted BCR. In addition to previous predictors of EPE and BCR, low serum testosterone and PTV are valuable predictors of EPE and BCR after LRP.

  14. Relative Risks for Lethal Prostate Cancer Based on Complete Family History of Prostate Cancer Death.

    Science.gov (United States)

    Albright, Frederick S; Stephenson, Robert A; Agarwal, Neeraj; Cannon-Albright, Lisa A

    2017-01-01

    There are few published familial relative risks (RR) for lethal prostate cancer. This study estimates RRs for lethal prostate cancer based on comprehensive family history data, with the goal of improving identification of those men at highest risk of dying from prostate cancer. We used a population-based genealogical resource linked to a statewide electronic SEER cancer registry and death certificates to estimate relative risks (RR) for death from prostate cancer based upon family history. Over 600,000 male probands were analyzed, representing a variety of family history constellations of lethal prostate cancer. RR estimates were based on the ratio of the observed to the expected number of lethal prostate cancer cases using internal rates. RRs for lethal prostate cancer based on the number of affected first-degree relatives (FDR) ranged from 2.49 (95% CI: 2.27, 2.73) for exactly 1 FDR to 5.30 (2.13, 10.93) for ≥3 affected FDRs. In an absence of affected FDRs, increased risk was also significant for increasing numbers of affected second-degree or third degree relatives. Equivalent risks were observed for similar maternal and paternal family history. This study provides population-based estimates of lethal prostate cancer risk based on lethal prostate cancer family history. Many family history constellations associated with two to greater than five times increased risk for lethal prostate cancer were identified. These lethal prostate cancer risk estimates hold potential for use in identification, screening, early diagnosis, and treatment of men at high risk for death from prostate cancer. Prostate77:41-48, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  15. Estimating traffic volume on Wyoming low volume roads using linear and logistic regression methods

    Directory of Open Access Journals (Sweden)

    Dick Apronti

    2016-12-01

    Full Text Available Traffic volume is an important parameter in most transportation planning applications. Low volume roads make up about 69% of road miles in the United States. Estimating traffic on the low volume roads is a cost-effective alternative to taking traffic counts. This is because traditional traffic counts are expensive and impractical for low priority roads. The purpose of this paper is to present the development of two alternative means of cost-effectively estimating traffic volumes for low volume roads in Wyoming and to make recommendations for their implementation. The study methodology involves reviewing existing studies, identifying data sources, and carrying out the model development. The utility of the models developed were then verified by comparing actual traffic volumes to those predicted by the model. The study resulted in two regression models that are inexpensive and easy to implement. The first regression model was a linear regression model that utilized pavement type, access to highways, predominant land use types, and population to estimate traffic volume. In verifying the model, an R2 value of 0.64 and a root mean square error of 73.4% were obtained. The second model was a logistic regression model that identified the level of traffic on roads using five thresholds or levels. The logistic regression model was verified by estimating traffic volume thresholds and determining the percentage of roads that were accurately classified as belonging to the given thresholds. For the five thresholds, the percentage of roads classified correctly ranged from 79% to 88%. In conclusion, the verification of the models indicated both model types to be useful for accurate and cost-effective estimation of traffic volumes for low volume Wyoming roads. The models developed were recommended for use in traffic volume estimations for low volume roads in pavement management and environmental impact assessment studies.

  16. Methodology for generating waste volume estimates

    International Nuclear Information System (INIS)

    Miller, J.Q.; Hale, T.; Miller, D.

    1991-09-01

    This document describes the methodology that will be used to calculate waste volume estimates for site characterization and remedial design/remedial action activities at each of the DOE Field Office, Oak Ridge (DOE-OR) facilities. This standardized methodology is designed to ensure consistency in waste estimating across the various sites and organizations that are involved in environmental restoration activities. The criteria and assumptions that are provided for generating these waste estimates will be implemented across all DOE-OR facilities and are subject to change based on comments received and actual waste volumes measured during future sampling and remediation activities. 7 figs., 8 tabs

  17. The Effect of Tumor-Prostate Ratio on Biochemical Recurrence after Radical Prostatectomy

    Directory of Open Access Journals (Sweden)

    Sung Yong Cho

    2016-08-01

    Full Text Available Purpose: Prostate tumor volume calculated after surgery using pathologic tissue has been shown to be an independent risk factor for biochemical recurrence. Nonetheless, prostate size varies among individuals, regardless of the presence or absence of cancer. We assumed to be lower margin positive rate in the surgical operation, when the prostate volume is larger and the tumor lesion is same. Thus, we defined the tumor-prostate ratio in the ratio of tumor volume to prostate volume. In order to compensate the prostate tumor volume, the effect of tumor-prostate ratio on biochemical recurrence was examined. Materials and Methods: This study included 251 patients who underwent open retropubic radical prostatectomy for prostate cancer in a single hospital. We analyzed the effects of tumor volume and tumor-prostate ratio, as well as the effects of known risk factors for biochemical recurrence, on the duration of disease-free survival. Results: In the univariate analysis, the risk factors that significantly impacted disease-free survival time were found to be a prostate-specific antigen level ≥10 ng/mL, a tumor volume ≥5 mL, tumor-prostate ratio ≥10%, tumor capsular invasion, lymph node invasion, positive surgical margins, and seminal vesicle invasion. In the multivariate analysis performed to evaluate the risk factors found to be significant in the univariate analysis, positive surgical margins (hazard ratio=3.066 and a tumor density ≥10% (hazard ratio=1.991 were shown to be significant risk factors for biochemical recurrence. Conclusions: Tumor-prostate ratio, rather than tumor volume, should be regarded as a significant risk factor for biochemical recurrence.

  18. Evaluation of permanent I-125 prostate implants using radiography and magnetic resonance imaging

    International Nuclear Information System (INIS)

    Moerland, Marinus A.; Wijrdeman, Harm K.; Beersma, Robert; Bakker, Chris J.G.; Battermann, Jan J.

    1997-01-01

    Purpose: The aim of this study is the evaluation of permanent I-125 prostate implants using radiography and magnetic resonance imaging (MRI). Methods and Materials: Twenty-one patients underwent radiography on the simulator and MRI within 3 days after implantation of the I-125 seeds. Isocentric radiographs were used for reconstruction of the seed distribution, after which registration with the seed-induced signal voids on MRI provided the seed positions in relation to the prostate. The prostate was contoured on the transversal magnetic resonance images, and dose-volume histograms were computed to evaluate the implants. The validity of the ellipsoidal prostate volume approximation, as applied in preimplant dose calculation, was assessed by comparison of ellipsoidal volumes given by prostate width, height, and length and prostate volumes obtained by a slice-by-slice contouring method, both on postimplant MRI. Prostate volume changes due to postimplant prostate swelling were assessed from radiographs taken at 3 days and 1 month after the implantation. Results: The seeds were readily identified on T 1 -weighted spin-echo images and matched with the seed distribution reconstructed from the isocentric radiographs. The matching error, averaged over 21 patients, amounted to 1.8 ± 0.4 mm (mean ± standard deviation). The fractions of the prostate volumes receiving the prescribed matched peripheral dose (MPD) ranged from 32 to 71% (mean ± standard deviation: 60 ± 10%). Prostate volumes, obtained by the contouring method on postimplant MRI, were a factor 1.5 ± 0.3 larger than the ellipsoidal volumes given by the prostate dimensions on postimplant MRI. Prostate volumes 3 days after the implantation were a factor 1.3 ± 0.2 larger than the prostate volumes 1 month after the implantation. Registration of the reconstructed seed distribution and the MR images showed inaccuracies in seed placement, for example, two or more seeds clustering together or seeds outside the prostate

  19. Synergistic interaction of benign prostatic hyperplasia and prostatitis on prostate cancer risk

    Science.gov (United States)

    Hung, S-C; Lai, S-W; Tsai, P-Y; Chen, P-C; Wu, H-C; Lin, W-H; Sung, F-C

    2013-01-01

    Background: The incidence of prostate cancer is much lower in Asian men than in Western men. This study investigated whether prostate cancer is associated with prostatitis, benign prostatic hyperplasia (BPH), and other medical conditions in the low-incidence population. Methods: From the claims data obtained from the universal National Health Insurance of Taiwan, we identified 1184 patients with prostate cancer diagnosed from 1997 to 2008. Controls comprised 4736 men randomly selected from a cancer-free population. Both groups were 50 years of age or above. Medical histories between the two groups were compared. Results: Multivariate logistic regression analysis showed that prostatitis and BPH had stronger association with prostate cancer than the other medical conditions tested. Compared with men without prostatitis and BPH, a higher odds ratio (OR) for prostate cancer was associated with BPH (26.2, 95% confidence interval (CI) 20.8–33.0) than with prostatitis (10.5, 95% CI=3.36–32.7). Men with both conditions had an OR of 49.2 (95% CI=34.7–69.9). Conclusion: Men with prostate cancer have strong association with prostatitis and/or BPH. Prostatitis interacts with BPH, resulting in higher estimated relative risk of prostate cancer in men suffering from both conditions. PMID:23612451

  20. Disease volume and distribution as drivers of treatment decisions in metastatic prostate cancer: From chemohormonal therapy to stereotactic ablative radiotherapy of oligometastases.

    Science.gov (United States)

    Saluja, Ronak; Cheung, Patrick; Zukotynski, Katherine; Emmenegger, Urban

    2016-05-01

    The prognosis of men with metastatic, castration-sensitive prostate cancer (CSPC) depends on both the distribution and extent of metastases, among other things. Patients with low-volume or oligometastatic disease have improved survival compared with those with high-volume metastases. While chemohormonal therapy is the new standard of care for men with high-volume metastatic CSPC, stereotactic ablative radiotherapy (SABR) is emerging as a promising treatment option with low toxicity for the management of oligometastatic CSPC. Our review summarizes the current evidence on the role of SABR in oligometastatic prostate cancer. SABR shows control rates of metastases ranging from 88% to 100% at 6 months to 3 years, and progression-free survival commonly reported as >50% for the first 12 months. In addition, SABR may allow androgen-deprivation therapy to be delayed by more than 2 years in selected patients, minimizing the chronic side effects associated with such therapy. However, much still needs to be learned before SABR can be implemented as standard treatment for oligometastatic prostate cancer. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Changes in prostate shape and volume and their implications for radiotherapy after introduction of endorectal balloon as determined by MRI at 3T.

    NARCIS (Netherlands)

    Heijmink, S.W.T.P.J.; Scheenen, T.W.J.; Lin, E.N.J.T. van; Visser, A.G.; Kiemeney, L.A.L.M.; Witjes, J.A.; Barentsz, J.O.

    2009-01-01

    PURPOSE: To determine the changes in prostate shape and volume after the introduction of an endorectal coil (ERC) by means of magnetic resonance imaging (MRI) at 3T. METHODS AND MATERIALS: A total of 44 consecutive patients with biopsy-proven prostate cancer underwent separate MRI examinations at 3T

  2. Development of prostate voxel models for brachytherapy treatment

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Adriano M.; Reis, Lucas P.; Grynberg, Suely E., E-mail: amsantos@cdtn.b [Center for Development of Nuclear Technology (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2011-07-01

    The tools developed recently in the areas of computer graphics and animation movies to computer games allow the creation of new voxel anthropomorphic phantoms with better resolution and thus, more anatomical details. These phantoms can be used in nuclear applications, especially in radiation protection for estimating doses in cases of occupational or accidental radioactive incidents, and in medical and biological applications. For dose estimates, the phantoms are coupled to a Monte Carlo code, which will be responsible for the transport of radiation in this environment. This study aimed to develop a computational tool to estimate the isodose curves in the prostate after brachytherapy seed implants. For this, we have created a model called FANTPROST in the shape of a 48 mm side cube, with a standard prostate inserted in the center of this cube with different distributions of brachytherapy seeds in this volume. The prostate, according to this model, was obtained from the phantom voxels MASH2 developed by Numerical Dosimetry Group, Department of Nuclear Energy - Federal University of Pernambuco. The modeling of the seeds, added to FANTPROST, was done through the use of geometric information of Iodine-125 Amersham 6711 commercial seed. The simulations were performed by the code MCNP5 for spatial distributions containing different amounts of seeds within the FANTPROST. The obtained curves allowed an estimation of the behavior of the maximum dose that decreases with distance, showing that this tool can be used for a more accurate analysis of the effects produced by the presence of such seeds in the prostate and its vicinity. (author)

  3. The role of chronic prostatic inflammation in the pathogenesis and progression of benign prostatic hyperplasia (BPH).

    Science.gov (United States)

    Gandaglia, Giorgio; Briganti, Alberto; Gontero, Paolo; Mondaini, Nicola; Novara, Giacomo; Salonia, Andrea; Sciarra, Alessandro; Montorsi, Francesco

    2013-08-01

    Several different stimuli may induce chronic prostatic inflammation, which in turn would lead to tissue damage and continuous wound healing, thus contributing to prostatic enlargement. Patients with chronic inflammation and benign prostatic hyperplasia (BPH) have been shown to have larger prostate volumes, more severe lower urinary tract symptoms (LUTS) and a higher probability of acute urinary retention than their counterparts without inflammation. Chronic inflammation could be a predictor of poor response to BPH medical treatment. Thus, the ability to identify patients with chronic inflammation would be crucial to prevent BPH progression and develop target therapies. Although the histological examination of prostatic tissue remains the only available method to diagnose chronic inflammation, different parameters, such as prostatic calcifications, prostate volume, LUTS severity, storage and prostatitis-like symptoms, poor response to medical therapies and urinary biomarkers, have been shown to be correlated with chronic inflammation. The identification of patients with BPH and chronic inflammation might be crucial in order to develop target therapies to prevent BPH progression. In this context, clinical, imaging and laboratory parameters might be used alone or in combination to identify patients that harbour chronic prostatic inflammation. © 2013 BJU International.

  4. A pilot study evaluating a new questionnaire for prostatic symptom scoring, the SPSS, and its sensitivity as constructed to objective measures of outflow obstruction.

    Science.gov (United States)

    Yano, Masataka; Kitahara, Satoshi; Yasuda, Kosaku; Yamanishi, Tomonori; Nakai, Hideo; Yanagisawa, Ryouzo; Morozumi, Makoto; Homma, Yukio

    2004-05-01

    To evaluate the extent to which our newly developed questionnaire, the Saitama Prostate Symptom Score (SPSS), for prostatic symptom scoring reflects objective findings in benign prostatic hyperplasia (clinical BPH) and to compare it with the International Prostate Symptom Score (IPSS) with regard to diagnostic sensitivity in clinical BPH. In this study, both the SPSS and the IPSS were self-administered by patients. Free uroflowmetry, a pressure-flow study and the measurement of prostatic volume were carried out. There was no significant correlation between the results of the IPSS questionnaire and the urethral obstruction grade estimated by Schaefer or Abrams-Griffiths nomograms. The total score of the SPSS was correlated with these nomograms (P = 0.0487 and P = 0.0413, respectively). There was no significant correlation between the results of the IPSS questionnaire and the total volume or transition zone volume of the prostate, whereas the total score of the SPSS correlated with the total volume of the gland and transition zone volume (P = 0.0044 and P= 0.0051, respectively). This study revealed the SPSS to correlate with objective findings satisfactorily. However, there are still several aspects of the SPSS which need to be improved upon, and the questionnaire should be studied in larger numbers of patients suffering from lower urinary tract symptoms.

  5. Dosimetry in VMAT for prostate using ionization chambers of different volumes

    International Nuclear Information System (INIS)

    Groppo, Daniela P.; Anderson, Ernani; Pavan, Guilherme A.; Caldas, Linda V.E.

    2016-01-01

    The volumetric modulated arc therapy is one of the most modern radiotherapy techniques. The advents of this modality in the dose delivery can also contribute to errors during the execution of the treatment, therefore various types of quality control are carried out. The individual assessment of dose delivered to the patient is also an important quality control test and required by the current regulations. The objective of this study was to evaluate the use of different volume ionization chambers for dosimetry of VMAT treatments for prostate cancer. Three ionization chambers were evaluated and all of them showed satisfactory results. (author)

  6. Prostatic intraepithelial neoplasia-like ductal prostatic adenocarcinoma: A case suitable for active surveillance?

    Directory of Open Access Journals (Sweden)

    Soroush Rais-Bahrami

    2017-01-01

    Full Text Available In contrast to typical prostatic ductal adenocarcinoma, prostatic intraepithelial neoplasia (PIN-like ductal adenocarcinoma is a rare variant of prostate cancer with low-grade clinical behavior. We report a case of a 66-year-old African-American male with an elevated serum prostate-specific antigen who underwent multiparametric prostate magnetic resonance imaging (MRI and MRI/ultrasound fusion-guided biopsies. Pathology demonstrated low-volume Gleason score 3 + 3 = 6 (Grade Group 1, acinar adenocarcinoma involving one core and PIN-like ductal adenocarcinoma on a separate core. Herein, we discuss the potential role of active surveillance for patients with this rare variant of prostate cancer found in the era of advanced imaging with multiparametric MRI for prostate cancer.

  7. [Correlation of IL-8 and IL-6 in prostatic fluid with serum prostate-specific antigen level in patients with benign prostatic hyperplasia complicated by prostatitis].

    Science.gov (United States)

    Ren, Xingfei; Wu, Chunlei; Yu, Qinnan; Zhu, Feng; Liu, Pei; Zhang, Huiqing

    2016-01-01

    To investigate the correlation of the levels of interleukin-8 (IL-8) and IL-6 in the prostatic fluid with serum levels of serum prostate-specific antigen (PSA) in patients with benign prostatic hyperplasia (BPH) complicated by prostatitis. A series of 211 patients undergoing surgery of BPH were divided into BPH group (n=75) and BPH with prostatitis group (n=136) according to the white blood cell count in the prostatic fluid. The clinical and laboratory findings were compared between the two groups, and stepwise regression analysis was used to assess the association of IL-8 and IL-6 with serum PSA level. No significant differences were found in age, BMI, blood pressure, blood glucose, blood lipids, IPSS score, PSA-Ratio, or prostate volume between the two groups (Pprostatitis had significantly increased serum PSA and prostate fluid IL-8 and IL-6 levels compared with those without prostatitis (Pprostatic fluid were all positively correlated with serum PSA level. Prostatitis is an important risk factor for elevated serum PSA level in patients with BPH, and both IL-8 and IL-6 levels in the prostatic fluid are correlated with serum PSA level.

  8. Prevalence and prognosis of low-volume, oligorecurrent, hormone-sensitive prostate cancer amenable to lesion ablative therapy.

    Science.gov (United States)

    De Bruycker, Aurélie; Lambert, Bieke; Claeys, Tom; Delrue, Louke; Mbah, Chamberlain; De Meerleer, Gert; Villeirs, Geert; De Vos, Filip; De Man, Kathia; Decaestecker, Karel; Fonteyne, Valérie; Lumen, Nicolaas; Ameye, Filip; Billiet, Ignace; Joniau, Steven; Vanhaverbeke, Friedl; Duthoy, Wim; Ost, Piet

    2017-12-01

    To describe the anatomical patterns of prostate cancer (PCa) recurrence after primary therapy and to investigate if patients with low-volume disease have a better prognosis as compared with their counterparts. Patients eligible for an 18-F choline positron-emission tomography (PET)-computed tomography (CT) were enrolled in a prospective cohort study. Eligible patients had asymptomatic biochemical recurrence after primary PCa treatment and testosterone levels >50 ng/mL. The number of lesions was counted per scan. Patients with isolated local recurrence (LR) or with ≤3 metastases (with or without LR) were considered to have low-volume disease and patients with >3 metastases to have high-volume disease. Descriptive statistics were used to report recurrences. Cox regression analysis was used to investigate the influence of prognostic variables on the time to developing castration-resistant PCa (CRPC). In 208 patients, 625 sites of recurrence were detected in the lymph nodes (N1/M1a: 30%), the bone (18%), the prostate (bed; 11%), viscera (4%), or a combination of any of the previous (37%). In total, 153 patients (74%) had low-volume recurrence and 55 patients (26%) had high-volume recurrence. The 3-year CRPC-free survival rate for the whole cohort was 79% (95% confidence interval 43-55), 88% for low-volume recurrences and 50% for high-volume recurrences (P < 0.001). Longer PSA doubling time at time of recurrence and low-volume disease were associated with a longer time to CRPC. Three out of four patients with PCa with a 18-F choline PET-CT-detected recurrence have low-volume disease, potentially amenable to local therapy. Patients with low-volume disease have a better prognosis as compared with their counterparts. Lymph node recurrence was the most dominant failure pattern. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

  9. Post-mortem virtual estimation of free abdominal blood volume

    International Nuclear Information System (INIS)

    Ampanozi, Garyfalia; Hatch, Gary M.; Ruder, Thomas D.; Flach, Patricia M.; Germerott, Tanja; Thali, Michael J.; Ebert, Lars C.

    2012-01-01

    Purpose: The purpose of this retrospective study was to examine the reliability of virtually estimated abdominal blood volume using segmentation from postmortem computed tomography (PMCT) data. Materials and methods: Twenty-one cases with free abdominal blood were investigated by PMCT and autopsy. The volume of the blood was estimated using a manual segmentation technique (Amira, Visage Imaging, Germany) and the results were compared to autopsy data. Six of 21 cases had undergone additional post-mortem computed tomographic angiography (PMCTA). Results: The virtually estimated abdominal blood volumes did not differ significantly from those measured at autopsy. Additional PMCTA did not bias data significantly. Conclusion: Virtual estimation of abdominal blood volume is a reliable technique. The virtual blood volume estimation is a useful tool to deliver additional information in cases where autopsy is not performed or in cases where a postmortem angiography is performed

  10. Impact of geometric uncertainties on evaluation of treatment techniques for prostate cancer

    International Nuclear Information System (INIS)

    Craig, Tim; Wong, Eugene; Bauman, Glenn; Battista, Jerry; Van Dyk, Jake

    2005-01-01

    Purpose: To assess the impact of patient repositioning and internal organ motion on prostate treatment plans using three-dimensional conformal and intensity-modulated radiotherapy. Methods and materials: Four-field, six-field, and simplified intensity-modulated arc therapy plans were generated for 5 prostate cancer patients. The planning target volume was created by adding a 1-cm margin to the clinical target volume. A convolution model was used to estimate the effect of random geometric uncertainties during treatment. Dose statistics, tumor control probabilities, and normal tissue complication probabilities were compared with and without the presence of uncertainty. The impact of systematic uncertainties was also investigated. Results: Compared with the planned treatments, the delivered dose distribution with random geometric uncertainties displayed an increase in the apparent minimal dose to the prostate and seminal vesicles and a decrease in the rectal volume receiving a high dose. This increased the tumor control probabilities and decreased the normal tissue complication probabilities. Changes were seen in the percentage of prostate volume receiving 100% and 95% of the prescribed dose, and the minimal dose and tumor control probabilities for the target volume. In addition, the volume receiving at least 65 Gy, the minimal dose, and normal tissue complication probabilities changed considerably for the rectum. The simplified intensity-modulated arc therapy technique was the most sensitive to systematic errors, especially in the anterior-posterior and superior-inferior directions. Conclusion: Geometric uncertainties should be considered when evaluating treatment plans. Contrary to the widely held belief, increased conformation of the dose distribution is not always associated with increased sensitivity to random geometric uncertainties if a sufficient planning target volume margin is used. Systematic errors may have a variable effect, depending on the treatment

  11. Effects of uncertainty in model predictions of individual tree volume on large area volume estimates

    Science.gov (United States)

    Ronald E. McRoberts; James A. Westfall

    2014-01-01

    Forest inventory estimates of tree volume for large areas are typically calculated by adding model predictions of volumes for individual trees. However, the uncertainty in the model predictions is generally ignored with the result that the precision of the large area volume estimates is overestimated. The primary study objective was to estimate the effects of model...

  12. Ejaculatory Function After Permanent 125I Prostate Brachytherapy for Localized Prostate Cancer

    International Nuclear Information System (INIS)

    Huyghe, Eric; Delannes, Martine; Wagner, Fabien M.; Delaunay, Boris; Nohra, Joe; Thoulouzan, Matthieu; Shut-Yee, J. Yeung; Plante, Pierre; Soulie, Michel; Thonneau, Patrick; Bachaud, Jean Marc

    2009-01-01

    Purpose: Ejaculatory function is an underreported aspect of male sexuality in men treated for prostate cancer. We conducted the first detailed analysis of ejaculatory function in patients treated with permanent 125 I prostate brachytherapy for localized prostate cancer. Patients and Methods: Of 270 sexually active men with localized prostate cancer treated with permanent 125 I prostate brachytherapy, 241 (89%), with a mean age of 65 years (range, 43-80), responded to a mailed questionnaire derived from the Male Sexual Health Questionnaire regarding ejaculatory function. Five aspects of ejaculatory function were examined: frequency, volume, dry ejaculation, pleasure, and pain. Results: Of the 241 sexually active men, 81.3% had conserved ejaculatory function after prostate brachytherapy; however, the number of patients with rare/absent ejaculatory function was double the pretreatment number (p < .0001). The latter finding was correlated with age (p < .001) and the preimplant International Index of Erectile Function score (p < .001). However, 84.9% of patients with maintained ejaculatory function after implantation reported a reduced volume of ejaculate compared with 26.9% before (p < .001), with dry ejaculation accounting for 18.7% of these cases. After treatment, 30.3% of the patients experienced painful ejaculation compared with 12.9% before (p = .0001), and this was associated with a greater number of implanted needles (p = .021) and the existence of painful ejaculation before implantation (p < .0001). After implantation, 10% of patients who continued to be sexually active experienced no orgasm compared with only 1% before treatment. in addition, more patients experienced late/difficult or weak orgasms (p = .001). Conclusion: Most men treated with brachytherapy have conserved ejaculatory function after prostate brachytherapy. However, most of these men experience a reduction in volume and a deterioration in orgasm.

  13. Prostatic Artery Embolization for Enlarged Prostates Due to Benign Prostatic Hyperplasia. How I Do It

    International Nuclear Information System (INIS)

    Carnevale, Francisco C.; Antunes, Alberto A.

    2013-01-01

    Prostatic artery embolization (PAE) has emerged as an alternative to surgical treatments for benign prostatic hyperplasia (BPH). Patient selection and refined technique are essential for good results. Urodynamic evaluation and magnetic resonance imaging are very important and technical limitations are related to elderly patients with tortuous and atherosclerotic vessels, anatomical variations, difficulty visualizing and catheterizing small diameter arteries feeding the prostate, and the potential risk of bladder and rectum ischemia. The use of small-diameter hydrophilic microcatheters is mandatory. Patients can be treated safely by PAE with low rates of side effects, reducing prostate volume with clinical symptoms and quality of life improvement without urinary incontinence, ejaculatory disorders, or erectile dysfunction. A multidisciplinary approach with urologists and interventional radiologists is essential to achieve better results

  14. Prostatic Artery Embolization for Enlarged Prostates Due to Benign Prostatic Hyperplasia. How I Do It

    Energy Technology Data Exchange (ETDEWEB)

    Carnevale, Francisco C., E-mail: fcarnevale@uol.com.br [University of Sao Paulo Medical School, Interventional Radiology Unit (Brazil); Antunes, Alberto A., E-mail: antunesuro@uol.com.br [University of Sao Paulo Medical School, Division of Urology (Brazil)

    2013-12-15

    Prostatic artery embolization (PAE) has emerged as an alternative to surgical treatments for benign prostatic hyperplasia (BPH). Patient selection and refined technique are essential for good results. Urodynamic evaluation and magnetic resonance imaging are very important and technical limitations are related to elderly patients with tortuous and atherosclerotic vessels, anatomical variations, difficulty visualizing and catheterizing small diameter arteries feeding the prostate, and the potential risk of bladder and rectum ischemia. The use of small-diameter hydrophilic microcatheters is mandatory. Patients can be treated safely by PAE with low rates of side effects, reducing prostate volume with clinical symptoms and quality of life improvement without urinary incontinence, ejaculatory disorders, or erectile dysfunction. A multidisciplinary approach with urologists and interventional radiologists is essential to achieve better results.

  15. Factors predicting for postimplantation urinary retention after permanent prostate brachytherapy

    International Nuclear Information System (INIS)

    Lee, Nancy; Wuu, C.-S.; Brody, Rachel; Laguna, Joe L.; Katz, Aaron E.; Bagiella, Emilia; Ennis, Ronald D.

    2000-01-01

    Purpose: Urinary retention requiring catheterization is a known complication among prostate cancer patients treated with permanent interstitial radioactive seed implantation. However, the factors associated with this complication are not well known. This study was conducted to determine these factors. Methods and Materials: Ninety-one consecutive prostate cancer patients treated with permanent interstitial implantation at our institution from 1996 to 1999 were evaluated. All patients underwent pre-implant ultrasound and postimplant CT volume studies. Isotopes used were 125 I (54 patients) or 103 Pd (37 patients). Twenty-three patients were treated with a combination of 45 Gy of external beam radiation therapy as well as seed implantation, of which only 3 patients were treated with 125 I. Mean pretreatment prostate ultrasound volume was 35.4 cc (range, 10.0-70.2 cc). The mean planning ultrasound target volume (PUTV) was 39.6 cc (range, 16.1-74.5 cc), whereas the mean posttreatment CT target volume was 55.0 cc (range, 20.2-116 cc). Patient records were reviewed to determine which patients required urinary catheterization for relief of urinary obstruction. The following factors were analyzed as predictors for urinary retention: clinical stage; Gleason score; prostate-specific antigen; external beam radiation therapy; hormone therapy; pre-implant urinary symptoms (asymptomatic/nocturia x 1 vs. more significant urinary symptoms); pretreatment ultrasound prostate volume; PUTV; PUTV within the 125%, 150%, 200%, 250%, 300% isodose lines; postimplant CT volume within the 125%, 150%, 200%, 250%, 300% isodose lines; D90; D80; D50; ratio of post-CT volume to the PUTV; the absolute change in volume between the CT volume and PUTV; number of needles used; activity per seed; and the total activity of the implant. Statistical analyses using logistic regression and χ2 were performed. Results: Eleven of 91 (12%) became obstructed. Significant factors predicting for urinary retention

  16. African-American Men with Gleason Score 3+3=6 Prostate Cancer Produce Less Prostate Specific Antigen than Caucasian Men: A Potential Impact on Active Surveillance.

    Science.gov (United States)

    Kryvenko, Oleksandr N; Balise, Raymond; Soodana Prakash, Nachiketh; Epstein, Jonathan I

    2016-02-01

    We assess the difference in prostate specific antigen production between African-American and Caucasian men with Gleason score 3+3=6 prostate cancer. We measured tumor volume in 414 consecutive radical prostatectomies from men with National Comprehensive Cancer Network(®) low risk prostate cancer (348 Caucasian, 66 African-American) who had Gleason score 3+3=6 disease at radical prostatectomy. We then compared clinical presentation, pathological findings, prostate specific antigen, prostate specific antigen density and prostate specific antigen mass (an absolute amount of prostate specific antigen in patient's circulation) between African-American and Caucasian men. The t-test and Wilcoxon rank sum were used for comparison of means. African-American and Caucasian men had similar clinical findings based on age, body mass index and prostate specific antigen. There were no statistically significant differences between the dominant tumor nodule volume and total tumor volume (mean 0.712 vs 0.665 cm(3), p=0.695) between African-American and Caucasian men. Prostates were heavier in African-American men (mean 55.4 vs 46.3 gm, p prostate tissue contributing to prostate specific antigen in African-American men, prostate specific antigen mass was not different from that of Caucasian men (mean 0.55 vs 0.558 μg, p=0.95). Prostate specific antigen density was significantly less in African-American men due to larger prostates (mean 0.09 vs 0.105, p prostate cancer produce less prostate specific antigen than Caucasian men. African-American and Caucasian men had equal serum prostate specific antigen and prostate specific antigen mass despite significantly larger prostates in African-American men with all other parameters, particularly total tumor volume, being the same. This finding has practical implications in T1c cases diagnosed with prostate cancer due to prostate specific antigen screening. Lowering the prostate specific antigen density threshold in African-American men may

  17. Dose Volume Histogram analysis for rectum and urethral reaction of prostate cancer

    International Nuclear Information System (INIS)

    Yanagi, Takeshi; Tsuji, Hiroshi; Kamada, Tadashi; Tsujii, Hirohiko

    2005-01-01

    The aim of this study is to evaluate the clinically relevant parameters for rectum and urethral reaction using DVH (dose volume histogram) in carbon ion radiotherapy of prostate cancer. In this year, we studied the urinary reaction mainly. 35 patients with prostate cancer were treated with carbon ion beams between June 1995 and December 1997. The applied dose was escalated from 54.0 GyE to 72.0 GyE in fixed 20 fractions. Clinical urinary reaction and rectum reaction were reviewed using Radiation Therapy Oncology Group (RTOG) scoring system for acute reactions, RTOG/European Organization for Research and Treatment of Cancer (EORTC) scoring system for late reactions. Taking the ROI (region of interest) for DVH of urethra, we used surrogate one that was derived from the observation of MR images. 35 patients were analyzed for acute urinary reaction and 34 for late urinary reaction in the study of this year. DVH analysis suggested difference among the grades for acute and late reactions. These analysis appears to be a useful tool for predicting the urinary reactions. (author)

  18. Elevated Prostate Health Index (phi) and Biopsy Reclassification During Active Surveillance of Prostate Cancer.

    Science.gov (United States)

    Andreas, Darian; Tosoian, Jeffrey J; Landis, Patricia; Wolf, Sacha; Glavaris, Stephanie; Lotan, Tamara L; Schaeffer, Edward M; Sokoll, Lori J; Ross, Ashley E

    2016-07-01

    The Prostate Health Index (phi) has been FDA approved for decision-making regarding prostate biopsy. Phi has additionally been shown to positively correlate with tumor volume, extraprostatic disease and higher Gleason grade tumors. Here we describe a case in which an elevated phi encouraged biopsy of a gentleman undergoing active surveillance leading to reclassification of his disease as high risk prostate cancer.

  19. Dynamics of rectal balloon implant shrinkage in prostate VMAT. Influence on anorectal dose and late rectal complication risk

    International Nuclear Information System (INIS)

    Vanneste, Ben G.L.; Wijk, Y. van; Lutgens, L.C.; Limbergen, E.J. van; Lambin, P.; Lin, E.N. van; Beek, K. van de; Hoffmann, A.L.

    2018-01-01

    To assess the effect of a shrinking rectal balloon implant (RBI) on the anorectal dose and complication risk during the course of moderately hypofractionated prostate radiotherapy. In 15 patients with localized prostate cancer, an RBI was implanted. A weekly kilovolt cone-beam computed tomography (CBCT) scan was acquired to measure the dynamics of RBI volume and prostate-rectum separation. The absolute anorectal volume encompassed by the 2 Gy equieffective 75 Gy isodose (V 75Gy ) was recalculated as well as the mean anorectal dose. The increase in estimated risk of grade 2-3 late rectal bleeding (LRB) between the start and end of treatment was predicted using nomograms. The observed acute and late toxicities were evaluated. A significant shrinkage of RBI volumes was observed, with an average volume of 70.4% of baseline at the end of the treatment. Although the prostate-rectum separation significantly decreased over time, it remained at least 1 cm. No significant increase in V 75Gy of the anorectum was observed, except in one patient whose RBI had completely deflated in the third week of treatment. No correlation between mean anorectal dose and balloon deflation was found. The increase in predicted LRB risk was not significant, except in the one patient whose RBI completely deflated. The observed toxicities confirmed these findings. Despite significant decrease in RBI volume the high-dose rectal volume and the predicted LRB risk were unaffected due to a persistent spacing between the prostate and the anterior rectal wall. (orig.) [de

  20. Analysis of dose volume histogram parameters to estimate late bladder and rectum complications after high-dose (70-78 Gy) conformal radiotherapy for prostate cancer

    International Nuclear Information System (INIS)

    Boersma, L.J.; Brink, M. van den; Bruce, A.; Gras, L.; Velde, A. te; Lebesque, J.V.

    1997-01-01

    Purpose: To investigate whether Dose Volume Histogram (DVH) parameters can be used to identify risk groups for developing late gastrointestinal (GI) and genitourinary (GU) complications after conformal radiotherapy for prostate cancer, and to examine the effect of using different morbidity scoring systems on the results of these analyses. Materials and Methods: DVH parameters were analyzed for 130 patients with localized prostate cancer, treated with conformal radiotherapy in a dose-escalating protocol (70-78 Gy, 2 Gy per fraction). The incidence of late (> 6 months) GI and GU complications was scored based on questionnaires and classified using the RTOG/EORTC and the SOMA/LENT scoring system. Moreover, patients were classified as being a rectal bleeder or no rectal bleeder and a distinction was made between non-severe and severe (requiring one or more laser treatments) rectal bleeding. The median follow-up time was 22 months. It was investigated whether the relative and absolute rectal wall volumes, irradiated to various dose levels (≥ 60 Gy, ≥ 65 Gy, ≥ 70 Gy and ≥ 75 Gy) were correlated with the observed actuarial incidences of GI complications. First, the analysis was performed using volume as a continuous variable. Subsequently, for each dose level in the DVH the rectal wall volumes were dichotomized using different volumes as cut-off levels. Twenty cut-off levels were tested on their ability to discriminate between high and low risk for developing GI complications (Fig.). The relationship between bladder wall volumes irradiated to various dose levels and observed actuarial GU complications was investigated using the absolute bladder wall volumes, measured as a continuous variable. For both GI and GU complications, the role of the prescribed radiation dose and the maximum radiation dose in the rectal and bladder wall was analyzed as well. Results: None of the DVH parameters of the rectal wall was significantly correlated with the actuarial incidences of

  1. A note on stereological estimation of the volume-weighted second moment of particle volume

    DEFF Research Database (Denmark)

    Jensen, E B; Sørensen, Flemming Brandt

    1991-01-01

    It is shown that for a variety of biological particle shapes, the volume-weighted second moment of particle volume can be estimated stereologically using only the areas of particle transects, which can be estimated manually by point-counting....

  2. Stereological estimation of nuclear mean volume in invasive meningiomas

    DEFF Research Database (Denmark)

    Madsen, C; Schrøder, H D

    1996-01-01

    A stereological estimation of nuclear mean volume in bone and brain invasive meningiomas was made. For comparison the nuclear mean volume of benign meningiomas was estimated. The aim was to investigate whether this method could discriminate between these groups. We found that the nuclear mean...... volume in the bone and brain invasive meningiomas was larger than in the benign tumors. The difference was significant and moreover it was seen that there was no overlap between the two groups. In the bone invasive meningiomas the nuclear mean volume appeared to be larger inside than outside the bone....... No significant difference in nuclear mean volume was found between brain and bone invasive meningiomas. The results demonstrate that invasive meningiomas differ from benign meningiomas by an objective stereological estimation of nuclear mean volume (p

  3. Postoperative Radiotherapy in Prostate Cancer: The Case of the Missing Target

    International Nuclear Information System (INIS)

    Croke, Jennifer; Malone, Shawn; Roustan Delatour, Nicolas; Belanger, Eric; Avruch, Leonard; Morash, Christopher; Kayser, Cathleen; Underhill, Kathryn; Spaans, Johanna

    2012-01-01

    Purpose: Postoperative radiotherapy (XRT) increases survival in high-risk prostate cancer patients. Approximately 50% of patients on long-term follow-up relapse despite adjuvant XRT and the predominant site of failure remains local. Four consensus guidelines define postoperative clinical target volume (CTV) in prostate cancer. We explore the possibility that inadequate CTV coverage is an important cause of local failure. This study evaluates the utility of preoperative magnetic resonance imaging (MRI) in defining prostate bed CTV. Methods and Materials: Twenty prostate cancer patients treated with postoperative XRT who also had preoperative staging MRI were included. The four guidelines were applied and the CTVs were expanded to create planning target volumes (PTVs). Preoperative MRIs were fused with postoperative planning CT scans. MRI-based prostate and gross visible tumors were contoured. Three-dimensional (3D) conformal four- and six-field XRT plans were developed and dose–volume histograms analyzed. Subtraction analysis was conducted to assess the adequacy of prostate/gross tumor coverage. Results: Gross tumor was visible in 18 cases. In all 20 cases, the consensus CTVs did not fully cover the MRI-defined prostate. On average, 35% of the prostate volume and 32% of the gross tumor volume were missed using six-field 3D treatment plans. The entire MRI-defined gross tumor volume was completely covered in only two cases (six-field plans). The expanded PTVs did not cover the entire prostate bed in 50% of cases. Prostate base and mid-zones were the predominant site of inadequate coverage. Conclusions: Current postoperative CTV guidelines do not adequately cover the prostate bed and/or gross tumor based on preoperative MRI imaging. Additionally, expanded PTVs do not fully cover the prostate bed in 50% of cases. Inadequate CTV definition is likely a major contributing factor for the high risk of relapse despite adjuvant XRT. Preoperative imaging may lead to more

  4. Iodine-125 thin seeds decrease prostate swelling during transperineal interstitial permanent prostate brachytherapy

    International Nuclear Information System (INIS)

    Beydoun, Nadine; Bucci, Joseph A.; Chin, Yaw S.; Malouf, David

    2014-01-01

    Prostate swelling following seed implantation is a well-recognised phenomenon. The purpose of this intervention was to assess whether using thinner seeds reduces post-implant swelling with permanent prostate brachytherapy. Eighteen consecutive patients eligible for prostate seed brachytherapy underwent seed implantation using iodine-125 (I-125) thin seeds. Operative time, dosimetry, prostate swelling and toxicity were assessed and compared with standard I-125 stranded seed controls, sourced from the department's brachytherapy database. A learning curve was noted with the thin seeds in terms of greater bending and deviation of needles from their intended path. This translated into significantly longer total operative time (88 vs 103 minutes; P=0.009, 95% confidence interval (CI) 4.1-24.3) and time per needle insertion (2.6 vs 3.7 minutes; P<0.001, 95% CI 0.5-1.3) for the thin seeds. Day 30 prostate volumes were significantly smaller in the thin seed group compared with standard seeds (40.9cc vs 46.8cc; P=0.001, 95% CI 1.5-5.6). The ratio of preoperative transrectal ultrasound to day 30 post-implant CT volume was also smaller in the thin seed group (1.2±0.1 for standard seeds vs 1.1±0.1 for thin seeds). Post-implant dosimetric parameters were comparable for both groups. No significant differences were seen in acute urinary morbidity or quality of life between the two groups. I-125 thin seeds are associated with an initial learning curve, with longer operative time, even for experienced brachytherapists. The significant reduction in day 30 prostate volumes with the thin seeds has useful implications in terms of optimising dose coverage to the prostate in the early period post-implantation, as well as improving the accuracy of post-implant dosimetric assessments.

  5. Estimation of lung volume and pulmonary blood volume from radioisotopic images

    International Nuclear Information System (INIS)

    Kanazawa, Minoru

    1989-01-01

    Lung volume and pulmonary blood volume in man were estimated from the radioisotopic image using single photon emission computed tomography (SPECT). Six healthy volunteers were studied in a supine position with normal and altered lung volumes by applying continuous negative body-surface pressure (CNP) and by positive end-expiratory pressure (PEEP). 99m Tc labeled human serum albumin was administered as an aerosol to image the lungs. The CNP caused the diaphragm to be lowered and it increased the mean lung tissue volume obtained by SPECT from 3.09±0.49 l for baseline to 3.67±0.62 l for 10 cmH 2 O (p 2 O (p 2 O), respectively. The PEEP also increased the lung tissue volume to 3.68±0.68 l for 10 cmH 2 O as compared with the baseline (p 2 O PEEP. The lung tissue volume obtained by SPECT showed a positive correlation with functional residual capacity measured by the He dilution method (r=0.91, p 99m Tc-labeled red blood cells. The L/H ratio decreased after either the CNP or PEEP, suggesting a decrease in the blood volume per unit lung volume. However, it was suggested that the total pulmonary blood volume increased slightly either on the CNP (+7.4% for 10 cmH 2 O, p 2 O,p<0.05) when we extrapolated the L/H ratio to the whole lungs by multiplying the lung tissue volume obtained by SPECT. We concluded that SPECT could offer access to the estimation of lung volume and pulmonary blood volume in vivo. (author)

  6. A large, benign prostatic cyst presented with an extremely high serum prostate-specific antigen level.

    Science.gov (United States)

    Chen, Han-Kuang; Pemberton, Richard

    2016-01-08

    We report a case of a patient who presented with an extremely high serum prostate specific antigen (PSA) level and underwent radical prostatectomy for presumed prostate cancer. Surprisingly, the whole mount prostatectomy specimen showed only small volume, organ-confined prostate adenocarcinoma and a large, benign intraprostatic cyst, which was thought to be responsible for the PSA elevation. 2016 BMJ Publishing Group Ltd.

  7. Grading-System-Dependent Volume Effects for Late Radiation-Induced Rectal Toxicity After Curative Radiotherapy for Prostate Cancer

    International Nuclear Information System (INIS)

    Laan, Hans Paul van der; Bergh, Alphons van den; Schilstra, Cornelis; Vlasman, Renske; Meertens, Harm; Langendijk, Johannes A.

    2008-01-01

    Purpose: To assess the association between the dose distributions in the rectum and late Radiation Therapy Oncology Group and the European Organisation for Research and Treatment of Cancer (RTOG/EORTC), Late Effects of Normal Tissue SOMA, and Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 graded rectal toxicity among patients with prostate cancer treated with RT. Methods and Materials: Included in the study were 124 patients who received three-dimensional conformal RT for prostate cancer to a total dose of 70 Gy in 2-Gy fractions. All patients completed questionnaires regarding rectum complaints before RT and during long-term follow-up. Late rectum Grade 2 or worse toxicity, according to RTOG/EORTC, LENT SOMA, and CTCAE v3.0 criteria, was analyzed in relation to rectal dose and volume parameters. Results: Dose-volume thresholds (V40 ≥65%, V50 ≥55%, V65 ≥45%, V70 ≥20%, and a rectum volume ≤140 cm 3 ), significantly discriminated patients with late Grade 0-1 and Grade 2 or worse rectal toxicity, particularly using the LENT SOMA and CTCAE v3.0 systems. The rectum volume receiving ≥70 Gy (V70) was most predictive for late Grade 2 or worse rectal toxicity with each of the grading systems. The associations were strongest, however, with use of the LENT SOMA system. Conclusions: Volume effects for late radiation-induced rectal toxicity are present, but their clinical significance depends on the grading system used. This should be taken into account in the interpretation of studies reporting on radiation-induced rectal toxicity

  8. Quantitative CT: technique dependence of volume estimation on pulmonary nodules

    Science.gov (United States)

    Chen, Baiyu; Barnhart, Huiman; Richard, Samuel; Colsher, James; Amurao, Maxwell; Samei, Ehsan

    2012-03-01

    Current estimation of lung nodule size typically relies on uni- or bi-dimensional techniques. While new three-dimensional volume estimation techniques using MDCT have improved size estimation of nodules with irregular shapes, the effect of acquisition and reconstruction parameters on accuracy (bias) and precision (variance) of the new techniques has not been fully investigated. To characterize the volume estimation performance dependence on these parameters, an anthropomorphic chest phantom containing synthetic nodules was scanned and reconstructed with protocols across various acquisition and reconstruction parameters. Nodule volumes were estimated by a clinical lung analysis software package, LungVCAR. Precision and accuracy of the volume assessment were calculated across the nodules and compared between protocols via a generalized estimating equation analysis. Results showed that the precision and accuracy of nodule volume quantifications were dependent on slice thickness, with different dependences for different nodule characteristics. Other parameters including kVp, pitch, and reconstruction kernel had lower impact. Determining these technique dependences enables better volume quantification via protocol optimization and highlights the importance of consistent imaging parameters in sequential examinations.

  9. Comparison of Real-Time Intraoperative Ultrasound-Based Dosimetry With Postoperative Computed Tomography-Based Dosimetry for Prostate Brachytherapy

    International Nuclear Information System (INIS)

    Nag, Subir; Shi Peipei; Liu Bingren; Gupta, Nilendu; Bahnson, Robert R.; Wang, Jian Z.

    2008-01-01

    Purpose: To evaluate whether real-time intraoperative ultrasound (US)-based dosimetry can replace conventional postoperative computed tomography (CT)-based dosimetry in prostate brachytherapy. Methods and Materials: Between December 2001 and November 2002, 82 patients underwent 103 Pd prostate brachytherapy. An interplant treatment planning system was used for real-time intraoperative transrectal US-guided treatment planning. The dose distribution was updated according to the estimated seed position to obtain the dose-volume histograms. Postoperative CT-based dosimetry was performed a few hours later using the Theraplan-Plus treatment planning system. The dosimetric parameters obtained from the two imaging modalities were compared. Results: The results of this study revealed correlations between the US- and CT-based dosimetry. However, large variations were found in the implant-quality parameters of the two modalities, including the doses covering 100%, 90%, and 80% of the prostate volume and prostate volumes covered by 100%, 150%, and 200% of the prescription dose. The mean relative difference was 38% and 16% for doses covering 100% and 90% of the prostate volume and 10% and 21% for prostate volumes covered by 100% and 150% of the prescription dose, respectively. The CT-based volume covered by 200% of the prescription dose was about 30% greater than the US-based one. Compared with CT-based dosimetry, US-based dosimetry significantly underestimated the dose to normal organs, especially for the rectum. The average US-based maximal dose and volume covered by 100% of the prescription dose for the rectum was 72 Gy and 0.01 cm 3 , respectively, much lower than the 159 Gy and 0.65 cm 3 obtained using CT-based dosimetry. Conclusion: Although dosimetry using intraoperative US-based planning provides preliminary real-time information, it does not accurately reflect the postoperative CT-based dosimetry. Until studies have determined whether US-based dosimetry or

  10. Impact of target volume coverage with Radiation Therapy Oncology Group (RTOG) 98-05 guidelines for transrectal ultrasound guided permanent Iodine-125 prostate implants

    International Nuclear Information System (INIS)

    Horwitz, Eric M.; Mitra, Raj K.; Uzzo, Robert G.; Das, Indra J.; Pinover, Wayne H.; Hanlon, Alexandra L.; McNeeley, Shawn W.; Hanks, Gerald E.

    2003-01-01

    Purpose: Despite the wide use of permanent prostate implants for the treatment of early stage prostate cancer, there is no consensus for optimal pre-implant planning guidelines that results in maximal post-implant target coverage. The purpose of this study was to compare post-implant target volume coverage and dosimetry between patients treated before and after Radiation Therapy Oncology Group (RTOG) 98-05 guidelines were adopted using several dosimetric endpoints. Materials and methods: Ten consecutively treated patients before the adoption of the RTOG 98-05 planning guidelines were compared with ten consecutively treated patients after implementation of the guidelines. Pre-implant planning for patients treated pre-RTOG was based on the clinical target volume (CTV) defined by the pre-implant TRUS definition of the prostate. The CTV was expanded in each dimension according to RTOG 98-05 and defined as the planning target volume. The evaluation target volume was defined as the post-implant computed tomography definition of the prostate based on RTOG 98-05 protocol recommendations. Implant quality indicators included V 100 , V 90 , V 100 , and Coverage Index (CI). Results: The pre-RTOG median V 100 , V 90 , D 90 , and CI values were 82.8, 88.9%, 126.5 Gy, and 17.1, respectively. The median post-RTOG V 100 , V 90 , D 90 , and CI values were 96.0, 97.8%, 169.2 Gy, and 4.0, respectively. These differences were all statistically significant. Conclusions: Implementation of the RTOG 98-05 implant planning guidelines has increased coverage of the prostate by the prescription isodose lines compared with our previous technique, as indicated by post-implant dosimetry indices such as V 100 , V 90 , D 90 . The CI was also improved significantly with the protocol guidelines. Our data confirms the validity of the RTOG 98-05 implant guidelines for pre-implant planning as it relates to enlargement of the CTV to ensure adequate margin between the CTV and the prescription isodose

  11. Daily online localization using implanted fiducial markers and its impact on planning target volume for carcinoma prostate.

    Science.gov (United States)

    Khosa, Robin; Nangia, Sapna; Chufal, Kundan S; Ghosh, D; Kaul, Rakesh; Sharma, Lalit

    2010-01-01

    Aim of the study was to assess prostate motion on daily basis with respect to setup and to compare the shifts based on bony anatomy and gold fiducial markers. Gold fiducial markers were inserted in prostate under U/S guidance and daily portal images were taken and compared with digitally reconstructed images, both using bony landmarks and fiducial markers as reference. A dose of 2 MU was given for two orthogonal images daily. The mean and standard deviation of displacement using gold seeds and bone were calculated. Systematic and random errors were generated. The planning target volume (PTV) was calculated using the Van Herk formula. A total of 180 portal images from 10 patients were studied. The mean displacement along x, y and z axes was 1.67 mm, 3.58 mm, and 1.76 mm using fiducial markers and 2.12 mm, 3.47 mm, and 2.09 mm using bony landmarks, respectively. The mean internal organ motion was 1.23 mm (+1.45), 3.11 mm (+2.69 mm); and 1.87 mm (+1.67 mm) along x, y and z axes, respectively. The PTV to account for prostate motion if daily matching was not done was 4.64 mm, 10.41 mm and 4.40 mm along lateral, superoinferior, and anteroposterior directions, respectively. If bony landmarks were used for daily matching, margins of 3.61 mm, 7.31 mm, and 4.72 mm in lateral, superoinferior, and anteroposterior directions should be added to the clinical target volume. Daily alignment using gold fiducial markers is an effective method of localizing prostate displacement. It provides the option of reducing margins, thus limiting normal tissue toxicity and allowing the possibility of dose escalation for better long-term control.

  12. Differentiation of prostate cancer from normal prostate tissue in an animal model: conventional MRI and dynamic contrast-enhanced MRI

    International Nuclear Information System (INIS)

    Gemeinhardt, O.; Prochnow, D.; Taupitz, M.; Hamm, B.; Beyersdorff, D.; Luedemann, L.; Abramjuk, C.

    2005-01-01

    Purpose: to differentiate orthotopically implanted prostate cancer from normal prostate tissue using magnetic resonance imaging (MRI) and Gd-DTPA-BMA-enhanced dynamic MRI in the rat model. Material and methods: tumors were induced in 15 rats by orthotopic implantation of G subline Dunning rat prostatic tumor cells. MRI was performed 56 to 60 days after tumor cell implantation using T1-weighted spin-echo, T2-weighted turbo SE sequences, and a 2D FLASH sequence for the contrast medium based dynamic study. The interstitial leakage volume, normalized permeability and the permeability surface area product of tumor and healthy prostate were determined quantitatively using a pharmacokinetic model. The results were confirmed by histologic examination. Results: axial T2-weighted TSE images depicted low-intensity areas suspicious for tumor in all 15 animals. The mean tumor volume was 46.5 mm3. In the dynamic study, the suspicious areas in all animals displayed faster and more pronounced signal enhancement than surrounding prostate tissue. The interstitial volume and the permeability surface area product of the tumors increased significantly by 420% (p<0.001) and 424% (p<0.001), respectively, compared to normal prostate tissue, while no significant difference was seen for normalized permeability alone. Conclusion: the results of the present study demonstrate that quantitative analysis of contrast-enhanced dynamic MRI data enables differentiation of small, slowly growing orthotopic prostate cancer from normal prostate tissue in the rat model. (orig.)

  13. Incidence of late rectal bleeding in high-dose conformal radiotherapy of prostate cancer using equivalent uniform dose-based and dose-volume-based normal tissue complication probability models

    International Nuclear Information System (INIS)

    Soehn, Matthias; Yan Di; Liang Jian; Meldolesi, Elisa; Vargas, Carlos; Alber, Markus

    2007-01-01

    Purpose: Accurate modeling of rectal complications based on dose-volume histogram (DVH) data are necessary to allow safe dose escalation in radiotherapy of prostate cancer. We applied different equivalent uniform dose (EUD)-based and dose-volume-based normal tissue complication probability (NTCP) models to rectal wall DVHs and follow-up data for 319 prostate cancer patients to identify the dosimetric factors most predictive for Grade ≥ 2 rectal bleeding. Methods and Materials: Data for 319 patients treated at the William Beaumont Hospital with three-dimensional conformal radiotherapy (3D-CRT) under an adaptive radiotherapy protocol were used for this study. The following models were considered: (1) Lyman model and (2) logit-formula with DVH reduced to generalized EUD (3) serial reconstruction unit (RU) model (4) Poisson-EUD model, and (5) mean dose- and (6) cutoff dose-logistic regression model. The parameters and their confidence intervals were determined using maximum likelihood estimation. Results: Of the patients, 51 (16.0%) showed Grade 2 or higher bleeding. As assessed qualitatively and quantitatively, the Lyman- and Logit-EUD, serial RU, and Poisson-EUD model fitted the data very well. Rectal wall mean dose did not correlate to Grade 2 or higher bleeding. For the cutoff dose model, the volume receiving > 73.7 Gy showed most significant correlation to bleeding. However, this model fitted the data more poorly than the EUD-based models. Conclusions: Our study clearly confirms a volume effect for late rectal bleeding. This can be described very well by the EUD-like models, of which the serial RU- and Poisson-EUD model can describe the data with only two parameters. Dose-volume-based cutoff-dose models performed worse

  14. Brain Volume Estimation Enhancement by Morphological Image Processing Tools

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    Zeinali R.

    2017-12-01

    Full Text Available Background: Volume estimation of brain is important for many neurological applications. It is necessary in measuring brain growth and changes in brain in normal/ abnormal patients. Thus, accurate brain volume measurement is very important. Magnetic resonance imaging (MRI is the method of choice for volume quantification due to excellent levels of image resolution and between-tissue contrast. Stereology method is a good method for estimating volume but it requires to segment enough MRI slices and have a good resolution. In this study, it is desired to enhance stereology method for volume estimation of brain using less MRI slices with less resolution. Methods: In this study, a program for calculating volume using stereology method has been introduced. After morphologic method, dilation was applied and the stereology method enhanced. For the evaluation of this method, we used T1-wighted MR images from digital phantom in BrainWeb which had ground truth. Results: The volume of 20 normal brain extracted from BrainWeb, was calculated. The volumes of white matter, gray matter and cerebrospinal fluid with given dimension were estimated correctly. Volume calculation from Stereology method in different cases was made. In three cases, Root Mean Square Error (RMSE was measured. Case I with T=5, d=5, Case II with T=10, D=10 and Case III with T=20, d=20 (T=slice thickness, d=resolution as stereology parameters. By comparing these results of two methods, it is obvious that RMSE values for our proposed method are smaller than Stereology method. Conclusion: Using morphological operation, dilation allows to enhance the estimation volume method, Stereology. In the case with less MRI slices and less test points, this method works much better compared to Stereology method.

  15. In vivo MRI volumetric measurement of prostate regression and growth in mice

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    Nalcioglu Orhan

    2007-07-01

    Full Text Available Abstract Background Mouse models for treatment of late-stage prostate cancer are valuable tools, but assessing the extent of growth of the prostate and particularly its regression due to therapeutic intervention or castration is difficult due to the location, small size and interdigitated anatomy of the prostate gland in situ. Temporal monitoring of mouse prostate regression requires multiple animals and examination of histological sections. Methods Initially, T2-weighted magnetic resonance imaging (MRI was performed on normal year-old C57/BL6 mice. Individual mice were repeatedly imaged using inhalation anesthesia to establish the reproducibility of the method and to follow hormone manipulation of the prostate volume. Subsequently, MRI fat signal was suppressed using a chemical shift-selective (CHESS pulse to avoid signal contamination and enhance discrimination of the prostate. Results High field (7T MRI provides high resolution (117 × 117 μm in plane, highly reproducible images of the normal mouse prostate. Despite long imaging times, animals can be imaged repeatedly to establish reliability of volume measurements. Prostate volume declines following castration and subsequently returns to normal with androgen administration in the same animal. CHESS imaging allowed discrimination of both the margins of the prostate and the dorsal-lateral lobes of the prostate (DLP from the ventral lobes (VP. Castration results in a 40% reduction in the volume of the DLP and a 75% reduction in the volume of the VP. Conclusion MRI assessment of the volume of the mouse prostate is precise and reproducible. MRI improves volumetric determination of the extent of regression and monitoring of the same mouse over time during the course of treatment is possible. Since assessing groups of animals at each time point is avoided, this improves the accuracy of the measurement of any manipulation effect and reduces the number of animals required.

  16. Estimated costs of treatment of benign prostate hyperplasia in Brazil

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    Haylton J. Suaid

    2003-06-01

    Full Text Available INTRODUCTION: The treatment of benign prostate hyperplasia (BPH presents 2 options: medical or surgical, and there are doubts about what is the best treatment since 80% of patients who undergo surgery become asymptomatic and 10 to 40% of those under medical regimen undergo surgery within a 5 years period. It is difficult to assess the actual costs of treating BPH in Brazil due to several factors, among them regional particularities and the scarcity of current statistical data. PATIENTS AND METHODS: Recently, in the Ribeirão Preto area, São Paulo, Brazil, the IPSS (International Prostatic Symptoms Score and quality of life were verified in 934 volunteers. It was determined the percentage of individuals with ages ranging from 40 to 79 years with moderate symptoms (score 8-19 and with severe symptoms (score 20-35, values for which are indicated medical and surgical treatment, respectively, according to the Brazilian Society of Urology consensus on BPH. Data on Brazilian population in that age range were obtained from the Brazilian Institute of Geography and Statistics referent to the year of 2000. It was determined the number of patients, according to the criteria above, subjected to either one of the treatments mentioned. Surgical costs of prostate transurethral resection were researched according to Unified Health System - SUS tables (US$ 173 and of Brazilian Medical Society - AMB with a mean cost in 3 hospitals of US$ 933. Drug costs were calculated by the annual mean price (US$ 355 of 4 alpha-blockers (tamsulosin, alfuzosin, doxazosin and terazosin. RESULTS: The estimated population for medical treatment was 5,397,321 individuals, with a cost corresponding to US$ 1,916,489,055.00. The estimated population for surgical treatment was 2,040,299 men, what would represent a cost of US$ 353,291,204.00 based on the SUS table and of US$ 1,904,279,066.00 based on AMB with hospital expenses included. CONCLUSION: All theses facts induce us to predict

  17. Prevalence of benign prostatic hyperplasia and prostate cancer and its relative factors in Lanzhou

    International Nuclear Information System (INIS)

    Zhong Ganping; Wang Jiaji; Yue Zhongjin; Chen Xuehong

    2003-01-01

    To investigate the benign prostatic hyperplasia (BPH) and prostate cancer in Lanzhou, an investigation of the incidence of BPH and prostate cancer in 1356 male inhabitants over 50 years of age has been carried out including I-PSS, life quality (L), volume of prostate (V) and digital rectal examination. Plasma testosterone (T) and prostate specific antigen (PSA) were assayed in 145 cases. The incidence of BPH was 35.03%, being 41.04% in urban and 30.05% in rural inhabitants. The increase of BPH has been higher in urban inhabitants (P<0.05). The incidence of prostate cancer was 2.05%, being 3.09% in urban and 2.02% in rural inhabitants, the increase of prostate cancer has been higher in urban inhabitants (P< 0.05). A significant increase of prostate specific antigen was noted in prostate cancer patients (P<0.05). Conclusions: The increase of BPH and prostate cancer has been higher in urban inhabitants. The age, diet and residential areas might associate with a higher incidence of BPH and prostate cancer

  18. Complications of laser enucleation of the prostate: Results at two institutions

    Directory of Open Access Journals (Sweden)

    Chu-Hao Weng

    2017-12-01

    Conclusion: Laser enucleation of the prostate was a safe treatment with low significant complication rate, even for large-volume prostates. The complication rates between diode and thulium lasers were not significantly different. The reoperation rate of laser enucleation was very low but patients with extremely large prostate volume may have higher risk.

  19. Pharmacokinetic MRI of the prostate. Parameters for differentiating low-grade and high-grade prostate cancer

    International Nuclear Information System (INIS)

    Franiel, T.; Taupitz, M.; Asbach, P.; Beyersdorff, D.; Luedemann, L.; Rost, J.

    2009-01-01

    Purpose: to investigate whether pharmacokinetic MRI parameters ''perfusion, blood volume, mean transit time (MTT), interstitial volume, permeability, extraction coefficient, delay, and dispersion'' allow the differentiation of low-grade (Gleason score ≤ 6) and high-grade (Gleason score ≥ 7) prostate cancer. Materials and method: forty-two patients with prostate cancer verified by biopsy (PSA 2.7 to 31.4ng/ml) and scheduled for prostatectomy underwent MRI at 1.5 Tesla using the dynamic contrast-enhanced inversion-prepared dual-contrast gradient echo sequence (temporal resolution, 1.65 s) and a combined endorectal body phased array coil. Parametric maps were computed using a sequential 3-compartment model and the corresponding post-processing algorithms. A total of 41 areas of prostate cancer (15 low-grade, 26 high-grade cancers) in 32 patients were able to be correlated with the prostatectomy specimens and were included in the analysis. Results: low-grade prostate cancers had a higher mean blood volume (1.76% vs. 1.64%, p = 0.039), longer MTT (6.39 s vs. 3.25 s, p -1 vs. 3.86 min -1 , p = 0.011) than high-grade cancers. No statistically significant difference was found for perfusion (p = 0.069), interstitial volume (p = 0.849), extraction coefficient (p = 0.615), delay (p = 0.489), and dispersion (p = 0.306). (orig.)

  20. Prediction of PSA bounce after permanent prostate brachytherapy for localized prostate cancer

    International Nuclear Information System (INIS)

    Kanai, Kunimitsu; Nakashima, Jun; Sugawara, Akitomo

    2009-01-01

    We aimed to calculate the frequency and features of the development of a prostate-specific antigen (PSA) bounce after prostate brachytherapy alone, to correlate the bounce with clinical and dosimetric factors and to identify factors that predict PSA bounce. PSA bounce was evaluated in 86 patients with T1-T2 prostate cancer who underwent radioactive seed implantation using iodine-125 (I-125) without hormonal therapy or external-beam radiation therapy (EBRT) from September 2004 to December 2007. A PSA bounce was defined as a rise of at least 0.4 ng/ml greater than a previous PSA level with a subsequent decline equal to, or less than, the initial nadir. Calculated by the Kaplan-Meier method, the incidence of PSA bounce at a 2-year follow-up was 26%. Median time to the PSA bounce was 15 months. Univariate analysis demonstrated that age, dose received by 90% of the prostate gland (D90), volume of gland receiving 100% of the prescribed dose (V100), and V150 were significantly associated with the PSA bounce, while pretreatment PSA level, Gleason score, pretreatment prostate volume, clinical T stage, and V200 were not. In multivariate analysis, age 67 years or less and D90 more than 180 Gy were identified as independent factors for predicting the PSA bounce (P<0.05). PSA bounce is not a rare phenomenon after prostate brachytherapy. It is more common in younger patients and patients receiving higher doses of radiation. (author)

  1. Volume and hormonal effects for acute side effects of rectum and bladder during conformal radiotherapy for prostate cancer

    International Nuclear Information System (INIS)

    Peeters, Stephanie T.H.; Hoogeman, Mischa S.; Heemsbergen, Wilma D.; Slot, Annerie; Tabak, Hans; Koper, Peter C.M.; Lebesque, Joos V.

    2005-01-01

    Purpose: To identify dosimetric variables predictive of acute gastrointestinal (GI) and genitourinary (GU) toxicity and to determine whether hormonal therapy (HT) is independently associated with acute GI and GU toxicity in prostate cancer patients treated with conformal radiotherapy (RT). Methods and Materials: This analysis was performed on 336 patients participating in a multicenter (four hospitals) randomized trial comparing 68 Gy and 78 Gy. The clinical target volume consisted of the prostate with or without the seminal vesicles, depending on the risk of seminal vesicle involvement. The margin from the clinical target volume to the planning target volume was 1 cm. For these patients, the treatment plan for a total dose of 68 Gy was used, because nearly all toxicity appeared before the onset of the 10-Gy boost. Acute toxicity ( 3 months before RT). Results: Acute GI toxicity Grade 2 or worse was seen in 46% of the patients. Patients with long-term neoadjuvant HT experienced less Grade 2 or worse toxicity (27%) compared with those receiving short-term neoadjuvant HT (50%) and no HT (50%). The volumes of the prostate and seminal vesicles were significantly smaller in both groups receiving neoadjuvant HT compared with those receiving no HT. In multivariate logistic regression analysis, including the two statistically significant clinical variables neoadjuvant HT and hospital, a volume effect was found for the relative, as well as absolute, rectal wall volumes exposed to intermediate and high doses. Of all the length parameters, the relative rectal length irradiated to doses of ≥5 Gy and ≥30 Gy and absolute lengths receiving ≥5-15 and 30 Gy were significant. Acute GU toxicity Grade 2 or worse was reported in 56% of cases. For patients with pretreatment GU symptoms, the rate was 93%. The use of short-term and long-term neoadjuvant HT resulted in more GU toxicity (73% and 71%) compared with no HT (50%). In multivariate analysis, containing the variables

  2. Irradiation of the prostate and pelvic lymph nodes with an adaptive algorithm

    International Nuclear Information System (INIS)

    Hwang, A. B.; Chen, J.; Nguyen, T. B.; Gottschalk, A. G.; Roach, M. R. III; Pouliot, J.

    2012-01-01

    Purpose: The simultaneous treatment of pelvic lymph nodes and the prostate in radiotherapy for prostate cancer is complicated by the independent motion of these two target volumes. In this work, the authors study a method to adapt intensity modulated radiation therapy (IMRT) treatment plans so as to compensate for this motion by adaptively morphing the multileaf collimator apertures and adjusting the segment weights. Methods: The study used CT images, tumor volumes, and normal tissue contours from patients treated in our institution. An IMRT treatment plan was then created using direct aperture optimization to deliver 45 Gy to the pelvic lymph nodes and 50 Gy to the prostate and seminal vesicles. The prostate target volume was then shifted in either the anterior-posterior direction or in the superior-inferior direction. The treatment plan was adapted by adjusting the aperture shapes with or without re-optimizing the segment weighting. The dose to the target volumes was then determined for the adapted plan. Results: Without compensation for prostate motion, 1 cm shifts of the prostate resulted in an average decrease of 14% in D-95%. If the isocenter is simply shifted to match the prostate motion, the prostate receives the correct dose but the pelvic lymph nodes are underdosed by 14% ± 6%. The use of adaptive morphing (with or without segment weight optimization) reduces the average change in D-95% to less than 5% for both the pelvic lymph nodes and the prostate. Conclusions: Adaptive morphing with and without segment weight optimization can be used to compensate for the independent motion of the prostate and lymph nodes when combined with daily imaging or other methods to track the prostate motion. This method allows the delivery of the correct dose to both the prostate and lymph nodes with only small changes to the dose delivered to the target volumes.

  3. Prostatic specific antigen for prostate cancer detection

    Directory of Open Access Journals (Sweden)

    Lucas Nogueira

    2009-10-01

    Full Text Available Prostate-specific antigen (PSA has been used for prostate cancer detection since 1994. PSA testing has revolutionized our ability to diagnose, treat, and follow-up patients. In the last two decades, PSA screening has led to a substantial increase in the incidence of prostate cancer (PC. This increased detection caused the incidence of advanced-stage disease to decrease at a dramatic rate, and most newly diagnosed PC today are localized tumors with a high probability of cure. PSA screening is associated with a 75% reduction in the proportion of men who now present with metastatic disease and a 32.5% reduction in the age-adjusted prostate cancer mortality rate through 2003. Although PSA is not a perfect marker, PSA testing has limited specificity for prostate cancer detection, and its appropriate clinical application remains a topic of debate. Due to its widespread use and increased over-detection, the result has been the occurrence of over-treatment of indolent cancers. Accordingly, several variations as regards PSA measurement have emerged as useful adjuncts for prostate cancer screening. These procedures take into consideration additional factors, such as the proportion of different PSA isoforms (free PSA, complexed PSA, pro-PSA and B PSA, the prostate volume (PSA density, and the rate of change in PSA levels over time (PSA velocity or PSA doubling time. The history and evidence underlying each of these parameters are reviewed in the following article.

  4. Prostatic specific antigen for prostate cancer detection.

    Science.gov (United States)

    Nogueira, Lucas; Corradi, Renato; Eastham, James A

    2009-01-01

    Prostate-specific antigen (PSA) has been used for prostate cancer detection since 1994. PSA testing has revolutionized our ability to diagnose, treat, and follow-up patients. In the last two decades, PSA screening has led to a substantial increase in the incidence of prostate cancer (PC). This increased detection caused the incidence of advanced-stage disease to decrease at a dramatic rate, and most newly diagnosed PC today are localized tumors with a high probability of cure. PSA screening is associated with a 75% reduction in the proportion of men who now present with metastatic disease and a 32.5% reduction in the age-adjusted prostate cancer mortality rate through 2003. Although PSA is not a perfect marker, PSA testing has limited specificity for prostate cancer detection, and its appropriate clinical application remains a topic of debate. Due to its widespread use and increased over-detection, the result has been the occurrence of over-treatment of indolent cancers. Accordingly, several variations as regards PSA measurement have emerged as useful adjuncts for prostate cancer screening. These procedures take into consideration additional factors, such as the proportion of different PSA isoforms (free PSA, complexed PSA, pro-PSA and B PSA), the prostate volume (PSA density), and the rate of change in PSA levels over time (PSA velocity or PSA doubling time). The history and evidence underlying each of these parameters are reviewed in the following article.

  5. Clinical and microbiological characteristics of spontaneous acute prostatitis and transrectal prostate biopsy-related acute prostatitis: Is transrectal prostate biopsy-related acute prostatitis a distinct acute prostatitis category?

    Science.gov (United States)

    Kim, Jong Wook; Oh, Mi Mi; Bae, Jae Hyun; Kang, Seok Ho; Park, Hong Seok; Moon, Du Geon

    2015-06-01

    This study aimed to compare the clinical and microbiological characteristics between acute bacterial prostatitis and transrectal biopsy-related acute prostatitis. We retrospectively reviewed the records of 135 patients hospitalized for acute prostatitis in three urological centers between 2004 and 2013. Acute bacterial prostatitis was diagnosed according to typical symptoms, findings of physical examination, and laboratory test results. Clinical variables, laboratory test results, and anti-microbial susceptibility results were reviewed. Patients were classified into the spontaneous acute prostatitis group (S-ABP) or biopsy-related acute prostatitis (Bx-ABP) for comparison of their clinical, laboratory, and microbiological findings. The mean age of all patients was 61.7 ± 12.9 years. Compared with S-ABP patients, Bx-ABP patients were significantly older, had larger prostate volumes, higher PSA values, higher peak fever temperatures, and higher incidence of septicemia and antibiotic-resistant bacteria. Overall, of the 135 patients, 57.8% had positive bacterial urine and/or blood cultures. Bx-ABP patients had a higher incidence of bacterial (urine and/or blood) positive cultures compared to S-ABP patients (66.7% versus 55.6%). Escherichia coli was the predominant organism in both groups, but it was more common in Bx-ABP (88.9%) than in S-ABP (66.7%). Extended spectrum beta-lactamase -producing bacteria accounted for 64.7% of culture-positive patients in the Bx-ABP group compared to 13.3% in the S-ABP group. Bx-ABP patients showed a higher incidence of septicemia and antibiotic-resistant bacteria than S-ABP patients. These results have important implications for the management and antimicrobial treatment of Bx-ABP, which may well deserve to be considered a distinct prostatitis category. Copyright © 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  6. Impact of pharmacologic therapy for benign prostatic hyperplasia on prostate volume and free testosterone and consequently on urinary parameters and sexual desire in men

    Directory of Open Access Journals (Sweden)

    Stojanović Nebojša

    2017-01-01

    Full Text Available Background/Aim. Pharmacologic therapy for benign prostatic hyperplasia (BPH relieves disease progression and affects the androgen hormone status. A decrease in the level of free testosterone (freeT within total testosterone (totalT leads to symptoms of sexual dysfunction. The aim of this study was to show the impact of pharmacological treatment for BPH on prostate volume (PV and levels of freeT and, consequently, on urinary parameters and sexual desire in men during 6 months of administration. Methods. This clinical prospective study included 156 BPH patients with moderate urinary symptoms – International Prostate Symptom Score (IPSS 30 mL and prostate specific antigen (PSA value < 4 ng/mL. The average age of patients was 61.16 ± 2.97 years. The performed tests included determination of tumor markers (PSA, free PSA, hormones (totalT, freeT, freeT/totalT ratio, trans abdominal ultrasonography and uroflowmetry. Urinary symptoms were measured by IPSS and the Quality of Life (QoL questionnaire while the changes in sexual desire were measured using the International Index of Erectile Function (IIEF questionnaire. Four groups were formed, 39 patients each. The group 1 received alpha1- blocker (AB tamsulosin, the group 2, 5 alpha-reductase inhibitor (5-ARI finasteride, the group 3, combined therapy of both drugs (tamsulosin and finasteride, while the group 4 (control group had no therapy. Follow-ups were performed every three and six months during therapy administration. Results. Prostate volume significantly decreased in the patients on combined therapy (-6.95 ± 2.00; p < 0.001 and finasteride (-6.67 ± 3.35. In the finasteride group, the levels of freeT (-4.23 ± 5.2; p < 0.001 and freeT/totalT ratio (-0.12 0.08; p < 0.001 significantly decreased as did the freeT (-2.64 ± 7.81 and freeT/totalT ratio (-0.09 ± 0.13 in the combined therapy group. Uroflowmetry showed a significant improvement in all parameters and all the therapy groups. Combined

  7. Evaluation of PSA-age volume score in predicting prostate cancer in Chinese populationArticle Subject.

    Science.gov (United States)

    Wu, Yi-Shuo; Wu, Xiao-Bo; Zhang, Ning; Jiang, Guang-Liang; Yu, Yang; Tong, Shi-Jun; Jiang, Hao-Wen; Mao, Shan-Hua; Na, Rong; Ding, Qiang

    2018-02-06

    This study was performed to evaluate prostate-specific antigen-age volume (PSA-AV) scores in predicting prostate cancer (PCa) in a Chinese biopsy population. A total of 2355 men who underwent initial prostate biopsy from January 2006 to November 2015 in Huashan Hospital were recruited in the current study. The PSA-AV scores were calculated and assessed together with PSA and PSA density (PSAD) retrospectively. Among 2133 patients included in the analysis, 947 (44.4%) were diagnosed with PCa. The mean age, PSA, and positive rates of digital rectal examination result and transrectal ultrasound result were statistically higher in men diagnosed with PCa (all P PSA-AV were 0.864 and 0.851, respectively, in predicting PCa in the entire population, both performed better than PSA (AUC = 0.805; P PSA-AV was more obvious in subgroup with PSA ranging from 2.0 ng ml-1 to 20.0 ng ml-1. A PSA-AV score of 400 had a sensitivity and specificity of 93.7% and 40.0%, respectively. In conclusion, the PSA-AV score performed equally with PSAD and was better than PSA in predicting PCa. This indicated that PSA-AV score could be a useful tool for predicting PCa in Chinese population.

  8. Body mass index influences prostate cancer risk at biopsy in Japanese men.

    Science.gov (United States)

    Masuda, Hitoshi; Kagawa, Makoto; Kawakami, Satoru; Numao, Noboru; Matsuoka, Yoh; Yokoyama, Minato; Yamamoto, Shinya; Yonese, Junji; Fukui, Iwao; Kihara, Kazunori

    2013-07-01

    To determine the relationship between body mass index and prostate cancer risk at biopsy in Japanese men, and to compared the risk with that of Caucasian men. We retrospectively evaluated 3966 men with prostate-specific antigen levels from 2.5 to 19.9 ng/mL who underwent an initial extended prostate biopsy. Using logistic regression, odds ratios of each body mass index category for risk of prostate cancer and high-grade disease (Gleason score ≥4 + 3) were estimated after controlling for age, prostate-specific antigen, %free prostate-specific antigen, prostate volume, digital rectal examination findings, family history of prostate cancer and the number of biopsy cores. Patients were divided into six categories according to their body mass index (kg/m(2) ) as follows: body mass index and prostate cancer risk at biopsy, with an increased risk observed in men whose body mass index was ≥27.0 compared with the reference group. A significantly increased risk starting at body mass index ≥25.0 was found in high-grade disease. In contrast to our results, there has been no reported increase in the risk of prostate cancer at biopsy in Caucasians within the overweight range (body mass index of 25.0-29.9 based on World Health Organization classification). Japanese men within the overweight body mass index range who have an elevated prostate-specific antigen level also have a significant risk of harboring prostate cancer, especially high-grade disease. Overweight Japanese might be at greater prostate cancer risk at biopsy than overweight Caucasians. © 2012 The Japanese Urological Association.

  9. Volume study pre and post-implant brachytherapy prostate for establishment of PTV margins; Estudio de volumenes pre y post-implante en braquiterapia de prostata para establecimiento de margenes del PTV

    Energy Technology Data Exchange (ETDEWEB)

    Jimenez Dominguez, M.; Carrasco Herrera, M.; Baeza Trujillo, M.; Herrador Cordoba, M.

    2011-07-01

    Treatment of prostate cancer by permanent implantation of radioactive seeds is now a good alternative to radical surgery or radiotherapy, as it provides a good tumor control while the risk is reduced by a lower complication irradiation of adjacent healthy organs. The large volume change during seed implantation occurs in the prostate of the patient, makes it important to consider margins around the organs of interest both to ensure optimal coverage and minimal tumor irradiation of healthy tissue. Analyze how the volume varies during and after implantation and establish a margin around the prostate to the practice of our hospital are the two objectives of this work.

  10. Using Photogrammetry to Estimate Tank Waste Volumes from Video

    Energy Technology Data Exchange (ETDEWEB)

    Field, Jim G. [Washington River Protection Solutions, LLC, Richland, WA (United States)

    2013-03-27

    Washington River Protection Solutions (WRPS) contracted with HiLine Engineering & Fabrication, Inc. to assess the accuracy of photogrammetry tools as compared to video Camera/CAD Modeling System (CCMS) estimates. This test report documents the results of using photogrammetry to estimate the volume of waste in tank 241-C-I04 from post-retrieval videos and results using photogrammetry to estimate the volume of waste piles in the CCMS test video.

  11. Using Photogrammetry to Estimate Tank Waste Volumes from Video

    International Nuclear Information System (INIS)

    Field, Jim G.

    2013-01-01

    Washington River Protection Solutions (WRPS) contracted with HiLine Engineering and Fabrication, Inc. to assess the accuracy of photogrammetry tools as compared to video Camera/CAD Modeling System (CCMS) estimates. This test report documents the results of using photogrammetry to estimate the volume of waste in tank 241-C-I04 from post-retrieval videos and results using photogrammetry to estimate the volume of waste piles in the CCMS test video

  12. Stereological estimation of the mean and variance of nuclear volume from vertical sections

    DEFF Research Database (Denmark)

    Sørensen, Flemming Brandt

    1991-01-01

    The application of assumption-free, unbiased stereological techniques for estimation of the volume-weighted mean nuclear volume, nuclear vv, from vertical sections of benign and malignant nuclear aggregates in melanocytic skin tumours is described. Combining sampling of nuclei with uniform...... probability in a physical disector and Cavalieri's direct estimator of volume, the unbiased, number-weighted mean nuclear volume, nuclear vN, of the same benign and malignant nuclear populations is also estimated. Having obtained estimates of nuclear volume in both the volume- and number distribution...... to the larger malignant nuclei. Finally, the variance in the volume distribution of nuclear volume is estimated by shape-independent estimates of the volume-weighted second moment of the nuclear volume, vv2, using both a manual and a computer-assisted approach. The working procedure for the description of 3-D...

  13. Micro CT based truth estimation of nodule volume

    Science.gov (United States)

    Kinnard, L. M.; Gavrielides, M. A.; Myers, K. J.; Zeng, R.; Whiting, B.; Lin-Gibson, S.; Petrick, N.

    2010-03-01

    With the advent of high-resolution CT, three-dimensional (3D) methods for nodule volumetry have been introduced, with the hope that such methods will be more accurate and consistent than currently used planar measures of size. However, the error associated with volume estimation methods still needs to be quantified. Volume estimation error is multi-faceted in the sense that there is variability associated with the patient, the software tool and the CT system. A primary goal of our current research efforts is to quantify the various sources of measurement error and, when possible, minimize their effects. In order to assess the bias of an estimate, the actual value, or "truth," must be known. In this work we investigate the reliability of micro CT to determine the "true" volume of synthetic nodules. The advantage of micro CT over other truthing methods is that it can provide both absolute volume and shape information in a single measurement. In the current study we compare micro CT volume truth to weight-density truth for spherical, elliptical, spiculated and lobulated nodules with diameters from 5 to 40 mm, and densities of -630 and +100 HU. The percent differences between micro CT and weight-density volume for -630 HU nodules range from [-21.7%, -0.6%] (mean= -11.9%) and the differences for +100 HU nodules range from [-0.9%, 3.0%] (mean=1.7%).

  14. Chromosomal aberrations in benign prostatic hyperplasia patients

    Directory of Open Access Journals (Sweden)

    Muammer Altok

    2016-01-01

    Full Text Available Purpose: To investigate the chromosomal changes in patients with benign prostatic hyperplasia (BPH. Materials and Methods: A total of 54 patients diagnosed with clinical BPH underwent transurethral prostate resection to address their primary urological problem. All patients were evaluated by use of a comprehensive medical history and rectal digital examination. The preoperative evaluation also included serum prostate-specific antigen (PSA measurement and ultrasonographic measurement of prostate volume. Prostate cancer was detected in one patient, who was then excluded from the study. We performed conventional cytogenetic analyses of short-term cultures of 53 peripheral blood samples obtained from the BPH patients. Results: The mean (±standard deviation age of the 53 patients was 67.8±9.4 years. The mean PSA value of the patients was 5.8±7.0 ng/mL. The mean prostate volume was 53.6±22.9 mL. Chromosomal abnormalities were noted in 5 of the 53 cases (9.4%. Loss of the Y chromosome was the most frequent chromosomal abnormality and was observed in three patients (5.7%. There was no statistically significant relationship among age, PSA, prostate volume, and chromosomal changes. Conclusions: Loss of the Y chromosome was the main chromosomal abnormality found in our study. However, this coexistence did not reach a significant level. Our study concluded that loss of the Y chromosome cannot be considered relevant for the diagnosis of BPH as it is for prostate cancer. Because BPH usually occurs in aging men, loss of the Y chromosome in BPH patients may instead be related to the aging process.

  15. Rectal Balloon for the Immobilization of the Prostate Internal Motion

    International Nuclear Information System (INIS)

    Lee, Sang Kyu; Beak, Jong Geal; Kim, Joo Ho; Jeon, Byong Chul; Cho, Jeong Hee; Kim, Dong Wook; Song, Tae Soo; Cho, Jae Ho; Na, Soo Kyong

    2005-01-01

    The using of endo-rectal balloon has proposed as optimal method that minimized the motion of prostate and the dose of rectum wall volume for treated prostate cancer patients, so we make the customized rectal balloon device. In this study, we analyzed the efficiency of the Self-customized rectal balloon in the aspects of its reproducibility. In 5 patients, for treatment planning, each patient was acquired CT slice images in state of with and without rectal balloon. Also they had CT scanning same repeated third times in during radiation treatment (IMRT). In each case, we analyzed the deviation of rectal balloon position and verified the isodose distribution of rectum wall at closed prostate. Using the rectal balloon, we minimized the planning target volume (PTV) by decreased the internal motion of prostate and overcome the dose limit of radiation therapy in prostate cancer by increased the gap between the rectum wall and high dose region. The using of rectal balloon, although, was reluctant to treat by patients. View a point of immobilization of prostate internal motion and dose escalation of GTV (gross tumor volume), its using consider large efficient for treated prostate cancer patients.

  16. A predictive model to guide management of the overlap region between target volume and organs at risk in prostate cancer volumetric modulated arc therapy

    International Nuclear Information System (INIS)

    Mattes, Malcolm D.; Lee, Jennifer C.; Einaiem, Sara; Guirguis, Adel; Ikoro, N. C.; Ashamalla Hani

    2013-01-01

    The goal of this study is to determine whether the magnitude of overlap between planning target volume (PTV) and rectum (Rectum overlap ) or PTV and bladder (Bladder overlap ) in prostate cancer volumetric-modulated arc therapy (VMAT) is predictive of the dose-volume relationships achieved after optimization, and to identify predictive equations and cutoff values using these overlap volumes beyond which the Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC) dose-volume constraints are unlikely to be met. Fifty-seven patients with prostate cancer underwent VMAT planning using identical optimization conditions and normalization. The PTV (for the 50.4 Gy primary plan and 30.6 Gy boost plan) included 5 to 10 mm margins around the prostate and seminal vesicles. Pearson correlations, linear regression analyses, and receiver operating characteristic (ROC) curves were used to correlate the percentage overlap with dose-volume parameters. The percentage Rectum overlap and Bladder overlap correlated with sparing of that organ but minimally impacted other dose-volume parameters, predicted the primary plan rectum V 45 and bladder V 50 with R 2 = 0.78 and R 2 = 0.83, respectively, and predicted the boost plan rectum V 30 and bladder V 30 with R 2 = 0.53 and R 2 = 0.81, respectively. The optimal cutoff value of boost Rectumoverlap to predict rectum V75 >15% was 3.5% (sensitivity 100%, specificity 94%, p overlap to predict bladder V 80 >10% was 5.0% (sensitivity 83%, specificity 100%, p < 0.01). The degree of overlap between PTV and bladder or rectum can be used to accurately guide physicians on the use of interventions to limit the extent of the overlap region prior to optimization.

  17. Resveratrol improves prostate fibrosis during progression of urinary dysfunction in chronic prostatitis.

    Science.gov (United States)

    He, Yi; Zeng, Hui-Zhi; Yu, Yang; Zhang, Jia-Shu; Duan, Xingping; Zeng, Xiao-Na; Gong, Feng-Tao; Liu, Qi; Yang, Bo

    2017-09-01

    We investigated whether prostate fibrosis was associated with urinary dysfunction in chronic prostatitis (CP) and whether resveratrol improved urinary dysfunction and the underlying molecular mechanism. Rat model of CP was established via subcutaneous injections of DPT vaccine and subsequently treated with resveratrol. Bladder pressure and volume tests investigated the effect of resveratrol on urinary dysfunction in CP rats. Western blotting and immunohistochemical staining examined the expression level of C-kit/SCF and TGF-β/Wnt/β-catenin. Compared to the control group, the maximum capacity of the bladder, residual urine volume and maximum voiding pressure, the activity of C-kit/SCF and TGF-β/Wnt/β-catenin pathways were increased significantly in the CP group. Resveratrol treatment significantly improved these factors. CP induced significantly prostate fibrosis, which exhibits a close relationship with urinary dysfunction. Resveratrol improved fibrosis, which may be associated with the suppression of C-kit/SCF and TGF-β/Wnt/β-catenin pathway. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Prostate Health Index improves multivariable risk prediction of aggressive prostate cancer.

    Science.gov (United States)

    Loeb, Stacy; Shin, Sanghyuk S; Broyles, Dennis L; Wei, John T; Sanda, Martin; Klee, George; Partin, Alan W; Sokoll, Lori; Chan, Daniel W; Bangma, Chris H; van Schaik, Ron H N; Slawin, Kevin M; Marks, Leonard S; Catalona, William J

    2017-07-01

    To examine the use of the Prostate Health Index (PHI) as a continuous variable in multivariable risk assessment for aggressive prostate cancer in a large multicentre US study. The study population included 728 men, with prostate-specific antigen (PSA) levels of 2-10 ng/mL and a negative digital rectal examination, enrolled in a prospective, multi-site early detection trial. The primary endpoint was aggressive prostate cancer, defined as biopsy Gleason score ≥7. First, we evaluated whether the addition of PHI improves the performance of currently available risk calculators (the Prostate Cancer Prevention Trial [PCPT] and European Randomised Study of Screening for Prostate Cancer [ERSPC] risk calculators). We also designed and internally validated a new PHI-based multivariable predictive model, and created a nomogram. Of 728 men undergoing biopsy, 118 (16.2%) had aggressive prostate cancer. The PHI predicted the risk of aggressive prostate cancer across the spectrum of values. Adding PHI significantly improved the predictive accuracy of the PCPT and ERSPC risk calculators for aggressive disease. A new model was created using age, previous biopsy, prostate volume, PSA and PHI, with an area under the curve of 0.746. The bootstrap-corrected model showed good calibration with observed risk for aggressive prostate cancer and had net benefit on decision-curve analysis. Using PHI as part of multivariable risk assessment leads to a significant improvement in the detection of aggressive prostate cancer, potentially reducing harms from unnecessary prostate biopsy and overdiagnosis. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

  19. MR-CT registration using a Ni-Ti prostate stent in image-guided radiotherapy of prostate cancer.

    Science.gov (United States)

    Korsager, Anne Sofie; Carl, Jesper; Østergaard, Lasse Riis

    2013-06-01

    In image-guided radiotherapy of prostate cancer defining the clinical target volume often relies on magnetic resonance (MR). The task of transferring the clinical target volume from MR to standard planning computed tomography (CT) is not trivial due to prostate mobility. In this paper, an automatic local registration approach is proposed based on a newly developed removable Ni-Ti prostate stent. The registration uses the voxel similarity measure mutual information in a two-step approach where the pelvic bones are used to establish an initial registration for the local registration. In a phantom study, the accuracy was measured to 0.97 mm and visual inspection showed accurate registration of all 30 data sets. The consistency of the registration was examined where translation and rotation displacements yield a rotation error of 0.41° ± 0.45° and a translation error of 1.67 ± 2.24 mm. This study demonstrated the feasibility for an automatic local MR-CT registration using the prostate stent.

  20. Toward Prostate Cancer Contouring Guidelines on Magnetic Resonance Imaging: Dominant Lesion Gross and Clinical Target Volume Coverage Via Accurate Histology Fusion

    International Nuclear Information System (INIS)

    Gibson, Eli; Bauman, Glenn S.; Romagnoli, Cesare; Cool, Derek W.; Bastian-Jordan, Matthew; Kassam, Zahra; Gaed, Mena; Moussa, Madeleine; Gómez, José A.; Pautler, Stephen E.; Chin, Joseph L.; Crukley, Cathie; Haider, Masoom A.

    2016-01-01

    Purpose: Defining prostate cancer (PCa) lesion clinical target volumes (CTVs) for multiparametric magnetic resonance imaging (mpMRI) could support focal boosting or treatment to improve outcomes or lower morbidity, necessitating appropriate CTV margins for mpMRI-defined gross tumor volumes (GTVs). This study aimed to identify CTV margins yielding 95% coverage of PCa tumors for prospective cases with high likelihood. Methods and Materials: Twenty-five men with biopsy-confirmed clinical stage T1 or T2 PCa underwent pre-prostatectomy mpMRI, yielding T2-weighted, dynamic contrast-enhanced, and apparent diffusion coefficient images. Digitized whole-mount histology was contoured and registered to mpMRI scans (error ≤2 mm). Four observers contoured lesion GTVs on each mpMRI scan. CTVs were defined by isotropic and anisotropic expansion from these GTVs and from multiparametric (unioned) GTVs from 2 to 3 scans. Histologic coverage (proportions of tumor area on co-registered histology inside the CTV, measured for Gleason scores [GSs] ≥6 and ≥7) and prostate sparing (proportions of prostate volume outside the CTV) were measured. Nonparametric histologic-coverage prediction intervals defined minimal margins yielding 95% coverage for prospective cases with 78% to 92% likelihood. Results: On analysis of 72 true-positive tumor detections, 95% coverage margins were 9 to 11 mm (GS ≥ 6) and 8 to 10 mm (GS ≥ 7) for single-sequence GTVs and were 8 mm (GS ≥ 6) and 6 mm (GS ≥ 7) for 3-sequence GTVs, yielding CTVs that spared 47% to 81% of prostate tissue for the majority of tumors. Inclusion of T2-weighted contours increased sparing for multiparametric CTVs with 95% coverage margins for GS ≥6, and inclusion of dynamic contrast-enhanced contours increased sparing for GS ≥7. Anisotropic 95% coverage margins increased the sparing proportions to 71% to 86%. Conclusions: Multiparametric magnetic resonance imaging–defined GTVs expanded by appropriate margins

  1. Toward Prostate Cancer Contouring Guidelines on Magnetic Resonance Imaging: Dominant Lesion Gross and Clinical Target Volume Coverage Via Accurate Histology Fusion

    Energy Technology Data Exchange (ETDEWEB)

    Gibson, Eli [Robarts Research Institute, University of Western Ontario, London, Ontario (Canada); Biomedical Engineering, University of Western Ontario, London, Ontario (Canada); Centre for Medical Image Computing, University College London, London (United Kingdom); Department of Radiology, Radboud University Medical Centre, Nijmegen (Netherlands); Bauman, Glenn S., E-mail: glenn.bauman@lhsc.on.ca [Lawson Health Research Institute, London, Ontario (Canada); Department of Oncology, University of Western Ontario, London, Ontario (Canada); Romagnoli, Cesare; Cool, Derek W. [Department of Medical Imaging, University of Western Ontario, London, Ontario (Canada); Bastian-Jordan, Matthew [Department of Medical Imaging, University of Western Ontario, London, Ontario (Canada); Queensland Health, Brisbane, Queensland (Australia); Kassam, Zahra [Department of Medical Imaging, University of Western Ontario, London, Ontario (Canada); Gaed, Mena [Robarts Research Institute, University of Western Ontario, London, Ontario (Canada); Department of Pathology, University of Western Ontario, London, Ontario (Canada); Moussa, Madeleine; Gómez, José A. [Department of Pathology, University of Western Ontario, London, Ontario (Canada); Pautler, Stephen E.; Chin, Joseph L. [Lawson Health Research Institute, London, Ontario (Canada); Department of Urology, University of Western Ontario, London, Ontario (Canada); Crukley, Cathie [Robarts Research Institute, University of Western Ontario, London, Ontario (Canada); Lawson Health Research Institute, London, Ontario (Canada); Haider, Masoom A. [Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); and others

    2016-09-01

    Purpose: Defining prostate cancer (PCa) lesion clinical target volumes (CTVs) for multiparametric magnetic resonance imaging (mpMRI) could support focal boosting or treatment to improve outcomes or lower morbidity, necessitating appropriate CTV margins for mpMRI-defined gross tumor volumes (GTVs). This study aimed to identify CTV margins yielding 95% coverage of PCa tumors for prospective cases with high likelihood. Methods and Materials: Twenty-five men with biopsy-confirmed clinical stage T1 or T2 PCa underwent pre-prostatectomy mpMRI, yielding T2-weighted, dynamic contrast-enhanced, and apparent diffusion coefficient images. Digitized whole-mount histology was contoured and registered to mpMRI scans (error ≤2 mm). Four observers contoured lesion GTVs on each mpMRI scan. CTVs were defined by isotropic and anisotropic expansion from these GTVs and from multiparametric (unioned) GTVs from 2 to 3 scans. Histologic coverage (proportions of tumor area on co-registered histology inside the CTV, measured for Gleason scores [GSs] ≥6 and ≥7) and prostate sparing (proportions of prostate volume outside the CTV) were measured. Nonparametric histologic-coverage prediction intervals defined minimal margins yielding 95% coverage for prospective cases with 78% to 92% likelihood. Results: On analysis of 72 true-positive tumor detections, 95% coverage margins were 9 to 11 mm (GS ≥ 6) and 8 to 10 mm (GS ≥ 7) for single-sequence GTVs and were 8 mm (GS ≥ 6) and 6 mm (GS ≥ 7) for 3-sequence GTVs, yielding CTVs that spared 47% to 81% of prostate tissue for the majority of tumors. Inclusion of T2-weighted contours increased sparing for multiparametric CTVs with 95% coverage margins for GS ≥6, and inclusion of dynamic contrast-enhanced contours increased sparing for GS ≥7. Anisotropic 95% coverage margins increased the sparing proportions to 71% to 86%. Conclusions: Multiparametric magnetic resonance imaging–defined GTVs expanded by appropriate margins

  2. The relationship between histological prostatitis and lower urinary tract symptoms and sexual function.

    Science.gov (United States)

    Kumsar, Sukru; Kose, Osman; Aydemir, Huseyin; Halis, Fikret; Gokce, Ahmet; Adsan, Oztug; Akkaya, Zeynep Kahyaoglu

    2016-01-01

    This prospective analysis assessed the effect of histological prostatitis on lower urinary tract functions and sexual function. The patients were separated into two groups as histologically observed prostatitis (Group A) and no prostatitis (Group B) according to the biopsy outcomes. International prostate symptom score, international index of erectile function-5 scores, maximal and average flow rate, and residual urine volumes were compared statistically between groups. There was no significant difference (P>0.05) in baseline age (t=0.64), body mass index value (t=0.51), prostate volume (t=0.87), prostate-specific antigen levels (t=0.43), maximal (t=0.84) and average flow rate (t=0.59), and post-void residual urine volume (t=0.71). Mean international prostate symptom score in patients with prostatitis was numerically but not significantly higher than that in those without prostatitis (t=0.794, P=0.066). Mean international index of erectile function-5 score in the prostatitis group was significantly lower than that in those without prostatitis (t=1.854, P=0.013). Histological prostatitis notably affected sexual function of patients and may serve as a major risk factor for sexual dysfunction while having little effect on lower urinary tract symptoms.

  3. Force estimation from OCT volumes using 3D CNNs.

    Science.gov (United States)

    Gessert, Nils; Beringhoff, Jens; Otte, Christoph; Schlaefer, Alexander

    2018-05-04

    Estimating the interaction forces of instruments and tissue is of interest, particularly to provide haptic feedback during robot-assisted minimally invasive interventions. Different approaches based on external and integrated force sensors have been proposed. These are hampered by friction, sensor size, and sterilizability. We investigate a novel approach to estimate the force vector directly from optical coherence tomography image volumes. We introduce a novel Siamese 3D CNN architecture. The network takes an undeformed reference volume and a deformed sample volume as an input and outputs the three components of the force vector. We employ a deep residual architecture with bottlenecks for increased efficiency. We compare the Siamese approach to methods using difference volumes and two-dimensional projections. Data were generated using a robotic setup to obtain ground-truth force vectors for silicon tissue phantoms as well as porcine tissue. Our method achieves a mean average error of [Formula: see text] when estimating the force vector. Our novel Siamese 3D CNN architecture outperforms single-path methods that achieve a mean average error of [Formula: see text]. Moreover, the use of volume data leads to significantly higher performance compared to processing only surface information which achieves a mean average error of [Formula: see text]. Based on the tissue dataset, our methods shows good generalization in between different subjects. We propose a novel image-based force estimation method using optical coherence tomography. We illustrate that capturing the deformation of subsurface structures substantially improves force estimation. Our approach can provide accurate force estimates in surgical setups when using intraoperative optical coherence tomography.

  4. The incidence of inclusion of the sigmoid colon and small bowel in the planning target volume in radiotherapy for prostate cancer

    International Nuclear Information System (INIS)

    Meerleer, G.O. de; Vakaet, L.; Neve, W.J. de; Villeirs, G.M.; Delrue, L.J.

    2004-01-01

    Background and purpose: in radiotherapy for prostate cancer, the rectum is considered the dose-limiting organ. The incidence of overlap between the sigmoid colon and/or small bowel and the planning target volume (PTV) as well as the dose to sigmoid colon and small bowel were investigated. Patients and methods: the CT data of 75 prostate cancer patients were analyzed. The clinical target volume (CTV) consisted of prostate and seminal vesicles. The PTV was defined as a three-dimensional expansion of the CTV with a 10-mm margin in craniocaudal and a 7-mm margin in the other directions. All patients were planned to a mean CTV dose of at least 76 Gy. Minimum CTV dose was set at 70 Gy. Dose inhomogeneity within the CTV was kept between 12% and 17%. Sigmoid colon was defined upward from the level where the rectum turned in a transverse plane. Contrast-filled small bowel was contoured on all slices where it was visible. The presence of sigmoid colon and/or small bowel in close vicinity to or overlapping with the PTV was recorded. For each case, the dose to the sigmoid colon and small bowel was calculated. Results: the PTV was found to overlap with the sigmoid colon in 60% and with the small bowel in 19% of the cases. In these patients, mean maximum dose to the sigmoid colon was 76.2 Gy (5th-95th percentile: 70.0-80.7 Gy). Mean maximum dose to the small bowel was 74.9 Gy (5th-95th percentile: 68.0-80.0 Gy). Conclusion: when systematically investigating the anatomic position of sigmoid colon and small bowel in patients accepted for prostate irradiation, parts of both organs were often observed in close vicinity to the PTV. Apart from the rectum, these organs may be dose-limiting in prostate radiotherapy. (orig.)

  5. The incidence of inclusion of the sigmoid colon and small bowel in the planning target volume in radiotherapy for prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Meerleer, G.O. de; Vakaet, L.; Neve, W.J. de [Dept. of Radiation Oncology, Gent Univ. Hospital, Gent (Belgium); Villeirs, G.M.; Delrue, L.J. [Dept. of Radiology, Gent Univ. Hospital, Gent (Belgium)

    2004-09-01

    Background and purpose: in radiotherapy for prostate cancer, the rectum is considered the dose-limiting organ. The incidence of overlap between the sigmoid colon and/or small bowel and the planning target volume (PTV) as well as the dose to sigmoid colon and small bowel were investigated. Patients and methods: the CT data of 75 prostate cancer patients were analyzed. The clinical target volume (CTV) consisted of prostate and seminal vesicles. The PTV was defined as a three-dimensional expansion of the CTV with a 10-mm margin in craniocaudal and a 7-mm margin in the other directions. All patients were planned to a mean CTV dose of at least 76 Gy. Minimum CTV dose was set at 70 Gy. Dose inhomogeneity within the CTV was kept between 12% and 17%. Sigmoid colon was defined upward from the level where the rectum turned in a transverse plane. Contrast-filled small bowel was contoured on all slices where it was visible. The presence of sigmoid colon and/or small bowel in close vicinity to or overlapping with the PTV was recorded. For each case, the dose to the sigmoid colon and small bowel was calculated. Results: the PTV was found to overlap with the sigmoid colon in 60% and with the small bowel in 19% of the cases. In these patients, mean maximum dose to the sigmoid colon was 76.2 Gy (5th-95th percentile: 70.0-80.7 Gy). Mean maximum dose to the small bowel was 74.9 Gy (5th-95th percentile: 68.0-80.0 Gy). Conclusion: when systematically investigating the anatomic position of sigmoid colon and small bowel in patients accepted for prostate irradiation, parts of both organs were often observed in close vicinity to the PTV. Apart from the rectum, these organs may be dose-limiting in prostate radiotherapy. (orig.)

  6. Prostate-specific antigen (PSA) density in the diagnostic algorithm of prostate cancer.

    Science.gov (United States)

    Nordström, Tobias; Akre, Olof; Aly, Markus; Grönberg, Henrik; Eklund, Martin

    2018-04-01

    Screening for prostate cancer using prostate-specific antigen (PSA) alone leads to un-necessary biopsying and overdiagnosis. PSA density is easily accessible, but early evidence on its use for biopsy decisions was conflicting and use of PSA density is not commonly recommended in guidelines. We analyzed biopsy outcomes in 5291 men in the population-based STHLM3 study with PSA ≥ 3 ng/ml and ultrasound-guided prostate volume measurements by using percentages and regression models. PSA density was calculated as total PSA (ng/ml) divided by prostate volume (ml). Main endpoint was clinically significant cancer (csPCa) defined as Gleason Score ≥ 7. The median PSA-density was 0.10 ng/ml 2 (IQR 0.075-0.14). PSA-density was associated with the risk of finding csPCa both with and without adjusting for the additional clinical information age, family history, previous biopsies, total PSA and free/total PSA (OR 1.06; 95% CI:1.05-1.07 and OR 1.07, 95% CI 1.06-1.08). Discrimination for csPCa was better when PSA density was added to a model with additional clinical information (AUC 0.75 vs. 0.73, P PSA-density. Omitting prostate biopsy for men with PSA-density ≤0.07 ng/ml 2 would save 19.7% of biopsy procedures, while missing 6.9% of csPCa. PSA-density cutoffs of 0.10 ng/ml 2 and 0.15 ng/ml 2 resulted in detection of 77% (729/947) and 49% (461/947) of Gleason Score ≥7 tumors. PSA-density might inform biopsy decisions, and spare some men from the morbidity associated with a prostate biopsy and diagnosis of low-grade prostate cancer.

  7. An Adaptive Off-Line Procedure for Radiotherapy of Prostate Cancer

    International Nuclear Information System (INIS)

    Nuver, Tonnis T.; Hoogeman, Mischa S.; Remeijer, Peter; Herk, Marcel van; Lebesque, Joos V.

    2007-01-01

    Purpose: To determine the planning target volume (PTV) margin for an adaptive radiotherapy procedure that uses five computed tomography (CT) scans to calculate an average prostate position and rectum shape. To evaluate alternative methods to determine an average rectum based on a single delineation. Methods and Materials: Repeat CT scans (8-13) of 19 patients were used. The contoured prostates of the first four scans were matched on the planning CT (pCT) prostate contours. With the resulting translations and rotations the average prostate position was determined. An average rectum was obtained by either averaging the coordinates of corresponding points on the rectal walls or by selecting the 'best' rectum or transforming the pCT rectum. Dose distributions were calculated for various expanded average prostates. The remaining CT scans were used to determine the dose received by prostate and rectum during treatment. Results: For the prostate of the pCT scan and a 10-mm margin, all patients received more than 95% of the prescribed dose to 95% of the prostate. For the average prostate, a margin of 7 mm was needed to obtain a similar result (average PTV reduction 30%). The average rectum overestimated the mean dose to the rectum by 0.4 ± 1.6 Gy, which was better than the pCT rectum (2.1 ± 3.0 Gy) and the alternative average rectums (1.0 ± 2.6 Gy and 1.4 ± 3.2 Gy). Conclusions: Our adaptive procedure allows for reduction of the PTV margin to 7 mm without decreasing prostate coverage during treatment. For accurate estimation of the rectum dose, rectums need to be delineated and averaged over multiple scans

  8. Multivariate analysis of factors predicting prostate dose in intensity-modulated radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Tomita, Tsuneyuki [Division of Radiology, Osaka Red Cross Hospital, Osaka (Japan); Nakamura, Mitsuhiro, E-mail: m_nkmr@kuhp.kyoto-u.ac.jp [Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto (Japan); Hirose, Yoshinori; Kitsuda, Kenji; Notogawa, Takuya; Miki, Katsuhito [Division of Radiology, Osaka Red Cross Hospital, Osaka (Japan); Nakamura, Kiyonao; Ishigaki, Takashi [Department of Radiation Oncology, Osaka Red Cross Hospital, Osaka (Japan)

    2014-01-01

    We conducted a multivariate analysis to determine relationships between prostate radiation dose and the state of surrounding organs, including organ volumes and the internal angle of the levator ani muscle (LAM), based on cone-beam computed tomography (CBCT) images after bone matching. We analyzed 270 CBCT data sets from 30 consecutive patients receiving intensity-modulated radiation therapy for prostate cancer. With patients in the supine position on a couch with the HipFix system, data for center of mass (COM) displacement of the prostate and the state of individual organs were acquired and compared between planning CT and CBCT scans. Dose distributions were then recalculated based on CBCT images. The relative effects of factors on the variance in COM, dose covering 95% of the prostate volume (D{sub 95%}), and percentage of prostate volume covered by the 100% isodose line (V{sub 100%}) were evaluated by a backward stepwise multiple regression analysis. COM displacement in the anterior-posterior direction (COM{sub AP}) correlated significantly with the rectum volume (δVr) and the internal LAM angle (δθ; R = 0.63). Weak correlations were seen for COM in the left-right (R = 0.18) and superior-inferior directions (R = 0.31). Strong correlations between COM{sub AP} and prostate D{sub 95%} and V{sub 100%} were observed (R ≥ 0.69). Additionally, the change ratios in δVr and δθ remained as predictors of prostate D{sub 95%} and V{sub 100%}. This study shows statistically that maintaining the same rectum volume and LAM state for both the planning CT simulation and treatment is important to ensure the correct prostate dose in the supine position with bone matching.

  9. Prostate Brachytherapy With Oblique Needles to Treat Large Glands and Overcome Pubic Arch Interference

    International Nuclear Information System (INIS)

    Ryu, Bon; Bax, Jeff; Edirisinge, Chandima; Lewis, Craig; Chen, Jeff; D’Souza, David; Fenster, Aaron; Wong, Eugene

    2012-01-01

    Purpose: First, to show that low-dose-rate prostate brachytherapy plans using oblique needle trajectories are more successful than parallel trajectories for large prostates with pubic arch interference (PAI); second, to test the accuracy of delivering an oblique plan by using a three-dimensional (3D) transrectal ultrasonography (TRUS)-guided mechatronic system. Methods and Materials: Prostates were contoured for 5 subjects’ 3D TRUS images showing a maximum PAI of ≤1 cm and a prostate volume of <50 cc. Two planning studies were done. First, prostate contours were artificially enlarged to 45 to 80 cc in 5- to 10-cc increments for a single subject. Second, all subject prostate contours were enlarged to 60 cc. For each study, three types of plans were manually created for comparison: a parallel needle template (PT) plan, a parallel needle no-template (PNT) plan, and an oblique needle no-template (OBL) plan. Needle positions and angles were not discretized for nontemplate plans. European Society for Therapeutic Radiology and Oncology dose-volume histogram guidelines, iodine-125 (145-Gy prescription, 0.43 U), and needle angles of <15° were used. An OBL plan was delivered to a pubic arch containing a 60-cc prostate phantom that mimicked the anatomy of the subject with the greatest PAI (23% by volume). Results: In the increasing-prostate volume study, OBL plans were successful for prostates of ≤80 cc, and PT plans were successful for prostates of <65 cc. In paired, one-sided t tests for the 60-cc volume study, OBL plans showed dosimetric improvements for all organs compared to both of the parallel type plans (p < 0.05); PNT plans showed a benefit only in planning target volumes receiving more than 100 Gy compared to PT plans. A computed tomography scan of the phantom showed submillimeter seed placement accuracy in all directions. Conclusion: OBL plans were significantly better than parallel plans, and an OBL plan was accurately delivered to a 60-cc prostate phantom

  10. PREVENTION OF DYSURIA AFTER HIFU THERAPY FOR PROSTATE CANCER

    Directory of Open Access Journals (Sweden)

    A. Yu. Shestaev

    2014-01-01

    Full Text Available Objective: to identify factors for the development of dysuria and its prevention in patients with prostate cancer (PC after high-intensity focused ultrasound (HIFU therapy.Subjects and methods. In September 2008 to June 2013, the Clinic of Urology, S.M. Kirov Military Medical Academy, treated 98 patients, by performing HIFU sessions on an Ablatherm apparatus (EDAP, France. All the patients underwent transurethral resection of the prostate (TURP to reduce the volume of the ablated tissue. The patients were divided into 2 groups: 1 29 patients underwent TURP 3 days before HIFU therapy; 2 69 did this 1 month before major surgery. Each group was divided into 2 subgroups: 1 after ultrasound ablation, a urethral catheter was inserted for 10 days; 2 epicystostoma was applied, followed by its overlapping on day 3 postablation and spontaneous urination. The postoperative incidence of dysuria was estimated from subjective (complaints, voiding diary, and Inter-national Prostate Symptom Score and objective (uroflowmetry, small pelvic ultrasonography with determination of residual urine volume criteria.Results. In the patients who had undergone TURP one month before HIFU therapy, grades I–II urinary incontinence and urethral pros-tatic stricture occurred much less infrequently than in those who had undergone this maneuver 3 days prior to major surgery. Urinary in-continence and urethral prostatic stricture occurred 2-fold more frequently after TURP being carried out 3 days before HIFU therapy than after the urethral catheter being inserted. TURP performed one month before HIFU therapy showed no great difference in the incidence complications regardless of the type of bladder drainage.Conclusion. The short interval between TURP and HIFU therapy for PC increases the risk of postoperative dysuric events. The optimal time to perform TURP prior to HIFU therapy is 1 month.

  11. PREVENTION OF DYSURIA AFTER HIFU THERAPY FOR PROSTATE CANCER

    Directory of Open Access Journals (Sweden)

    A. Yu. Shestaev

    2014-07-01

    Full Text Available Objective: to identify factors for the development of dysuria and its prevention in patients with prostate cancer (PC after high-intensity focused ultrasound (HIFU therapy.Subjects and methods. In September 2008 to June 2013, the Clinic of Urology, S.M. Kirov Military Medical Academy, treated 98 patients, by performing HIFU sessions on an Ablatherm apparatus (EDAP, France. All the patients underwent transurethral resection of the prostate (TURP to reduce the volume of the ablated tissue. The patients were divided into 2 groups: 1 29 patients underwent TURP 3 days before HIFU therapy; 2 69 did this 1 month before major surgery. Each group was divided into 2 subgroups: 1 after ultrasound ablation, a urethral catheter was inserted for 10 days; 2 epicystostoma was applied, followed by its overlapping on day 3 postablation and spontaneous urination. The postoperative incidence of dysuria was estimated from subjective (complaints, voiding diary, and Inter-national Prostate Symptom Score and objective (uroflowmetry, small pelvic ultrasonography with determination of residual urine volume criteria.Results. In the patients who had undergone TURP one month before HIFU therapy, grades I–II urinary incontinence and urethral pros-tatic stricture occurred much less infrequently than in those who had undergone this maneuver 3 days prior to major surgery. Urinary in-continence and urethral prostatic stricture occurred 2-fold more frequently after TURP being carried out 3 days before HIFU therapy than after the urethral catheter being inserted. TURP performed one month before HIFU therapy showed no great difference in the incidence complications regardless of the type of bladder drainage.Conclusion. The short interval between TURP and HIFU therapy for PC increases the risk of postoperative dysuric events. The optimal time to perform TURP prior to HIFU therapy is 1 month.

  12. Percutaneous MR-guided cryoablation of prostate cancer: initial experience

    International Nuclear Information System (INIS)

    Gangi, Afshin; Tsoumakidou, Georgia; Abdelli, Omar; Buy, Xavier; Mathelin, Michel de; Jacqmin, Didier; Lang, Herve

    2012-01-01

    We report our initial experience and the technical feasibility of transperineal prostate cryoablation under MR guidance. Percutaneous MR-guided cryoablation was performed in 11 patients with prostatic adenocarcinoma contraindicated for surgery (mean age: 72 years, mean Gleason score: 6.45, mean prostate-specific antigen (PSA): 6.21 ng/ml, T1-2c/N0/M0, mean: prostate volume 36.44 ml). Free-hand probe positioning was performed under real-time MR imaging. Four to seven cryoprobes were inserted into the prostate, depending on gland volume. The ice ball was monitored using real-time and high-resolution BLADE multi-planar imaging. Patients were followed at 1, 3, 6, 9 and 12 months after the procedure with serum PSA level and post-ablation MRI. Prostate cryoablation was technically feasible in 10/11 patients. The ice ball was clearly and sharply visualised in all cases as a signal-void area. Mean ice-ball volume was 53.3 ml. Mean follow-up was 15 months (range: 1-25). Mean PSA nadir was 0.33 ng/ml (range: 0.02-0.94 ng/ml). Mean hospitalisation was 5 days (range: 3-13). Complications included a urethro-rectal fistula, urinary infection, transient dysuria and scrotal pain. MR-guided prostate cryoablation is feasible and promising, with excellent monitoring of the ice ball. Future perspectives could include the use of MR guidance for focal prostate cancer cryotherapy. (orig.)

  13. Percutaneous MR-guided cryoablation of prostate cancer: initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Gangi, Afshin; Tsoumakidou, Georgia; Abdelli, Omar; Buy, Xavier [University Hospital of Strasbourg, Department of Interventional Radiology, Strasbourg (France); Mathelin, Michel de [University of Strasbourg, Lsiit, Strasbourg (France); Jacqmin, Didier; Lang, Herve [University Hospital of Strasbourg, Department of Urology, Strasbourg (France)

    2012-08-15

    We report our initial experience and the technical feasibility of transperineal prostate cryoablation under MR guidance. Percutaneous MR-guided cryoablation was performed in 11 patients with prostatic adenocarcinoma contraindicated for surgery (mean age: 72 years, mean Gleason score: 6.45, mean prostate-specific antigen (PSA): 6.21 ng/ml, T1-2c/N0/M0, mean: prostate volume 36.44 ml). Free-hand probe positioning was performed under real-time MR imaging. Four to seven cryoprobes were inserted into the prostate, depending on gland volume. The ice ball was monitored using real-time and high-resolution BLADE multi-planar imaging. Patients were followed at 1, 3, 6, 9 and 12 months after the procedure with serum PSA level and post-ablation MRI. Prostate cryoablation was technically feasible in 10/11 patients. The ice ball was clearly and sharply visualised in all cases as a signal-void area. Mean ice-ball volume was 53.3 ml. Mean follow-up was 15 months (range: 1-25). Mean PSA nadir was 0.33 ng/ml (range: 0.02-0.94 ng/ml). Mean hospitalisation was 5 days (range: 3-13). Complications included a urethro-rectal fistula, urinary infection, transient dysuria and scrotal pain. MR-guided prostate cryoablation is feasible and promising, with excellent monitoring of the ice ball. Future perspectives could include the use of MR guidance for focal prostate cancer cryotherapy. (orig.)

  14. Unsteady force estimation using a Lagrangian drift-volume approach

    Science.gov (United States)

    McPhaden, Cameron J.; Rival, David E.

    2018-04-01

    A novel Lagrangian force estimation technique for unsteady fluid flows has been developed, using the concept of a Darwinian drift volume to measure unsteady forces on accelerating bodies. The construct of added mass in viscous flows, calculated from a series of drift volumes, is used to calculate the reaction force on an accelerating circular flat plate, containing highly-separated, vortical flow. The net displacement of fluid contained within the drift volumes is, through Darwin's drift-volume added-mass proposition, equal to the added mass of the plate and provides the reaction force of the fluid on the body. The resultant unsteady force estimates from the proposed technique are shown to align with the measured drag force associated with a rapid acceleration. The critical aspects of understanding unsteady flows, relating to peak and time-resolved forces, often lie within the acceleration phase of the motions, which are well-captured by the drift-volume approach. Therefore, this Lagrangian added-mass estimation technique opens the door to fluid-dynamic analyses in areas that, until now, were inaccessible by conventional means.

  15. Estimation of lung volumes from chest radiographs using shape information

    International Nuclear Information System (INIS)

    Pierce, R.J.; Brown, D.J.; Holmes, M.; Cumming, G.; Denison, D.M.

    1979-01-01

    The cross-sectional shapes of the chest and its contained structures were assessed in post-mortem anatomical sections and from computerised tomographic scans in living subjects. These shapes are described by simple equations that can be used to increase the accuracy of measuring lung volumes from chest radiographs. Radiographic estimates of total lung capacity, using the equations, were compared with plethysmographic and single-breath helium dilution measurements in 35 normal subjects. After correction for posture effects the radiographic estimates of TLC, which measure the displacement volume of the lung, exceeded the plethysmographic estimates of contained gas volume by a mean of 720 ml, which was taken as the volume of tissue, blood, and water in the lungs. The single-breath dilution estimates of TLC fell short of the plethysmographic values by a mean of 480 ml, taken as the volume of contained gas that was inaccessible to helium in 10 seconds. The tomographic studies suggested that the radiographic technique of measuring lung displacement volumes has an accuracy of +- 210 ml. The method is rapid and simple to use and the intra- and inter-observer variabilities of <1% and <5% respectively. (author)

  16. Men with spinal cord injury have a smaller prostate than men without

    DEFF Research Database (Denmark)

    Hvarness, Helle; Jakobsen, Henrik; Biering-Sørensen, Fin

    2007-01-01

    To compare prostate volume and number of ejaculations in men with and without spinal cord injury (SCI).......To compare prostate volume and number of ejaculations in men with and without spinal cord injury (SCI)....

  17. Evaluation of different set-up error corrections on dose-volume metrics in prostate IMRT using CBCT images

    International Nuclear Information System (INIS)

    Hirose, Yoshinori; Tomita, Tsuneyuki; Kitsuda, Kenji; Notogawa, Takuya; Miki, Katsuhito; Nakamura, Mitsuhiro; Nakamura, Kiyonao; Ishigaki, Takashi

    2014-01-01

    We investigated the effect of different set-up error corrections on dose-volume metrics in intensity-modulated radiotherapy (IMRT) for prostate cancer under different planning target volume (PTV) margin settings using cone-beam computed tomography (CBCT) images. A total of 30 consecutive patients who underwent IMRT for prostate cancer were retrospectively analysed, and 7-14 CBCT datasets were acquired per patient. Interfractional variations in dose-volume metrics were evaluated under six different set-up error corrections, including tattoo, bony anatomy, and four different target matching groups. Set-up errors were incorporated into planning the isocenter position, and dose distributions were recalculated on CBCT images. These processes were repeated under two different PTV margin settings. In the on-line bony anatomy matching groups, systematic error (Σ) was 0.3 mm, 1.4 mm, and 0.3 mm in the left-right, anterior-posterior (AP), and superior-inferior directions, respectively. Σ in three successive off-line target matchings was finally comparable with that in the on-line bony anatomy matching in the AP direction. Although doses to the rectum and bladder wall were reduced for a small PTV margin, averaged reductions in the volume receiving 100% of the prescription dose from planning were within 2.5% under all PTV margin settings for all correction groups, with the exception of the tattoo set-up error correction only (≥ 5.0%). Analysis of variance showed no significant difference between on-line bony anatomy matching and target matching. While variations between the planned and delivered doses were smallest when target matching was applied, the use of bony anatomy matching still ensured the planned doses. (author)

  18. Using Mobile Device Samples to Estimate Traffic Volumes

    Science.gov (United States)

    2017-12-01

    In this project, TTI worked with StreetLight Data to evaluate a beta version of its traffic volume estimates derived from global positioning system (GPS)-based mobile devices. TTI evaluated the accuracy of average annual daily traffic (AADT) volume :...

  19. Magnetic resonance imaging in the radiation treatment planning of localized prostate cancer using intra-prostatic fiducial markers for computed tomography co-registration

    International Nuclear Information System (INIS)

    Parker, C.C.; Damyanovich, A.; Haycocks, T.; Haider, M.; Bayley, A.; Catton, C.N.

    2003-01-01

    Purpose: To assess the feasibility, and potential implications, of using intra-prostatic fiducial markers, rather than bony landmarks, for the co-registration of computed tomography (CT) and magnetic resonance (MR) images in the radiation treatment planning of localized prostate cancer. Methods: All men treated with conformal therapy for localized prostate cancer underwent routine pre-treatment insertion of prostatic fiducial markers to assist with gross target volume (GTV) delineation and to identify prostate positioning during therapy. Six of these men were selected for investigation. Phantom MRI measurements were obtained to quantify image distortion, to determine the most suitable gold alloy marker composition, and to identify the spin-echo sequences that optimized both marker identification and the contrast between the prostate and the surrounding tissues. The GTV for each patient was contoured independently by three radiation oncologists on axial planning CT slices, and on axial MRI slices fused to the CT slices by matching the implanted fiducial markers. From each set of contours the scan common volume (SCV), and the scan encompassing volume (SEV), were obtained. The ratio SEV/SCV for a given scan is a measure of inter-observer variation in contouring. For each of the 18 patient-observer combinations the observer common volume (OCV) and the observer encompassing volume (OEV) was obtained. The ratio OEV/OCV for a given patient-observer combination is a measure of the inter-modality variation in contouring. The distance from the treatment planning isocenter to the prostate contours was measured and the discrepancy between the CT- and the MR-defined contour recorded. The discrepancies between the CT- and MR-defined contours of the posterior prostate were recorded in the sagittal plane at 1-cm intervals above and below the isocenter. Results: Phantom measurements demonstrated trivial image distortion within the required field of view, and an 18K Au/Cu alloy to

  20. The application of three-dimensional contrast-enhanced ultrasound to measure volume of affected tissue after HIFU treatment for localized prostate cancer

    NARCIS (Netherlands)

    Sedelaar, J. P.; Aarnink, R. G.; van Leenders, G. J.; Beerlage, H. P.; Debruyne, F. M.; Wijkstra, H.; de la Rosette, J. J.

    2000-01-01

    INTRODUCTION: Adequate monitoring of volume and location of affected tissue might provide helpful information when performing localized ablative therapy for prostate cancer. We hypothesize that the change in blood flow patterns after therapy in comparison to the blood flow pattern prior to therapy

  1. Comparison of Statistically Modeled Contaminated Soil Volume Estimates and Actual Excavation Volumes at the Maywood FUSRAP Site - 13555

    Energy Technology Data Exchange (ETDEWEB)

    Moore, James [U.S. Army Corps of Engineers - New York District 26 Federal Plaza, New York, New York 10278 (United States); Hays, David [U.S. Army Corps of Engineers - Kansas City District 601 E. 12th Street, Kansas City, Missouri 64106 (United States); Quinn, John; Johnson, Robert; Durham, Lisa [Argonne National Laboratory, Environmental Science Division 9700 S. Cass Ave., Argonne, Illinois 60439 (United States)

    2013-07-01

    As part of the ongoing remediation process at the Maywood Formerly Utilized Sites Remedial Action Program (FUSRAP) properties, Argonne National Laboratory (Argonne) assisted the U.S. Army Corps of Engineers (USACE) New York District by providing contaminated soil volume estimates for the main site area, much of which is fully or partially remediated. As part of the volume estimation process, an initial conceptual site model (ICSM) was prepared for the entire site that captured existing information (with the exception of soil sampling results) pertinent to the possible location of surface and subsurface contamination above cleanup requirements. This ICSM was based on historical anecdotal information, aerial photographs, and the logs from several hundred soil cores that identified the depth of fill material and the depth to bedrock under the site. Specialized geostatistical software developed by Argonne was used to update the ICSM with historical sampling results and down-hole gamma survey information for hundreds of soil core locations. The updating process yielded both a best guess estimate of contamination volumes and a conservative upper bound on the volume estimate that reflected the estimate's uncertainty. Comparison of model results to actual removed soil volumes was conducted on a parcel-by-parcel basis. Where sampling data density was adequate, the actual volume matched the model's average or best guess results. Where contamination was un-characterized and unknown to the model, the actual volume exceeded the model's conservative estimate. Factors affecting volume estimation were identified to assist in planning further excavations. (authors)

  2. Effects of prostatic inflammation on LUTS and alpha blocker treatment outcomes

    Directory of Open Access Journals (Sweden)

    Ha Na Lee

    2014-06-01

    Full Text Available Purpose To evaluate the association between prostatic inflammation and lower urinary tract symptoms (LUTS, and to identify the effects of prostatic inflammation on the treatment with an alpha blocker. Materials and Methods 111 Participants who were aged ≥ 50 years, the presence of LUTS (maximal flow rate < 20 m/s, IPSS ≥ 11, and an elevated PSA level (3-20ng/mL were treated with tamsulosin 0.2mg once daily for 3 months after prostate biopsies. Prostatic inflammation was scored as none (0, mild (I, moderate (II, or marked (III. LUTS parameters including urine flow rates, IPSS, PSA, and prostate volume were evaluated. Results Inflammation grading resulted in 25, 60, and 26 patients that were grade 0, I, and II, respectively. Lower grade inflammation was related to higher urine flow rate at baseline. Patients with higher inflammation grades had larger prostate volumes, larger total and transitional zone volumes, and higher PSA levels. Overall, urine flow rates and residual urine volume were improved after 3 months of alpha blocker therapy. Eighty percent of patients with grade 0 inflammation, 73% of patients with grade I inflammation, and 92.3% of patients with grade II inflammation showed improvement of LUTS after treatment. Longer duration of treatment was related to a decreased chance of improvement of LUTS. Patients with increased IPSS voiding subscales could be predictive of improvement of LUTS. Conclusions Patients with high grade inflammation had lower flow rates and higher prostatic volumes than patients with low grade inflammation. Inflammation grade did not affect the outcomes of alpha blocker treatment.

  3. Prostate Artery Embolization for Complete Urinary Outflow Obstruction Due to Benign Prostatic Hypertrophy

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Simon Chun Ho, E-mail: simonyu@cuhk.edu.hk; Cho, Carmen Chi Min; Hung, Esther Hiu Yee [The Chinese University of Hong Kong, Department of Imaging and Interventional Radiology (Hong Kong); Chiu, Peter Ka Fung; Yee, Chi Hang; Ng, Chi Fai [The Chinese University of Hong Kong, Department of Surgery, Prince of Wales Hospital (Hong Kong)

    2017-01-15

    BackgroundWe aimed to evaluate the effectiveness of PAE in weaning of catheter and relieving obstructive urinary symptoms in patients with acute urinary retention (AUR) due to benign prostatic hypertrophy (BPH) and failed trial without catheter (TWOC).Materials and MethodsIn this prospective study approved by the institutional review board, a signed informed consent was obtained. Eighteen consecutive patients with AUR due to BPH and failed TWOC were recruited. Nineteen consecutive patients with BPH but without AUR were recruited as a control. Patients with CTA evidence of arterial occlusion or significant stenosis along the prostate artery access path were excluded. PAE was performed using microspheres (100–300 μm diameter). Outcome assessment included successful weaning of catheter in 2 weeks, procedure-related complications, change of symptomatology and urodynamic findings at 1 month as compared to baseline, percent non-perfused prostate volume, and prostate volume reduction on MRI at 2 weeks.ResultsTwo patients in the study group and four in the control group were excluded due to arterial pathology. Embolization of bilateral prostate arteries was achieved in all patients in both the groups (100%). There was no complication. The catheter was successfully weaned in 87.5% (14/16) of patients within 14 days in the treatment group. There was no significant difference in patient demographics, prostate characteristics, and all outcome assessment parameters between both the groups.ConclusionsPAE was probably safe and effective in weaning of catheter and relieving obstructive urinary symptoms in patients due to BPH, with treatment outcomes comparable to those without AUR.

  4. Prostate Artery Embolization for Complete Urinary Outflow Obstruction Due to Benign Prostatic Hypertrophy

    International Nuclear Information System (INIS)

    Yu, Simon Chun Ho; Cho, Carmen Chi Min; Hung, Esther Hiu Yee; Chiu, Peter Ka Fung; Yee, Chi Hang; Ng, Chi Fai

    2017-01-01

    BackgroundWe aimed to evaluate the effectiveness of PAE in weaning of catheter and relieving obstructive urinary symptoms in patients with acute urinary retention (AUR) due to benign prostatic hypertrophy (BPH) and failed trial without catheter (TWOC).Materials and MethodsIn this prospective study approved by the institutional review board, a signed informed consent was obtained. Eighteen consecutive patients with AUR due to BPH and failed TWOC were recruited. Nineteen consecutive patients with BPH but without AUR were recruited as a control. Patients with CTA evidence of arterial occlusion or significant stenosis along the prostate artery access path were excluded. PAE was performed using microspheres (100–300 μm diameter). Outcome assessment included successful weaning of catheter in 2 weeks, procedure-related complications, change of symptomatology and urodynamic findings at 1 month as compared to baseline, percent non-perfused prostate volume, and prostate volume reduction on MRI at 2 weeks.ResultsTwo patients in the study group and four in the control group were excluded due to arterial pathology. Embolization of bilateral prostate arteries was achieved in all patients in both the groups (100%). There was no complication. The catheter was successfully weaned in 87.5% (14/16) of patients within 14 days in the treatment group. There was no significant difference in patient demographics, prostate characteristics, and all outcome assessment parameters between both the groups.ConclusionsPAE was probably safe and effective in weaning of catheter and relieving obstructive urinary symptoms in patients due to BPH, with treatment outcomes comparable to those without AUR.

  5. A predictive model to guide management of the overlap region between target volume and organs at risk in prostate cancer volumetric modulated arc therapy

    Energy Technology Data Exchange (ETDEWEB)

    Mattes, Malcolm D.; Lee, Jennifer C.; Einaiem, Sara; Guirguis, Adel; Ikoro, N. C.; Ashamalla Hani [Dept. of Radiation Oncology, New York Methodist Hospital, Brooklyn (United States)

    2013-12-15

    The goal of this study is to determine whether the magnitude of overlap between planning target volume (PTV) and rectum (Rectum{sub overlap}) or PTV and bladder (Bladder{sub overlap}) in prostate cancer volumetric-modulated arc therapy (VMAT) is predictive of the dose-volume relationships achieved after optimization, and to identify predictive equations and cutoff values using these overlap volumes beyond which the Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC) dose-volume constraints are unlikely to be met. Fifty-seven patients with prostate cancer underwent VMAT planning using identical optimization conditions and normalization. The PTV (for the 50.4 Gy primary plan and 30.6 Gy boost plan) included 5 to 10 mm margins around the prostate and seminal vesicles. Pearson correlations, linear regression analyses, and receiver operating characteristic (ROC) curves were used to correlate the percentage overlap with dose-volume parameters. The percentage Rectum{sub overlap} and Bladder{sub overlap} correlated with sparing of that organ but minimally impacted other dose-volume parameters, predicted the primary plan rectum V{sub 45} and bladder V{sub 50} with R{sup 2} = 0.78 and R{sup 2} = 0.83, respectively, and predicted the boost plan rectum V{sub 30} and bladder V{sub 30} with R{sup 2} = 0.53 and R{sup 2} = 0.81, respectively. The optimal cutoff value of boost Rectumoverlap to predict rectum V75 >15% was 3.5% (sensitivity 100%, specificity 94%, p < 0.01), and the optimal cutoff value of boost Bladder{sub overlap} to predict bladder V{sub 80} >10% was 5.0% (sensitivity 83%, specificity 100%, p < 0.01). The degree of overlap between PTV and bladder or rectum can be used to accurately guide physicians on the use of interventions to limit the extent of the overlap region prior to optimization.

  6. Planning magnetic resonance imaging for prostate cancer intensity-modulated radiation therapy: Impact on target volumes, radiotherapy dose and androgen deprivation administration.

    Science.gov (United States)

    Horsley, Patrick J; Aherne, Noel J; Edwards, Grace V; Benjamin, Linus C; Wilcox, Shea W; McLachlan, Craig S; Assareh, Hassan; Welshman, Richard; McKay, Michael J; Shakespeare, Thomas P

    2015-03-01

    Magnetic resonance imaging (MRI) scans are increasingly utilized for radiotherapy planning to contour the primary tumors of patients undergoing intensity-modulated radiation therapy (IMRT). These scans may also demonstrate cancer extent and may affect the treatment plan. We assessed the impact of planning MRI detection of extracapsular extension, seminal vesicle invasion, or adjacent organ invasion on the staging, target volume delineation, doses, and hormonal therapy of patients with prostate cancer undergoing IMRT. The records of 509 consecutive patients with planning MRI scans being treated with IMRT for prostate cancer between January 2010 and July 2012 were retrospectively reviewed. Tumor staging and treatment plans before and after MRI were compared. Of the 509 patients, 103 (20%) were upstaged and 44 (9%) were migrated to a higher risk category as a result of findings at MRI. In 94 of 509 patients (18%), the MRI findings altered management. Ninety-four of 509 patients (18%) had a change to their clinical target volume (CTV) or treatment technique, and in 41 of 509 patients (8%) the duration of hormone therapy was changed because of MRI findings. The use of radiotherapy planning MRI altered CTV design, dose and/or duration of androgen deprivation in 18% of patients in this large, single institution series of men planned for dose-escalated prostate IMRT. This has substantial implications for radiotherapy target volumes and doses, as well as duration of androgen deprivation. Further research is required to investigate whether newer MRI techniques can simultaneously fulfill staging and radiotherapy contouring roles. © 2014 Wiley Publishing Asia Pty Ltd.

  7. Radiographic heart-volume estimation in normal cats

    International Nuclear Information System (INIS)

    Ahlberg, N.E.; Hansson, K.; Svensson, L.; Iwarsson, K.

    1989-01-01

    Heart volume mensuration was evaluated on conventional radiographs from eight normal cats in different body positions using computed tomography (CT). Heart volumes were calculated from orthogonal thoracic radiographs in ventral and dorsal recumbency and from radiographs exposed with a vertical X-ray beam in dorsal and lateral recumbency using the formula for an ellipsoid body. Heart volumes were also estimated with CT in ventral, dorsal, right lateral and left lateral recumbency. No differences between heart volumes from CT in ventral recumbency and those from CT in right and left lateral recumbency were seen. In dorsal recumbency, however, significantly lower heart volumes were obtained. Heart volumes from CT in ventral recumbency were similar to those from radiographs in ventral and dorsal recumbency and dorsal/left lateral recumbency. Close correlation was also demonstrated between heart volumes from radiographs in dorsal/ left lateral recumbency and body weights of the eight cats

  8. An improved distance-to-dose correlation for predicting bladder and rectum dose-volumes in knowledge-based VMAT planning for prostate cancer

    Science.gov (United States)

    Wall, Phillip D. H.; Carver, Robert L.; Fontenot, Jonas D.

    2018-01-01

    The overlap volume histogram (OVH) is an anatomical metric commonly used to quantify the geometric relationship between an organ at risk (OAR) and target volume when predicting expected dose-volumes in knowledge-based planning (KBP). This work investigated the influence of additional variables contributing to variations in the assumed linear DVH-OVH correlation for the bladder and rectum in VMAT plans of prostate patients, with the goal of increasing prediction accuracy and achievability of knowledge-based planning methods. VMAT plans were retrospectively generated for 124 prostate patients using multi-criteria optimization. DVHs quantified patient dosimetric data while OVHs quantified patient anatomical information. The DVH-OVH correlations were calculated for fractional bladder and rectum volumes of 30, 50, 65, and 80%. Correlations between potential influencing factors and dose were quantified using the Pearson product-moment correlation coefficient (R). Factors analyzed included the derivative of the OVH, prescribed dose, PTV volume, bladder volume, rectum volume, and in-field OAR volume. Out of the selected factors, only the in-field bladder volume (mean R  =  0.86) showed a strong correlation with bladder doses. Similarly, only the in-field rectal volume (mean R  =  0.76) showed a strong correlation with rectal doses. Therefore, an OVH formalism accounting for in-field OAR volumes was developed to determine the extent to which it improved the DVH-OVH correlation. Including the in-field factor improved the DVH-OVH correlation, with the mean R values over the fractional volumes studied improving from  -0.79 to  -0.85 and  -0.82 to  -0.86 for the bladder and rectum, respectively. A re-planning study was performed on 31 randomly selected database patients to verify the increased accuracy of KBP dose predictions by accounting for bladder and rectum volume within treatment fields. The in-field OVH led to significantly more precise

  9. Magnetic resonance assessment of prostate localization variability in intensity-modulated radiotherapy for prostate cancer

    International Nuclear Information System (INIS)

    Villeirs, Geert M.; Meerleer, Gert O. de; Verstraete, Koenraad L.; Neve, Wilfried J. de

    2004-01-01

    Purpose: To measure prostate motion with magnetic resonance imaging (MRI) during a course of intensity-modulated radiotherapy. Methods and materials: Seven patients with prostate carcinoma were scanned supine on a 1.5-Tesla MRI system with weekly pretreatment and on-treatment HASTE T2-weighted images in 3 orthogonal planes. The bladder and rectal volumes and position of the prostatic midpoint (PMP) and margins relative to the bony pelvis were measured. Results: All pretreatment positions were at the mean position as computed from the on-treatment scans in each patient. The PMP variability (given as 1 SD) in the anterior-posterior (AP), superior-inferior (SI), and right-left (RL) directions was 2.6, 2.4, and 1.0 mm, respectively. The largest variabilities occurred at the posterior (3.2 mm), superior (2.6 mm), and inferior (2.6 mm) margins. A strong correlation was found between large rectal volume (>95th percentile) and anterior PMP displacement. A weak correlation was found between bladder volume and superior PMP displacement. Conclusions: All pretreatment positions were representative of the subsequent on-treatment positions. A clinical target volume (CTV) expansion of 5.3 mm in any direction was sufficient to ascertain a 95% coverage of the CTV within the planning target volume (PTV), provided that a rectal suppository is administered to avoid rectal overdistension and that the patient has a comfortably filled bladder (<300 mL)

  10. Mapping of nodal disease in locally advanced prostate cancer: Rethinking the clinical target volume for pelvic nodal irradiation based on vascular rather than bony anatomy

    International Nuclear Information System (INIS)

    Shih, Helen A.; Harisinghani, Mukesh; Zietman, Anthony L.; Wolfgang, John A.; Saksena, Mansi; Weissleder, Ralph

    2005-01-01

    Purpose: Toxicity from pelvic irradiation could be reduced if fields were limited to likely areas of nodal involvement rather than using the standard 'four-field box.' We employed a novel magnetic resonance lymphangiographic technique to highlight the likely sites of occult nodal metastasis from prostate cancer. Methods and Materials: Eighteen prostate cancer patients with pathologically confirmed node-positive disease had a total of 69 pathologic nodes identifiable by lymphotropic nanoparticle-enhanced MRI and semiquantitative nodal analysis. Fourteen of these nodes were in the para-aortic region, and 55 were in the pelvis. The position of each of these malignant nodes was mapped to a common template based on its relation to skeletal or vascular anatomy. Results: Relative to skeletal anatomy, nodes covered a diffuse volume from the mid lumbar spine to the superior pubic ramus and along the sacrum and pelvic side walls. In contrast, the nodal metastases mapped much more tightly relative to the large pelvic vessels. A proposed pelvic clinical target volume to encompass the region at greatest risk of containing occult nodal metastases would include a 2.0-cm radial expansion volume around the distal common iliac and proximal external and internal iliac vessels that would encompass 94.5% of the pelvic nodes at risk as defined by our node-positive prostate cancer patient cohort. Conclusions: Nodal metastases from prostate cancer are largely localized along the major pelvic vasculature. Defining nodal radiation treatment portals based on vascular rather than bony anatomy may allow for a significant decrease in normal pelvic tissue irradiation and its associated toxicities

  11. Transurethral Resection of the Prostate (TURP) Versus Original and PErFecTED Prostate Artery Embolization (PAE) Due to Benign Prostatic Hyperplasia (BPH): Preliminary Results of a Single Center, Prospective, Urodynamic-Controlled Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Carnevale, Francisco C., E-mail: fcarnevale@uol.com.br [University of Sao Paulo Medical School, Interventional Radiology Unit (Brazil); Iscaife, Alexandre, E-mail: iscaifeboni@yahoo.com.br; Yoshinaga, Eduardo M., E-mail: dumuracca@ig.com.br [University of Sao Paulo Medical School, Division of Urology (Brazil); Moreira, Airton Mota, E-mail: motamoreira@gmail.com [University of Sao Paulo Medical School, Interventional Radiology Unit (Brazil); Antunes, Alberto A., E-mail: antunesuro@uol.com.br; Srougi, Miguel, E-mail: srougi@uol.com.br [University of Sao Paulo Medical School, Division of Urology (Brazil)

    2016-01-15

    PurposeTo compare clinical and urodynamic results of transurethral resection of the prostate (TURP) to original and PErFecTED prostate artery embolization (PAE) methods for benign prostatic hyperplasia.MethodsWe prospectively randomized 30 patients to receive TURP or original PAE (oPAE) and compared them to a cohort of patients treated by PErFecTED PAE, with a minimum of 1-year follow-up. Patients were assessed for urodynamic parameters, prostate volume, international prostate symptom score (IPSS), and quality of life (QoL).ResultsAll groups were comparable for all pre-treatment parameters except bladder contractility and peak urine flow rate (Q{sub max}), both of which were significantly better in the TURP group, and IIEF score, which was significantly higher among PErFecTED PAE patients than TURP patients. All groups experienced significant improvement in IPSS, QoL, prostate volume, and Q{sub max}. TURP and PErFecTED PAE both resulted in significantly lower IPSS than oPAE but were not significantly different from one another. TURP resulted in significantly higher Q{sub max} and significantly smaller prostate volume than either original or PErFecTED PAE but required spinal anesthesia and hospitalization. Two patients in the oPAE group with hypocontractile bladders experienced recurrence of symptoms and were treated with TURP. In the TURP group, urinary incontinence occurred in 4/15 patients (26.7 %), rupture of the prostatic capsule in 1/15 (6.7 %), retrograde ejaculation in all patients (100 %), and one patient was readmitted for temporary bladder irrigation due to hematuria.ConclusionsTURP and PAE are both safe and effective treatments. TURP and PErFecTED PAE yield similar symptom improvement, but TURP is associated with both better urodynamic results and more adverse events.

  12. Permanent Prostate Brachytherapy in Prostate Glands 3

    International Nuclear Information System (INIS)

    Mayadev, Jyoti; Merrick, Gregory S.; Reed, Joshua R.; Butler, Wayne M.; Galbreath, Robert W.; Allen, Zachariah A.; Wallner, Kent E.

    2010-01-01

    Purpose: To investigate the dosimetry, treatment-related morbidity, and biochemical outcomes for brachytherapy in patients with prostate glands 3 . Methods and Materials: From November 1996 to October 2006, 104 patients with prostate glands 3 underwent brachytherapy. Multiple prostate, urethral, and rectal dosimetric parameters were evaluated. Treatment-related urinary and rectal morbidity were assessed from patient questionnaires. Cause-specific survival, biochemical progression-free survival, and overall survival were recorded. Results: The median patient age, follow up, and pre-treatment ultrasound volume was 64 years, 5.0 years and 17.6cm 3 , respectively. Median day 0 dosimetry was significant for the following: V100 98.5%, D90 126.1% and R100 <0.5% of prescription dose. The mean urethral and maximum urethral doses were 119.6% and 133.8% of prescription. The median time to International Prostate Symptom Score resolution was 4 months. There were no RTOG grade III or IV rectal complications. The cause-specific survival, biochemical progression-free survival, and overall survival rates were 100%, 92.5%, and 77.8% at 9 years. For biochemically disease-free patients, the median most recent postbrachytherapy PSA value was 0.02 ng/mL. Conclusion: Our results demonstrate that brachytherapy for small prostate glands is highly effective, with an acceptable morbidity profile, excellent postimplant dosimetry, acceptable treatment-related morbidity, and favorable biochemical outcomes.

  13. Photogrammetry and Laser Imagery Tests for Tank Waste Volume Estimates: Summary Report

    Energy Technology Data Exchange (ETDEWEB)

    Field, Jim G. [Washington River Protection Solutions, LLC, Richland, WA (United States)

    2013-03-27

    Feasibility tests were conducted using photogrammetry and laser technologies to estimate the volume of waste in a tank. These technologies were compared with video Camera/CAD Modeling System (CCMS) estimates; the current method used for post-retrieval waste volume estimates. This report summarizes test results and presents recommendations for further development and deployment of technologies to provide more accurate and faster waste volume estimates in support of tank retrieval and closure.

  14. Photogrammetry and Laser Imagery Tests for Tank Waste Volume Estimates: Summary Report

    International Nuclear Information System (INIS)

    Field, Jim G.

    2013-01-01

    Feasibility tests were conducted using photogrammetry and laser technologies to estimate the volume of waste in a tank. These technologies were compared with video Camera/CAD Modeling System (CCMS) estimates; the current method used for post-retrieval waste volume estimates. This report summarizes test results and presents recommendations for further development and deployment of technologies to provide more accurate and faster waste volume estimates in support of tank retrieval and closure

  15. Unilateral Versus Bilateral Prostatic Arterial Embolization for Lower Urinary Tract Symptoms in Patients with Prostate Enlargement

    Energy Technology Data Exchange (ETDEWEB)

    Bilhim, Tiago, E-mail: tiagobilhim@hotmail.com [Universidade Nova de Lisboa (UNL), Departamento Universitario de Anatomia, Faculdade de Ciencias Medicas (FCM) (Portugal); Pisco, Joao; Rio Tinto, Hugo; Fernandes, Lucia [Interventional Radiology, Saint Louis Hospital (Portugal); Campos Pinheiro, Luis [Universidade Nova de Lisboa (UNL), Departamento Universitario de Urologia, Faculdade de Ciencias Medicas (FCM) (Portugal); Duarte, Marisa; Pereira, Jose A. [Interventional Radiology, Saint Louis Hospital (Portugal); Oliveira, Antonio G. [Universidade Nova de Lisboa (UNL), Biostatistics Department, Faculdade de Ciencias Medicas (FCM) (Portugal); O' Neill, Joao [Universidade Nova de Lisboa (UNL), Departamento Universitario de Anatomia, Faculdade de Ciencias Medicas (FCM) (Portugal)

    2013-04-15

    This study was designed to compare baseline data and clinical outcome between patients with prostate enlargement/benign prostatic hyperplasia (PE/BPH) who underwent unilateral and bilateral prostatic arterial embolization (PAE) for the relief of lower urinary tract symptoms (LUTS). This single-center, ambispective cohort study compared 122 consecutive patients (mean age 66.7 years) with unilateral versus bilateral PAE from March 2009 to December 2011. Selective PAE was performed with 100- and 200-{mu}m nonspherical polyvinyl alcohol (PVA) particles by a unilateral femoral approach. Bilateral PAE was performed in 103 (84.4 %) patients (group A). The remaining 19 (15.6 %) patients underwent unilateral PAE (group B). Mean follow-up time was 6.7 months in group A and 7.3 months in group B. Mean prostate volume, PSA, International prostate symptom score/quality of life (IPSS/QoL) and post-void residual volume (PVR) reduction, and peak flow rate (Qmax) improvement were 19.4 mL, 1.68 ng/mL, 11.8/2.0 points, 32.9 mL, and 3.9 mL/s in group A and 11.5 mL, 1.98 ng/mL, 8.9/1.4 points, 53.8 mL, and 4.58 mL/s in group B. Poor clinical outcome was observed in 24.3 % of patients from group A and 47.4 % from group B (p = 0.04). PAE is a safe and effective technique that can induce 48 % improvement in the IPSS score and a prostate volume reduction of 19 %, with good clinical outcome in up to 75 % of treated patients. Bilateral PAE seems to lead to better clinical results; however, up to 50 % of patients after unilateral PAE may have a good clinical outcome.

  16. Unilateral Versus Bilateral Prostatic Arterial Embolization for Lower Urinary Tract Symptoms in Patients with Prostate Enlargement

    International Nuclear Information System (INIS)

    Bilhim, Tiago; Pisco, João; Rio Tinto, Hugo; Fernandes, Lúcia; Campos Pinheiro, Luís; Duarte, Marisa; Pereira, José A.; Oliveira, António G.; O’Neill, João

    2013-01-01

    This study was designed to compare baseline data and clinical outcome between patients with prostate enlargement/benign prostatic hyperplasia (PE/BPH) who underwent unilateral and bilateral prostatic arterial embolization (PAE) for the relief of lower urinary tract symptoms (LUTS). This single-center, ambispective cohort study compared 122 consecutive patients (mean age 66.7 years) with unilateral versus bilateral PAE from March 2009 to December 2011. Selective PAE was performed with 100- and 200-μm nonspherical polyvinyl alcohol (PVA) particles by a unilateral femoral approach. Bilateral PAE was performed in 103 (84.4 %) patients (group A). The remaining 19 (15.6 %) patients underwent unilateral PAE (group B). Mean follow-up time was 6.7 months in group A and 7.3 months in group B. Mean prostate volume, PSA, International prostate symptom score/quality of life (IPSS/QoL) and post-void residual volume (PVR) reduction, and peak flow rate (Qmax) improvement were 19.4 mL, 1.68 ng/mL, 11.8/2.0 points, 32.9 mL, and 3.9 mL/s in group A and 11.5 mL, 1.98 ng/mL, 8.9/1.4 points, 53.8 mL, and 4.58 mL/s in group B. Poor clinical outcome was observed in 24.3 % of patients from group A and 47.4 % from group B (p = 0.04). PAE is a safe and effective technique that can induce 48 % improvement in the IPSS score and a prostate volume reduction of 19 %, with good clinical outcome in up to 75 % of treated patients. Bilateral PAE seems to lead to better clinical results; however, up to 50 % of patients after unilateral PAE may have a good clinical outcome.

  17. Prostate Contouring Variation: Can It Be Fixed?

    International Nuclear Information System (INIS)

    Khoo, Eric L.H.; Schick, Karlissa; Plank, Ashley W.; Poulsen, Michael; Wong, Winnie W.G.; Middleton, Mark; Martin, Jarad M.

    2012-01-01

    Purpose: To assess whether an education program on CT and MRI prostate anatomy would reduce inter- and intraobserver prostate contouring variation among experienced radiation oncologists. Methods and Materials: Three patient CT and MRI datasets were selected. Five radiation oncologists contoured the prostate for each patient on CT first, then MRI, and again between 2 and 4 weeks later. Three education sessions were then conducted. The same contouring process was then repeated with the same datasets and oncologists. The observer variation was assessed according to changes in the ratio of the encompassing volume to intersecting volume (volume ratio [VR]), across sets of target volumes. Results: For interobserver variation, there was a 15% reduction in mean VR with CT, from 2.74 to 2.33, and a 40% reduction in mean VR with MRI, from 2.38 to 1.41 after education. A similar trend was found for intraobserver variation, with a mean VR reduction for CT and MRI of 9% (from 1.51 to 1.38) and 16% (from 1.37 to 1.15), respectively. Conclusion: A well-structured education program has reduced both inter- and intraobserver prostate contouring variations. The impact was greater on MRI than on CT. With the ongoing incorporation of new technologies into routine practice, education programs for target contouring should be incorporated as part of the continuing medical education of radiation oncologists.

  18. MR-CT registration using a Ni-Ti prostate stent in image-guided radiotherapy of prostate cancer

    International Nuclear Information System (INIS)

    Korsager, Anne Sofie; Østergaard, Lasse Riis; Carl, Jesper

    2013-01-01

    Purpose: In image-guided radiotherapy of prostate cancer defining the clinical target volume often relies on magnetic resonance (MR). The task of transferring the clinical target volume from MR to standard planning computed tomography (CT) is not trivial due to prostate mobility. In this paper, an automatic local registration approach is proposed based on a newly developed removable Ni-Ti prostate stent.Methods: The registration uses the voxel similarity measure mutual information in a two-step approach where the pelvic bones are used to establish an initial registration for the local registration.Results: In a phantom study, the accuracy was measured to 0.97 mm and visual inspection showed accurate registration of all 30 data sets. The consistency of the registration was examined where translation and rotation displacements yield a rotation error of 0.41° ± 0.45° and a translation error of 1.67 ± 2.24 mm.Conclusions: This study demonstrated the feasibility for an automatic local MR-CT registration using the prostate stent.

  19. MR-CT registration using a Ni-Ti prostate stent in image-guided radiotherapy of prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Korsager, Anne Sofie; Ostergaard, Lasse Riis [Department of Health Science and Technology, Aalborg University, Aalborg 9220 (Denmark); Carl, Jesper [Department of Medical Physics, Oncology, Aalborg Hospital, Aalborg 9100 (Denmark)

    2013-06-15

    Purpose: In image-guided radiotherapy of prostate cancer defining the clinical target volume often relies on magnetic resonance (MR). The task of transferring the clinical target volume from MR to standard planning computed tomography (CT) is not trivial due to prostate mobility. In this paper, an automatic local registration approach is proposed based on a newly developed removable Ni-Ti prostate stent.Methods: The registration uses the voxel similarity measure mutual information in a two-step approach where the pelvic bones are used to establish an initial registration for the local registration.Results: In a phantom study, the accuracy was measured to 0.97 mm and visual inspection showed accurate registration of all 30 data sets. The consistency of the registration was examined where translation and rotation displacements yield a rotation error of 0.41 Degree-Sign {+-} 0.45 Degree-Sign and a translation error of 1.67 {+-} 2.24 mm.Conclusions: This study demonstrated the feasibility for an automatic local MR-CT registration using the prostate stent.

  20. Comparison of the clinical parameters of benign prostate hyperplasia in diabetic and non diabetic patients

    Directory of Open Access Journals (Sweden)

    Levent Ozcan

    2017-03-01

    Full Text Available Objective: We evaluated the correlation between benign prostate hyperplasia (BPH measures and diabetes mellitus in men with benign prostate hyperplasia in a prospective study. Materials and methods: Between 2008-2012, 100 diabetic and 200 non diabetic patients undergoing surgery due to benign prostate hyperplasia were enrolled in the study. The parameters evaluated for each patients included prostate volume, fasting blood glucose, HbA1c, total testosterone, total prostatic specific antigen (T-PSA, triglicerides, total cholesterol and body mass index (BMI. A questionnaire including international prostate symptom score (IPSS was sdministered and uroflow test measuring the peak urinary flow rate was performed to appreciate the complaints of the patients objectively. Results: Diabetic patients are more likely to have larger prostate volume. The symptom score evaluated by IPSS and post micturition residual volume were also significantly higher in diabetic groups. The other statistically significant different parameter between two groups was total testosterone that diabetic patients tend to have lower levels. Diabetic counterparts were established to have higher BMI. No statistically significant differentiation was observed about trigliceryde and total cholesterol levels and uroflow rates. Conclusions: Our study suggests a positive correlation between high prostate volume and diagnosis of diabetes mellitus in patients with benign prostatic hyperplasia. We also observed a positive correlation between symptom scores and post micturion residual volumes and diagnosis of diabetes mellitus suggesting that the presence of diabetes is related to both static and dynamic components of benign prostate hyperplasia. Additionally testosterone levels were lower in diabetic patients. Further studies need to confirm these relationship in a larger population.

  1. Combination of prostate imaging reporting and data system (PI-RADS) score and prostate-specific antigen (PSA) density predicts biopsy outcome in prostate biopsy naïve patients.

    Science.gov (United States)

    Washino, Satoshi; Okochi, Tomohisa; Saito, Kimitoshi; Konishi, Tsuzumi; Hirai, Masaru; Kobayashi, Yutaka; Miyagawa, Tomoaki

    2017-02-01

    To assess the value of the Prostate Imaging Reporting and Data System (PI-RADS) scoring system, for prostate multi-parametric magnetic resonance imaging (mpMRI) to detect prostate cancer, and classical parameters, such as prostate-specific antigen (PSA) level, prostate volume and PSA density, for predicting biopsy outcome in biopsy naïve patients who have suspected prostate cancer. Patients who underwent mpMRI at our hospital, and who had their first prostate biopsy between July 2010 and April 2014, were analysed retrospectively. The prostate biopsies were taken transperineally under transrectal ultrasonography guidance. In all, 14 cores were biopsied as a systematic biopsy in all patients. Two cognitive fusion-targeted biopsy cores were added for each lesion in patients who had suspicious or equivocal lesions on mpMRI. The PI-RADS scoring system version 2.0 (PI-RADS v2) was used to describe the MRI findings. Univariate and multivariate analyses were performed to determine significant predictors of prostate cancer and clinically significant prostate cancer. In all, 288 patients were analysed. The median patient age, PSA level, prostate volume and PSA density were 69 years, 7.5 ng/mL, 28.7 mL, and 0.26 ng/mL/mL, respectively. The biopsy results were benign, clinically insignificant, and clinically significant prostate cancer in 129 (45%), 18 (6%) and 141 (49%) patients, respectively. The multivariate analysis revealed that PI-RADS v2 score and PSA density were independent predictors for prostate cancer and clinically significant prostate cancer. When PI-RADS v2 score and PSA density were combined, a PI-RADS v2 score of ≥4 and PSA density ≥0.15 ng/mL/mL, or PI-RADS v2 score of 3 and PSA density of ≥0.30 ng/mL/mL, was associated with the highest clinically significant prostate cancer detection rates (76-97%) on the first biopsy. Of the patients in this group with negative biopsy results, 22% were subsequently diagnosed as prostate cancer. In contrast, a PI

  2. Clinical results from first use of prostate stent as fiducial for radiotherapy of prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Carl, Jesper; Nielsen, Jane (Dept. of Medical Physics, Dept. of Oncology, Aalborg Hospital, Aarhus Univ. Hospital, Aalborg (Denmark)), e-mail: jhc@rn.dk; Holmberg, Mats (Dept. of Oncology, Aalborg Hospital, Aarhus Univ. Hospital, Aalborg (Denmark)); Larsen, Erik Hoejkjaer; Fabrin, Knud (Dept. of Urology, Aalborg Hospital, Aarhus Univ. Hospital, Aalborg (Denmark)); Fisker, Rune V. (Dept. of Radiology, Aalborg Hospital, Aarhus Univ. Hospital, Aalborg (Denmark))

    2011-05-15

    Purpose. A clinical feasibility study using a removable prostate stent as fiducial for image-guided radiotherapy (IGRT) of localized prostate cancer (PC). Material and methods. The study included patients with local or locally advanced PC. The clinical target volume (CTV) was outlined on magnetic resonance (MR) images co-registered to planning computer tomography (CT) images. Daily online IGRT was delivered using the stent as fiducial. Risk of migration was estimated using multiple MR. Acute urinary toxicity was scored using the international prostate symptom score (IPSS). Late gastro-intestinal (GI) and genito-urinary (GU) toxicity was scored using the Radio Therapy Oncology Group (RTOG) score, biochemical failure (BF) was defined as an elevation of prostate specific antigen (PSA) above nadir plus 2 ng/ml after radiotherapy. Results. One hundred men were enrolled in the study. Ninety completed radiotherapy with the stent as fiducial. No migration of the stent was seen, but three cases of dislocation of the stent to the bladder were observed. Acute urinary toxicity based on IPSS was comparable to toxicity in patients who had gold markers (GM) as fiducials. Removal of the stent was associated with a high frequency of urinary retention. Late GI and GU toxicity and BF were comparable to those of other studies, but longer observation time is needed. Conclusions. This study reports the first clinical results of using a prostate stent as fiducial. No migration of the stent observed. Dislocation of the stent to the urinary bladder was observed in three cases, requiring removal of the stent and insertion of a new fiducial. Acute toxicity during radiotherapy evaluated from IPSS was comparable to toxicity in patients with GM. Removal of the stent was associated with a high frequency of post procedural urinary retention. Late toxicity and BF were comparable to those of other studies, though longer observation time is needed

  3. Clinical results from first use of prostate stent as fiducial for radiotherapy of prostate cancer

    International Nuclear Information System (INIS)

    Carl, Jesper; Nielsen, Jane; Holmberg, Mats; Larsen, Erik Hoejkjaer; Fabrin, Knud; Fisker, Rune V.

    2011-01-01

    Purpose. A clinical feasibility study using a removable prostate stent as fiducial for image-guided radiotherapy (IGRT) of localized prostate cancer (PC). Material and methods. The study included patients with local or locally advanced PC. The clinical target volume (CTV) was outlined on magnetic resonance (MR) images co-registered to planning computer tomography (CT) images. Daily online IGRT was delivered using the stent as fiducial. Risk of migration was estimated using multiple MR. Acute urinary toxicity was scored using the international prostate symptom score (IPSS). Late gastro-intestinal (GI) and genito-urinary (GU) toxicity was scored using the Radio Therapy Oncology Group (RTOG) score, biochemical failure (BF) was defined as an elevation of prostate specific antigen (PSA) above nadir plus 2 ng/ml after radiotherapy. Results. One hundred men were enrolled in the study. Ninety completed radiotherapy with the stent as fiducial. No migration of the stent was seen, but three cases of dislocation of the stent to the bladder were observed. Acute urinary toxicity based on IPSS was comparable to toxicity in patients who had gold markers (GM) as fiducials. Removal of the stent was associated with a high frequency of urinary retention. Late GI and GU toxicity and BF were comparable to those of other studies, but longer observation time is needed. Conclusions. This study reports the first clinical results of using a prostate stent as fiducial. No migration of the stent observed. Dislocation of the stent to the urinary bladder was observed in three cases, requiring removal of the stent and insertion of a new fiducial. Acute toxicity during radiotherapy evaluated from IPSS was comparable to toxicity in patients with GM. Removal of the stent was associated with a high frequency of post procedural urinary retention. Late toxicity and BF were comparable to those of other studies, though longer observation time is needed

  4. Clinical results from first use of prostate stent as fiducial for radiotherapy of prostate cancer.

    Science.gov (United States)

    Carl, Jesper; Nielsen, Jane; Holmberg, Mats; Larsen, Erik Hoejkjaer; Fabrin, Knud; Fisker, Rune V

    2011-05-01

    A clinical feasibility study using a removable prostate stent as fiducial for image-guided radiotherapy (IGRT) of localized prostate cancer (PC). The study included patients with local or locally advanced PC. The clinical target volume (CTV) was outlined on magnetic resonance (MR) images co-registered to planning computer tomography (CT) images. Daily online IGRT was delivered using the stent as fiducial. Risk of migration was estimated using multiple MR. Acute urinary toxicity was scored using the international prostate symptom score (IPSS). Late gastro-intestinal (GI) and genito-urinary (GU) toxicity was scored using the Radio Therapy Oncology Group (RTOG) score, biochemical failure (BF) was defined as an elevation of prostate specific antigen (PSA) above nadir plus 2 ng/ml after radiotherapy. One hundred men were enrolled in the study. Ninety completed radiotherapy with the stent as fiducial. No migration of the stent was seen, but three cases of dislocation of the stent to the bladder were observed. Acute urinary toxicity based on IPSS was comparable to toxicity in patients who had gold markers (GM) as fiducials. Removal of the stent was associated with a high frequency of urinary retention. Late GI and GU toxicity and BF were comparable to those of other studies, but longer observation time is needed. This study reports the first clinical results of using a prostate stent as fiducial. No migration of the stent observed. Dislocation of the stent to the urinary bladder was observed in three cases, requiring removal of the stent and insertion of a new fiducial. Acute toxicity during radiotherapy evaluated from IPSS was comparable to toxicity in patients with GM. Removal of the stent was associated with a high frequency of post procedural urinary retention. Late toxicity and BF were comparable to those of other studies, though longer observation time is needed.

  5. The Relationship of Histologically Diagnosed Chronic Prostatic Inflammation and Lower Urinary Tract Symptoms

    Directory of Open Access Journals (Sweden)

    Sebahattin Albayrak

    2014-03-01

    Full Text Available Aim: To evaluate the relationship between pre-biopsy PSA levels, International Prostate Symptom Score (IPSS, maximum urinary flow rate (Qmax, prostate volume and positive core numbers of histologically proved chronic prostatitis in the patients whom underwent transrectal ultrasound guided biopsy for elevated prostate specific antigen (PSA levels. Material and Method: Between January 2012 and 2014, 152 patients underwent TRUS biopsy. Their medical records are examined retrospectively. The mean age of the patients were 62 (45-75. The pathologic specimens were evaluated for the number of cores with chronic prostatitis and percentage of prostatitis. Pre-biopsy levels of PSA, IPSS, maximum urinary flow rate, prostate volume are compared with the number positive cores for chronic prostatitis and their percentages. These variables also compared in the non-chronic prostatitis patients. Results: There was no statistically significant correlation between the positive number of cores for chronic prostatitis and age (P=0.5, r=0.055, a positive correlation was observed between IPSS (P

  6. Stereological estimation of the mean and variance of nuclear volume from vertical sections

    DEFF Research Database (Denmark)

    Sørensen, Flemming Brandt

    1991-01-01

    The application of assumption-free, unbiased stereological techniques for estimation of the volume-weighted mean nuclear volume, nuclear vv, from vertical sections of benign and malignant nuclear aggregates in melanocytic skin tumours is described. Combining sampling of nuclei with uniform...... probability in a physical disector and Cavalieri's direct estimator of volume, the unbiased, number-weighted mean nuclear volume, nuclear vN, of the same benign and malignant nuclear populations is also estimated. Having obtained estimates of nuclear volume in both the volume- and number distribution...... of volume, a detailed investigation of nuclear size variability is possible. Benign and malignant nuclear populations show approximately the same relative variability with regard to nuclear volume, and the presented data are compatible with a simple size transformation from the smaller benign nuclei...

  7. Clinical utility of the percentage of positive prostate biopsies in predicting prostate cancer-specific and overall survival after radiotherapy for patients with localized prostate cancer

    International Nuclear Information System (INIS)

    D'Amico, Anthony V.; Keshaviah, Aparna; Manola, Judith; Cote, Kerri; Loffredo, Marian; Iskrzytzky, Olga; Renshaw, Andrew A.

    2002-01-01

    Purpose: To determine whether the percentage of positive prostate biopsies provides clinically relevant information to a previously established risk stratification system with respect to the end points of prostate cancer-specific survival (PCSS) and overall survival after radiotherapy for patients with clinically localized prostate cancer. Methods and Materials: A Cox regression multivariable analysis was used to evaluate the ability of the percentage of positive prostate biopsies to predict PCSS and overall survival for 381 men who underwent radiotherapy for localized prostate cancer during the prostate-specific antigen era. Results: At a median follow-up of 4.3 years (range 0.8-13.3), the presence of ≤50% positive biopsies vs. >50% positive biopsies provided a clinically relevant stratification of the 7-year estimates of PCSS (100% vs. 57%, p=0.004) in intermediate-risk patients. Moreover, all patients could be stratified into a minimal or high-risk cohort on the basis of the 10-year estimates of PCSS (100% vs. 55%, p 50%] intermediate-risk + high-risk) cohort for prostate cancer-specific death after conventional dose radiotherapy. Additional follow-up and independent validation are needed to confirm these findings

  8. Evaluation of permanent I-125 prostate implants using radiographs and MRI

    International Nuclear Information System (INIS)

    Moerland, M.A.; Beersma, R.; Bhagwandien, R.; Wijrdeman, H.K.; Battermann, J.J.

    1995-01-01

    Introduction: Localized prostatic cancer is managed by radical prostatectomy, external beam irradiation or a permanent implant with I-125 seeds. Permanent implants are indicated for small tumours (T1-T2) with a well to moderate histological differentiation. The technique used is a transrectal ultrasound guided transperineal implantation technique, which aims for a seed and dose distribution such that the initial doserate line of 7.8 cGy/h encompasses the prostate resulting in an accumulated dose of 160 Gy. Up till now the seed and dose distribution is evaluated from isocentric radiographs, which do not show the relation with the prostate. Objectives: The aim of this study is the development of a technique to reconstruct and evaluate the seed and dose distribution within the prostate. Methods: Twenty patients underwent radiography on the simulator and scanning on a whole body NMR system within 3 days after implantation of the I-125 seeds. Isocentric radiographs were used for reconstruction of the seed distribution, after which registration with the MR images provided the seed positions in relation to the prostate. Volume dose histograms were used to evaluate the implants. Results: The I-125 seeds and the prostate anatomy were well depicted on T1-weighted spin echo images with minimal read out gradient strength. To date, ten implants were evaluated. According to our method, the prostate volumes receiving the prescribed dose of 160 Gy ranged from 30 to 70% of the total prostate volumes. Conclusion: The combination of isocentric radiographs and MRI enables reconstruction of the seed and dose distribution in relation to the prostate and the computation of dose volume histograms, which may be of value in the evaluation of implant quality

  9. A retrospective study: correlation of histologic inflammation in biopsy specimens of Chinese men undergoing surgery for benign prostatic hyperplasia with serum prostate-specific antigen.

    Science.gov (United States)

    Song, Lingmin; Zhu, Yuchun; Han, Ping; Chen, Ni; Lin, Dao; Lai, Jianyu; Wei, Qiang

    2011-03-01

    To reveal the correlation between benign prostatic hyperplasia (BPH) histologic inflammation and serum prostate-specific antigen (sPSA) concentrations, and the possible mechanism. Patients underwent surgery at the Urology Department of West China Hospital of Sichuan University were retrospectively studied. Preoperative sPSA and transrectal ultrasonography were measured. According to the histopathological classification system for chronic prostatic inflammation proposed by the Chronic Prostatitis Collaborative Research Network (CPCRN) and the International Prostatitis Collaborative Network (IPCN), we classified the histologic sections of prostatic biopsy into glandular, periglandular, and stromal inflammation by the anatomical location of inflammatory infiltration. The glandular inflammation was graded according to the inflammatory aggressiveness. The periglandular and stromal inflammation were graded according to the inflammatory density. The correlation between histologic inflammation and sPSA was studied by a multiple regression model in conjunction with age and total prostatic volume. A total of 454 patients with exclusively BPH were analyzed. The periglandular inflammatory infiltration was the most common pattern (95.6%). Single regression analysis revealed that total prostatic volume, the aggressiveness of glandular inflammation, and the intensity of periglandular and stromal inflammation were correlated with sPSA. However, the multiple regression analysis revealed that only the total prostatic volume and the aggressiveness of glandular inflammation were correlated significantly with sPSA (R = .389, 0.289; P = .000). The aggressiveness of glandular inflammatory infiltration in BPH is a significant contributor to elevated sPSA levels. The theory of leakage may be the most reasonable mechanism to reveal the correlation morphologically. We should take inflammation into consideration when interpreting the abnormal elevating of sPSA levels. Copyright © 2011

  10. Relative biological effectiveness (RBE) of fast neutrons with the Dunning rat prostate tumor R3327-HI

    International Nuclear Information System (INIS)

    Wenz, F.; Lohr, F.; Peschke, P.; Wolber, G.; Hoever, K.H.; Hahn, E.W.

    1993-01-01

    Human prostate tumors are known to be good candidates for neutron therapy. The Dunning rat prostate tumor system R3327 was found in many studies to be an excellent model for human prostate tumors. There is still a paucity of studies on the response of the Dunning tumors to fast neutrons. Tumors of the R3327-HI subline are moderately well differentiated and mucin producing. They show one euploid cell population, a bromodeoxyuridine labelling index of 5%, a potential doubling time of 8.9 days, a volume doubling time of about ten days and a cell loss rate of 10%. Tumors were transplanted s.c. in the distal thigh of Copenhagen rats and treated with 60 Co-photons (10, 20, 30, 40 Gy, 45 cGy/min) and 14-MeV-neutrons (8, 10, 12 Gy, 7 to 11 cGy/min). Tumor volumes were measured twice weekly. Growth delay was defined as time in days until the tumors reached twice their treatment volume. Linear regressions on the median growth delays of the different treatment groups were calculated. The ratio of the neutron- and photon-slopes yielded an RBE of 3.1±0.3. Additionally isoeffect-RBE values between 2.3 and 2.6 were graphically estimated. (orig.) [de

  11. Estimating volume, biomass, and potential emissions of hand-piled fuels

    Science.gov (United States)

    Clinton S. Wright; Cameron S. Balog; Jeffrey W. Kelly

    2009-01-01

    Dimensions, volume, and biomass were measured for 121 hand-constructed piles composed primarily of coniferous (n = 63) and shrub/hardwood (n = 58) material at sites in Washington and California. Equations using pile dimensions, shape, and type allow users to accurately estimate the biomass of hand piles. Equations for estimating true pile volume from simple geometric...

  12. relationship between prostate volume and ipss in african men with ...

    African Journals Online (AJOL)

    Administrator

    Tan JK, Png DJ, Liew LC, Li MK, Wong ML. Prevalence of prostatitis-like symptoms in Singapore: a population- based study. Singapore Medical Journal. 2002;. 43(4):189-193. Ming Yin, Sheldon B, Uma C, Michael JB, Rajiv D. Prevalence of Incidental Prostate Cancer in the General. Population: A Study of Healthy Organ ...

  13. Comparison of prostate cancer gene 3 score, prostate health index and percentage free prostate-specific antigen for differentiating histological inflammation from prostate cancer and other non-neoplastic alterations of the prostate at initial biopsy.

    Science.gov (United States)

    De Luca, Stefano; Passera, Roberto; Bollito, Enrico; Manfredi, Matteo; Scarpa, Roberto Mario; Sottile, Antonino; Randone, Donato Franco; Porpiglia, Francesco

    2014-12-01

    To determine if prostate cancer gene 3 (PCA3) score, Prostate Health Index (PHI), and percent free prostate-specific antigen (%fPSA) may be used to differentiate prostatitis from prostate cancer (PCa), benign prostatic hyperplasia (BPH) and high-grade prostate intraepithelial neoplasia (HG-PIN) in patients with elevated PSA and negative digital rectal examination (DRE). in the present prospective study, 274 patients, undergoing PCA3 score, PHI and %fPSA assessments before initial biopsy, were enrolled. Three multivariate logistic regression models were used to test PCA3 score, PHI and %fPSA as risk factors for prostatitis vs. PCa, vs. BPH, and vs. HG-PIN. All the analyses were performed for the whole patient cohort and for the 'gray zone' of PSA (4-10 ng/ml) cohort (188 individuals). The determinants for prostatitis vs. PCa were PCA3 score, PHI and %fPSA (Odds Ratio [OR]=0.97, 0.96 and 0.94, respectively). Unit increase of PHI was the only risk factor for prostatitis vs. BPH (OR=1.06), and unit increase of PCA3 score for HG-PIN vs. prostatitis (OR=0.98). In the 'gray zone' PSA cohort, the determinants for prostatitis vs. PCa were PCA3 score, PHI and %fPSA (OR=0.96, 0.94 and 0.92, respectively), PCA3 score and PHI for prostatitis vs. BPH (OR=0.96 and 1.08, respectively), and PCA3 score for prostatitis vs. HG-PIN (OR=0.97). The clinical benefit of using PCA3 score and PHI to estimate prostatitis vs. PCa was comparable; even %fPSA had good diagnostic performance, being a faster and cheaper marker. PHI was the only determinant for prostatitis vs. BPH, while PCA3 score for prostatitis vs. HG-PIN. Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  14. Prostatic disorders in acromegalic patients experience of a Brazilian center

    Directory of Open Access Journals (Sweden)

    Livia L. Correa

    2013-06-01

    Full Text Available Introduction Published data suggest that patients with acromegaly have an increased prevalence of prostate disorders. Objective To evaluate prostatic disorders in acromegalic patients comparing these results after one year of treatment of acromegaly and with a group of healthy men. Materials and Methods This study was composed of two parts: sectional study comparing patients with healthy controls (baseline and prospective, longitudinal study (at baseline and after one year of treatment. Forty acromegalic patients were enrolled and evaluated at baseline and after one year with the application of international prostatic symptoms score (IPSS, digital rectal examination, measurements of growth hormone (GH, insulin-like growth factor-I (IGF-I, insulin-like growth factor-binding protein-3 (IGFBP-3, sex hormone-binding globulin (SHBG, prolactin, luteinizing hormone (LH, follicle-stimulating hormone (FSH, total testosterone, total and free prostate-specific antigen (PSA levels and prostate ultrasonography (US. Thirty healthy men were selected as control group. Results We stratified patients and controls according to age, considering 40 years-old as cut off. Healthy controls under 40 had IPSS values lower than acromegalic patients. When considering only older patients and controls prostate hyperplasia and structural abnormalities were more frequent in acromegalics. After one year of treatment there was significant decrease in GH, IGF-I and prostate volume in acromegalics over 40 years-old. Conclusions Acromegalics under 40 have more urinary symptoms according to IPSS and above 40 years-old higher frequency of structural changes and increased prostate volume than healthy men. Significant reduction of GH and IGF-I levels during treatment of acromegaly leads to decrease in the prostate volume.

  15. Validation of equations for pleural effusion volume estimation by ultrasonography.

    Science.gov (United States)

    Hassan, Maged; Rizk, Rana; Essam, Hatem; Abouelnour, Ahmed

    2017-12-01

    To validate the accuracy of previously published equations that estimate pleural effusion volume using ultrasonography. Only equations using simple measurements were tested. Three measurements were taken at the posterior axillary line for each case with effusion: lateral height of effusion ( H ), distance between collapsed lung and chest wall ( C ) and distance between lung and diaphragm ( D ). Cases whose effusion was aspirated to dryness were included and drained volume was recorded. Intra-class correlation coefficient (ICC) was used to determine the predictive accuracy of five equations against the actual volume of aspirated effusion. 46 cases with effusion were included. The most accurate equation in predicting effusion volume was ( H  +  D ) × 70 (ICC 0.83). The simplest and yet accurate equation was H  × 100 (ICC 0.79). Pleural effusion height measured by ultrasonography gives a reasonable estimate of effusion volume. Incorporating distance between lung base and diaphragm into estimation improves accuracy from 79% with the first method to 83% with the latter.

  16. Valid and efficient manual estimates of intracranial volume from magnetic resonance images

    International Nuclear Information System (INIS)

    Klasson, Niklas; Olsson, Erik; Rudemo, Mats; Eckerström, Carl; Malmgren, Helge; Wallin, Anders

    2015-01-01

    Manual segmentations of the whole intracranial vault in high-resolution magnetic resonance images are often regarded as very time-consuming. Therefore it is common to only segment a few linearly spaced intracranial areas to estimate the whole volume. The purpose of the present study was to evaluate how the validity of intracranial volume estimates is affected by the chosen interpolation method, orientation of the intracranial areas and the linear spacing between them. Intracranial volumes were manually segmented on 62 participants from the Gothenburg MCI study using 1.5 T, T 1 -weighted magnetic resonance images. Estimates of the intracranial volumes were then derived using subsamples of linearly spaced coronal, sagittal or transversal intracranial areas from the same volumes. The subsamples of intracranial areas were interpolated into volume estimates by three different interpolation methods. The linear spacing between the intracranial areas ranged from 2 to 50 mm and the validity of the estimates was determined by comparison with the entire intracranial volumes. A progressive decrease in intra-class correlation and an increase in percentage error could be seen with increased linear spacing between intracranial areas. With small linear spacing (≤15 mm), orientation of the intracranial areas and interpolation method had negligible effects on the validity. With larger linear spacing, the best validity was achieved using cubic spline interpolation with either coronal or sagittal intracranial areas. Even at a linear spacing of 50 mm, cubic spline interpolation on either coronal or sagittal intracranial areas had a mean absolute agreement intra-class correlation with the entire intracranial volumes above 0.97. Cubic spline interpolation in combination with linearly spaced sagittal or coronal intracranial areas overall resulted in the most valid and robust estimates of intracranial volume. Using this method, valid ICV estimates could be obtained in less than five

  17. Proton Therapy Coverage for Prostate Cancer Treatment

    International Nuclear Information System (INIS)

    Vargas, Carlos; Wagner, Marcus; Mahajan, Chaitali; Indelicato, Daniel; Fryer, Amber; Falchook, Aaron; Horne, David C.; Chellini, Angela; McKenzie, Craig C.; Lawlor, Paula C.; Li Zuofeng; Lin Liyong; Keole, Sameer

    2008-01-01

    Purpose: To determine the impact of prostate motion on dose coverage in proton therapy. Methods and Materials: A total of 120 prostate positions were analyzed on 10 treatment plans for 10 prostate patients treated using our low-risk proton therapy prostate protocol (University of Florida Proton Therapy Institute 001). Computed tomography and magnetic resonance imaging T 2 -weighted turbo spin-echo scans were registered for all cases. The planning target volume included the prostate with a 5-mm axial and 8-mm superoinferior expansion. The prostate was repositioned using 5- and 10-mm one-dimensional vectors and 10-mm multidimensional vectors (Points A-D). The beam was realigned for the 5- and 10-mm displacements. The prescription dose was 78 Gy equivalent (GE). Results: The mean percentage of rectum receiving 70 Gy (V 70 ) was 7.9%, the bladder V 70 was 14.0%, and the femoral head/neck V 50 was 0.1%, and the mean pelvic dose was 4.6 GE. The percentage of prostate receiving 78 Gy (V 78 ) with the 5-mm movements changed by -0.2% (range, 0.006-0.5%, p > 0.7). However, the prostate V 78 after a 10-mm displacement changed significantly (p 78 coverage had a large and significant reduction of 17.4% (range, 13.5-17.4%, p 78 coverage of the clinical target volume. The minimal prostate dose was reduced 33% (25.8 GE), on average, for Points A-D. The prostate minimal dose improved from 69.3 GE to 78.2 GE (p < 0.001) with realignment for 10-mm movements. Conclusion: The good dose coverage and low normal doses achieved for the initial plan was maintained with movements of ≤5 mm. Beam realignment improved coverage for 10-mm displacements

  18. Does Small Prostate Predict High Grade Prostate Cancer?

    International Nuclear Information System (INIS)

    Caliskan, S.; Kaba, S.; Koca, O.; Ozturk, M. I.

    2017-01-01

    Objective: The current study is aimed to assess the patients who underwent radical prostatectomy for prostate cancer and investigate the association between prostate size and adverse outcomes at final pathology. Study Design: Comparative, descriptive study. Place and Duration of Study: Haydarpasa Numune Training and Research Hospital, Turkey, from January 2008 to January 2016. Methodology: The patients treated with open radical prostatectomy for prostate cancer were reviewed. Patient characteristics including prostate specific antigen (PSA), free PSA levels, age, biopsy, and radical prostatectomy results were recorded. The patients whose data were complete or prostate weight was equal to or less than 80 gm, were included in the study. Patients with < 40 gm prostate weight was in group 1 and the patients in group 2 had a prostate weight from 40 to 80 gm. High grade prostate cancer was defined to have a Gleason score between 7 or higher at biopsy and final pathology. Pathology and biopsy results were compared within groups. MedCalc Statistical Software demo version was used for statistical analyses. Results: There were 162 patients in this study. Of these, 71 (43.82 percent) patients were in group 1 and 91 (56.17 percent) patients were in group 2. The age ranged from 49 to 76 years. Mean value of 62.70 +-6.82 and 65.82 +- 5.66 years in group 1 and 2, respectively. Fifty (70.42 percent) and 68 patients (74.74 percent) had a Gleason score of 6 in group 1 and 2, respectively. Organconfined disease was reported in 53 patients (74.64 percent) in group 1 and in 78 patients (85.71 percent) in group 2. Gleason score concordance between biopsy and prostatectomy was reported in 61 patients (67.03 percent) and downgrading was detected in 4 patients (4.4 percent) in group 2. The median tumor volume of the patients was 4.47 cm/sup 3/ in group 1 and 6 cm/sup 3/ in group 2 (p=0.502). High grade prostate cancer was reported in 52.11 percent and 45.05 percent of the patients in

  19. Genitourinary Toxicity After High-Dose-Rate (HDR) Brachytherapy Combined With Hypofractionated External Beam Radiotherapy for Localized Prostate Cancer: An Analysis to Determine the Correlation Between Dose-Volume Histogram Parameters in HDR Brachytherapy and Severity of Toxicity

    International Nuclear Information System (INIS)

    Ishiyama, Hiromichi; Kitano, Masashi; Satoh, Takefumi; Kotani, Shouko; Uemae, Mineko; Matsumoto, Kazumasa; Okusa, Hiroshi; Tabata, Ken-ichi; Baba, Shiro; Hayakawa, Kazushige

    2009-01-01

    Purpose: To evaluate the severity of genitourinary (GU) toxicity in high-dose-rate (HDR) brachytherapy combined with hypofractionated external beam radiotherapy (EBRT) for prostate cancer and to explore factors that might affect the severity of GU toxicity. Methods and Materials: A total of 100 Japanese men with prostate cancer underwent 192 Ir HDR brachytherapy combined with hypofractionated EBRT. Mean (SD) dose to 90% of the planning target volume was 6.3 (0.7) Gy per fraction of HDR. After 5 fractions of HDR treatment, EBRT with 10 fractions of 3 Gy was administrated. The urethral volume receiving 1-15 Gy per fraction in HDR brachytherapy (V1-V15) and the dose to at least 5-100% of urethral volume in HDR brachytherapy (D5-D100) were compared between patients with Grade 3 toxicity and those with Grade 0-2 toxicity. Prostate volume, patient age, and International Prostate Symptom Score were also compared between the two groups. Results: Of the 100 patients, 6 displayed Grade 3 acute GU toxicity, and 12 displayed Grade 3 late GU toxicity. Regarding acute GU toxicity, values of V1, V2, V3, and V4 were significantly higher in patients with Grade 3 toxicity than in those with Grade 0-2 toxicity. Regarding late GU toxicity, values of D70, D80, V12, and V13 were significantly higher in patients with Grade 3 toxicity than in those with Grade 0-2 toxicity. Conclusions: The severity of GU toxicity in HDR brachytherapy combined with hypofractionated EBRT for prostate cancer was relatively high. The volume of prostatic urethra was associated with grade of acute GU toxicity, and urethral dose was associated with grade of late GU toxicity.

  20. Prostate Cancer Predictive Simulation Modelling, Assessing the Risk Technique (PCP-SMART): Introduction and Initial Clinical Efficacy Evaluation Data Presentation of a Simple Novel Mathematical Simulation Modelling Method, Devised to Predict the Outcome of Prostate Biopsy on an Individual Basis.

    Science.gov (United States)

    Spyropoulos, Evangelos; Kotsiris, Dimitrios; Spyropoulos, Katherine; Panagopoulos, Aggelos; Galanakis, Ioannis; Mavrikos, Stamatios

    2017-02-01

    We developed a mathematical "prostate cancer (PCa) conditions simulating" predictive model (PCP-SMART), from which we derived a novel PCa predictor (prostate cancer risk determinator [PCRD] index) and a PCa risk equation. We used these to estimate the probability of finding PCa on prostate biopsy, on an individual basis. A total of 371 men who had undergone transrectal ultrasound-guided prostate biopsy were enrolled in the present study. Given that PCa risk relates to the total prostate-specific antigen (tPSA) level, age, prostate volume, free PSA (fPSA), fPSA/tPSA ratio, and PSA density and that tPSA ≥ 50 ng/mL has a 98.5% positive predictive value for a PCa diagnosis, we hypothesized that correlating 2 variables composed of 3 ratios (1, tPSA/age; 2, tPSA/prostate volume; and 3, fPSA/tPSA; 1 variable including the patient's tPSA and the other, a tPSA value of 50 ng/mL) could operate as a PCa conditions imitating/simulating model. Linear regression analysis was used to derive the coefficient of determination (R 2 ), termed the PCRD index. To estimate the PCRD index's predictive validity, we used the χ 2 test, multiple logistic regression analysis with PCa risk equation formation, calculation of test performance characteristics, and area under the receiver operating characteristic curve analysis using SPSS, version 22 (P regression revealed the PCRD index as an independent PCa predictor, and the formulated risk equation was 91% accurate in predicting the probability of finding PCa. On the receiver operating characteristic analysis, the PCRD index (area under the curve, 0.926) significantly (P < .001) outperformed other, established PCa predictors. The PCRD index effectively predicted the prostate biopsy outcome, correctly identifying 9 of 10 men who were eventually diagnosed with PCa and correctly ruling out PCa for 9 of 10 men who did not have PCa. Its predictive power significantly outperformed established PCa predictors, and the formulated risk equation

  1. Strategies to reduce the systematic error due to tumor and rectum motion in radiotherapy of prostate cancer

    International Nuclear Information System (INIS)

    Hoogeman, Mischa S.; Herk, Marcel van; Bois, Josien de; Lebesque, Joos V.

    2005-01-01

    Background and purpose: The goal of this work is to develop and evaluate strategies to reduce the uncertainty in the prostate position and rectum shape that arises in the preparation stage of the radiation treatment of prostate cancer. Patients and methods: Nineteen prostate cancer patients, who were treated with 3-dimensional conformal radiotherapy, received each a planning CT scan and 8-13 repeat CT scans during the treatment period. We quantified prostate motion relative to the pelvic bone by first matching the repeat CT scans on the planning CT scan using the bony anatomy. Subsequently, each contoured prostate, including seminal vesicles, was matched on the prostate in the planning CT scan to obtain the translations and rotations. The variation in prostate position was determined in terms of the systematic, random and group mean error. We tested the performance of two correction strategies to reduce the systematic error due to prostate motion. The first strategy, the pre-treatment strategy, used only the initial rectum volume in the planning CT scan to adjust the angle of the prostate with respect to the left-right (LR) axis and the shape and position of the rectum. The second strategy, the adaptive strategy, used the data of repeat CT scans to improve the estimate of the prostate position and rectum shape during the treatment. Results: The largest component of prostate motion was a rotation around the LR axis. The systematic error (1 SD) was 5.1 deg and the random error was 3.6 deg (1 SD). The average LR-axis rotation between the planning and the repeat CT scans correlated significantly with the rectum volume in the planning CT scan (r=0.86, P<0.0001). Correction of the rotational position on the basis of the planning rectum volume alone reduced the systematic error by 28%. A correction, based on the data of the planning CT scan and 4 repeat CT scans reduced the systematic error over the complete treatment period by a factor of 2. When the correction was

  2. The estimated volume of the fibroid uterus: a comparison of ultrasound and bimanual examination versus volume at MRI or hysterectomy

    NARCIS (Netherlands)

    Stoelinga, Barbara; Huirne, Judith; Heymans, Martijn W.; Reekers, Jim A.; Ankum, Willem M.; Hehenkamp, Wouter J. K.

    2015-01-01

    The volume of a fibroid uterus before performing hysterectomy is typically estimated through bimanual examination and confirmed by ultrasonography. This study compares estimated volumes by bimanual examination and ultrasound examination with MRI and actual volumes obtained from histopathology, as

  3. Saw palmetto for benign prostatic hyperplasia.

    Science.gov (United States)

    Bent, Stephen; Kane, Christopher; Shinohara, Katsuto; Neuhaus, John; Hudes, Esther S; Goldberg, Harley; Avins, Andrew L

    2006-02-09

    Saw palmetto is used by over 2 million men in the United States for the treatment of benign prostatic hyperplasia and is commonly recommended as an alternative to drugs approved by the Food and Drug Administration. In this double-blind trial, we randomly assigned 225 men over the age of 49 years who had moderate-to-severe symptoms of benign prostatic hyperplasia to one year of treatment with saw palmetto extract (160 mg twice a day) or placebo. The primary outcome measures were changes in the scores on the American Urological Association Symptom Index (AUASI) and the maximal urinary flow rate. Secondary outcome measures included changes in prostate size, residual urinary volume after voiding, quality of life, laboratory values, and the rate of reported adverse effects. There was no significant difference between the saw palmetto and placebo groups in the change in AUASI scores (mean difference, 0.04 point; 95 percent confidence interval, -0.93 to 1.01), maximal urinary flow rate (mean difference, 0.43 ml per minute; 95 percent confidence interval, -0.52 to 1.38), prostate size, residual volume after voiding, quality of life, or serum prostate-specific antigen levels during the one-year study. The incidence of side effects was similar in the two groups. In this study, saw palmetto did not improve symptoms or objective measures of benign prostatic hyperplasia. (ClinicalTrials.gov number, NCT00037154.). Copyright 2006 Massachusetts Medical Society.

  4. Preoperative TRAM free flap volume estimation for breast reconstruction in lean patients.

    Science.gov (United States)

    Minn, Kyung Won; Hong, Ki Yong; Lee, Sang Woo

    2010-04-01

    To obtain pleasing symmetry in breast reconstruction with transverse rectus abdominis myocutaneous (TRAM) free flap, a large amount of abdominal flap is elevated and remnant tissue is trimmed in most cases. However, elevation of abundant abdominal flap can cause excessive tension in donor site closure and increase the possibility of hypertrophic scarring especially in lean patients. The TRAM flap was divided into 4 zones in routine manner; the depth and dimension of the 4 zones were obtained using ultrasound and AutoCAD (Autodesk Inc., San Rafael, CA), respectively. The acquired numbers were then multiplied to obtain an estimate of volume of each zone and the each zone volume was added. To confirm the relation between the estimated volume and the actual volume, authors compared intraoperative actual TRAM flap volumes with preoperative estimated volumes in 30 consecutive TRAM free flap breast reconstructions. The estimated volumes and the actual elevated volumes of flap were found to be correlated by regression analysis (r = 0.9258, P Autodesk Inc.) allow the authors to attain the precise volume desired for elevation. This method provides advantages in terms of minimal flap trimming, easier closure of donor sites, reduced scar widening and symmetry, especially in lean patients.

  5. Frequency Analysis of Gradient Estimators in Volume Rendering

    NARCIS (Netherlands)

    Bentum, Marinus Jan; Lichtenbelt, Barthold B.A.; Malzbender, Tom

    1996-01-01

    Gradient information is used in volume rendering to classify and color samples along a ray. In this paper, we present an analysis of the theoretically ideal gradient estimator and compare it to some commonly used gradient estimators. A new method is presented to calculate the gradient at arbitrary

  6. Improving volume loss estimates of the northwestern Greenland Ice Sheet 2002-2010

    DEFF Research Database (Denmark)

    Korsgaard, Niels Jákup; Khan, Shfaqat Abbas; Kjeldsen, Kristian Kjellerup

    Studies have been carried out using various methods to estimate the Greenland ice sheet mass balance. Remote sensing techniques used to determine the ice sheet volume includes airborne and satellite radar and laser methods and measurements of ice flow of outlet glaciers use InSAR satellite radar......) does not work on sloping surfaces and is affected by radar penetration into the snow. InSAR estimates require knowledge of outlet glacier thickness. GRACE has limited spatial resolution and is affected by mass variations not just from ice changes, but also from hydrologic and ocean mass variability...... and mass redistribution within the solid Earth. The accuracy of ice mass and ice volume estimates can be assessed by comparing results from different techniques. Here, we focus on volume loss estimates from ICESat, ATM and LVIS data. We estimate catchment-wide ice volume change in northwest Greenland...

  7. Comparison of 2D and 3D algorithms for adding a margin to the gross tumor volume in the conformal radiotherapy planning of prostate cancer

    International Nuclear Information System (INIS)

    Khoo, V.S.; Bedford, J.L.; Webb, S.; Dearnaley, D.P.

    1997-01-01

    Purpose: To evaluate the adequacy of tumor volume coverage using a three dimensional (3D) margin growing algorithm compared to a two dimensional (2D) margin growing algorithm in the conformal radiotherapy planning of prostate cancer. Methods and Materials: Two gross tumor volumes (GTV) were segmented in each of ten patients with localized prostate cancer: prostate gland only (PO) and prostate with seminal vesicles (PSV). A margin of 10 mm was applied to these two groups (PO and PSV) using both the 2D and 3D margin growing algorithms. The true planning target volume (PTV) was defined as the region delineated by the 3D algorithm. Adequacy of geometric coverage of the GTV with the two algorithms was examined throughout the target volume. Discrepancies between the two margin methods were measured in the transaxial plane. Results: The 2D algorithm underestimated the PTV by 17% (range 12-20) in the PO group and by 20% (range 13-28) for the PSV group when compared to the 3D algorithm. For both the PO and PSV groups, the inferior coverage of the PTV was consistently underestimated by the 2D margin algorithm when compared to the 3D margins with a mean radial distance of 4.8 mm (range 0-10). In the central region of the prostate gland, the anterior, posterior, and lateral PTV borders were underestimated with the 2D margin in both the PO and PSV groups by a mean of 3.6 mm (range 0-9), 2.1 mm (range 0-8), and 1.8 (range 0-9) respectively. The PTV coverage of the PO group superiorly was radially underestimated by 4.5mm (range 0-14) when comparing the 2D margins to the 3D margins. For the PSV group, the junction region between the prostate and the seminal vesicles was underestimated by the 2D margin by a mean transaxial distance of 18.1 mm in the anterior PTV border (range 4-30), 7.2 mm posteriorly (range 0-20), and 3.7 mm laterally (range 0-14). The superior region of the seminal vesicles in the PSV group was also consistently underestimated with a radial discrepancy of 3.3 mm

  8. Virtual simulation of radiotherapeutic treatment of the prostate

    Energy Technology Data Exchange (ETDEWEB)

    Haest, K; Vanregemorter, J [Algemeen Ziekenhuis Middelheim, Antwerp (Belgium). Dept. of Radiotherapy; Van Dam, J [Louvain Univ. (Belgium)

    1995-12-01

    Virtual simulation allows to simulate the radiotherapeutic treatment by computer, based on a CT scan of the patient in treatment position. The routinely obtained CT scans of prostate cancer patients in treatment position were used after conventional simulation for a parallel virtual simulation. In a first step the three-dimensional electron density data of the CT were used to outline the prostate and critical organs as three-dimensional volumes of interest. Based on the 3D information of the pre-defined target volume and a pre-set 3D margin, beams and beam blocks were automatically generated according to the beam set-up. A beam`s-eye view of the volumes of interest was calculated for each beam, superimposed on a digitally reconstructed radiograph using the actual divergence of the beam. At the same time the dose distribution was computed for the fields and blocks generated by the virtual simulator. The resulting Dose Volume Histograms for prostate, rectum and bladder were reviewed and compared with the Dose Volume Histograms obtained from the conventional simulation process. During both virtual and conventional simulation, time commitments required for all the members of the radiotherapy treatment team were recorded. It is concluded that routine use of virtual simulation is possible in a busy radiation oncology department; virtual simulation results in most cases in smaller field sizes than conventional simulation; Dose Volume Histograms show that virtual simulation of the prostate minimizes the dose delivered to the bladder; a shift in workload can be expected from technicians towards physicists and medical doctors with an overall decrease in time for both personnel and patient.

  9. Virtual simulation of radiotherapeutic treatment of the prostate

    International Nuclear Information System (INIS)

    Haest, K.; Vanregemorter, J.

    1995-01-01

    Virtual simulation allows to simulate the radiotherapeutic treatment by computer, based on a CT scan of the patient in treatment position. The routinely obtained CT scans of prostate cancer patients in treatment position were used after conventional simulation for a parallel virtual simulation. In a first step the three-dimensional electron density data of the CT were used to outline the prostate and critical organs as three-dimensional volumes of interest. Based on the 3D information of the pre-defined target volume and a pre-set 3D margin, beams and beam blocks were automatically generated according to the beam set-up. A beam's-eye view of the volumes of interest was calculated for each beam, superimposed on a digitally reconstructed radiograph using the actual divergence of the beam. At the same time the dose distribution was computed for the fields and blocks generated by the virtual simulator. The resulting Dose Volume Histograms for prostate, rectum and bladder were reviewed and compared with the Dose Volume Histograms obtained from the conventional simulation process. During both virtual and conventional simulation, time commitments required for all the members of the radiotherapy treatment team were recorded. It is concluded that routine use of virtual simulation is possible in a busy radiation oncology department; virtual simulation results in most cases in smaller field sizes than conventional simulation; Dose Volume Histograms show that virtual simulation of the prostate minimizes the dose delivered to the bladder; a shift in workload can be expected from technicians towards physicists and medical doctors with an overall decrease in time for both personnel and patient

  10. High-dose (70-78 GY) conformal radiotherapy for prostate cancer; the relation between observed late bladder and rectum complications and parameters derived from the dose volume histograms

    International Nuclear Information System (INIS)

    Lebesque, J.V.; Bruce, A.; Boersma, L.J.; Velde, A. te

    1996-01-01

    Purpose: To determine the incidence of late gastrointestinal (GI) and genitourinary (GU) complications after conformal radiotherapy for prostate cancer, and to investigate the relation between these observed incidences and parameters derived from the Dose Volume Histograms (DVHs) of rectum and bladder wall. Patients and Methods: Hundred and thirty patients with T 2-4 G 1-3 N 0 M 0 prostate cancer were treated with conformal radiotherapy with the simultaneous boost technique in a dose-escalating protocol; 78 patients received a total dose of 70 Gy, 11 patients 74 - 76 Gy and 41 patients 78 Gy, each with a dose of 2 Gy per fraction. DVHs of the rectal wall were used to calculate NTCPs according to the model of Kutcher et al. with the estimated parameter values (n = 0.12, m = 0.15, TD 50 = 80 Gy) according to Burman et al. The median follow-up was 17 months (range 6 - 72 months). The crude and actuarial incidence of late (> 6 months) GI and GU complications were determined using the RTOG/EORTC morbidity scoring system (Grade I to IV). Results: Neither for late GI nor for GU complaints, a grade IV complication was observed. GU complaints occurred in 90 patients (69%): 54 patients (42%) only experienced grade I toxicity, 26 patients (20%) had grade II toxicity, and 10 patients (8%) had grade III complications, of which 8 patients (6%) developed a urethral (7 pts) or ureteric stenosis (1 pt). The actuarial incidence of grade III GU complications was 10% at 2 years. Since bladder wall DVHs are unreliable and most grade III complications were not related to the bladder, the grade II and/or III complications were analyzed in terms of the total prescribed dose only, but no correlation could be demonstrated. GI complications occurred in 71 patients (55%): 59 patients (45%) developed a grade I complication, 11 a grade II complication and only 1 patient required laser treatment twice and blood transfusion because of rectal bleeding (grade III). The actuarial incidence of GI

  11. Visceral adiposity index is associated with benign prostatic enlargement in non-diabetic patients: a cross-sectional study.

    Science.gov (United States)

    Besiroglu, Huseyin; Ozbek, Emin; Dursun, Murat; Otunctemur, Alper

    2018-03-01

    To evaluate the association between visceral adiposity index (VAI) - a novel indicator for the assessment of visceral adipose tissue and prostate enlargement in non diabetic patients. Four hundred patients who were admitted to the Urology clinic between January and December 2014 with complaints of BPH(benign prostatic hyperplasia )/LUTS(male lower urinary tract symptoms)were enrolled in this cross-sectional study. Patients were divided into two groups according to their prostate volume and international prostate symptom score (IPSS) value. They were compared in terms of age, body mass index (BMI), VAI, prostate volume, PSA, post micturional residual volume (PMRV), uroflowmetry Q max value, triglyceride (TG), high density lipoprotein-cholesterol (HDL-C) and fasting blood sugar (FBS). Although univariate analyses reveal that age, BMI, waist circumference (WC), FBS, TG, HDL-C level and TG/HDL ratio were correlated with prostate volume, only age [1.125 OR (1.088-1.164), p = .00001], BMI [1.119 OR (1.040-1.204), p = .003], TG [1.043 OR (1.016-1.071), p = .002], HDL-C [0.923 OR (0.860-0.990), p = .025] and VAI [1.194 OR (1.110-1.305), p = .011] were statistically significant in multivariate analysis. A positive correlation was found between VAI value and prostate volume in the Spearman correlation test (r = 0.29, p = .00001). The calculated area under the curve (AUC) for prostate volumes of 30, 40 and 50 ml were 0.680 (0.621-0.738), 0.625 (0.570-0.681) and 0.590 (0.528-0.652), respectively. Our study revealed a positive correlation between VAI and prostate volume. Our results are needed to be tested with well-designed randomized prospective cohort studies.

  12. Stereological estimation of nuclear volume in benign and atypical meningiomas

    DEFF Research Database (Denmark)

    Madsen, C; Schrøder, H D

    1993-01-01

    A stereological estimation of nuclear volume in benign and atypical meningiomas was made. The aim was to investigate whether this method could discriminate between these two meningeal neoplasms. The difference was significant and it was moreover seen that there was no overlap between the two groups....... The results demonstrate that atypical meningiomas can be distinguished from benign meningiomas by an objective stereological estimation of nuclear volume....

  13. Prostate MRI findings in patients treated for testosterone deficiency while on active surveillance for low-risk prostate cancer

    Science.gov (United States)

    Hashimoto, Takeshi; Rahul, Krishnan; Takeda, Toshikazu; Benfante, Nicole; Mulhall, John P.; Hricak, Hedvig; Eastham, James A.; Vargas, Hebert Alberto

    2017-01-01

    Objective To investigate the multiparametric prostate magnetic resonance imaging (mpMRI) findings in patients treated with testosterone replacement therapy (TRT) while on active surveillance (AS) for low-risk prostate cancer. Methods We retrospectively reviewed 12 patients who underwent mpMRI before and after TRT while on AS. Changes in serum testosterone level, prostate specific antigen (PSA), prostate biopsy findings, prostate volume and Prostate Imaging Reporting and Data System Version 2 (PI-RADSv2) score before and after TRT were summarized. Results Following TRT, there was a significant increase in serum testosterone (516.5 ng/dl vs. 203.0 ng/dl), PSA (4.2 ng/ml vs. 3.3 ng/ml) and prostate volume (55.2 cm3 vs. 39.4 cm3). Two patients had biopsy progression during the study periods. The PI-RADSv2 scores before and after TRT were unchanged in 10/12 patients; none of these demonstrated biopsy progression on post TRT. The PI-RADSv2 scores increased after TRT in 2/12 patients; both showed Gleason score upgrade on follow-up biopsy. One of these two patients underwent radical treatment due to clinical progression. The area under the curve calculated from PI-RADSv2 score after TRT was 0.90, which was better than that calculated from post TRT PSA level (0.48). Conclusions After TRT, mpMRI findings remained stable in patients without biopsy progression, while PI-RADSv2 score increase was identified in patients with Gleason score upgrade on follow-up biopsy. PMID:27665357

  14. Prostate position late in the course of external beam therapy: patterns and predictors

    International Nuclear Information System (INIS)

    Zellars, Richard C.; Roberson, Peter L.; Strawderman, Myla; Zhang Daowen; Sandler, Howard M.; Haken, Randall K. ten; Osher, David; McLaughlin, P. William

    2000-01-01

    Purpose: To examine prostate and seminal vesicles position late in the course of radiation therapy and to determine the effect and predictive value of the bladder and rectum on prostate and seminal vesicles positioning. Methods and Materials: Twenty-four patients with localized prostate cancer underwent a computerized tomography scan (CT1) before the start of radiation therapy. After 4-5 weeks of radiation therapy, a second CT scan (CT2) was obtained. All patients were scanned in the supine treatment position with instructions to maintain a full bladder. The prostate, seminal vesicles, bladder, and rectum were contoured. CT2 was aligned via fixed bony anatomy to CT1. The geometrical center and volume of each structure were obtained and directly compared. Results: The prostate shifted along a diagonal axis extending from an anterior-superior position to a posterior-inferior position. The dominant shift was to a more posterior-inferior position. On average, bladder and rectal volumes decreased to 51% (no. +-no. 29%) and 82% (no. +-no. 45%) of their pretreatment values, respectively. Multiple regression analysis (MRA) revealed that bladder movement and volume change and upper rectum movement were independently associated with prostate motion (p = 0.016, p = 0.003, and p = 0.052 respectively). Conclusion: Patients are often instructed to maintain a full bladder during a course of external beam radiation therapy, in the hopes of decreasing bladder and small bowel toxicity. However, our study shows that large bladder volumes late in therapy are strongly associated with posterior prostate displacement. This prostate displacement may result in marginal miss

  15. Urethral dose and increment of international prostate symptom score (IPSS) in transperineal permanent interstitial implant (TPI) of prostate cancer

    International Nuclear Information System (INIS)

    Murakami, N.; Itami, J.; Okuma, K.; Marino, H.; Ban, T.; Nakazato, M.; Kanai, K.; Naoi, K.; Fuse, M.; Nakagawa, K.

    2008-01-01

    Purpose: to find the factors which influence the acute increment of international prostate symptom score (IPSS) after transperineal permanent interstitial implant (TPI) using 125 I seeds. Patients and methods: from April 2004 through September 2006, 104 patients with nonmetastatic prostate cancer underwent TPI without external-beam irradiation. Median patient age was 70 years with a median follow-up of 13.0 months. 73 patients (70%) received neoadjuvant hormone therapy. The increment of IPSS was defined as the difference between pre- and postimplant maximal IPSS. Clinical, treatment, and dosimetric parameters evaluated included age, initial prostate-specific antigen, Gleason Score, neoadjuvant hormone therapy, initial IPSS, post-TPI prostatic volume, number of implanted seeds, prostate V 100 , V 150 , D 90 , urethral D max , and urethral D 90 . In order to further evaluate detailed urethral doses, the base and apical urethra were defined and the dosimetric parameters were calculated. Results: the IPSS peaked 3 months after TPI and returned to baseline at 12-15 months. Multivariate analysis demonstrated a statistically significant correlation of post-TPI prostatic volume, number of implanted seeds, and the dosimetric parameters of the base urethra with IPSS increment. Conclusion: the base urethra appears to be susceptible to radiation and the increased dose to this region deteriorates IPSS. It remains unclear whether the base urethral dose relates to the incidence of late urinary morbidities. (orig.)

  16. Does Inflammation Mediate the Obesity and BPH Relationship? An Epidemiologic Analysis of Body Composition and Inflammatory Markers in Blood, Urine, and Prostate Tissue, and the Relationship with Prostate Enlargement and Lower Urinary Tract Symptoms.

    Science.gov (United States)

    Fowke, Jay H; Koyama, Tatsuki; Fadare, Oluwole; Clark, Peter E

    2016-01-01

    BPH is a common disease associated with age and obesity. However, the biological pathways between obesity and BPH are unknown. Our objective was to investigate biomarkers of systemic and prostate tissue inflammation as potential mediators of the obesity and BPH association. Participants included 191 men without prostate cancer at prostate biopsy. Trained staff measured weight, height, waist and hip circumferences, and body composition by bioelectric impedance analysis. Systemic inflammation was estimated by serum IL-6, IL-1β, IL-8, and TNF-α; and by urinary prostaglandin E2 metabolite (PGE-M), F2-isoprostane (F2iP), and F2-isoprostane metabolite (F2iP-M) levels. Prostate tissue was scored for grade, aggressiveness, extent, and location of inflammatory regions, and also stained for CD3 and CD20 positive lymphocytes. Analyses investigated the association between multiple body composition scales, systemic inflammation, and prostate tissue inflammation against BPH outcomes, including prostate size at ultrasound and LUTS severity by the AUA-symptom index (AUA-SI). Prostate size was significantly associated with all obesity measures. For example, prostate volume was 5.5 to 9.0 mls larger comparing men in the 25th vs. 75th percentile of % body fat, fat mass (kg) or lean mass (kg). However, prostate size was not associated with proinflammatory cytokines, PGE-M, F2iP, F2iP-M, prostate tissue inflammation scores or immune cell infiltration. In contrast, the severity of prostate tissue inflammation was significantly associated with LUTS, such that there was a 7 point difference in AUA-SI between men with mild vs. severe inflammation (p = 0.004). Additionally, men with a greater waist-hip ratio (WHR) were significantly more likely to have severe prostate tissue inflammation (p = 0.02), and a high WHR was significantly associated with moderate/severe LUTS (OR = 2.56, p = 0.03) among those participants with prostate tissue inflammation. The WHR, an estimate of centralized

  17. Calf muscle volume estimates: Implications for Botulinum toxin treatment?

    DEFF Research Database (Denmark)

    Bandholm, Thomas; Sonne-Holm, Stig; Thomsen, Carsten

    2007-01-01

    An optimal botulinum toxin dose may be related to the volume of the targeted muscle. We investigated the suitability of using ultrasound and anthropometry to estimate gastrocnemius and soleus muscle volume. Gastrocnemius and soleus muscle thickness was measured in 11 cadaveric human legs, using...

  18. Prospective Randomized Comparison of Monopolar TURP, Bipolar TURP and Photoselective Vaporization of the Prostate in Patients with Benign Prostatic Obstruction: 36 Months Outcome.

    Science.gov (United States)

    Kumar, Niraj; Vasudeva, Pawan; Kumar, Anup; Singh, Harbinder

    2018-01-01

    To assess durability of efficacy of monopolar transurethral resection of the prostate (TURP), bipolar TURP, and photoselective vaporization of the prostate (PVP) using 120W Green light laser at 36 months follow up. The 186 patients who presented with benign prostatic obstruction and planned for surgery were randomized into three groups: Group A - monopolar TURP; group B - bipolar TURP; and group C - PVP. International Prostate Symptom Score (IPSS), International Index of Erectile Function-5 (IIEF-5) score, quality of life (QoL) score, maximum flow rate (Qmax), prostate volume and postvoid residual urine (PVRU) were analyzed up to 36 months follow up. The improvement observed in the mean IPSS, QoL score, Qmax, prostate volume and PVRU at 12-month was sustained till 36 months follow up. However, the mean IIEF-5 score did not show improvement in any group. Few complications noted in second and third year of follow up compared to first year follow up. The results of subgroups analysis did not reveal any significant finding, different from group analysis, for efficacy parameters. Monopolar TURP, Bipolar TURP and PVP provides durable and comparable efficacy at 36 months follow up in patients with prostate size <80 mL. © 2016 John Wiley & Sons Australia, Ltd.

  19. Quantification of Prostate and Seminal Vesicle Interfraction Variation During IMRT

    International Nuclear Information System (INIS)

    Frank, Steven J.; Dong Lei; Kudchadker, Rajat J.; De Crevoisier, Renaud; Lee, Andrew K.; Cheung, Rex; Choi, Seungtaek; O'Daniel, Jennifer; Tucker, Susan L.; Wang He; Kuban, Deborah A.

    2008-01-01

    Purpose: To quantify the interfraction variability in prostate and seminal vesicle (SV) positions during a course of intensity-modulated radiotherapy (IMRT) using an integrated computed tomography (CT)-linear accelerator system and to assess the impact of rectal and bladder volume changes. Methods and Materials: We studied 15 patients who had undergone IMRT for prostate carcinoma. Patients had one pretreatment planning CT scan followed by three in-room CT scans per week using a CT-on-rails system. The prostate, bladder, rectum, and pelvic bony anatomy were contoured in 369 CT scans. Using the planning CT scan as a reference, the volumetric and positional changes were analyzed in the subsequent CT scans. Results: For all 15 patients, the mean systematic internal prostate and SV variation was 0.1 ± 4.1 mm and 1.2 ± 7.3 mm in the anteroposterior axis, -0.5 ± 2.9 mm and -0.7 ± 4.5 mm in the superoinferior axis, and 0.2 ± 0.9 mm and -0.9 ± 1.9 mm in the lateral axis, respectively. The mean magnitude of the three-dimensional displacement vector was 4.6 ± 3.5 mm for the prostate and 7.6 ± 4.7 mm for the SVs. The rectal and bladder volume changes during treatment correlated with the anterior and superior displacement of the prostate and SVs. Conclusion: The dominant prostate and SV variations occurred in the anteroposterior and superoinferior directions. The systematic prostate and SV variation between the treatment planning CT and daily therapy as a result of the rectal and bladder volume changes emphasizes the need for daily directed target localization and/or immobilization techniques

  20. Optimum timing for image-based dose evaluation of 125I and 103Pd prostate seed implants

    International Nuclear Information System (INIS)

    Yue Ning; Chen Zhe; Peschel, Richard; Dicker, Adam P.; Waterman, Frank M.; Nath, Ravinder

    1999-01-01

    Purpose/Objective: Image-based dose evaluation of permanent brachytherapy implants for prostate cancer is important for optimal patient management after implantation. Because of edema caused by the surgical procedure in the implantation, if the dose evaluation is based on the images obtained too early after implantation, dose coverage will usually be underestimated. Conversely, if the images are obtained too late, the dose coverage will be overestimated. This study uses a biomathematical model to simulate edema and its resolution on 29 patients, so that the optimum time to obtain image scans and perform dose evaluation can be investigated and estimated. Methods and Materials: Edema of a prostate and its resolution has been shown to follow an exponential function V(t) = V(0)(1 + ΔV[e -0.693t/Te - 1]) where ΔV is the initial relative increase in the prostate volume due to edema (and is related to edema magnitude), and T e (edema half-life) is the time for the edema to decrease by half in volume. In this study, edema was simulated by increasing the volume of preimplant prostate (obtained from ultrasound volume study) to a given magnitude of edema. Similarly, the locations of planned seeds were changed to their corresponding locations in the edematous prostate proportionally. The edema was then allowed to resolve according to the exponential function. The correct dose distribution was calculated by taking into account the dynamic variations of the prostate volume, seed locations, and source strengths with respect to time. Dose volume histograms (DVHs) were then generated from this dose distribution. The conventional postimplant DVHs, which assume the prostate volume and seed locations are as in the image scans and constant in time, were also calculated based on the simulated image scans for various days postimplantation. The conventional DVHs of prostate on various days after implantation were compared to the DVH calculated assuming dynamic conditions. The optimum

  1. SU-E-J-164: Estimation of DVH Variation for PTV Due to Interfraction Organ Motion in Prostate VMAT Using Gaussian Error Function

    International Nuclear Information System (INIS)

    Lewis, C; Jiang, R; Chow, J

    2015-01-01

    Purpose: We developed a method to predict the change of DVH for PTV due to interfraction organ motion in prostate VMAT without repeating the CT scan and treatment planning. The method is based on a pre-calculated patient database with DVH curves of PTV modelled by the Gaussian error function (GEF). Methods: For a group of 30 patients with different prostate sizes, their VMAT plans were recalculated by shifting their PTVs 1 cm with 10 increments in the anterior-posterior, left-right and superior-inferior directions. The DVH curve of PTV in each replan was then fitted by the GEF to determine parameters describing the shape of curve. Information of parameters, varying with the DVH change due to prostate motion for different prostate sizes, was analyzed and stored in a database of a program written by MATLAB. Results: To predict a new DVH for PTV due to prostate interfraction motion, prostate size and shift distance with direction were input to the program. Parameters modelling the DVH for PTV were determined based on the pre-calculated patient dataset. From the new parameters, DVH curves of PTVs with and without considering the prostate motion were plotted for comparison. The program was verified with different prostate cases involving interfraction prostate shifts and replans. Conclusion: Variation of DVH for PTV in prostate VMAT can be predicted using a pre-calculated patient database with DVH curve fitting. The computing time is fast because CT rescan and replan are not required. This quick DVH estimation can help radiation staff to determine if the changed PTV coverage due to prostate shift is tolerable in the treatment. However, it should be noted that the program can only consider prostate interfraction motions along three axes, and is restricted to prostate VMAT plan using the same plan script in the treatment planning system

  2. Is Dose Deformation–Invariance Hypothesis Verified in Prostate IGRT?

    Energy Technology Data Exchange (ETDEWEB)

    Simon, Antoine, E-mail: antoine.simon@univ-rennes1.fr [INSERM, U1099, 35000 Rennes (France); Laboratoire Traitement du Signal et de l' Image, Université de Rennes 1, 35000 Rennes (France); Le Maitre, Amandine; Nassef, Mohamed; Rigaud, Bastien [INSERM, U1099, 35000 Rennes (France); Laboratoire Traitement du Signal et de l' Image, Université de Rennes 1, 35000 Rennes (France); Castelli, Joël [INSERM, U1099, 35000 Rennes (France); Laboratoire Traitement du Signal et de l' Image, Université de Rennes 1, 35000 Rennes (France); Department of Radiotherapy, Centre Eugène Marquis, 35000 Rennes (France); Acosta, Oscar; Haigron, Pascal [INSERM, U1099, 35000 Rennes (France); Laboratoire Traitement du Signal et de l' Image, Université de Rennes 1, 35000 Rennes (France); Lafond, Caroline; Crevoisier, Renaud de [INSERM, U1099, 35000 Rennes (France); Laboratoire Traitement du Signal et de l' Image, Université de Rennes 1, 35000 Rennes (France); Department of Radiotherapy, Centre Eugène Marquis, 35000 Rennes (France)

    2017-03-15

    Purpose: To assess dose uncertainties resulting from the dose deformation–invariance hypothesis in prostate cone beam computed tomography (CT)–based image guided radiation therapy (IGRT), namely to evaluate whether rigidly propagated planned dose distribution enables good estimation of fraction dose distributions. Methods and Materials: Twenty patients underwent a CT scan for planning intensity modulated radiation therapy–IGRT delivering 80 Gy to the prostate, followed by weekly CT scans. Two methods were used to obtain the dose distributions on the weekly CT scans: (1) recalculating the dose using the original treatment plan; and (2) rigidly propagating the planned dose distribution. The cumulative doses were then estimated in the organs at risk for each dose distribution by deformable image registration. The differences between recalculated and propagated doses were finally calculated for the fraction and the cumulative dose distributions, by use of per-voxel and dose-volume histogram (DVH) metrics. Results: For the fraction dose, the mean per-voxel absolute dose difference was <1 Gy for 98% and 95% of the fractions for the rectum and bladder, respectively. The maximum dose difference within 1 voxel reached, however, 7.4 Gy in the bladder and 8.0 Gy in the rectum. The mean dose differences were correlated with gas volume for the rectum and patient external contour variations for the bladder. The mean absolute differences for the considered volume receiving greater than or equal to dose x (V{sub x}) of the DVH were between 0.37% and 0.70% for the rectum and between 0.53% and 1.22% for the bladder. For the cumulative dose, the mean differences in the DVH were between 0.23% and 1.11% for the rectum and between 0.55% and 1.66% for the bladder. The largest dose difference was 6.86%, for bladder V{sub 80Gy}. The mean dose differences were <1.1 Gy for the rectum and <1 Gy for the bladder. Conclusions: The deformation–invariance hypothesis was

  3. Estimating the Volumes of Solid Figures with Curved Surfaces.

    Science.gov (United States)

    Cohen, Donald

    1991-01-01

    Several examples of solid figures that calculus students can use to exercise their skills at estimating volume are presented. Although these figures are bounded by surfaces that are portions of regular cylinders, it is interesting to note that their volumes can be expressed as rational numbers. (JJK)

  4. Interobserver Delineation variation using CT versus combined CT + MRI in intensity- modulated radiotherapy for prostate cancer

    International Nuclear Information System (INIS)

    Villeirs, G.M.; Verstraete, K.L.; Vaerenbergh, K. van; Vakaet, L.; Bral, S.; Claus, F.; Neve, W.J. de; Meerleer, G.O. de

    2005-01-01

    Purpose: to quantify interobserver variation of prostate and seminal vesicle delineations using CT only versus CT + MRI in consensus reading with a radiologist. Material and methods: the prostate and seminal vesicles of 13 patients treated with intensity-modulated radiotherapy for prostatic adenocarcinoma were retrospectively delineated by three radiation oncologists on CT only and on CT + MRI in consensus reading with a radiologist. The volumes and margin positions were calculated and intermodality and interobserver variations were assessed for the clinical target volume (CTV), seminal vesicles, prostate and three prostatic subdivisions (apical, middle and basal third). Results: using CT + MRI as compared to CT alone, the mean CTV, prostate and seminal vesicle volumes significantly decreased by 6.54%, 5.21% and 10.47%, respectively. More importantly, their standard deviations significantly decreased by 63.06%, 62.65% and 44.83%, respectively. The highest level of variation was found at the prostatic apex, followed by the prostatic base and seminal vesicles. Conclusion: addition of MRI to CT in consensus reading with a radiologist results in a moderate decrease of the CTV, but an important decrease of the interobserver delineation variation, especially at the prostatic apex. (orig.)

  5. Initial clinical assessment of CT-MRI image fusion software in localization of the prostate for 3D conformal radiation therapy

    International Nuclear Information System (INIS)

    Kagawa, Kazufumi; Lee, W. Robert; Schultheiss, Timothy E.; Hunt, Margie A.; Shaer, Andrew H.; Hanks, Gerald E.

    1997-01-01

    Purpose: To assess the utility of image fusion software and compare MRI prostate localization with CT localization in patients undergoing 3D conformal radiation therapy of prostate cancer. Materials and Methods: After a phantom study was performed to ensure the accuracy of image fusion procedure, 22 prostate cancer patients had CT and MRI studies before the start of radiotherapy. Immobilization casts used during radiation treatment were also used for both imaging studies. After the clinical target volume (CTV) (prostate or prostate + seminal vesicles) was defined on CT, slices from the MRI study were reconstructed to precisely match the CT slices by identifying three common bony landmarks on each study. The CTV was separately defined on the matched MRI slices. Data related to the size and location of the prostate were compared between CT and MRI. The spatial relationship between the tip of urethrogram cone on CT and prostate apex seen on MRI was also estimated. Results: The phantom study showed the registration discrepancies between CT and MRI smaller than 1.0 mm in any pair in comparison. The patient study showed a mean image registration error of 0.9 (± 0.6) mm. The average prostate volume was 63.0 (± 25.8) cm 3 and 50.9 (± 22.9) cm 3 determined by CT and MRI, respectively. The difference in prostate location with the two studies usually differed at the base and at the apex of the prostate. On the transverse MRI, the prostate apex was situated 7.1 (± 4.5) mm dorsal and 15.1 (± 4.0) mm cephalad to the tip of urethrogram cone. Conclusions: CT-MRI image fusion study made it possible to compare the two modalities directly. MRI localization of the prostate is more accurate than CT, and indicates the distance from cone to apex is 15 mm. CT-MRI image fusion technique provides valuable supplements to CT technology for more precise targeting of the prostate cancer

  6. Digital image analysis of testicular and prostatic ultrasonographic echogencity and heterogeneity in dogs and the relation to semen quality.

    Science.gov (United States)

    Moxon, Rachel; Bright, Lucy; Pritchard, Beth; Bowen, I Mark; de Souza, Mírley Barbosa; da Silva, Lúcia Daniel Machado; England, Gary C W

    2015-09-01

    A semi-automated ultrasonographic method was developed to measure echogenicity and heterogeneity of the testes and prostate gland and relationships of these measures with semen quality were assessed in 43 fertile dogs. The relationship between animal age and body weight upon the volume of the testes, epididymal tail volume and prostate volume were also established. Mean testicular echogenicity was negatively correlated with the percentage of morphologically normal live spermatozoa (more echogenic testes were associated with fewer normal sperm) but not with any other semen quality measure. Mean testicular heterogeneity was positively correlated with the total spermatozoal output (more heterogenous testes, being those with anechoic parenchyma and prominent echogenic stippling, were associated with greater sperm output) but not with any other semen quality measure. There was no relationship between either mean prostatic echogenicity or mean prostatic heterogeneity and any semen quality measure. There was no relationship between age and any testicular or prostatic parameter; however bodyweight was significantly correlated with total testicular volume, total epididymal tail volume and total prostatic volume. Testicular and prostatic ultrasonographic echogenicity and heterogeneity can be objectively assessed using digital image analysis and testicular echogenicity and heterogeneity may be useful adjunct measurements in a breeding soundness examination. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Volume estimation of Pterogyne nitens in pure plantation in the southwest of Bahia

    Directory of Open Access Journals (Sweden)

    Magno Pacheco Fraga

    2014-09-01

    Full Text Available The knowledge of wood volume is essential to determine the logging productive potential of a forest plantation. However, as this variable isn’t easily measurable it’s necessary the obtainment by estimation. This study aims to select volumetric models and analyze the efficiency of three different methods to estimate the wood volume (form factor, form quotient and adjusted volumetric equation to the species Pterogyne nitens Tul. in pure plantation in Vitoria da Conquista, State of Bahia, Brazil. The sampled trees were logged and rigorously cubed, andeight volumetric models were adjusted. The best models were selected based on the pondered value of the statistical parameters scores and residues distribution. Stoate model presented the best performance to estimate the bole volume and the total wood volume of Pterogyne nitens with bark. Nevertheless, for the bole volume, Koperzky and Gehrhardt model presented similar estimates as Stoate’s, being also indicated to this species. Among the methods used to estimate volume, it is recommended the use of adjusted volumetric models.

  8. Effect of material property heterogeneity on biomechanical modeling of prostate under deformation

    International Nuclear Information System (INIS)

    Samavati, Navid; McGrath, Deirdre M; Ménard, Cynthia; Jewett, Michael A S; Van der Kwast, Theo; Brock, Kristy K

    2015-01-01

    Biomechanical model based deformable image registration has been widely used to account for prostate deformation in various medical imaging procedures. Biomechanical material properties are important components of a biomechanical model. In this study, the effect of incorporating tumor-specific material properties in the prostate biomechanical model was investigated to provide insight into the potential impact of material heterogeneity on the prostate deformation calculations. First, a simple spherical prostate and tumor model was used to analytically describe the deformations and demonstrate the fundamental effect of changes in the tumor volume and stiffness in the modeled deformation. Next, using a clinical prostate model, a parametric approach was used to describe the variations in the heterogeneous prostate model by changing tumor volume, stiffness, and location, to show the differences in the modeled deformation between heterogeneous and homogeneous prostate models. Finally, five clinical prostatectomy examples were used in separately performed homogeneous and heterogeneous biomechanical model based registrations to describe the deformations between 3D reconstructed histopathology images and ex vivo magnetic resonance imaging, and examine the potential clinical impact of modeling biomechanical heterogeneity of the prostate. The analytical formulation showed that increasing the tumor volume and stiffness could significantly increase the impact of the heterogeneous prostate model in the calculated displacement differences compared to the homogeneous model. The parametric approach using a single prostate model indicated up to 4.8 mm of displacement difference at the tumor boundary compared to a homogeneous model. Such differences in the deformation of the prostate could be potentially clinically significant given the voxel size of the ex vivo MR images (0.3  ×  0.3  ×  0.3 mm). However, no significant changes in the registration accuracy were

  9. Modeling Approach for Estimating Co-Produced Water Volumes and Saltwater Disposal Volumes in Oklahoma

    Science.gov (United States)

    Murray, K. E.

    2016-12-01

    Management of produced fluids has become an important issue in Oklahoma because large volumes of saltwater are co-produced with oil and gas, and disposed into saltwater disposal wells at high rates. Petroleum production increased from 2009-2015, especially in central and north-central Oklahoma where the Mississippian and Hunton zones were redeveloped using horizontal wells and dewatering techniques that have led to a disproportional increase in produced water volumes. Improved management of co-produced water, including desalination for beneficial reuse and decreased saltwater disposal volumes, is only possible if spatial and temporal trends can be defined and related to the producing zones. It is challenging to quantify the volumes of co-produced water by region or production zone because co-produced water volumes are generally not reported. Therefore, the goal of this research is to estimate co-produced water volumes for 2008-present with an approach that can be replicated as petroleum production shifts to other regions. Oil and gas production rates from subsurface zones were multiplied by ratios of H2O:oil and H2O:gas for the respective zones. Initial H2O:oil and H2O:gas ratios were adjusted/calibrated, by zone, to maximize correlation of county-scale produced H2O estimates versus saltwater disposal volumes from 2013-2015. These calibrated ratios were then used to compute saltwater disposal volumes from 2008-2012 because of apparent data gaps in reported saltwater disposal volumes during that timeframe. This research can be used to identify regions that have the greatest need for produced water treatment systems. The next step in management of produced fluids is to explore optimal energy-efficient strategies that reduce deleterious effects.

  10. Normal tissue complication probabilities correlated with late effects in the rectum after prostate conformal radiotherapy

    International Nuclear Information System (INIS)

    Dale, Einar; Olsen, Dag R.; Fossa, Sophie D.

    1999-01-01

    Purpose: Radiation therapy of deep-sited tumours will always result in normal tissue doses to some extent. The aim of this study was to calculate different risk estimates of late effects in the rectum for a group of cancer prostate patients treated with conformal radiation therapy (CRT) and correlate these estimates with the occurrences of late effects. Since the rectum is a hollow organ, several ways of generating dose-volume distributions over the organ are possible, and we wanted to investigate two of them. Methods and Materials: A mathematical model, known as the Lyman-Kutcher model, conventionally used to estimate normal tissue complication probabilities (NTCP) associated with radiation therapy, was applied to a material of 52 cancer prostate patients. The patients were treated with a four field box technique, with the rectum as organ at risk. Dose-volume histograms (DVH) were generated for the whole rectum (including the cavity) and of the rectum wall. One to two years after the treatment, the patients completed a questionnaire concerning bowel (rectum) related morbidity quantifying the extent of late effects. Results: A correlation analysis using Spearman's rank correlation coefficient, for NTCP values calculated from the DVHs and the patients' scores, gave correlation coefficients which were not statistically significant at the p max , of the whole rectum, correlated better to observed late toxicity than D max derived from histograms of the rectum wall. Correlation coefficients from 'high-dose' measures were larger than those calculated from the NTCP values. Accordingly, as the volume parameter of the Lyman-Kutcher model was reduced, raising the impact of small high-dose volumes on the NTCP values, the correlation between observed effects and NTCP values became significant at p < 0.01 level. Conclusions: 1) High-dose levels corresponding to small volume fractions of the cumulative dose-volume histograms were best correlated with the occurrences of late

  11. Is there any association between National Institute of Health category IV prostatitis and prostate-specific antigen levels in patients with low-risk localized prostate cancer?

    Science.gov (United States)

    Doluoglu, Omer Gokhan; Ceylan, Cavit; Kilinc, Fatih; Gazel, Eymen; Resorlu, Berkan; Odabas, Oner

    2016-01-01

    We investigated the association between National Institute of Health category IV prostatitis and prostate-specific antigen levels in patients with low-risk localized prostate cancer. The data of 440 patients who had undergone prostate biopsies due to high PSA levels and suspicious digital rectal examination findings were reviewed retrospectively. The patients were divided into two groups based on the presence of accompanying NIH IV prostatitis. The exclusion criteria were as follows: Gleason score>6, PSA level>20ng/mL, >2 positive cores, >50% cancerous tissue per biopsy, urinary tract infection, urological interventions at least 1 week previously (cystoscopy, urethral catheterization, or similar procedure), history of prostate biopsy, and history of androgen or 5-alpha reductase use. All patient's age, total PSA and free PSA levels, ratio of free to total PSA, PSA density and prostate volume were recorded. In total, 101 patients were included in the study. Histopathological examination revealed only PCa in 78 (77.2%) patients and PCa+NIH IV prostatitis in 23 (22.7%) patients. The median total PSA level was 7.4 (3.5-20.0) ng/mL in the PCa+NIH IV prostatitis group and 6.5 (0.6-20.0) ng/mL in the PCa group (p=0.67). The PSA level was≤10ng/mL in 60 (76.9%) patients in the PCa group and in 16 (69.6%) patients in the PCa+NIH IV prostatitis group (p=0.32). Our study showed no statistically significant difference in PSA levels between patients with and without NIH IV prostatitis accompanying PCa.

  12. Development of a semi-automatic alignment tool for accelerated localization of the prostate

    International Nuclear Information System (INIS)

    Hua Chiaho; Lovelock, D. Michael; Mageras, Gikas S.; Katz, Matthew S.; Mechalakos, James; Lief, Eugene P.; Hollister, Timothy; Lutz, Wendell R.; Zelefsky, Michael J.; Ling, Clifton C.

    2003-01-01

    Purpose: Delivering high dose to prostate with external beam radiation has been shown to improve local tumor control. However, it has to be carefully performed to avoid partial target miss and delivering excessive dose to surrounding normal tissues. One way to achieve safe dose escalation is to precisely localize prostate immediately before daily treatment. Therefore, the radiation can be accurately delivered to the target. Once the prostate position is determined with high confidence, planning target volume (PTV) safety margin might be reduced for further reduction of rectal toxicity. A rapid computed tomography (CT)-based online prostate localization method is presented for this purpose. Methods and Materials: Immediately before each treatment session, the patient is immobilized and undergoes a CT scan in the treatment position using a CT scanner situated in the treatment room. At the CT console, posterior, anterior, left, and right extents of the prostate are manually identified on each axial slice. The translational prostate displacements relative to the planned position are estimated by simultaneously fitting these identified extents from this CT scan to a template created from the finely sliced planning CT scan. A total of 106 serial CT scans from 8 prostate cancer patients were performed immediately before treatments and used to retrospectively evaluate the precision of this daily prostate targeting method. The three-dimensional displacement of the prostate with respect to its planned position was estimated. Results: Five axial slices from each treatment CT scan were sufficient to produce a reliable correction when compared with prostate center of gravity (CoG) displacements calculated from physician-drawn contours. The differences (mean ± SD) between these two correction schemes in the right-left (R/L), posterior-anterior (P/A), and superior-inferior (S/I) directions are 0.0 ± 0.4 mm, 0.0 ± 0.7 mm, and -0.4 ± 1.9 mm, respectively. With daily CT extent

  13. Estimation of soil properties and free product volume from baildown tests

    International Nuclear Information System (INIS)

    Zhu, J.L.; Parker, J.C.; Lundy, D.A.; Zimmerman, L.M.

    1993-01-01

    Baildown tests, involving measurement of water and free product levels in a monitoring well after bailing, are often performed at spill sites to estimate the oil volume per unit area -- which the authors refer to as ''oil specific volume.'' Spill volume is estimated by integrating oil specific volume over the areal domain of the spill. Existing methods for interpreting baildown tests are based on grossly simplistic approximations of soil capillary properties that cannot accurately describe the transient well response. A model for vertical equilibrium oil distributions based on the van Genuchten capillary model has been documented and verified in the laboratory and in the field by various authors. The model enables oil specific volume and oil transmissivity to be determined as functions of well product thickness. This paper describes a method for estimating van Genuchten capillary parameters, as well as aquifer hydraulic conductivity, from baildown tests. The results yield the relationships of oil specific volume and oil transmissivity to apparent product thickness, which may be used, in turn, to compute spill volume and to model free product plume movement and free product recovery. The method couples a finite element model for radial flow of oil and water to a well with a nonlinear parameter estimation algorithm. Effects of the filter pack around the well in the fluid level response are considered explicitly by the model. The method, which is implemented in the program BAILTEST, is applied to field data from baildown tests. The results indicate that hydrographs of water and oil levels are accurately described by the model

  14. Choline PET based dose-painting in prostate cancer - Modelling of dose effects

    International Nuclear Information System (INIS)

    Niyazi, Maximilian; Bartenstein, Peter; Belka, Claus; Ganswindt, Ute

    2010-01-01

    Several randomized trials have documented the value of radiation dose escalation in patients with prostate cancer, especially in patients with intermediate risk profile. Up to now dose escalation is usually applied to the whole prostate. IMRT and related techniques currently allow for dose escalation in sub-volumes of the organ. However, the sensitivity of the imaging modality and the fact that small islands of cancer are often dispersed within the whole organ may limit these approaches with regard to a clear clinical benefit. In order to assess potential effects of a dose escalation in certain sub-volumes based on choline PET imaging a mathematical dose-response model was developed. Based on different assumptions for α/β, γ50, sensitivity and specificity of choline PET, the influence of the whole prostate and simultaneous integrated boost (SIB) dose on tumor control probability (TCP) was calculated. Based on the given heterogeneity of all potential variables certain representative permutations of the parameters were chosen and, subsequently, the influence on TCP was assessed. Using schedules with 74 Gy within the whole prostate and a SIB dose of 90 Gy the TCP increase ranged from 23.1% (high detection rate of choline PET, low whole prostate dose, high γ50/ASTRO definition for tumor control) to 1.4% TCP gain (low sensitivity of PET, high whole prostate dose, CN + 2 definition for tumor control) or even 0% in selected cases. The corresponding initial TCP values without integrated boost ranged from 67.3% to 100%. According to a large data set of intermediate-risk prostate cancer patients the resulting TCP gains ranged from 22.2% to 10.1% (ASTRO definition) or from 13.2% to 6.0% (CN + 2 definition). Although a simplified mathematical model was employed, the presented model allows for an estimation in how far given schedules are relevant for clinical practice. However, the benefit of a SIB based on choline PET seems less than intuitively expected. Only under the

  15. Selenite Treatment Inhibits LAPC-4 Tumor Growth and Prostate-Specific Antigen Secretion in a Xenograft Model of Human Prostate Cancer

    International Nuclear Information System (INIS)

    Bhattacharyya, Rumi S.; Husbeck, Bryan; Feldman, David; Knox, Susan J.

    2008-01-01

    Purpose: Selenium compounds have known chemopreventive effects on prostate cancer. However selenite, an inorganic form of selenium, has not been extensively studied as a treatment option for prostate cancer. Our previous studies have demonstrated the inhibition of androgen receptor expression and androgen stimulated prostate-specific antigen (PSA) expression by selenite in human prostate cancer cell lines. In this study, we investigated the in vivo effects of selenite as a therapy to treat mice with established LAPC-4 tumors. Methods and Materials: Male mice harboring androgen-dependent LAPC-4 xenograft tumors were treated with selenite (2 mg/kg intraperitoneally three times per week) or vehicle for 42 days. In addition, androgen-independent LAPC-4 xenograft tumors were generated in female mice over 4 to 6 months. Once established, androgen-independent LAPC-4 tumor fragments were passaged into female mice and were treated with selenite or vehicle for 42 days. Changes in tumor volume and serum PSA levels were assessed. Results: Selenite significantly decreased androgen-dependent LAPC-4 tumor growth in male mice over 42 days (p < 0.001). Relative tumor volume was decreased by 41% in selenite-treated animals compared with vehicle-treated animals. The inhibition of LAPC-4 tumor growth corresponded to a marked decrease in serum PSA levels (p < 0.01). In the androgen-independent LAPC-4 tumors in female mice, selenite treatment decreased tumor volume by 58% after 42 days of treatment (p < 0.001). Conclusions: These results suggest that selenite may have potential as a novel therapeutic agent to treat both androgen-dependent and androgen-independent prostate cancer

  16. Dosimetry in VMAT for prostate using ionization chambers of different volumes; Verificacao dosimetrica em VMAT para prostata com camaras de ionizacao de volumes diferentes

    Energy Technology Data Exchange (ETDEWEB)

    Groppo, Daniela P.; Anderson, Ernani; Pavan, Guilherme A., E-mail: danielagroppo@grupocoi.com, E-mail: ernanianderson@grupocoi.com [Clinicas Oncologicas Integradas (Grupo COI), Rio de Janeiro, RJ (Brazil); Caldas, Linda V.E., E-mail: lcaldas@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2016-07-01

    The volumetric modulated arc therapy is one of the most modern radiotherapy techniques. The advents of this modality in the dose delivery can also contribute to errors during the execution of the treatment, therefore various types of quality control are carried out. The individual assessment of dose delivered to the patient is also an important quality control test and required by the current regulations. The objective of this study was to evaluate the use of different volume ionization chambers for dosimetry of VMAT treatments for prostate cancer. Three ionization chambers were evaluated and all of them showed satisfactory results. (author)

  17. Comparison of MR imaging and urodynamic findings in benign prostatic hyperplasia

    International Nuclear Information System (INIS)

    Alam, A.M.; Ishida, Jun; Igawa, Mikio; Sugimura, Kazuro; Okizuka, Hiromi

    2000-01-01

    In benign prostatic hyperplasia (BPH), it is uncertain whether the size of the prostate is related to the degree of urodynamically demonstrated bladder outlet obstruction. We compared MR imaging findings and urodynamic data in patients with surgically confirmed BPH. We prospectively studied 43 benign prostatic hyperplasia (BPH) patients in whom transurethral resection of the prostate (TURP) was planned. We obtained T1- and T2-weighted images in the transverse and sagittal planes with a 1.5 Tesla superconducting unit. The predicted volume of the inner gland and the peripheral zone were obtained on T2-weighted transverse images. Prostatic protrusion into the urinary bladder (IB protrusion) and the inner gland ratio (IG ratio: inner gland volume/total prostatic volume) were determined. IB protrusion and inner IG ratio were significantly greater in patients with severe stenosis than in those without. A surgical capsule (SC) was seen in 20 of 25 patients (80%) with severe stenosis and 8 of 18 (44%) of those without it. The accuracy of IB protrusion + IG ratio, IB protrusion + surgical capsule, and IB protrusion + IG ratio + surgical capsule was 89%, and that of IG ratio + surgical capsule was 86%. The inner gland ratio, protrusion into the bladder, and presence of surgical capsule were the most important factors in bladder outlet obstruction. The probability of outlet stenosis increases in patients with more than two of these criteria. (author)

  18. Comparison of MR imaging and urodynamic findings in benign prostatic hyperplasia

    Energy Technology Data Exchange (ETDEWEB)

    Alam, A.M.; Ishida, Jun; Igawa, Mikio [Shimane Medical Univ., Izumo (Japan); Sugimura, Kazuro; Okizuka, Hiromi

    2000-04-01

    In benign prostatic hyperplasia (BPH), it is uncertain whether the size of the prostate is related to the degree of urodynamically demonstrated bladder outlet obstruction. We compared MR imaging findings and urodynamic data in patients with surgically confirmed BPH. We prospectively studied 43 benign prostatic hyperplasia (BPH) patients in whom transurethral resection of the prostate (TURP) was planned. We obtained T1- and T2-weighted images in the transverse and sagittal planes with a 1.5 Tesla superconducting unit. The predicted volume of the inner gland and the peripheral zone were obtained on T2-weighted transverse images. Prostatic protrusion into the urinary bladder (IB protrusion) and the inner gland ratio (IG ratio: inner gland volume/total prostatic volume) were determined. IB protrusion and inner IG ratio were significantly greater in patients with severe stenosis than in those without. A surgical capsule (SC) was seen in 20 of 25 patients (80%) with severe stenosis and 8 of 18 (44%) of those without it. The accuracy of IB protrusion + IG ratio, IB protrusion + surgical capsule, and IB protrusion + IG ratio + surgical capsule was 89%, and that of IG ratio + surgical capsule was 86%. The inner gland ratio, protrusion into the bladder, and presence of surgical capsule were the most important factors in bladder outlet obstruction. The probability of outlet stenosis increases in patients with more than two of these criteria. (author)

  19. Transurethral resection of prostate in benign prostatic enlargement with underactive bladder: A retrospective outcome analysis

    Directory of Open Access Journals (Sweden)

    Ashok Kumar Sokhal

    2017-01-01

    Results: The mean follow-up period was 22.4 ± 6.2 months. Mean prostate volume was 42.8 ± 6.4 ml and mean serum prostate-specific antigen was 2.3 ± 1.8 ng/ml. The International Prostate Symptom Score changed from 24.6 ± 4.2 preoperatively to 10.8 ± 5.8 postoperatively which was found statistically significant. Quality of life (QOL score changed from 4.8 ± 1.2 to 2.6 ± 0.4. Twenty-two patients out of 174 remained on a per-urethral catheter or clean intermittent catheterization due to voiding failure after TURP beyond 1 month. Conclusions: TURP should be considered a viable treatment option in men with enlarged prostate with underactive detrusor who had poor response to medical treatment. Preoperative counseling and postoperative follow-up are crucial in the management of such patients.

  20. Long-term follow-up after modern radical prostate cancer radiotherapy

    DEFF Research Database (Denmark)

    Sander, Lotte

    that clinical target volumes are up to 30% smaller on MRI delineation compared to computer tomography delineation. The overall aim of the thesis was to explore the use of MRI target planning and a Nicle-Titanium prostate stent as fiducial marker for both MR-CT co-registration and image guided radiotherapy....... radiotherapy is a well established treatment modality for prostate cancer. Accuracy and precision are key words with regard to optimal survival and minimal toxicity in modern radiotherapy and are fundamentals in modern radiotherapy. Modern imaging has improved the ability to define radiotherapy target volumes......A significant increase in the prostate cancer incidence has made prostate cancer a major health problem in recent years. Because of the often but unfortunately not always indolent nature of the disease, over-diagnosis and over-treatment are relevant clinical and ethic dilemmas. External beam...

  1. Taper-based system for estimating stem volumes of upland oaks

    Science.gov (United States)

    Donald E. Hilt

    1980-01-01

    A taper-based system for estimating stem volumes is developed for Central States upland oaks. Inside bark diameters up the stem are predicted as a function of dbhib, total height, and powers and relative height. A Fortran IV computer program, OAKVOL, is used to predict cubic and board-foot volumes to any desired merchantable top dib. Volumes of...

  2. Estimating wood volume from canopy area in deciduous woodlands ...

    African Journals Online (AJOL)

    In this study we tested the predictive ability of canopy area in estimating wood volume in deciduous woodlands of Zimbabwe. The study was carried out in four sites of different climatic conditions. We used regression analysis to statistically quantify the prediction of wood volume from canopy area at species and stand level ...

  3. Ultrasound and PET-CT image fusion for prostate brachytherapy image guidance

    International Nuclear Information System (INIS)

    Hasford, F.

    2015-01-01

    Fusion of medical images between different cross-sectional modalities is widely used, mostly where functional images are fused with anatomical data. Ultrasound has for some time now been the standard imaging technique used for treatment planning of prostate cancer cases. While this approach is laudable and has yielded some positive results, latest developments have been the integration of images from ultrasound and other modalities such as PET-CT to compliment missing properties of ultrasound images. This study has sought to enhance diagnosis and treatment of prostate cancers by developing MATLAB algorithms to fuse ultrasound and PET-CT images. The fused ultrasound-PET-CT image has shown to contain improved quality of information than the individual input images. The fused image has the property of reduced uncertainty, increased reliability, robust system performance, and compact representation of information. The objective of co-registering the ultrasound and PET-CT images was achieved by conducting performance evaluation of the ultrasound and PET-CT imaging systems, developing image contrast enhancement algorithm, developing MATLAB image fusion algorithm, and assessing accuracy of the fusion algorithm. Performance evaluation of the ultrasound brachytherapy system produced satisfactory results in accordance with set tolerances as recommended by AAPM TG 128. Using an ultrasound brachytherapy quality assurance phantom, average axial distance measurement of 10.11 ± 0.11 mm was estimated. Average lateral distance measurements of 10.08 ± 0.07 mm, 20.01 ± 0.06 mm, 29.89 ± 0.03 mm and 39.84 ± 0.37 mm were estimated for the inter-target distances corresponding to 10 mm, 20 mm, 30 mm and 40 mm respectively. Volume accuracy assessment produced measurements of 3.97 cm 3 , 8.86 cm 3 and 20.11 cm 3 for known standard volumes of 4 cm 3 , 9 cm 3 and 20 cm 3 respectively. Depth of penetration assessment of the ultrasound system produced an estimate of 5.37 ± 0.02 cm

  4. TOTAL WOOD VOLUME ESTIMATION OF EUCALYPTUS SPECIES BY IMAGES OF LANDSAT SATELLITE

    Directory of Open Access Journals (Sweden)

    Elias Fernando Berra

    2012-12-01

    Full Text Available http://dx.doi.org/10.5902/198050987566Models relating spectral answers with biophysical parameters aim estimate variables, like wood volume, without the necessity of frequent field measurements. The objective was to develop models to estimate wood volume by Landsat 5 TM images, supported by regional forest inventory data. The image was geo-referenced and converted to spectral reflectance. After, the images-index NDVI (Normalized Difference Vegetation Index and SR (Simple Ratio was generated. The reflectance values of the bands (TM1, TM2, TM3 e TM4 and of the indices (NDVI and SR was related with the wood volume. The biggest correlation with volume was with the NDVI and SR indices. The variables selection was made by Stepwise method, which returned three regression models as significant to explain the variation in volume. Finally, the best fitted model was selected (volume = -830,95 + 46,05 (SR + 107,47 (TM2, which was applied on the Landsat image where the pixels had started to represent the estimated volume in m³/ha on the Eucalyptus sp. production units. This model, significant at 95% confidence level, explains 68% of the wood volume variation.

  5. Prostatic Inflammation is Determinant for Prostate Overgrowth and Luts Severity in Men with Metabolic Syndrome: Highlights from Two Recently Published Multicentre Studies

    Directory of Open Access Journals (Sweden)

    Mauro Gacci

    2013-12-01

    Full Text Available Introduction: Several evidences have pointed out the possible association between Metabolic Syndrome (MetS and low urinary tract symptoms (LUTS/benign prostate hyperplasia (BPH. Recent epidemiological and histopatological evidences suggested chronic inflammation is a crucial event in BPH pathogenesis. Aim of this study is to demonstrate the correlation among pre-operatory LUTS/BPH severity, MetS features and inflammatory infiltrates in prostatectomy specimens of patients with BPH, highlighting the results of two recently published multicentre studies analyzing all the data from a preclinical and clinical point of view. Materials and methods: We conducted two retrospective study in 271 and 244 consecutive men treated with simple prostatectomy for LUTS/BPH in two tertiary referral centres. Prostate diameters and volume were measured by transrectal ultrasound, LUTS were scored by IPSS, and obstruction diagnosed by uroflowmetry. MetS was defined according to DF & AHA/NHLBI criteria. The inflammatory infiltrate was investigated according to the scoring system of chronic prostatitis (CP-CPPS and scored as inflammation score (IS ranging 3 to 9 and glandular disruption (GD. In addition, we investigated the in vitro inflammatory effects of metabolic insults on human prostatic myofibroblast cells isolated from BPH patients (hBPH. Results: Of 271 men, 86 (31.7% were affected by MetS. Prostatic volume and the anterior-posterior (AP diameter were positively associated to the number of MetS components. Among MetS determinants, only dyslipidaemia (increased serum triglycerides and reduced serum HDL levels was significantly associated with an increased risk of having a prostatic volume >60cm3. IS in prostatectomy specimens showed a step- wise association with number of MetS factors (p=0.001. Dyslipidaemia was the only factor significantly associated with IS. Positive significant correlations among MetS, IS, GD and IPSS Scores were observed. In myofibroblastic h

  6. Prostate-specific antigen density values among patients with symptomatic prostatic enlargement in Nigeria.

    Science.gov (United States)

    Udeh, Emeka I; Nnabugwu, Ikenna I; Ozoemena, Francis O; Ugwumba, Fred O; Aderibigbe, Adesina S O; Ohayi, Samuel R; Echetabu, Kevin N

    2016-06-29

    This study aims to estimate the prostate-specific antigen density (PSAD) cutoff level for detecting prostate cancer (CAP) in Nigerian men with "grey zone PSA" (4-10 ng/ml) and normal digital rectal examination findings. We addressed this research question: Is the international PSAD cutoff of 0.15 ideal for detecting CAP in our symptomatic patients with "grey zone PSA?" To estimate the prostate-specific antigen density (PSAD) cutoff level for detecting CAP in Nigerian men with "grey zone PSA" (4-10 ng/ml) and normal digital rectal examination findings. Prospective. A tertiary medical center in Enugu, Nigeria. Two hundred and fifty-four men with either benign prostatic hyperplasia (BPH) or CAP were recruited. Patients with PSA above 4 ng/ml or abnormal digital rectal examination or hypoechoic lesion in the prostate were biopsied. PSAD and histology report of BPH or CAP. Ninety-seven patients had CAP while 157 had benign prostatic hyperplasia (BPH). Seventy-two patients had their serum PSA value within the range of 4.0 and 10 ng/ml. PSAD cutoff level to detect CAP was 0.04 (sensitivity 95.88 %; specificity 28.7 %). The PSAD cutoff level generated for Nigerian men in this study is 0.04 which is relatively different from international consensus. This PSAD cutoff level has a positive correlation with histology and could detect patients with CAP who have "grey zone PSA."

  7. Direct and simultaneous estimation of cardiac four chamber volumes by multioutput sparse regression.

    Science.gov (United States)

    Zhen, Xiantong; Zhang, Heye; Islam, Ali; Bhaduri, Mousumi; Chan, Ian; Li, Shuo

    2017-02-01

    Cardiac four-chamber volume estimation serves as a fundamental and crucial role in clinical quantitative analysis of whole heart functions. It is a challenging task due to the huge complexity of the four chambers including great appearance variations, huge shape deformation and interference between chambers. Direct estimation has recently emerged as an effective and convenient tool for cardiac ventricular volume estimation. However, existing direct estimation methods were specifically developed for one single ventricle, i.e., left ventricle (LV), or bi-ventricles; they can not be directly used for four chamber volume estimation due to the great combinatorial variability and highly complex anatomical interdependency of the four chambers. In this paper, we propose a new, general framework for direct and simultaneous four chamber volume estimation. We have addressed two key issues, i.e., cardiac image representation and simultaneous four chamber volume estimation, which enables accurate and efficient four-chamber volume estimation. We generate compact and discriminative image representations by supervised descriptor learning (SDL) which can remove irrelevant information and extract discriminative features. We propose direct and simultaneous four-chamber volume estimation by the multioutput sparse latent regression (MSLR), which enables jointly modeling nonlinear input-output relationships and capturing four-chamber interdependence. The proposed method is highly generalized, independent of imaging modalities, which provides a general regression framework that can be extensively used for clinical data prediction to achieve automated diagnosis. Experiments on both MR and CT images show that our method achieves high performance with a correlation coefficient of up to 0.921 with ground truth obtained manually by human experts, which is clinically significant and enables more accurate, convenient and comprehensive assessment of cardiac functions. Copyright © 2016 Elsevier

  8. The combination of ovarian volume and outline has better diagnostic accuracy than prostate-specific antigen (PSA) concentrations in women with polycystic ovarian syndrome (PCOs).

    Science.gov (United States)

    Bili, Eleni; Bili, Authors Eleni; Dampala, Kaliopi; Iakovou, Ioannis; Tsolakidis, Dimitrios; Giannakou, Anastasia; Tarlatzis, Basil C

    2014-08-01

    The aim of this study was to determine the performance of prostate specific antigen (PSA) and ultrasound parameters, such as ovarian volume and outline, in the diagnosis of polycystic ovary syndrome (PCOS). This prospective, observational, case-controlled study included 43 women with PCOS, and 40 controls. Between day 3 and 5 of the menstrual cycle, fasting serum samples were collected and transvaginal ultrasound was performed. The diagnostic performance of each parameter [total PSA (tPSA), total-to-free PSA ratio (tPSA:fPSA), ovarian volume, ovarian outline] was estimated by means of receiver operating characteristic (ROC) analysis, along with area under the curve (AUC), threshold, sensitivity, specificity as well as positive (+) and negative (-) likelihood ratios (LRs). Multivariate logistical regression models, using ovarian volume and ovarian outline, were constructed. The tPSA and tPSA:fPSA ratio resulted in AUC of 0.74 and 0.70, respectively, with moderate specificity/sensitivity and insufficient LR+/- values. In the multivariate logistic regression model, the combination of ovarian volume and outline had a sensitivity of 97.7% and a specificity of 97.5% in the diagnosis of PCOS, with +LR and -LR values of 39.1 and 0.02, respectively. In women with PCOS, tPSA and tPSA:fPSA ratio have similar diagnostic performance. The use of a multivariate logistic regression model, incorporating ovarian volume and outline, offers very good diagnostic accuracy in distinguishing women with PCOS patients from controls. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. Inference for lidar-assisted estimation of forest growing stock volume

    Science.gov (United States)

    Ronald E. McRoberts; Erik Næsset; Terje. Gobakken

    2013-01-01

    Estimates of growing stock volume are reported by the national forest inventories (NFI) of most countries and may serve as the basis for aboveground biomass and carbon estimates as required by an increasing number of international agreements. The probability-based (design-based) statistical estimators traditionally used by NFIs to calculate estimates are generally...

  10. A study of prostate delineation referenced against a gold standard created from the visible human data

    International Nuclear Information System (INIS)

    Gao Zhanrong; Wilkins, David; Eapen, Libni; Morash, Christopher; Wassef, Youssef; Gerig, Lee

    2007-01-01

    Purpose: To measure inter- and intra-observer variation and systematic error in CT based prostate delineation, where individual delineations are referenced against a gold standard produced from photographic anatomical images from the Visible Human Project (VHP). Materials and methods: The CT and anatomical images of the VHP male form the basic data set for this study. The gold standard was established based on 1 mm thick anatomical photographic images. These were registered against the 3 mm thick CT images that were used for target delineation. A total of 120 organ delineations were performed by six radiation oncologists. Results: The physician delineated prostate volume was on average 30% larger than the 'true' prostate volume, but on average included only 84% of the gold standard volume. Our study found a systematic delineation error such that posterior portions of the prostate were always missed while anteriorly some normal tissue was always defined as target. Conclusions: Our data suggest that radiation oncologists are more concerned with the unintentional inclusion of rectal tissue than they are in missing prostate volume. In contrast, they are likely to overextend the anterior boundary of the prostate to encompass normal tissue such as the bladder

  11. The diagnostic value of transrectal ultrasonography combined with prostate specific antigen density in prostate cancer

    International Nuclear Information System (INIS)

    Shen Weidong; Zha Yueqin; Wang Ajun; Hou Jianquan; Ouyang Jun

    2008-01-01

    Objective: To discuss the value of transrectal ultrasound (TRUS) and prostate specific antigen density (PSAD) and prostate specific antigen density of transition zone (PSATZ) for diagnosing prostate cancer. Methods: Chose cases of prostate cancer(PCa) and benign prostate hyperplasia(BPH), each was 19, all the eases were authenticated by pathology. Then compared the characteristic of prostate cancer with prostate specific antigen (PSA) and homologous PSAD, PSATZ. Results: Fourteen cases were discovered by ultrasound among the 19 PCa, the others were only diagnosed as BPH.Among the 14 cases, diffuse pathological changing was found in 1 patient, nodular changing in 13 patients (16 nodules were found). Among the 16 nodules, there were 13 hypoechoic nodules (75%) and 3 hyper echoic or compound echoic nodules (25%), and there were 13 nodules in outer zone and 3 nodules in transition zone.The PSA of PCa and BPH was 8.61-98.65 ng/ml [(48.79±25.34)ng/ml] and 0.58-28.36 ng/ml [(9.73±8.19)ng/ml]. There were no significant differences between the volume of prostate and prostate transition zone (P>0.05), but there were significant differences between the PSAD and PSATZ (P<0.01). That the PCa group was higher than that in the BPH group. Conclusion: It is higher sensitive but bess specific in diagonosis PCa by means of transrectal ultrasound. If it is combined with PSAD and PSATZ, the diagnostic rate of PCa is highly raised. (authors)

  12. Comparison of 2D and 3D algorithms for adding a margin to the gross tumor volume in the conformal radiotherapy planning of prostate cancer

    International Nuclear Information System (INIS)

    Khoo, Vincent S.; Bedford, James L.; Webb, Steve; Dearnaley, David P.

    1998-01-01

    Purpose: To evaluate the adequacy of tumor volume coverage using a three-dimensional (3D) margin-growing algorithm compared to a two-dimensional (2D) margin-growing algorithm in the conformal radiotherapy planning of prostate cancer. Methods and Materials: Two gross tumor volumes (GTV) were segmented in each of 10 patients with localized prostate cancer; prostate gland only (PO) and prostate with seminal vesicles (PSV). A predetermined margin of 10 mm was applied to these two groups (PO and PSV) using both 2D and 3D margin-growing algorithms. The 2D algorithm added a transaxial margin to each GTV slice, whereas the 3D algorithm added a volumetric margin all around the GTV. The true planning target volume (PTV) was defined as the region delineated by the 3D algorithm. The adequacy of geometric coverage of the GTV by the two algorithms was examined in a series of transaxial planes throughout the target volume. Results: The 2D margin-growing algorithm underestimated the PTV by 17% (range 12-20) in the PO group and by 20% (range 13-28) for the PSV group when compared to the 3D-margin algorithm. For the PO group, the mean transaxial difference between the 2D and 3D algorithm was 3.8 mm inferiorly (range 0-20), 1.8 mm centrally (range 0-9), and 4.4 mm superiorly (range 0-22). Considering all of these regions, the mean discrepancy anteriorly was 5.1 mm (range 0-22), posteriorly 2.2 (range 0-20), right border 2.8 mm (range 0-14), and left border 3.1 mm (range 0-12). For the PSV group, the mean discrepancy in the inferior region was 3.8 mm (range 0-20), central region of the prostate was 1.8 mm ( range 0-9), the junction region of the prostate and the seminal vesicles was 5.5 mm (range 0-30), and the superior region of the seminal vesicles was 4.2 mm (range 0-55). When the different borders were considered in the PSV group, the mean discrepancies for the anterior, posterior, right, and left borders were 6.4 mm (range 0-55), 2.5 mm (range 0-20), 2.6 mm (range 0-14), and 3

  13. Prostate specific antigen and acinar density: a new dimension, the "Prostatocrit".

    Science.gov (United States)

    Robinson, Simon; Laniado, Marc; Montgomery, Bruce

    2017-01-01

    Prostate-specific antigen densities have limited success in diagnosing prostate cancer. We emphasise the importance of the peripheral zone when considered with its cellular constituents, the "prostatocrit". Using zonal volumes and asymmetry of glandular acini, we generate a peripheral zone acinar volume and density. With the ratio to the whole gland, we can better predict high grade and all grade cancer. We can model the gland into its acinar and stromal elements. This new "prostatocrit" model could offer more accurate nomograms for biopsy. 674 patients underwent TRUS and biopsy. Whole gland and zonal volumes were recorded. We compared ratio and acinar volumes when added to a "clinic" model using traditional PSA density. Univariate logistic regression was used to find significant predictors for all and high grade cancer. Backwards multiple logistic regression was used to generate ROC curves comparing the new model to conventional density and PSA alone. Prediction of all grades of prostate cancer: significant variables revealed four significant "prostatocrit" parameters: log peripheral zone acinar density; peripheral zone acinar volume/whole gland acinar volume; peripheral zone acinar density/whole gland volume; peripheral zone acinar density. Acinar model (AUC 0.774), clinic model (AUC 0.745) (P=0.0105). Prediction of high grade prostate cancer: peripheral zone acinar density ("prostatocrit") was the only significant density predictor. Acinar model (AUC 0.811), clinic model (AUC 0.769) (P=0.0005). There is renewed use for ratio and "prostatocrit" density of the peripheral zone in predicting cancer. This outperforms all traditional density measurements. Copyright® by the International Brazilian Journal of Urology.

  14. Dosimetric benefit of DMLC tracking for conventional and sub-volume boosted prostate intensity-modulated arc radiotherapy

    Science.gov (United States)

    Pommer, Tobias; Falk, Marianne; Poulsen, Per R.; Keall, Paul J.; O'Brien, Ricky T.; Meidahl Petersen, Peter; Rosenschöld, Per Munck af

    2013-04-01

    This study investigated the dosimetric impact of uncompensated motion and motion compensation with dynamic multileaf collimator (DMLC) tracking for prostate intensity modulated arc therapy. Two treatment approaches were investigated; a conventional approach with a uniform radiation dose to the target volume and an intraprostatic lesion (IPL) boosted approach with an increased dose to a subvolume of the prostate. The impact on plan quality of optimizations with a leaf position constraint, which limited the distance between neighbouring adjacent MLC leaves, was also investigated. Deliveries were done with and without DMLC tracking on a linear acceleration with a high-resolution MLC. A cylindrical phantom containing two orthogonal diode arrays was used for dosimetry. A motion platform reproduced six patient-derived prostate motion traces, with the average displacement ranging from 1.0 to 8.9 mm during the first 75 s. A research DMLC tracking system was used for real-time motion compensation with optical monitoring for position input. The gamma index was used for evaluation, with measurements with a static phantom or the planned dose as reference, using 2% and 2 mm gamma criteria. The average pass rate with DMLC tracking was 99.9% (range 98.7-100%, measurement as reference), whereas the pass rate for untracked deliveries decreased distinctly as the average displacement increased, with an average pass rate of 61.3% (range 32.7-99.3%). Dose-volume histograms showed that DMLC tracking maintained the planned dose distributions in the presence of motion whereas traces with >3 mm average displacement caused clear plan degradation for untracked deliveries. The dose to the rectum and bladder had an evident dependence on the motion direction and amplitude for untracked deliveries, and the dose to the rectum was slightly increased for IPL boosted plans compared to conventional plans for anterior motion with large amplitude. In conclusion, optimization using a leaf position

  15. Data from frequency-volume charts versus symptom scores and quality of life score in men with lower urinary tract symptoms due to benign prostatic hyperplasia

    NARCIS (Netherlands)

    van Venrooij, GEPM; Eckhardt, MD; Gisolf, KWH; Boon, TA

    Objective: The aim is to study the relations between reported data on frequency-volume charts and the American Urological Association (AUA) symptom scores and quality of life score. Methods: Males with lower urinary tract symptoms due to benign prostatic hyperplasia (BPH), were consecutively

  16. Factors Predicting a Good Symptomatic Outcome After Prostate Artery Embolisation (PAE).

    Science.gov (United States)

    Maclean, D; Harris, M; Drake, T; Maher, B; Modi, S; Dyer, J; Somani, B; Hacking, N; Bryant, T

    2018-02-26

    As prostate artery embolisation (PAE) becomes an established treatment for benign prostatic obstruction, factors predicting good symptomatic outcome remain unclear. Pre-embolisation prostate size as a predictor is controversial with a handful of papers coming to conflicting conclusions. We aimed to investigate if an association existed in our patient cohort between prostate size and clinical benefit, in addition to evaluating percentage volume reduction as a predictor of symptomatic outcome following PAE. Prospective follow-up of 86 PAE patients at a single institution between June 2012 and January 2016 was conducted (mean age 64.9 years, range 54-80 years). Multiple linear regression analysis was performed to assess strength of association between clinical improvement (change in IPSS) and other variables, of any statistical correlation, through Pearson's bivariate analysis. No major procedural complications were identified and clinical success was achieved in 72.1% (n = 62) at 12 months. Initial prostate size and percentage reduction were found to have a significant association with clinical improvement. Multiple linear regression analysis (r 2  = 0.48) demonstrated that percentage volume reduction at 3 months (r = 0.68, p < 0.001) had the strongest correlation with good symptomatic improvement at 12 months after adjusting for confounding factors. Both the initial prostate size and percentage volume reduction at 3 months predict good symptomatic outcome at 12 months. These findings therefore aid patient selection and counselling to achieve optimal outcomes for men undergoing prostate artery embolisation.

  17. Individualized planning target volumes for intrafraction motion during hypofractionated intensity-modulated radiotherapy boost for prostate cancer

    International Nuclear Information System (INIS)

    Cheung, Patrick; Sixel, Katharina; Morton, Gerard; Loblaw, D. Andrew; Tirona, Romeo; Pang, Geordi; Choo, Richard; Szumacher, Ewa; DeBoer, Gerrit; Pignol, Jean-Philippe

    2005-01-01

    Purpose: The objective of the study was to access toxicities of delivering a hypofractionated intensity-modulated radiotherapy (IMRT) boost with individualized intrafraction planning target volume (PTV) margins and daily online correction for prostate position. Methods and materials: Phase I involved delivering 42 Gy in 21 fractions using three-dimensional conformal radiotherapy, followed by a Phase II IMRT boost of 30 Gy in 10 fractions. Digital fluoroscopy was used to measure respiratory-induced motion of implanted fiducial markers within the prostate. Electronic portal images were taken of fiducial marker positions before and after each fraction of radiotherapy during the first 9 days of treatment to calculate intrafraction motion. A uniform 10-mm PTV margin was used for the first phase of treatment. PTV margins for Phase II were patient-specific and were calculated from the respiratory and intrafraction motion data obtained from Phase I. The IMRT boost was delivered with daily online correction of fiducial marker position. Acute toxicity was measured using National Cancer Institute Common Toxicity Criteria, version 2.0. Results: In 33 patients who had completed treatment, the average PTV margin used during the hypofractionated IMRT boost was 3 mm in the lateral direction, 3 mm in the superior-inferior direction, and 4 mm in the anteroposterior direction. No patients developed acute Grade 3 rectal toxicity. Three patients developed acute Grade 3 urinary frequency and urgency. Conclusions: PTV margins can be reduced significantly with daily online correction of prostate position. Delivering a hypofractionated boost with this high-precision IMRT technique resulted in acceptable acute toxicity

  18. MRI to assess chemoprevention in transgenic adenocarcinoma of mouse prostate (TRAMP)

    International Nuclear Information System (INIS)

    Arbab, Ali S; Shankar, Adarsh; Varma, Nadimpalli RS; Deeb, Dorrah; Gao, Xiaohua; Iskander, ASM; Janic, Branislava; Ali, Meser M; Gautam, Subhash C

    2011-01-01

    The current method to determine the efficacy of chemoprevention in TRAMP mouse model of carcinoma of prostate (CaP) is by extracting and weighing the prostate at different time points or by immunohistochemistry analysis. Non-invasive determination of volumes of prostate glands and seminal vesicles before, during and after treatment would be valuable in investigating the efficacy of newer chemopreventive agents in CaP. The purpose of this study was to determine whether in vivo magnetic resonance imaging (MRI) using a 3 tesla clinical MRI system can be used to follow the effect of chemoprevention in TRAMP model of mouse CaP. Mice were randomized into control and treated groups. The animals in treated group received 10 µmol/kg of CDDO, 5 days a week for 20 weeks. Animals underwent in vivo MRI of prostate gland and seminal vesicles by a clinical 3 Tesla MRI system just before (at 5 weeks), during and at the end of treatment, at 25 weeks. T1-weighted and fat saturation (FATSAT) multiecho fast spin echo T2- weighted images (T2WI) were acquired. Volume of the prostate glands and seminal vesicles was determined from MR images. T2 signal intensity changes in the seminal vesicles were determined by subtracting higher echo time (TE) from lower TE T2WI. Following treatments all animals were sacrificed, prostate and seminal vesicles collected, and the tissues prepared for histological staining. All data were expressed as mean ± 1 standard deviation. Two-way or multivariate analysis of variance followed by post-hoc test was applied to determine the significant differences. A p-value of <0.05 was considered significant. Histological analysis indicated tumor in 100% of control mice, whereas 10% of the treated mice showed tumor in prostate gland. Both MRI and measured prostate weights showed higher volume/weight in control mouse group. MRI showed significantly higher volume of seminal vesicles in control animals and T2 signal intensity changes in seminal vesicles of control mice

  19. Unbiased estimation of the liver volume by the Cavalieri principle using magnetic resonance images

    International Nuclear Information System (INIS)

    Sahin, Buenyamin; Emirzeoglu, Mehmet; Uzun, Ahmet; Incesu, Luetfi; Bek, Yueksel; Bilgic, Sait; Kaplan, Sueleyman

    2003-01-01

    Objective: It is often useful to know the exact volume of the liver, such as in monitoring the effects of a disease, treatment, dieting regime, training program or surgical application. Some non-invasive methodologies have been previously described which estimate the volume of the liver. However, these preliminary techniques need special software or skilled performers and they are not ideal for daily use in clinical practice. Here, we describe a simple, accurate and practical technique for estimating liver volume without changing the routine magnetic resonance imaging scanning procedure. Materials and methods: In this study, five normal livers, obtained from cadavers, were scanned by 0.5 T MR machine, in horizontal and sagittal planes. The consecutive sections, in 10 mm thickness, were used to estimate the whole volume of the liver by means of the Cavalieri principle. The volume estimations were done by three different performers to evaluate the reproducibility. Results: There are no statistical differences between the performers and real liver volumes (P>0.05). There is also high correlation between the estimates of performers and the real liver volume (r=0.993). Conclusion: We conclude that the combination of MR imaging with the Cavalieri principle is a non-invasive, direct and unbiased technique that can be safely applied to estimate liver volume with a very moderate workload per individual

  20. Use of CT or MR dosimetry in high dose rate (HDR) brachytherapy for prostate cancer

    International Nuclear Information System (INIS)

    Liu, C.; Das, R.; See, A.; Duchesne, G.M.; Van Dyk, S.; Tai, K.H.

    2003-01-01

    Brachytherapy (BT) has, in recent years, become a well-utilised treatment option for prostate cancer. Tumour control probability relies on accurate dosimetry, which in turn relies on the accurate definition of the prostate gland. In external beam radiotherapy and BT, MRI has been shown to be a superior imaging modality when delineating the prostate gland especially at the apex. To date, data on MRI planning in prostate BT has focussed mainly on permanent interstitial implants. No data currently exists comparing MRI vs CT planning in HDR BT and its subsequent impact on prostate dosimetry. To determine the effects of MRI vs CT in HDR BT with respect to prostatic volumes and normal tissue doses, with the evaluations made using dose-volume histograms (DVH). Dosimetry parameters derived using CT and MRI (T2 weighted) scans of 11 patients who had received TRUS guided implants for HDR BT, were compared using the PlatoTM computer planning system. Treatment plans were generated on volumes marked by the same radiation oncologist for each patient. Comparison was made of the treatment plans (dosimetry) between: 1. CT generated plans; 2. CT generated plans assessed using MRI marked volumes and 3. MRI generated plans. We confirm the previously reported results that CT scans can overestimate prostatic volumes compared with MRI. Variations were noted in CT and MRI based plans that may allow improved sparing of the rectum and urethra when using MRI planning. The main disadvantages of using MRI scans are access to facilities as well as identifying a dummy source to adequately define the tips of our catheters. It is feasible to utilise MRI scans for HDR BT planning. The clearer definition of anatomical structures has added advantages when contouring the prostate

  1. Slides of News in precocious diagnostic in prostate cancer

    International Nuclear Information System (INIS)

    Garcia Guido, L.

    1998-01-01

    Collection of slides about diagnostic, techniques and treatment of prostate tumors.Studies made of point of view age, sex and prostate volume, race and population. As well as Screening, therapeutic results, morbidity level and tumors classification were presented in the working day to pay Homenage to Prof. Jorge Lockart

  2. Is transition zone index useful in assessing bladder outflow obstruction due to benign prostatic hyperplasia?: A prospective study

    Directory of Open Access Journals (Sweden)

    S L Sailo

    2006-01-01

    Full Text Available BACKGROUND: Benign prostatic enlargement (BPE is the commonest cause of bladder outlet obstruction in men above 50 years of age. Though pressure-flow study is the gold standard in establishing outlet obstruction, it is associated with definite morbidity. Several noninvasive parameters are described to diagnose outlet obstruction due to BPE and evaluate treatment efficacy. AIM: We studied the role of transitional zone index (TZI in assessing bladder outlet obstruction (BOO due to BPE. SETTING AND DESIGN: Prospective hospital-based cross-sectional diagnostic study. MATERIALS AND METHODS: Thirty-five men aged between 50 and 77 years with untreated lower urinary tract symptoms due to BPE were studied. Patients with prostate cancer, prostatitis, active UTI urethral stricture, neurovesical dysfunction and diabetes mellitus were excluded. All patients underwent a standard assessment using the American Urological Association (AUA symptom score, uroflow, pressure-flow (PF study and transrectal ultrasound (TRUS estimation of TZI. Investigators undertaking PF studies and TRUS were blinded to the investigation of others. From the PF studies, Abrams Griffith (AG number was calculated. Based on this, patients were grouped into obstructed (AG>40 and unobstructed (AG< 40 groups. STATISTICAL ANALYSIS: TZI was calculated and compared with PF studies using Mann-Whitney U test, logistic regression analysis and receiver operator characteristic curve (ROC. RESULTS: The mean age was 63.2 years (SD. The mean AUA scores and peak flow rate were 16.7 and 7.5 ml/sec, respectively. Of the 35 men, 21 were obstructed and 14 were unobstructed. TZI was not significantly different between the two groups, while the differences in age, AUA symptom score, prostate volume and TZ volume were statistically significant. Logistic regression model did not show any independent effect of TZI in predicting obstruction. ROC curve showed a poor overall accuracy in diagnosing obstruction due

  3. Changes of dose delivery distribution within the first month after permanent interstitial brachytherapy for prostate cancer

    International Nuclear Information System (INIS)

    Pinkawa, M.; Gagel, B.; Piroth, M.D.; Eble, M.J.; Borchers, H.; Jakse, G.

    2006-01-01

    Purpose: to evaluate changes of dose distribution for both the prostate and the surrounding tissues after permanent brachy therapy as monotherapy for prostate cancer. Patients and methods: in 35 patients, CT scans were performed before, 1 day after (day 1) and 1 month after the implantation (day 30). Changes of prostate volume, dosimetric parameters, and distances between posterior prostate contour and rectal wall as well as prostate contour and prescription isodose were analyzed. Results: prostate volume increased from 37 ± 11 cm 3 (mean ± standard deviation) to 49 ± 12 cm 3 on day 1 and dropped to 40 ± 9 cm 3 on day 30. Prostate V 100 increased from 87 ± 7% to 90 ± 7%, prostate D90 from 138 ± 21 Gy to 151 ± 30 Gy. Mean rectal volume covered by the prescription isodose rose from 0.4 cm 3 to 1.0 cm 3 ; a changing distance between the prostate and rectal wall was excluded as a reason. Prostate D 90 (day 1) and rectum V 100 (day 30) proved to be significantly higher for larger prostate sizes. The distance between the prescription isodose and the prostate contour increased particularly at the posterior and inferior borders: 1.9 mm and 2.5 mm on average (0.1 mm and -0.7 mm at opposite borders, respectively). Conclusion: with a decreasing edema of the prostate, an increasing dose both to the prostate and the anterior rectal wall resulted - the postimplant interval is essential for the dosimetry report. Due to a larger edema, a higher prescription dose might be needed for optimal cancer control in smaller prostates. Compared to day 1, the dose to the surrounding tissues increased on day 30, particularly at the posterior and inferior prostate borders. (orig.)

  4. Inverse treatment planning based on MRI for HDR prostate brachytherapy

    International Nuclear Information System (INIS)

    Citrin, Deborah; Ning, Holly; Guion, Peter; Li Guang; Susil, Robert C.; Miller, Robert W.; Lessard, Etienne; Pouliot, Jean; Xie Huchen; Capala, Jacek; Coleman, C. Norman; Camphausen, Kevin; Menard, Cynthia

    2005-01-01

    Purpose: To develop and optimize a technique for inverse treatment planning based solely on magnetic resonance imaging (MRI) during high-dose-rate brachytherapy for prostate cancer. Methods and materials: Phantom studies were performed to verify the spatial integrity of treatment planning based on MRI. Data were evaluated from 10 patients with clinically localized prostate cancer who had undergone two high-dose-rate prostate brachytherapy boosts under MRI guidance before and after pelvic radiotherapy. Treatment planning MRI scans were systematically evaluated to derive a class solution for inverse planning constraints that would reproducibly result in acceptable target and normal tissue dosimetry. Results: We verified the spatial integrity of MRI for treatment planning. MRI anatomic evaluation revealed no significant displacement of the prostate in the left lateral decubitus position, a mean distance of 14.47 mm from the prostatic apex to the penile bulb, and clear demarcation of the neurovascular bundles on postcontrast imaging. Derivation of a class solution for inverse planning constraints resulted in a mean target volume receiving 100% of the prescribed dose of 95.69%, while maintaining a rectal volume receiving 75% of the prescribed dose of <5% (mean 1.36%) and urethral volume receiving 125% of the prescribed dose of <2% (mean 0.54%). Conclusion: Systematic evaluation of image spatial integrity, delineation uncertainty, and inverse planning constraints in our procedure reduced uncertainty in planning and treatment

  5. Models for estimation of tree volume in the miombo woodlands of ...

    African Journals Online (AJOL)

    Volume of trees is an important parameter in forest management, but only volume models with limited geographical and tree size coverage have previously been developed for Tanzanian miombo woodlands. This study developed models for estimating total, merchantable stem and branches volume applicable for the entire ...

  6. K East basin sludge volume estimates for integrated water treatment system

    International Nuclear Information System (INIS)

    Pearce, K.L.

    1998-01-01

    This document provides estimates of the volume of sludge expected from Integrated Process Strategy (IPS) processing of the fuel elements and in the fuel storage canisters in K East Basin. The original estimates were based on visual observations of fuel element condition in the basin and laboratory measurements of canister sludge density. Revision 1 revised the volume estimates of sludge from processing of the fuel elements based on additional data from evaluations of material from the KE Basin fuel subsurface examinations. A nominal Working Estimate and an upper level Working Bound is developed for the canister sludge and the fuel wash sludge components in the KE Basin

  7. Prostatic cancer: intolerance and morbidity of external radiotherapy

    International Nuclear Information System (INIS)

    Douchez, J.; Fregevu, Y.; Allain, Y.M.; Cellier, P.; Fenton, J.; Hay, M.; Le Bourgeois, J.P.; Vincent, F.

    1985-01-01

    The pertherapeutic intolerance and morbidity are analyzed in a groupe of 597 patients with localized prostatic carcinoma treated by definitive radiotherapy between 1975 and 1982. Minimum follow-up is 2 years, median is 46 months. The results are compared to following parameters: associated diseases, associated surgical treatments, doses and irradiated target volumes. Pertherapeutic intolerance manifestations were found in 73% of patients and lead to complications. Urinary incontinence and chronic cystitis were more frequent after transurethral resection or prostatic target volume and by split course irradiation. Chronic diarrhea was more frequent when using large target volume. Leg edema was closely associated with pelvic lymphadenectomy. The control of pertherapeutic manifestations and the prevention of complications should improve survival in patients treated by external radiotherapy [fr

  8. Usefulness of transrectal ultrasound in diagnosing prostate cancer: comparison with digital rectal examination, prostate-specific antigen and prostate-specific antigen density

    International Nuclear Information System (INIS)

    Yoon, Jung Hwan; Kim, Bo Hyun; Choi, Sang Hee; Kim, Seung Hoon; Choi, Han Yong; Chai, Soo Eung; Yoon, Hye Kyung; Lee, Soon Jin; Choo, In Wook; Kim, Bo Kyung

    1998-01-01

    To determine the usefulness of transrectal ultrasonography (TRUS) in diagnosing prostate cancer by comparing the sensitivity, specificity, accuracy, and positive and negative predictive values of TRUS with those of serum prostate-specific antigen (PSA), prostate-specific antigen density (PSAD) and digital rectal examination (DRE). Two hundred and ten consecutive patients underwent TRUS-guided prostate biopsy due to elevated PSA and/or abnormal findings on TRUS or DRE. The TRUS findings were analyzed and correlated with pathological diagnosis. PSAD was calculated by dividing the serum PSA level by the prostate volume calculated on TRUS. The sensitivity, specificity, accuracy, and positive and negative predictive values of TRUS were compared with those of PSA, PSAD and DRE. Using ROC curve analysis, the combinations of these diagnostic methods were also evaluated for the determination of efficacy in diagnosing prostate cancer. The sensitivity and specificity of serum PSA (cut-off level, 4ng/ml), PSAD (cut-off level, 0.15ng/ml/cm 3 ), DRE, and TRUS were 96%/17%, 96%/37%, 72%/62%, and 89%/68%, respectively. On TRUS, the sensitivity and specificity of low echoic lesions and those of irregular outer margin were 89%/69%, and 60%/90%, respectively. TRUS was statistically more accurate than other diagnostic methods. Of the combinations of diagnostic methods, TRUS and PSAD were most accurate. TRUS demonstrated lower sensitivity but higher specificity than PSA or PSAD. Although it is an accurate modality for the diagnosis of prostate cancer, it cannot be used as a confirmative test due to its relatively low positive predictive value. A combination of diagnostic methods and random biopsy is needed in patients in whom prostate cancer is suspected.=20

  9. Abdominal fat volume estimation by stereology on CT: a comparison with manual planimetry.

    Science.gov (United States)

    Manios, G E; Mazonakis, M; Voulgaris, C; Karantanas, A; Damilakis, J

    2016-03-01

    To deploy and evaluate a stereological point-counting technique on abdominal CT for the estimation of visceral (VAF) and subcutaneous abdominal fat (SAF) volumes. Stereological volume estimations based on point counting and systematic sampling were performed on images from 14 consecutive patients who had undergone abdominal CT. For the optimization of the method, five sampling intensities in combination with 100 and 200 points were tested. The optimum stereological measurements were compared with VAF and SAF volumes derived by the standard technique of manual planimetry on the same scans. Optimization analysis showed that the selection of 200 points along with the sampling intensity 1/8 provided efficient volume estimations in less than 4 min for VAF and SAF together. The optimized stereology showed strong correlation with planimetry (VAF: r = 0.98; SAF: r = 0.98). No statistical differences were found between the two methods (VAF: P = 0.81; SAF: P = 0.83). The 95% limits of agreement were also acceptable (VAF: -16.5%, 16.1%; SAF: -10.8%, 10.7%) and the repeatability of stereology was good (VAF: CV = 4.5%, SAF: CV = 3.2%). Stereology may be successfully applied to CT images for the efficient estimation of abdominal fat volume and may constitute a good alternative to the conventional planimetric technique. Abdominal obesity is associated with increased risk of disease and mortality. Stereology may quantify visceral and subcutaneous abdominal fat accurately and consistently. The application of stereology to estimating abdominal volume fat reduces processing time. Stereology is an efficient alternative method for estimating abdominal fat volume.

  10. Erectile function after prostate brachytherapy

    International Nuclear Information System (INIS)

    Merrick, Gregory S.; Butler, Wayne M.; Wallner, Kent E.; Galbreath, Robert W.; Anderson, Richard L.; Kurko, Brian S.; Lief, Jonathan H.; Allen, Zachariah A.

    2005-01-01

    Purpose: To evaluate erectile function after permanent prostate brachytherapy using a validated patient-administered questionnaire and to determine the effect of multiple clinical, treatment, and dosimetric parameters on penile erectile function. Methods and materials: A total of 226 patients with preimplant erectile function determined by the International Index of Erectile Function (IIEF) questionnaire underwent permanent prostate brachytherapy in two prospective randomized trials between February 2001 and January 2003 for clinical Stage T1c-T2c (2002 American Joint Committee on Cancer) prostate cancer. Of the 226 patients, 132 were potent before treatment and, of those, 128 (97%) completed and returned the IIEF questionnaire after brachytherapy. The median follow-up was 29.1 months. Potency was defined as an IIEF score of ≥13. The clinical, treatment, and dosimetric parameters evaluated included patient age; preimplant IIEF score; clinical T stage; pretreatment prostate-specific antigen level; Gleason score; elapsed time after implantation; preimplant nocturnal erections; body mass index; presence of hypertension or diabetes mellitus; tobacco consumption; the volume of the prostate gland receiving 100%, 150%, and 200% of the prescribed dose (V 100/150/200 ); the dose delivered to 90% of the prostate gland (D 90 ); androgen deprivation therapy; supplemental external beam radiotherapy (EBRT); isotope; prostate volume; planning volume; and radiation dose to the proximal penis. Results: The 3-year actuarial rate of potency preservation was 50.5%. For patients who maintained adequate posttreatment erectile function, the preimplant IIEF score was 29, and in patients with brachytherapy-related ED, the preimplant IIEF score was 25. The median time to the onset of ED was 5.4 months. After brachytherapy, the median IIEF score was 20 in potent patients and 3 in impotent patients. On univariate analysis, the preimplant IIEF score, patient age, presence of nocturnal

  11. Correlation between uroflowmetry, prostate volume, postvoid residue, and lower urinary tract symptoms as measured by the International Prostate Symptom Score

    NARCIS (Netherlands)

    Ezz el Din, K.; Kiemeney, L. A.; de Wildt, M. J.; Debruyne, F. M.; de la Rosette, J. J.

    1996-01-01

    To evaluate the relation between lower urinary tract symptoms (LUTS) as measured by the International Prostate Symptom Score (IPSS) and noninvasive objective parameters of lower urinary tract dysfunction. Eight hundred three consecutive patients with LUTS and/or benign prostatic hyperplasia were

  12. A Comparison of daily megavoltage CT and ultrasound image guided radiation therapy for prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Peng Cheng; Kainz, Kristofer; Lawton, Colleen; Li, X. Allen [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin 53226 (United States)

    2008-12-15

    In order to quantify the differences between ultrasound-imaging and megavoltage-CT (MVCT) daily prostate localization in prostate-cancer radiotherapy and their dosimetric impacts, daily shifts were analyzed for a total of 140 prostate cancer patients; 106 positioned using ultrasound-based imaging [B-mode Acquisition and Targeting (BAT)], and 34 using the MVCT from a TomoTherapy Hi-Art unit. The shifts indicated by the two systems were compared statistically along the right/left (R/L), superior/inferior (S/I), and anterior/posterior (A/P) directions. The systematic and random variations among the daily alignments were calculated. Margins to account for these shifts were estimated. The mean shifts and standard deviations along the R/L, S/I, and A/P directions were -0.11{+-}3.80, 0.67{+-}4.67, and 2.71{+-}6.31 mm for BAT localizations and -0.98{+-}5.13, 0.27{+-}3.35, and 1.00{+-}4.22 mm for MVCT localizations, respectively. The systematic and random variations in daily shifts based on MVCT were generally smaller than those based on BAT, especially along the A/P direction. A t-test showed this difference to be statistically significant. The planning target volume margins in the A/P direction estimated to account for daily variations were 8.81 and 14.66 mm based on MVCT and BAT data, respectively. There was no statistically significant difference in the daily prostate movement pattern between the first few fractions and the remaining fractions. Dosimetric comparison of MVCT and BAT prostate alignments was performed for seven fractions from a patient. The degradation from the plan caused by the MVCT alignment is trivial, while that by BAT is substantial. The MVCT technique results in smaller variations in daily shifts than ultrasound imaging, indicating that MVCT is more reliable and precise for prostate localization. Ultrasound-based localization may overestimate the daily prostate motion, particularly in the A/P direction, negatively impacting prostate dose coverage

  13. A Comparison of daily megavoltage CT and ultrasound image guided radiation therapy for prostate cancer

    International Nuclear Information System (INIS)

    Peng Cheng; Kainz, Kristofer; Lawton, Colleen; Li, X. Allen

    2008-01-01

    In order to quantify the differences between ultrasound-imaging and megavoltage-CT (MVCT) daily prostate localization in prostate-cancer radiotherapy and their dosimetric impacts, daily shifts were analyzed for a total of 140 prostate cancer patients; 106 positioned using ultrasound-based imaging [B-mode Acquisition and Targeting (BAT)], and 34 using the MVCT from a TomoTherapy Hi-Art unit. The shifts indicated by the two systems were compared statistically along the right/left (R/L), superior/inferior (S/I), and anterior/posterior (A/P) directions. The systematic and random variations among the daily alignments were calculated. Margins to account for these shifts were estimated. The mean shifts and standard deviations along the R/L, S/I, and A/P directions were -0.11±3.80, 0.67±4.67, and 2.71±6.31 mm for BAT localizations and -0.98±5.13, 0.27±3.35, and 1.00±4.22 mm for MVCT localizations, respectively. The systematic and random variations in daily shifts based on MVCT were generally smaller than those based on BAT, especially along the A/P direction. A t-test showed this difference to be statistically significant. The planning target volume margins in the A/P direction estimated to account for daily variations were 8.81 and 14.66 mm based on MVCT and BAT data, respectively. There was no statistically significant difference in the daily prostate movement pattern between the first few fractions and the remaining fractions. Dosimetric comparison of MVCT and BAT prostate alignments was performed for seven fractions from a patient. The degradation from the plan caused by the MVCT alignment is trivial, while that by BAT is substantial. The MVCT technique results in smaller variations in daily shifts than ultrasound imaging, indicating that MVCT is more reliable and precise for prostate localization. Ultrasound-based localization may overestimate the daily prostate motion, particularly in the A/P direction, negatively impacting prostate dose coverage and rectal

  14. Proton MR spectroscopy of the prostate

    Energy Technology Data Exchange (ETDEWEB)

    Mueller-Lisse, Ullrich G. [Dept. of Clinical Radiology, Klinikum der Universitaet Muenchen, Standorte Grosshadern und Innenstadt, Ziemssenstrasse 1, D-80336 Munich (Germany)], E-mail: ullrich.mueller-lisse@med.uni-muenchen.de; Scherr, Michael K. [Dept. of Clinical Radiology, Klinikum der Universitaet Muenchen, Standorte Grosshadern und Innenstadt, Ziemssenstrasse 1, D-80336 Munich (Germany)

    2007-09-15

    Purpose: To summarize current technical and biochemical aspects and clinical applications of proton magnetic resonance spectroscopy (MRS) of the human prostate in vivo. Material and methods: Pertinent radiological and biochemical literature was searched and retrieved via electronic media (medline, pubmed). Basic concepts of MRS of the prostate and its clinical applications were extracted. Results: Clinical MRS is usually based on point resolved spectroscopy (PRESS) or spin echo (SE) sequences, along with outer volume suppression of signals from outside of the prostate. MRS of the prostate detects indicator lines of citrate, choline, and creatine. While healthy prostate tissue demonstrates high levels of citrate and low levels of choline that marks cell wall turnover, prostate cancer utilizes citrate for energy metabolism and shows high levels of choline. The ratio of (choline + creatine)/citrate distinguishes between healthy tissue and prostate cancer. Particularly when combined with magnetic resonance (MR) imaging, three-dimensional MRS imaging (3D-CSI, or 3D-MRSI) detects and localizes prostate cancer in the entire prostate with high sensitivity and specificity. Combined MR imaging and 3D-MRSI exceed the sensitivity and specificity of sextant biopsy of the prostate. When MRS and MR imaging agree on prostate cancer presence, the positive predictive value is about 80-90%. Distinction between healthy tissue and prostate cancer principally is maintained after various therapeutic treatments, including hormone ablation therapy, radiation therapy, and cryotherapy of the prostate. Conclusions: Since it is non-invasive, reliable, radiation-free, and essentially repeatable, combined MR imaging and 3D-MRSI of the prostate lends itself to the planning of biopsy and therapy, and to post-therapeutic follow-up. For broad clinical acceptance, it will be necessary to facilitate MRS examinations and their evaluation and make MRS available to a wider range of institutions.

  15. Paraganglioma of Prostatic Origin

    Directory of Open Access Journals (Sweden)

    B. Padilla-Fernández

    2012-01-01

    Full Text Available Introduction Paragangliomas are usually benign tumors arising from chromaffin cells located outside the adrenal gland. Prostatic paraganglioma is an unusual entity in adult patients, with only 10 cases reported in the medical literature. Case Report A 34-year-old male with a history of chronic prostatitis consulted for perineal pain. On digital rectal examination the prostate was enlarged and firm, without nodules. The PSA level was 0.8 ng/mL and the catecholamines in the urine were elevated. On ultrasound a retrovesical 9 cm mass of undetermined origin measuring was present. A PET-CT scan showed a pelvic lesion measuring 9 cm with moderate increase in glucidic metabolism localized in the area of the prostate. A biopsy of the prostate revealed a neuroendocrine tumor, possibly a prostatic paraganglioma. A body scintigraphy with MIBG I-123 ruled out the presence of metastases or multifocal tumor. A radical prostatectomy with excision of the pelvic mass was performed under adrenergic blockade. One year after surgery the patient is asymptomatic and disease free. Discussion/Conclusions Prostatic paraganglioma is a rare, usually benign tumor, which should be considered in the differential diagnosis of prostate tumors in young males. Its diagnosis is based on the determination of catecholamine in blood and 24-hour urine and in imaging studies principally scintigraphy with MIBG I-123. Diagnostic confirmation is by histopathological study. The treatment consists of radical resection under adrenergic blockade and volume expansion. Given the limited number of cases reported, it is difficult to establish prognostic factors. Malignancy is defined by clinical criteria, and requires life long follow-up.

  16. Association of polymorphisms in CYP19A1 and CYP3A4 genes with lower urinary tract symptoms, prostate volume, uroflow and PSA in a population-based sample.

    Science.gov (United States)

    Berges, Richard; Gsur, Andrea; Feik, Elisabeth; Höfner, Klaus; Senge, Theodor; Pientka, Ludger; Baierl, Andreas; Michel, Martin C; Ponholzer, Anton; Madersbacher, Stephan

    2011-04-01

    The known importance of testosterone for the development of benign prostatic hyperplasia (BPH) prompted us to test the hypothesis whether polymorphisms of two genes (CYP19A1 and CYP3A4) involved in testosterone metabolism are associated with clinical BPH-parameters. A random sample of the population-based Herne lower urinary tract symptoms cohort was analysed. All these men underwent a detailed urological work-up. Two polymorphisms in the CYP19A1 gene [rs700518 in exon 4 (A57G); rs10046 at the 3'UTR(C268T)] and one in the 3'UTR of CYP3A4 [rs2740574 (A392G)] were determined by TaqMan assay from genomic DNA of peripheral blood. These polymorphisms were correlated to clinical and laboratory BPH-parameters. A total of 392 men (65.4 ± 7.0 years; 52-79 years) were analysed. Mean International Prostate Symptom Score (IPSS; 7.5), Q (max) (15.4 ml/s), prostate volume (31 ml) and prostate specific antigen (PSA) (1.8 ng/ml) indicated a typical elderly population. Both polymorphisms in the CYP19A1 gene were not correlated to age, IPSS, Q (max), prostate volume and post-void residual volume. Serum PSA was higher in men carrying the heterozygous rs10046 genotype (2.0 ± 0.1 ng/ml) than in those with the CC-genotype (1.7 ± 0.2 ng/ml, P = 0.012). Men carrying one a mutated allele of the CYP3A4 gene had smaller prostates (27.0 ± 2.0 vs. 32 ± 0.8 ml, P = 0.02) and lower PSA levels (1.6 ± 0.3 vs. 1.9 ± 0.1 ng/ml). The inconsistent associations observed herein and for other gene polymorphisms warrant further studies. In general, the data regarding the association of gene polymorphism to BPH-parameters suggest that this disease is caused by multiple rather than a single genetic variant. A rigorous patient selection based on anatomo-pathological and hormonal profile may possible reduce the number of confounders for future studies thus enabling a more detailed assessment of the association between genetic factors and BPH-parameters.

  17. Estimating forest biomass and volume using airborne laser data

    Science.gov (United States)

    Nelson, Ross; Krabill, William; Tonelli, John

    1988-01-01

    An airborne pulsed laser system was used to obtain canopy height data over a southern pine forest in Georgia in order to predict ground-measured forest biomass and timber volume. Although biomass and volume estimates obtained from the laser data were variable when compared with the corresponding ground measurements site by site, the present models are found to predict mean total tree volume within 2.6 percent of the ground value, and mean biomass within 2.0 percent. The results indicate that species stratification did not consistently improve regression relationships for four southern pine species.

  18. Accuracy of Standing-Tree Volume Estimates Based on McClure Mirror Caliper Measurements

    Science.gov (United States)

    Noel D. Cost

    1971-01-01

    The accuracy of standing-tree volume estimates, calculated from diameter measurements taken by a mirror caliper and with sectional aluminum poles for height control, was compared with volume estimates calculated from felled-tree measurements. Twenty-five trees which varied in species, size, and form were used in the test. The results showed that two estimates of total...

  19. High serum dihydrotestosterone examined by ultrasensitive LC-MS/MS as a predictor of benign prostatic hyperplasia or Gleason score 6 cancer in men with prostate-specific antigen levels of 3-10 ng/mL.

    Science.gov (United States)

    Miyoshi, Y; Uemura, H; Suzuki, K; Shibata, Y; Honma, S; Harada, M; Kubota, Y

    2017-03-01

    There has been no consensus on the role of serum androgen concentrations in prostate cancer detection in men with prostate-specific antigen levels of 3-10 ng/mL. In this study, testosterone and dihydrotestosterone concentrations in blood were examined by a newly developed method using ultrasensitive liquid chromatography with two serially linked mass spectrometers (LC-MS/MS). We investigated the correlation between serum androgen levels and Gleason scores at biopsy. We analyzed data of 157 men with a total prostate-specific antigen range of 3-10 ng/mL who underwent initial systematic prostate needle biopsy for suspected prostate cancer between April 2000 and July 2003. Peripheral blood testosterone and dihydrotestosterone concentrations were determined by LC-MS/MS. Blood levels of testosterone and dihydrotestosterone were compared with pathological findings by multivariate analyses. Median values of prostate-specific antigen and prostate volume measured by ultrasound were 5.7 ng/mL and 31.4 cm 3 , respectively. Benign prostatic hyperplasia was diagnosed in 97 patients (61.8%), and prostate cancer was diagnosed in 60 (38.2%) patients, including 31 (19.7%) patients with a Gleason score of 6 and 29 (18.5%) patients with a Gleason score of 7-10. Median values of testosterone and dihydrotestosterone in blood were 3798.7 and 371.7 pg/mL, respectively. There was a strong correlation between serum testosterone and dihydrotestosterone. In multivariate analysis, age, prostate volume, and serum dihydrotestosterone were significant predictors of benign prostatic hyperplasia or prostate cancer with a Gleason score of 6. The area under the receiver operating characteristics curve for age, prostate volume, and serum dihydrotestosterone were 0.67, 0.67, and 0.67, respectively . We confirmed that high dihydrotestosterone blood levels can predict benign prostatic hyperplasia or prostate cancer with a Gleason score of 6 in men with prostate-specific antigen levels of 3-10

  20. A study on planning organ at risk volume for the rectum using cone beam computed tomography in the treatment of prostate cancer

    International Nuclear Information System (INIS)

    Prabhakar, Ramachandran; Oates, Richard; Jones, Daryl; Kron, Tomas; Cramb, Jim; Foroudi, Farshad; Geso, Moshi; Gill, Suki

    2014-01-01

    In this study, we analyzed planning organ at risk volume (PRV) for the rectum using a series of cone beam computed tomographies (CBCTs) acquired during the treatment of prostate cancer and evaluated the dosimetric effect of different PRV definitions. Overall, 21 patients with prostate cancer were treated radically with 78 Gy in 39 fractions had in total 418 CBCTs, each acquired at the end of the first 5 fractions and then every alternate fraction. The PRV was generated from the Boolean sum volume of the rectum obtained from first 5 fractions (PRV-CBCT-5) and from all CBCTs (PRV-CBCT-All). The PRV margin was compared at the superior, middle, and inferior slices of the contoured rectum to compare PRV-CBCT-5 and PRV-CBCT-All. We also compared the dose received by the planned rectum (Rectum-computed tomography [CT]), PRV-CBCT-5, PRV-CBCT-All, and average rectum (CBCT-AV-dose-volume histogram [DVH]) at critical dose levels. The average measured rectal volume for all 21 patients for Rectum-CT, PRV-CBCT-5, and PRV-CBCT-All was 44.3 ± 15.0, 92.8 ± 40.40, and 121.5 ± 36.7 cm 3 , respectively. For PRV-CBCT-All, the mean ± standard deviation displacement in the anterior, posterior, right, and left lateral directions in centimeters was 2.1 ± 1.1, 0.9 ± 0.5, 0.9 ± 0.8, and 1.1 ± 0.7 for the superior rectum; 0.8 ± 0.5, 1.1 ± 0.5, 1.0 ± 0.5, and 1.0 ± 0.5 for the middle rectum; and 0.3 ± 0.3; 0.9 ± 0.5; 0.4 ± 0.2, and 0.5 ± 0.3 for the inferior rectum, respectively. The first 5 CBCTs did not predict the PRV for individual patients. Our study shows that the PRV margin is different for superior, middle, and the inferior parts of the rectum, it is wider superiorly and narrower inferiorly. A uniform PRV margin does not represent the actual rectal variations during treatment for all treatment fractions. The large variation in interpatient rectal size implies a potential role for adaptive radiotherapy for prostate cancer

  1. Estimated maximal and current brain volume predict cognitive ability in old age

    Science.gov (United States)

    Royle, Natalie A.; Booth, Tom; Valdés Hernández, Maria C.; Penke, Lars; Murray, Catherine; Gow, Alan J.; Maniega, Susana Muñoz; Starr, John; Bastin, Mark E.; Deary, Ian J.; Wardlaw, Joanna M.

    2013-01-01

    Brain tissue deterioration is a significant contributor to lower cognitive ability in later life; however, few studies have appropriate data to establish how much influence prior brain volume and prior cognitive performance have on this association. We investigated the associations between structural brain imaging biomarkers, including an estimate of maximal brain volume, and detailed measures of cognitive ability at age 73 years in a large (N = 620), generally healthy, community-dwelling population. Cognitive ability data were available from age 11 years. We found positive associations (r) between general cognitive ability and estimated brain volume in youth (male, 0.28; females, 0.12), and in measured brain volume in later life (males, 0.27; females, 0.26). Our findings show that cognitive ability in youth is a strong predictor of estimated prior and measured current brain volume in old age but that these effects were the same for both white and gray matter. As 1 of the largest studies of associations between brain volume and cognitive ability with normal aging, this work contributes to the wider understanding of how some early-life factors influence cognitive aging. PMID:23850342

  2. 'Compromise position' image alignment to accommodate independent motion of multiple clinical target volumes during radiotherapy: A high risk prostate cancer example.

    Science.gov (United States)

    Rosewall, Tara; Yan, Jing; Alasti, Hamideh; Cerase, Carla; Bayley, Andrew

    2017-04-01

    Inclusion of multiple independently moving clinical target volumes (CTVs) in the irradiated volume causes an image guidance conundrum. The purpose of this research was to use high risk prostate cancer as a clinical example to evaluate a 'compromise' image alignment strategy. The daily pre-treatment orthogonal EPI for 14 consecutive patients were included in this analysis. Image matching was performed by aligning to the prostate only, the bony pelvis only and using the 'compromise' strategy. Residual CTV surrogate displacements were quantified for each of the alignment strategies. Analysis of the 388 daily fractions indicated surrogate displacements were well-correlated in all directions (r 2  = 0.95 (LR), 0.67 (AP) and 0.59 (SI). Differences between the surrogates displacements (95% range) were -0.4 to 1.8 mm (LR), -1.2 to 5.2 mm (SI) and -1.2 to 5.2 mm (AP). The distribution of the residual displacements was significantly smaller using the 'compromise' strategy, compared to the other strategies (p 0.005). The 'compromise' strategy ensured the CTV was encompassed by the PTV in all fractions, compared to 47 PTV violations when aligned to prostate only. This study demonstrated the feasibility of a compromise position image guidance strategy to accommodate simultaneous displacements of two independently moving CTVs. Application of this strategy was facilitated by correlation between the CTV displacements and resulted in no geometric excursions of the CTVs beyond standard sized PTVs. This simple image guidance strategy may also be applicable to other disease sites that concurrently irradiate multiple CTVs, such as head and neck, lung and cervix cancer. © 2016 The Royal Australian and New Zealand College of Radiologists.

  3. Dose-Volume Parameters of the Corpora Cavernosa Do Not Correlate With Erectile Dysfunction After External Beam Radiotherapy for Prostate Cancer: Results From a Dose-Escalation Trial

    International Nuclear Information System (INIS)

    Wielen, Gerard J. van der; Hoogeman, Mischa S.; Dohle, Gert R.; Putten, Wim L.J. van; Incrocci, Luca

    2008-01-01

    Purpose: To analyze the correlation between dose-volume parameters of the corpora cavernosa and erectile dysfunction (ED) after external beam radiotherapy (EBRT) for prostate cancer. Methods and Materials: Between June 1997 and February 2003, a randomized dose-escalation trial comparing 68 Gy and 78 Gy was conducted. Patients at our institute were asked to participate in an additional part of the trial evaluating sexual function. After exclusion of patients with less than 2 years of follow-up, ED at baseline, or treatment with hormonal therapy, 96 patients were eligible. The proximal corpora cavernosa (crura), the superiormost 1-cm segment of the crura, and the penile bulb were contoured on the planning computed tomography scan and dose-volume parameters were calculated. Results: Two years after EBRT, 35 of the 96 patients had developed ED. No statistically significant correlations between ED 2 years after EBRT and dose-volume parameters of the crura, the superiormost 1-cm segment of the crura, or the penile bulb were found. The few patients using potency aids typically indicated to have ED. Conclusion: No correlation was found between ED after EBRT for prostate cancer and radiation dose to the crura or penile bulb. The present study is the largest study evaluating the correlation between ED and radiation dose to the corpora cavernosa after EBRT for prostate cancer. Until there is clear evidence that sparing the penile bulb or crura will reduce ED after EBRT, we advise to be careful in sparing these structures, especially when this involves reducing treatment margins

  4. A Computable Plug-In Estimator of Minimum Volume Sets for Novelty Detection

    KAUST Repository

    Park, Chiwoo; Huang, Jianhua Z.; Ding, Yu

    2010-01-01

    A minimum volume set of a probability density is a region of minimum size among the regions covering a given probability mass of the density. Effective methods for finding the minimum volume sets are very useful for detecting failures or anomalies in commercial and security applications-a problem known as novelty detection. One theoretical approach of estimating the minimum volume set is to use a density level set where a kernel density estimator is plugged into the optimization problem that yields the appropriate level. Such a plug-in estimator is not of practical use because solving the corresponding minimization problem is usually intractable. A modified plug-in estimator was proposed by Hyndman in 1996 to overcome the computation difficulty of the theoretical approach but is not well studied in the literature. In this paper, we provide theoretical support to this estimator by showing its asymptotic consistency. We also show that this estimator is very competitive to other existing novelty detection methods through an extensive empirical study. ©2010 INFORMS.

  5. A Computable Plug-In Estimator of Minimum Volume Sets for Novelty Detection

    KAUST Repository

    Park, Chiwoo

    2010-10-01

    A minimum volume set of a probability density is a region of minimum size among the regions covering a given probability mass of the density. Effective methods for finding the minimum volume sets are very useful for detecting failures or anomalies in commercial and security applications-a problem known as novelty detection. One theoretical approach of estimating the minimum volume set is to use a density level set where a kernel density estimator is plugged into the optimization problem that yields the appropriate level. Such a plug-in estimator is not of practical use because solving the corresponding minimization problem is usually intractable. A modified plug-in estimator was proposed by Hyndman in 1996 to overcome the computation difficulty of the theoretical approach but is not well studied in the literature. In this paper, we provide theoretical support to this estimator by showing its asymptotic consistency. We also show that this estimator is very competitive to other existing novelty detection methods through an extensive empirical study. ©2010 INFORMS.

  6. Intralesional and metastatic heterogeneity in malignant melanomas demonstrated by stereologic estimates of nuclear volume

    DEFF Research Database (Denmark)

    Sørensen, Flemming Brandt; Erlandsen, M

    1990-01-01

    Regional variability of nuclear 3-dimensional size can be estimated objectively using point-sampled intercepts obtained from different, defined zones within individual neoplasms. In the present study, stereologic estimates of the volume-weighted mean nuclear volume, nuclear vv, within peripheral...... melanomas showed large interindividual variation. This finding emphasizes that unbiased estimates of nuclear vv are robust to regional heterogeneity of nuclear volume and thus suitable for purposes of objective, quantitative malignancy grading of melanomas....

  7. An estimate of the glacier ice volume in the Swiss Alps

    Science.gov (United States)

    Farinotti, Daniel; Huss, Matthias; Bauder, Andreas; Funk, Martin

    2009-08-01

    Changes in glacier volume are important for questions linked to sea-level rise, water resource management, and tourism industry. With the ongoing climate warming, the retreat of mountain glaciers is a major concern. Predictions of glacier changes, necessarily need the present ice volume as initial condition, and for transient modelling, the ice thickness distribution has to be known. In this paper, a method based on mass conservation and principles of ice flow dynamics is applied to 62 glaciers located in the Swiss Alps for estimating their ice thickness distribution. All available direct ice thickness measurements are integrated. The ice volumes are referenced to the year 1999 by means of a mass balance time series. The results are used to calibrate a volume-area scaling relation, and the coefficients obtained show good agreement with values reported in the literature. We estimate the total ice volume present in the Swiss Alps in the year 1999 to be 74 ± 9 km 3. About 12% of this volume was lost between 1999 and 2008, whereas the extraordinarily warm summer 2003 caused a volume loss of about 3.5%.

  8. Estimating Highway Volumes Using Vehicle Probe Data - Proof of Concept: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Hou, Yi [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Young, Stanley E [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Sadabadi, Kaveh [University of Maryland; SekuBa, PrzemysBaw [University of Maryland; Markow, Denise [I95 Corridor Coalition

    2018-03-13

    This paper examines the feasibility of using sampled commercial probe data in combination with validated continuous counter data to accurately estimate vehicle volume across the entire roadway network, for any hour during the year. Currently either real time or archived volume data for roadways at specific times are extremely sparse. Most volume data are average annual daily traffic (AADT) measures derived from the Highway Performance Monitoring System (HPMS). Although methods to factor the AADT to hourly averages for typical day of week exist, actual volume data is limited to a sparse collection of locations in which volumes are continuously recorded. This paper explores the use of commercial probe data to generate accurate volume measures that span the highway network providing ubiquitous coverage in space, and specific point-in-time measures for a specific date and time. The paper examines the need for the data, fundamental accuracy limitations based on a basic statistical model that take into account the sampling nature of probe data, and early results from a proof of concept exercise revealing the potential of probe type data calibrated with public continuous count data to meet end user expectations in terms of accuracy of volume estimates.

  9. O padrão 4 de Gleason e o volume tumoral no prognóstico do carcinoma da próstata Well differentiated localized prostate carcinoma: prognostic relevance of tertiary Gleason pattern 4 and tumor volume

    Directory of Open Access Journals (Sweden)

    Katia R. M. Leite

    2005-12-01

    recidivaram (p=0,046. CONCLUSÃO: O volume do adenocarcinoma de próstata é um parâmetro objetivo, de fácil avaliação e importante na previsão da recidiva bioquímica no carcinoma bem diferenciado da próstata. Por outro lado, a porcentagem do padrão menos diferenciado de Gleason também serve para prever recidiva à distância. Ambos os parâmetros devem ser incorporados em estudos futuros de terapias adjuvantes para o carcinoma da próstata.INTRODUCTION: Early introduction of adjuvant radiation or hormone therapy after radical prostatectomy has been advocated in recent literature aiming to improve survival rates in high risk prostate cancer. Traditional prognostic parameters such as serum PSA, Gleason score and clinical stage have been used to identify these cases however accuracy is far from ideal. Recently, tumor volume and presence and percentage of a tertiary less differentiated Gleason pattern have been considered better indicators of prostate cancer behavior. The purpose of this study was to evaluate the importance of presence and percentage of a Gleason pattern 4 and of tumor volume in the outcome of patients treated for well-differentiated prostate adenocarcinoma. METHODS: Seventy seven patients submitted to radical prostatectomy for well-differentiated prostate carcinoma, Gleason score 6 or less, and followed up for at least 5 years were selected. Thirty seven experienced biochemical recurrence while 40 did not. The percentage of Gleason pattern 4, the percentage of the gland involvement (considered as "tumor volume", capsular invasion and extraprostatic extension were submitted to univariate and multivariate analyses for the evaluation of possible associations with biochemical recurrence. RESULTS: Tumor volume was the most important parameter to predict biochemical recurrence by univariate and multivariate analysis. The median of tumor volume was 25.0% for patients who suffered recurrence, and 11.5% for those with no recurrence (p=0.003. The percentage of

  10. Estimation of standard liver volume in Chinese adult living donors.

    Science.gov (United States)

    Fu-Gui, L; Lu-Nan, Y; Bo, L; Yong, Z; Tian-Fu, W; Ming-Qing, X; Wen-Tao, W; Zhe-Yu, C

    2009-12-01

    To determine a formula predicting the standard liver volume based on body surface area (BSA) or body weight in Chinese adults. A total of 115 consecutive right-lobe living donors not including the middle hepatic vein underwent right hemi-hepatectomy. No organs were used from prisoners, and no subjects were prisoners. Donor anthropometric data including age, gender, body weight, and body height were recorded prospectively. The weights and volumes of the right lobe liver grafts were measured at the back table. Liver weights and volumes were calculated from the right lobe graft weight and volume obtained at the back table, divided by the proportion of the right lobe on computed tomography. By simple linear regression analysis and stepwise multiple linear regression analysis, we correlated calculated liver volume and body height, body weight, or body surface area. The subjects had a mean age of 35.97 +/- 9.6 years, and a female-to-male ratio of 60:55. The mean volume of the right lobe was 727.47 +/- 136.17 mL, occupying 55.59% +/- 6.70% of the whole liver by computed tomography. The volume of the right lobe was 581.73 +/- 96.137 mL, and the estimated liver volume was 1053.08 +/- 167.56 mL. Females of the same body weight showed a slightly lower liver weight. By simple linear regression analysis and stepwise multiple linear regression analysis, a formula was derived based on body weight. All formulae except the Hong Kong formula overestimated liver volume compared to this formula. The formula of standard liver volume, SLV (mL) = 11.508 x body weight (kg) + 334.024, may be applied to estimate liver volumes in Chinese adults.

  11. Are strict vegetarians protected against prostate cancer?

    Science.gov (United States)

    Tantamango-Bartley, Yessenia; Knutsen, Synnove F; Knutsen, Raymond; Jacobsen, Bjarne K; Fan, Jing; Beeson, W Lawrence; Sabate, Joan; Hadley, David; Jaceldo-Siegl, Karen; Penniecook, Jason; Herring, Patti; Butler, Terry; Bennett, Hanni; Fraser, Gary

    2016-01-01

    According to the American Cancer Society, prostate cancer accounts for ∼27% of all incident cancer cases among men and is the second most common (noncutaneous) cancer among men. The relation between diet and prostate cancer is still unclear. Because people do not consume individual foods but rather foods in combination, the assessment of dietary patterns may offer valuable information when determining associations between diet and prostate cancer risk. This study aimed to examine the association between dietary patterns (nonvegetarian, lacto-ovo-vegetarian, pesco-vegetarian, vegan, and semi-vegetarian) and prostate cancer incidence among 26,346 male participants of the Adventist Health Study-2. In this prospective cohort study, cancer cases were identified by matching to cancer registries. Cox proportional hazards regression analysis was performed to estimate HRs by using age as the time variable. In total, 1079 incident prostate cancer cases were identified. Around 8% of the study population reported adherence to the vegan diet. Vegan diets showed a statistically significant protective association with prostate cancer risk (HR: 0.65; 95% CI: 0.49, 0.85). After stratifying by race, the statistically significant association with a vegan diet remained only for the whites (HR: 0.63; 95% CI: 0.46, 0.86), but the multivariate HR for black vegans showed a similar but nonsignificant point estimate (HR: 0.69; 95% CI: 0.41, 1.18). Vegan diets may confer a lower risk of prostate cancer. This lower estimated risk is seen in both white and black vegan subjects, although in the latter, the CI is wider and includes the null. © 2016 American Society for Nutrition.

  12. Inter-fractional Target Displacement in the Prostate Image-Guided Radiotherapy using Cone Beam Computed Tomography

    International Nuclear Information System (INIS)

    Dong, Kap Sang; Back, Chang Wook; Jeong, Yun Jeong; Bae, Jae Beom; Choi, Young Eun; Sung, Ki Hoon

    2016-01-01

    To quantify the inter-fractional variation in prostate displacement and their dosimetric effects for prostate cancer treatment. A total of 176 daily cone-beam CT (CBCT) sets acquired for 6 prostate cancer patients treated with volumetric-modulated arc therapy (VMAT) were retrospectively reviewed. For each patient, the planning CT (pCT) was registered to each daily CBCT by aligning the bony anatomy. The prostate, rectum, and bladder were delineated on daily CBCT, and the contours of these organs in the pCT were copied to the daily CBCT. The concordance of prostate displacement, deformation, and size variation between pCT and daily CBCT was evaluated using the Dice similarity coefficient (DSC). The mean volume of prostate was 37.2 cm3 in the initial pCT, and the variation was around ±5% during the entire course of treatment for all patients. The mean DSC was 89.9%, ranging from 70% to 100% for prostate displacement. Although the volume change of bladder and rectum per treatment fraction did not show any correlation with the value of DSC (r=-0.084, p=0.268 and r=-0.162, p=0.032, respectively), a decrease in the DSC value was observed with increasing volume change of the bladder and rectum (r=-0.230,p=0.049 and r=-0.240,p=0.020, respectively). Consistency of the volume of the bladder and rectum cannot guarantee the accuracy of the treatment. Our results suggest that patient setup with the registration between the pCT and daily CBCT should be considered aligning soft tissue

  13. Inter-fractional Target Displacement in the Prostate Image-Guided Radiotherapy using Cone Beam Computed Tomography

    Energy Technology Data Exchange (ETDEWEB)

    Dong, Kap Sang; Back, Chang Wook; Jeong, Yun Jeong; Bae, Jae Beom; Choi, Young Eun; Sung, Ki Hoon [Dept. of Radiation Oncology, Gachon University Gil Medical Center, Incheon (Korea, Republic of)

    2016-12-15

    To quantify the inter-fractional variation in prostate displacement and their dosimetric effects for prostate cancer treatment. A total of 176 daily cone-beam CT (CBCT) sets acquired for 6 prostate cancer patients treated with volumetric-modulated arc therapy (VMAT) were retrospectively reviewed. For each patient, the planning CT (pCT) was registered to each daily CBCT by aligning the bony anatomy. The prostate, rectum, and bladder were delineated on daily CBCT, and the contours of these organs in the pCT were copied to the daily CBCT. The concordance of prostate displacement, deformation, and size variation between pCT and daily CBCT was evaluated using the Dice similarity coefficient (DSC). The mean volume of prostate was 37.2 cm3 in the initial pCT, and the variation was around ±5% during the entire course of treatment for all patients. The mean DSC was 89.9%, ranging from 70% to 100% for prostate displacement. Although the volume change of bladder and rectum per treatment fraction did not show any correlation with the value of DSC (r=-0.084, p=0.268 and r=-0.162, p=0.032, respectively), a decrease in the DSC value was observed with increasing volume change of the bladder and rectum (r=-0.230,p=0.049 and r=-0.240,p=0.020, respectively). Consistency of the volume of the bladder and rectum cannot guarantee the accuracy of the treatment. Our results suggest that patient setup with the registration between the pCT and daily CBCT should be considered aligning soft tissue.

  14. [Histopathological changes due to transurethural microwave thermotherapy associated with androgen deprivation therapy in patients with localized prostate cancer].

    Science.gov (United States)

    Jujo, Yutaka; Koshiba, Ken; Suzuki, Ryuta; Hoshiai, Osamu; Endo, Tadao; Aihara, Masahiro; Katsuta, Masayuki; Nakajo, Hirotaka

    2006-03-01

    The 2nd generation transurethral microwave thermotherapy (TUMT), equipped with high energy microwave generator and urethral cooling device is widely accepted as an less invasive effective modality to treat benign prostatic hyperplasia. For prostatic cancer, however, it is generally estimated as insufficient because of limitation in penetration of microwave into deep prostatic tissue. In this study, we examined histopathologic changes after androgen deprivation theraphy (ADT) and TUMT. Ten patients with localized prostate cancer underwent ADT for 3 months, and then TUMT was proceeded using Urowave (Dornier MedTech GmbH). Additional 3 months after TUMT and continued ADT, TURP in radical fashion was performed in all the patients, and all the resected chips were submitted for pathological study. Significant reduction in prostate volume was noted after NHT for 3 months from 37.4 +/- 9.6 ml to 22.0 +/- 5.6 ml. The pathological study of resected chips revealed progressive fibrotic changes without viable cancer cells in 9 of 10 patients. In 1 patient, however, some remnant of carcinomatous foci were noted in a resected chip from the middle lobe of the prostate. Although the number of patient is limited and longer follow-up is needed, the results in present series was interested and worth considering.

  15. Prostate cancer and inflammation: the evidence

    Science.gov (United States)

    Sfanos, Karen S; De Marzo, Angelo M

    2014-01-01

    Chronic inflammation is now known to contribute to several forms of human cancer, with an estimated 20% of adult cancers attributable to chronic inflammatory conditions caused by infectious agents, chronic noninfectious inflammatory diseases and / or other environmental factors. Indeed, chronic inflammation is now regarded as an ‘enabling characteristic’ of human cancer. The aim of this review is to summarize the current literature on the evidence for a role for chronic inflammation in prostate cancer aetiology, with a specific focus on recent advances regarding the following: (i) potential stimuli for prostatic inflammation; (ii) prostate cancer immunobiology; (iii) inflammatory pathways and cytokines in prostate cancer risk and development; (iv) proliferative inflammatory atrophy (PIA) as a risk factor lesion to prostate cancer development; and (v) the role of nutritional or other antiinflammatory compounds in reducing prostate cancer risk. PMID:22212087

  16. Clinical evaluation of embolization of the superior vesical prostatic artery for treatment of benign prostatic hyperplasia: a single-center retrospective study.

    Science.gov (United States)

    Qiu, Zhilei; Zhang, Changcun; Wang, Xinsheng; Cheng, Kai; Liang, Xin; Wang, Dawen; Hou, Sichuan; Wang, Xinsheng

    2017-12-01

    Non-surgical minimally invasive treatments are greatly needed for patients with symptomatic benign prostatic hyperplasia (BPH), for whom medical treatment has failed and surgery is contraindicated. This study retrospectively evaluated the efficacy and safety of super-selective prostatic artery embolization (PAE) for BPH, relative to transurethral resection of the prostate (TURP). To clinically evaluate the efficacy and safety of super-selective PAE for BPH, relative to TURP. From February 2012 to March 2015, patients with BPH underwent selective PAE (n = 17) or TURP (control group; n = 40). Prostate volume, maximum urinary flow rate (Qmax), International Prostate Symptoms Score (IPSS), and quality of life (QoL) score were evaluated at baseline and postoperative 3, 6, and 12 months. Complications were also recorded. All the procedures were technically successfully. At postoperative 1 year, patients given PAE had significantly greater prostate volume (64.6 ±10.2 ml), IPSS (23.9 ±4.9), and QoL (4.1 ±0.7) compared with the control patients (42.0 ±7.5 ml, 13.1 ±3.5, and 2.1 ±0.7, respectively). The Qmax of the PAE group (9.5 ±3.7 ml/s) was significantly lower than that of the control (21.8 ±4.2 ml/s). The changes in parameters of the TURP patients relative to the preoperative baseline were significantly greater than those of the PAE group. No severe complications occurred. Prostatic artery embolization was demonstrated as safe and effective and may be considered an alternative treatment for BPH patients, especially for those who are not candidates for or refuse surgery.

  17. Pathological upgrading in prostate cancer patients eligible for active surveillance: Does prostate-specific antigen density matter?

    Science.gov (United States)

    Jin, Byung-Soo; Kang, Seok-Hyun; Kim, Duk-Yoon; Oh, Hoon-Gyu; Kim, Chun-Il; Moon, Gi-Hak; Kwon, Tae-Gyun; Park, Jae-Shin

    2015-09-01

    To evaluate prospectively the role of prostate-specific antigen (PSA) density in predicting Gleason score upgrading in prostate cancer patients eligible for active surveillance (T1/T2, biopsy Gleason score≤6, PSA≤10 ng/mL, and ≤2 positive biopsy cores). Between January 2010 and November 2013, among patients who underwent greater than 10-core transrectal ultrasound-guided biopsy, 60 patients eligible for active surveillance underwent radical prostatectomy. By use of the modified Gleason criteria, the tumor grade of the surgical specimens was examined and compared with the biopsy results. Tumor upgrading occurred in 24 patients (40.0%). Extracapsular disease and positive surgical margins were found in 6 patients (10.0%) and 8 patients (17.30%), respectively. A statistically significant correlation between PSA density and postoperative upgrading was found (p=0.030); this was in contrast with the other studied parameters, which failed to reach significance, including PSA, prostate volume, number of biopsy cores, and number of positive cores. Tumor upgrading was also highly associated with extracapsular cancer extension (p=0.000). The estimated optimal cutoff value of PSA density was 0.13 ng/mL(2), obtained by receiver operating characteristic analysis (area under the curve=0.66; p=0.020; 95% confidence interval, 0.53-0.78). PSA density is a strong predictor of Gleason score upgrading after radical prostatectomy in patients eligible for active surveillance. Because tumor upgrading increases the potential for postoperative pathological adverse findings and prognosis, PSA density should be considered when treating and consulting patients eligible for active surveillance.

  18. Guidelines for target volume definition in post-operative radiotherapy for prostate cancer, on behalf of the EORTC Radiation Oncology Group

    International Nuclear Information System (INIS)

    Poortmans, Philip; Bossi, Alberto; Vandeputte, Katia; Bosset, Mathieu; Miralbell, Raymond; Maingon, Philippe; Boehmer, Dirk; Budiharto, Tom; Symon, Zvi; Bergh, Alfons C.M. van den; Scrase, Christopher; Poppel, Hendrik van; Bolla, Michel

    2007-01-01

    The appropriate application of 3-D conformal radiotherapy, intensity modulated radiotherapy or image guided radiotherapy for patients undergoing post-operative radiotherapy for prostate cancer requires a standardisation of the target volume definition and delineation as well as standardisation of the clinical quality assurance procedures. Recommendations for this are presented on behalf of the European Organisation for Research and Treatment of Cancer (EORTC) Radiation Oncology Group and in addition to the already published guidelines for radiotherapy as the primary treatment

  19. Estimation method for volumes of hot spots created by heavy ions

    International Nuclear Information System (INIS)

    Kanno, Ikuo; Kanazawa, Satoshi; Kajii, Yuji

    1999-01-01

    As a ratio of volumes of hot spots to cones, which have the same lengths and bottom radii with the ones of hot spots, a simple and convenient method for estimating the volumes of hot spots is described. This calculation method is useful for the study of damage producing mechanism in hot spots, and is also convenient for the estimation of the electron-hole densities in plasma columns created by heavy ions in semiconductor detectors. (author)

  20. A Comparison of Regional and SiteSpecific Volume Estimation Equations

    Science.gov (United States)

    Joe P. McClure; Jana Anderson; Hans T. Schreuder

    1987-01-01

    Regression equations for volume by region and site class were examined for lobiolly pine. The regressions for the Coastal Plain and Piedmont regions had significantly different slopes. The results shared important practical differences in percentage of confidence intervals containing the true total volume and in percentage of estimates within a specific proportion of...

  1. Ice thickness measurements and volume estimates for glaciers in Norway

    Science.gov (United States)

    Andreassen, Liss M.; Huss, Matthias; Melvold, Kjetil; Elvehøy, Hallgeir; Winsvold, Solveig H.

    2014-05-01

    Whereas glacier areas in many mountain regions around the world now are well surveyed using optical satellite sensors and available in digital inventories, measurements of ice thickness are sparse in comparison and a global dataset does not exist. Since the 1980s ice thickness measurements have been carried out by ground penetrating radar on many glaciers in Norway, often as part of contract work for hydropower companies with the aim to calculate hydrological divides of ice caps. Measurements have been conducted on numerous glaciers, covering the largest ice caps as well as a few smaller mountain glaciers. However, so far no ice volume estimate for Norway has been derived from these measurements. Here, we give an overview of ice thickness measurements in Norway, and use a distributed model to interpolate and extrapolate the data to provide an ice volume estimate of all glaciers in Norway. We also compare the results to various volume-area/thickness-scaling approaches using values from the literature as well as scaling constants we obtained from ice thickness measurements in Norway. Glacier outlines from a Landsat-derived inventory from 1999-2006 together with a national digital elevation model were used as input data for the ice volume calculations. The inventory covers all glaciers in mainland Norway and consists of 2534 glaciers (3143 glacier units) covering an area of 2692 km2 ± 81 km2. To calculate the ice thickness distribution of glaciers in Norway we used a distributed model which estimates surface mass balance distribution, calculates the volumetric balance flux and converts it into thickness using the flow law for ice. We calibrated this model with ice thickness data for Norway, mainly by adjusting the mass balance gradient. Model results generally agree well with the measured values, however, larger deviations were found for some glaciers. The total ice volume of Norway was estimated to be 275 km3 ± 30 km3. From the ice thickness data set we selected

  2. The Utility of PET/CT in the Planning of External Radiation Therapy for Prostate Cancer.

    Science.gov (United States)

    Calais, Jeremie; Cao, Minsong; Nickols, Nicholas G

    2018-04-01

    Radiotherapy and radical prostatectomy are the definitive treatment options for patients with localized prostate cancer. A rising level of prostate-specific antigen after radical prostatectomy indicates prostate cancer recurrence, and these patients may still be cured with salvage radiotherapy. To maximize chance for cure, the irradiated volumes should completely encompass the extent of disease. Therefore, accurate estimation of the location of disease is critical for radiotherapy planning in both the definitive and the salvage settings. Current first-line imaging for prostate cancer has limited sensitivity for detection of disease both at initial staging and at biochemical recurrence. Integration of PET into routine evaluation of prostate cancer patients may improve both staging accuracy and radiotherapy planning. 18 F-FDG PET/CT is now routinely used in radiation planning for several cancer types. However, 18 F-FDG PET/CT has low sensitivity for prostate cancer. Additional PET probes evaluated in prostate cancer include 18 F-sodium fluoride, 11 C-acetate, 11 C- or 18 F-choline, 18 F-fluciclovine, and 68 Ga- or 18 F-labeled ligands that bind prostate-specific membrane antigen (PSMA). PSMA ligands appear to be the most sensitive and specific but have not yet received Food and Drug Administration New Drug Application approval for use in the United States. Retrospective and prospective investigations suggest a potential major impact of PET/CT on prostate radiation treatment planning. Prospective trials randomizing patients to routine radiotherapy planning versus PET/CT-aided planning may show meaningful clinical outcomes. Prospective clinical trials evaluating the addition of 18 F-fluciclovine PET/CT for planning of salvage radiotherapy with clinical endpoints are under way. Prospective trials evaluating the clinical impact of PSMA PET/CT on prostate radiation planning are indicated. © 2018 by the Society of Nuclear Medicine and Molecular Imaging.

  3. A dimensionless dynamic contrast enhanced MRI parameter for intra-prostatic tumour target volume delineation: initial comparison with histology

    Science.gov (United States)

    Hrinivich, W. Thomas; Gibson, Eli; Gaed, Mena; Gomez, Jose A.; Moussa, Madeleine; McKenzie, Charles A.; Bauman, Glenn S.; Ward, Aaron D.; Fenster, Aaron; Wong, Eugene

    2014-03-01

    Purpose: T2 weighted and diffusion weighted magnetic resonance imaging (MRI) show promise in isolating prostate tumours. Dynamic contrast enhanced (DCE)-MRI has also been employed as a component in multi-parametric tumour detection schemes. Model-based parameters such as Ktrans are conventionally used to characterize DCE images and require arterial contrast agent (CR) concentration. A robust parameter map that does not depend on arterial input may be more useful for target volume delineation. We present a dimensionless parameter (Wio) that characterizes CR wash-in and washout rates without requiring arterial CR concentration. Wio is compared to Ktrans in terms of ability to discriminate cancer in the prostate, as demonstrated via comparison with histology. Methods: Three subjects underwent DCE-MRI using gadolinium contrast and 7 s imaging temporal resolution. A pathologist identified cancer on whole-mount histology specimens, and slides were deformably registered to MR images. The ability of Wio maps to discriminate cancer was determined through receiver operating characteristic curve (ROC) analysis. Results: There is a trend that Wio shows greater area under the ROC curve (AUC) than Ktrans with median AUC values of 0.74 and 0.69 respectively, but the difference was not statistically significant based on a Wilcoxon signed-rank test (p = 0.13). Conclusions: Preliminary results indicate that Wio shows potential as a tool for Ktrans QA, showing similar ability to discriminate cancer in the prostate as Ktrans without requiring arterial CR concentration.

  4. α-blockade, apoptosis, and prostate shrinkage: how are they related?

    Science.gov (United States)

    Chłosta, Piotr; Drewa, Tomasz; Kaplan, Steven

    2013-01-01

    The α1-adrenoreceptor antagonists, such as terazosin and doxazosin, induce prostate programmed cell death (apoptosis) within prostate epithelial and stromal cells in vitro. This treatment should cause prostate volume decrease, However, this has never been observed in clinical conditions. The aim of this paper is to review the disconnect between these two processes. PubMed and DOAJ were searched for papers related to prostate, apoptosis, and stem cell death. The following key words were used: prostate, benign prostate hyperplasia, programmed cell death, apoptosis, cell death, α1-adrenoreceptor antagonist, α-blockade, prostate epithelium, prostate stroma, stem cells, progenitors, and in vitro models. We have shown how discoveries related to stem cells can influence our understanding of α-blockade treatment for BPH patients. Prostate epithelial and mesenchymal compartments have stem (progenitors) and differentiating cells. These compartments are described in relation to experimental in vitro and in vivo settings. Apoptosis is observed within prostate tissue, but this effect has no clinical significance and cannot lead to prostate shrinkage. In part, this is due to stem cells that are responsible for prostate tissue regeneration and are resistant to apoptosis triggered by α1-receptor antagonists.

  5. Iodine-125 seed implantation (permanent brachytherapy) for clinically localized prostate cancer

    International Nuclear Information System (INIS)

    Ebara, Shin; Katayama, Yoshihisa; Tanimoto, Ryuta

    2008-01-01

    From January 2004 to March 2007, 308 patients with clinically localized prostate cancer were treated using iodine-125 ( 125 I) seed implantation (permanent brachytherapy) at Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences. We evaluated the treatment's efficacy and morbidity in 300 prostate cancer patients who were followed up for more than 1 month after brachytherapy. Based on the National Comprehensive Cancer Network (NCCN) guidelines, patients with a prostate volume of less than 40 ml in transrectal ultrasound imaging were classified as low or intermediate risk. The median patient age was 67 years (range 50 to 79 years), the median prostate-specific antigen (PSA) value before biopsy was 6.95 ng/ml (range 1.13 to 24.7 ng/ml), and the median prostate volume was 24.33 ml (range 9.3 to 41.76 ml). The median follow-up was 18 months (range 1 to 36 months) and the PSA levels decreased in almost all patients after brachytherapy. Although 194 of 300 patients (64.7%) complained of difficulty in urination, pollakisuria/urgency, miction pain, and/or urinary incontinence, all of which might be associated with radiation prostatitis during the first month after brachytherapy, these symptoms gradually improved. 125 I seed implantation brachytherapy is safe and effective for localized prostate cancer within short-term follow up. (author)

  6. Different rectal toxicity tolerance with and without simultaneous conventionally-fractionated pelvic lymph node treatment in patients receiving hypofractionated prostate radiotherapy

    International Nuclear Information System (INIS)

    McDonald, Andrew M; Baker, Christopher B; Popple, Richard A; Shekar, Kiran; Yang, Eddy S; Jacob, Rojymon; Cardan, Rex; Kim, Robert Y; Fiveash, John B

    2014-01-01

    To investigate added morbidity associated with the addition of pelvic elective nodal irradiation (ENI) to hypofractionated radiotherapy to the prostate. Two-hundred twelve patients, treated with hypofractionated radiotherapy to the prostate between 2004 and 2011, met the inclusion criteria for the analysis. All patients received 70 Gy to the prostate delivered over 28 fractions and 103 (49%) received ENI consisting of 50.4 Gy to the pelvic lymphatics delivered simultaneously in 1.8 Gy fractions. The mean dose-volume histograms were compared between the two subgroups defined by use of ENI, and various dose-volume parameters were analyzed for effect on late lower gastrointestinal (GI) and genitourinary (GU) toxicity. Acute grade 2 lower GI toxicity occurred in 38 (37%) patients receiving ENI versus 19 (17%) in those who did not (p = 0.001). The Kaplan-Meier estimate of grade ≥ 2 lower GI toxicity at 3 years was 15.3% for patients receiving ENI versus 5.3% for those who did not (p = 0.026). Each rectal isodose volume was increased for patients receiving ENI up to 50 Gy (p ≤ 0.021 for each 5 Gy increment). Across all patients, the absolute V 70 of the rectum was the only predictor of late GI toxicity. When subgroups, defined by the use of ENI, were analyzed separately, rectal V 70 was only predictive of late GI toxicity for patients who received ENI. For patients receiving ENI, V 70 > 3 cc was associated with an increased risk of late GI events. Elective nodal irradiation increases the rates of acute and late GI toxicity when delivered simultaneously with hypofractioanted prostate radiotherapy. The use of ENI appears to sensitize the rectum to hot spots, therefore we recommend added caution to minimize the volume of rectum receiving 100% of the prescription dose in these patients

  7. Different rectal toxicity tolerance with and without simultaneous conventionally-fractionated pelvic lymph node treatment in patients receiving hypofractionated prostate radiotherapy.

    Science.gov (United States)

    McDonald, Andrew M; Baker, Christopher B; Popple, Richard A; Shekar, Kiran; Yang, Eddy S; Jacob, Rojymon; Cardan, Rex; Kim, Robert Y; Fiveash, John B

    2014-06-03

    To investigate added morbidity associated with the addition of pelvic elective nodal irradiation (ENI) to hypofractionated radiotherapy to the prostate. Two-hundred twelve patients, treated with hypofractionated radiotherapy to the prostate between 2004 and 2011, met the inclusion criteria for the analysis. All patients received 70 Gy to the prostate delivered over 28 fractions and 103 (49%) received ENI consisting of 50.4 Gy to the pelvic lymphatics delivered simultaneously in 1.8 Gy fractions. The mean dose-volume histograms were compared between the two subgroups defined by use of ENI, and various dose-volume parameters were analyzed for effect on late lower gastrointestinal (GI) and genitourinary (GU) toxicity. Acute grade 2 lower GI toxicity occurred in 38 (37%) patients receiving ENI versus 19 (17%) in those who did not (p = 0.001). The Kaplan-Meier estimate of grade ≥ 2 lower GI toxicity at 3 years was 15.3% for patients receiving ENI versus 5.3% for those who did not (p = 0.026). Each rectal isodose volume was increased for patients receiving ENI up to 50 Gy (p ≤ 0.021 for each 5 Gy increment). Across all patients, the absolute V70 of the rectum was the only predictor of late GI toxicity. When subgroups, defined by the use of ENI, were analyzed separately, rectal V70 was only predictive of late GI toxicity for patients who received ENI. For patients receiving ENI, V70 > 3 cc was associated with an increased risk of late GI events. Elective nodal irradiation increases the rates of acute and late GI toxicity when delivered simultaneously with hypofractioanted prostate radiotherapy. The use of ENI appears to sensitize the rectum to hot spots, therefore we recommend added caution to minimize the volume of rectum receiving 100% of the prescription dose in these patients.

  8. Quantification of the volumetric benefit of image-guided radiotherapy (I.G.R.T.) in prostate cancer: Margins and presence probability map

    International Nuclear Information System (INIS)

    Cazoulat, G.; Crevoisier, R. de; Simon, A.; Louvel, G.; Manens, J.P.; Haigron, P.; Crevoisier, R. de; Louvel, G.; Manens, J.P.; Lafond, C.

    2009-01-01

    Purpose: To quantify the prostate and seminal vesicles (S.V.) anatomic variations in order to choose appropriate margins including intrapelvic anatomic variations. To quantify volumetric benefit of image-guided radiotherapy (I.G.R.T.). Patients and methods: Twenty patients, receiving a total dose of 70 Gy in the prostate, had a planning CT scan and eight weekly CT scans during treatment. Prostate and S.V. were manually contoured. Each weekly CT scan was registered to the planning CT scan according to three modalities: radiopaque skin marks, pelvis bone or prostate. For each patient, prostate and S.V. displacements were quantified. 3-dimensional maps of prostate and S.V. presence probability were established. Volumes including minimal presence probabilities were compared between the three modalities of registration. Result: For the prostate intrapelvic displacements, systematic and random variations and maximal displacements for the entire population were: 5 mm, 2.7 mm and 16.5 mm in anteroposterior axis; 2.7 mm, 2.4 mm and 11.4 mm in supero-inferior axis and 0.5 mm, 0.8 mm and 3.3 mm laterally. Margins according to van Herk recipe (to cover the prostate for 90% of the patients with the 95% isodose) were: 8 mm, 8.3 mm and 1.9 mm, respectively. The 100% prostate presence probability volumes correspond to 37%, 50% and 61% according to the registration modality. For the S.V., these volumes correspond to 8%, 14% and 18% of the S.V. volume. Conclusions: Without I.G.R.T., 5 mm prostate posterior margins are insufficient and should be at least 8 mm, to account for intrapelvic anatomic variations. Prostate registration almost doubles the 100% presence probability volume compared to skin registration. Deformation of S.V. will require either to increase dramatically margins (simple) or new planning (not realistic). (authors)

  9. Rapid estimate of solid volume in large tuff cores using a gas pycnometer

    International Nuclear Information System (INIS)

    Thies, C.; Geddis, A.M.; Guzman, A.G.

    1996-09-01

    A thermally insulated, rigid-volume gas pycnometer system has been developed. The pycnometer chambers have been machined from solid PVC cylinders. Two chambers confine dry high-purity helium at different pressures. A thick-walled design ensures minimal heat exchange with the surrounding environment and a constant volume system, while expansion takes place between the chambers. The internal energy of the gas is assumed constant over the expansion. The ideal gas law is used to estimate the volume of solid material sealed in one of the chambers. Temperature is monitored continuously and incorporated into the calculation of solid volume. Temperature variation between measurements is less than 0.1 degrees C. The data are used to compute grain density for oven-dried Apache Leap tuff core samples. The measured volume of solid and the sample bulk volume are used to estimate porosity and bulk density. Intrinsic permeability was estimated from the porosity and measured pore surface area and is compared to in-situ measurements by the air permeability method. The gas pycnometer accommodates large core samples (0.25 m length x 0.11 m diameter) and can measure solid volume greater than 2.20 cm 3 with less than 1% error

  10. Diagnostic accuracy of prostate health index to identify aggressive prostate cancer. An Institutional validation study.

    Science.gov (United States)

    Morote, J; Celma, A; Planas, J; Placer, J; Ferrer, R; de Torres, I; Pacciuci, R; Olivan, M

    2016-01-01

    New generations of tumor markers used to detect prostate cancer (PCa) should be able to discriminate men with aggressive PCa of those without PCa or nonaggressive tumors. The objective of this study has been to validate Prostate Health Index (PHI) as a marker of aggressive PCa in one academic institution. PHI was assessed in 357 men scheduled to prostatic biopsy between June of 2013 and July 2014 in one academic institution. Thereafter a subset of 183 men younger than 75 years and total PSA (tPSA) between 3.0 and 10.0 ng/mL, scheduled to it first prostatic biopsy, was retrospectively selected for this study. Twelve cores TRUS guided biopsy, under local anaesthesia, was performed in all cases. Total PSA, free PSA (fPSA), and [-2] proPSA (p2PSA) and prostate volume were determined before the procedure and %fPSA, PSA density (PSAd) and PHI were calculated. Aggressive tumors were considered if any Gleason 4 pattern was found. PHI was compared to %fPSA and PSAd through their ROC curves. Thresholds to detect 90%, 95% of all tumors and 95% and 100% of aggressive tumors were estimated and rates of unnecessary avoided biopsies were calculated and compared. The rate of PCa detection was 37.2% (68) and the rate of aggressive tumors was 24.6% (45). The PHI area under the curve was higher than those of %fPSA and PSAd to detect any PCa (0.749 vs 0.606 and 0.668 respectively) or to detect only aggressive tumors (0.786 vs 0.677 and 0.708 respectively), however, significant differences were not found. The avoided biopsy rates to detect 95% of aggressive tumors were 20.2% for PHI, 14.8% for %fPSA, and 23.5% for PSAd. Even more, to detect all aggressive tumors these rates dropped to 4.9% for PHI, 9.3% for %fPSA, and 7.9% for PSAd. PHI seems a good marker to PCa diagnosis. However, PHI was not superior to %fPSA and PSAd to identify at least 95% of aggressive tumors. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. [Experiences in the treatment of benign prostatic hyperplasia with high power potassium-titanyl-phosphate (KTP) laser].

    Science.gov (United States)

    Lipiński, Marek I; Peszyński-Drews, Cezary; Jeromin, Marek Z; Jeromin, Leszek M

    2006-01-01

    Benign prostatic hyperplasia (BPH) exist in about 70% men after 60 years old. High power KTP laser is a new tool for the treatment of BPH. 49 men were treated by photoselective vaporisation of the prostate (PVP) from August 2003 to May 2004. Thirty patients with follow-up period longer than 12 weeks (12 to 26 weeks) were analyzed. Preoperative prostate volume ranged from 31 to 136 cc. PSA range, estimated before treatment, was normal in all patients (pts). International Prostate Symptom Score (I-PSS) estimated before treatment was over 24 and Quality of Life (QoL) was over 3 in all pts. The maximum peak urinary flow (Qmax) before treatment ranged from 7.2 to 14.1 ml/s. One patient was catheterized with Foley catheter at the finish of the procedure. Two pts required catheterization in the first day after treatment. In two pts increasing of body temperature to 38 degrees C was observed in the first day after treatment. Twenty four hours after treatment haematuria required catheterization was observed in one patient. Seven days after treatment in 4 pts massive haematuria was observed (two required hospitalisation). In one patient because of urinary retention 4 weeks after PVP transurethral resection of the prostate was performed. Four weeks after PVP I-PSS decreased from 24 to 20 and after 12 weeks to 15. The Qmax increased and ranged from 11.3 ml/s to 17.1 ml/s 4 weeks after PVP and 12 weeks after PVP ranged from 15.1 to 22.8 ml/s. Photoselective vaporization of the prostate reduces I-PSS in all patients 12 weeks after procedure. Short follow-up period and a limited number of patients in study group cannot lead to ultimate conclusions. However the results encourage to undertaking further studies on PVP for the treatment of BPH.

  12. T2*-weighted image/T2-weighted image fusion in postimplant dosimetry of prostate brachytherapy

    International Nuclear Information System (INIS)

    Katayama, Norihisa; Takemoto, Mitsuhiro; Yoshio, Kotaro

    2011-01-01

    Computed tomography (CT)/magnetic resonance imaging (MRI) fusion is considered to be the best method for postimplant dosimetry of permanent prostate brachytherapy; however, it is inconvenient and costly. In T2 * -weighted image (T2 * -WI), seeds can be easily detected without the use of an intravenous contrast material. We present a novel method for postimplant dosimetry using T2 * -WI/T2-weighted image (T2-WI) fusion. We compared the outcomes of T2 * -WI/T2-WI fusion-based and CT/T2-WI fusion-based postimplant dosimetry. Between April 2008 and July 2009, 50 consecutive prostate cancer patients underwent brachytherapy. All the patients were treated with 144 Gy of brachytherapy alone. Dose-volume histogram (DVH) parameters (prostate D90, prostate V100, prostate V150, urethral D10, and rectal D2cc) were prospectively compared between T2 * -WI/T2-WI fusion-based and CT/T2-WI fusion-based dosimetry. All the DVH parameters estimated by T2 * -WI/T2-WI fusion-based dosimetry strongly correlated to those estimated by CT/T2-WI fusion-based dosimetry (0.77≤ R ≤0.91). No significant difference was observed in these parameters between the two methods, except for prostate V150 (p=0.04). These results show that T2 * -WI/T2-WI fusion-based dosimetry is comparable or superior to MRI-based dosimetry as previously reported, because no intravenous contrast material is required. For some patients, rather large differences were observed in the value between the 2 methods. We thought these large differences were a result of seed miscounts in T2 * -WI and shifts in fusion. Improving the image quality of T2 * -WI and the image acquisition speed of T2 * -WI and T2-WI may decrease seed miscounts and fusion shifts. Therefore, in the future, T2 * -WI/T2-WI fusion may be more useful for postimplant dosimetry of prostate brachytherapy. (author)

  13. A Phase III Randomized Trial of the Timing of Meloxicam With Iodine-125 Prostate Brachytherapy

    International Nuclear Information System (INIS)

    Crook, Juanita; Patil, Nikhilesh; Wallace, Kris; Borg, Jette; Zhou, David; Ma, Clement; Pond, Greg

    2010-01-01

    Purpose: Nonsteroidal anti-inflammatory medication is used to reduce prostate edema and urinary symptoms following prostate brachytherapy. We hypothesized that a cyclooxygenase-2 (COX-2) inhibitor regimen started 1 week prior to seed implant might diminish the inflammatory response, thus reducing edema, retention rates, and symptom severity. Methods and Materials: From March 2004 to February 2008, 316 men consented to an institutional review board-approved randomized study of a 4-week course of meloxicam, 7.5 mg orally twice per day, starting either on the day of implant or 1 week prior to implant. Brachytherapy was performed using iodine-125 seeds and was preplanned and performed under transrectal ultrasound (TRUS) and fluoroscopic guidance. Prostate volume obtained by MR imaging at 1 month was compared to baseline prostate volume obtained by TRUS planimetry and expressed as an edema factor. The trial endpoints were prostate edema at 1 month, International Prostate Symptom Score (IPSS) questionnaire results at 1 and 3 months, and any need for catheterization. Results: Results for 300 men were analyzed. Median age was 61 (range, 45-79 years), and median TRUS prostate volume was 35.7 cc (range, 18.1-69.5 cc). Median IPSS at baseline was 5 (range, 0-24) and was 15 at 1 month, 16 at 3 months, and 10 at 6 months. Catheterization was required for 7% of patients (6.2% day 0 arm vs. 7.9% day -7 arm; p = 0.65). The median edema factor at 1 month was 1.02 (range, 0.73-1.7). 1.01 day 0 arm vs. 1.05 day -7 arm. Baseline prostate volume remained the primary predictor of postimplant urinary retention. Conclusions: Starting meloxicam 1 week prior to brachytherapy compared to starting immediately after the procedure did not reduce 1-month edema, improve IPSSs at 1 or 3 months, or reduce the need for catheterization.

  14. Intra-fractional uncertainties in image-guided intensity-modulated radiotherapy (IMRT) of prostate cancer

    International Nuclear Information System (INIS)

    Polat, Buelent; Guenther, Iris; Wilbert, Juergen; Goebel, Joachim; Sweeney, Reinhart A.; Flentje, Michael; Guckenberger, Matthias

    2008-01-01

    To evaluate intra-fractional uncertainties during intensity-modulated radiotherapy (IMRT) of prostate cancer. During IMRT of 21 consecutive patients, kilovolt (kV) cone-beam computed tomography (CBCT) images were acquired prior to and immediately after treatment: a total of 252 treatment fractions with 504 CBCT studies were basis of this analysis. The prostate position in anterior-posterior (AP) direction was determined using contour matching; patient set-up based on the pelvic bony anatomy was evaluated using automatic image registration. Internal variability of the prostate position was the difference between absolute prostate and patient position errors. Intra-fractional changes of prostate position, patient position, rectal distension in AP direction and bladder volume were analyzed. With a median treatment time of 16 min, intra-fractional drifts of the prostate were > 5 mm in 12% of all fractions and a margin of 6 mm was calculated for compensation of this uncertainty. Mobility of the prostate was independent from the bony anatomy with poor correlation between absolute prostate motion and motion of the bony anatomy (R 2 = 0.24). A systematic increase of bladder filling by 41 ccm on average was observed; however, these changes did not influence the prostate position. Small variations of the prostate position occurred independently from intra-fractional changes of the rectal distension; a weak correlation between large internal prostate motion and changes of the rectal volume was observed (R 2 = 0.55). Clinically significant intra-fractional changes of the prostate position were observed and margins of 6 mm were calculated for this intra-fractional uncertainty. Repeated or continuous verification of the prostate position may allow further margin reduction. (orig.)

  15. Intra-fractional uncertainties in image-guided intensity-modulated radiotherapy (IMRT) of prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Polat, Buelent; Guenther, Iris; Wilbert, Juergen; Goebel, Joachim; Sweeney, Reinhart A.; Flentje, Michael; Guckenberger, Matthias [Wuerzburg Univ. (Germany). Dept. of Radiation Oncology

    2008-12-15

    To evaluate intra-fractional uncertainties during intensity-modulated radiotherapy (IMRT) of prostate cancer. During IMRT of 21 consecutive patients, kilovolt (kV) cone-beam computed tomography (CBCT) images were acquired prior to and immediately after treatment: a total of 252 treatment fractions with 504 CBCT studies were basis of this analysis. The prostate position in anterior-posterior (AP) direction was determined using contour matching; patient set-up based on the pelvic bony anatomy was evaluated using automatic image registration. Internal variability of the prostate position was the difference between absolute prostate and patient position errors. Intra-fractional changes of prostate position, patient position, rectal distension in AP direction and bladder volume were analyzed. With a median treatment time of 16 min, intra-fractional drifts of the prostate were > 5 mm in 12% of all fractions and a margin of 6 mm was calculated for compensation of this uncertainty. Mobility of the prostate was independent from the bony anatomy with poor correlation between absolute prostate motion and motion of the bony anatomy (R{sup 2} = 0.24). A systematic increase of bladder filling by 41 ccm on average was observed; however, these changes did not influence the prostate position. Small variations of the prostate position occurred independently from intra-fractional changes of the rectal distension; a weak correlation between large internal prostate motion and changes of the rectal volume was observed (R{sup 2} = 0.55). Clinically significant intra-fractional changes of the prostate position were observed and margins of 6 mm were calculated for this intra-fractional uncertainty. Repeated or continuous verification of the prostate position may allow further margin reduction. (orig.)

  16. Blood lipids and prostate cancer

    DEFF Research Database (Denmark)

    Bull, Caroline J; Bonilla, Carolina; Holly, Jeff M P

    2016-01-01

    Genetic risk scores were used as unconfounded instruments for specific lipid traits (Mendelian randomization) to assess whether circulating lipids causally influence prostate cancer risk. Data from 22,249 prostate cancer cases and 22,133 controls from 22 studies within the international PRACTICAL...... into logistic regression models to estimate the presence (and direction) of any causal effect of each lipid trait on prostate cancer risk. There was weak evidence for an association between the LDL genetic score and cancer grade: the odds ratio (OR) per genetically instrumented standard deviation (SD) in LDL.......95, 3.00; P = 0.08). The rs12916-T variant in 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) was inversely associated with prostate cancer (OR: 0.97; 95% CI: 0.94, 1.00; P = 0.03). In conclusion, circulating lipids, instrumented by our genetic risk scores, did not appear to alter prostate cancer risk...

  17. Transurethral vaporesection of prostate: diode laser or thulium laser?

    Science.gov (United States)

    Tan, Xinji; Zhang, Xiaobo; Li, Dongjie; Chen, Xiong; Dai, Yuanqing; Gu, Jie; Chen, Mingquan; Hu, Sheng; Bai, Yao; Ning, Yu

    2018-05-01

    This study compared the safety and effectiveness of the diode laser and thulium laser during prostate transurethral vaporesection for treating benign prostate hyperplasia (BPH). We retrospectively analyzed 205 patients with BPH who underwent a diode laser or thulium laser technique for prostate transurethral vaporesection from June 2016 to June 2017 and who were followed up for 3 months. Baseline characteristics of the patients, perioperative data, postoperative outcomes, and complications were compared. We also assessed the International Prostate Symptom Score (IPSS), quality of life (QoL), maximum flow rate (Q max ), average flow rate (AFR), and postvoid residual volume (PVR) at 1 and 3 months postoperatively to evaluate the functional improvement of each group. There were no significant differences between the diode laser and thulium laser groups related to age, prostate volume, operative time, postoperative hospital stays, hospitalization costs, or perioperative data. The catheterization time was 3.5 ± 0.8 days for the diode laser group and 4.7 ± 1.8 days for the thulium laser group (p diode laser and thulium laser contributes to safe, effective transurethral vaporesection in patients with symptomatic BPH. Diode laser, however, is better than thulium laser for prostate transurethral vaporesection because of its shorter catheterization time. The choice of surgical approach is more important than the choice of laser types during clinical decision making for transurethral laser prostatectomy.

  18. Estimation of gas and tissue lung volumes by MRI: functional approach of lung imaging.

    Science.gov (United States)

    Qanadli, S D; Orvoen-Frija, E; Lacombe, P; Di Paola, R; Bittoun, J; Frija, G

    1999-01-01

    The purpose of this work was to assess the accuracy of MRI for the determination of lung gas and tissue volumes. Fifteen healthy subjects underwent MRI of the thorax and pulmonary function tests [vital capacity (VC) and total lung capacity (TLC)] in the supine position. MR examinations were performed at inspiration and expiration. Lung volumes were measured by a previously validated technique on phantoms. Both individual and total lung volumes and capacities were calculated. MRI total vital capacity (VC(MRI)) was compared with spirometric vital capacity (VC(SP)). Capacities were correlated to lung volumes. Tissue volume (V(T)) was estimated as the difference between the total lung volume at full inspiration and the TLC. No significant difference was seen between VC(MRI) and VC(SP). Individual capacities were well correlated (r = 0.9) to static volume at full inspiration. The V(T) was estimated to be 836+/-393 ml. This preliminary study demonstrates that MRI can accurately estimate lung gas and tissue volumes. The proposed approach appears well suited for functional imaging of the lung.

  19. Dietary Lycopene, Angiogenesis, and Prostate Cancer: A Prospective Study in the Prostate-Specific Antigen Era

    Science.gov (United States)

    2014-01-01

    Background The role of lycopene in prostate cancer prevention remains controversial. We examined the associations between dietary lycopene intake and prostate cancer, paying particular attention to the influence of prostate-specific antigen screening, and evaluated tissue biomarkers in prostate cancers in relation to lycopene intake. Methods Among 49898 male health professionals, we obtained dietary information through questionnaires and ascertained total and lethal prostate cancer cases from 1986 through January 31, 2010. Cox regression was used to estimate multivariable hazard ratios (HRs) and 95% confidence intervals (CIs). Tissue microarrays and immunohistochemistry were used to assess tumor biomarker expression in a subset of men. Two-sided χ2 tests were used to calculate the P values. Results Higher lycopene intake was inversely associated with total prostate cancer and more strongly with lethal prostate cancer (top vs bottom quintile: HR = 0.72; 95% CI = 0.56 to 0.94; P trend = .04). In a restricted population of screened participants, the inverse associations became markedly stronger (for lethal prostate cancer: HR = 0.47; 95% CI = 0.29 to 0.75; P trend = .009). Comparing different measures of dietary lycopene, early intake, but not recent intake, was inversely associated with prostate cancer. Higher lycopene intake was associated with biomarkers in the cancer indicative of less angiogenic potential. Conclusions Dietary intake of lycopene was associated with reduced risk of lethal prostate cancer and with a lesser degree of angiogenesis in the tumor. Because angiogenesis is a strong progression factor, an endpoint of lethal prostate cancer may be more relevant than an endpoint of indolent prostate cancer for lycopene in the era of highly prevalent prostate-specific antigen screening. PMID:24463248

  20. [Giant prostatic calculus with neurogenic bladder disease and prostate diverticulum: a case report and review of the literature].

    Science.gov (United States)

    Li, Xiao-Shi; Quan, Chang-Yi; Li, Gang; Cai, Qi-Liang; Hu, Bin; Wang, Jiu-Wei; Niu, Yuan-Jie

    2013-02-01

    To study the etiology, clinical manifestation, diagnosis and treatment of giant prostatic calculus with neurogenic bladder disease and prostate diverticulum. We retrospectively analyzed the clinical data of a case of giant prostatic calculus with neurogenic bladder disease and prostate diverticulum and reviewed the relevant literature. The patient was a 37-year-old man, with urinary incontinence for 22 years and intermittent dysuria with frequent micturition for 9 years, aggravated in the past 3 months. He had received surgery for spina bifida and giant vesico-prostatic calculus. The results of preoperative routine urinary examination were as follows: WBC 17 -20/HPF, RBC 12 - 15/HPF. KUB, IVU and pelvic CT revealed spina bifida occulta, neurogenic bladder and giant prostatic calculus. The patient underwent TURP and transurethral lithotripsy with holmium-YAG laser. The prostatic calculus was carbonate apatite in composition. Urinary dynamic images at 2 weeks after surgery exhibited significant improvement in the highest urine flow rate and residual urine volume. Seventeen months of postoperative follow-up showed dramatically improved urinary incontinence and thicker urine stream. Prostate diverticulum with prostatic giant calculus is very rare, and neurogenic bladder may play a role in its etiology. Cystoscopy is an accurate screening method for its diagnosis. For the young patients and those who wish to retain sexual function, TURP combined with holmium laser lithotripsy can be employed, and intraoperative rectal examination should be taken to ensure complete removal of calculi.

  1. Prostatic Artery Embolization (PAE) for Benign Prostatic Hyperplasia (BPH) with Haematuria in the Absence of an Upper Urinary Tract Pathology.

    Science.gov (United States)

    Tapping, Charles R; Macdonald, Andrew; Hadi, Mo; Mortensen, Chloe; Crew, Jeremy; Protheroe, Andrew; Little, Mark W; Boardman, Phil

    2018-03-26

    To assess the effectiveness of prostate artery embolization (PAE) in the control of haematuria and in patients with benign prostatic hyperplasia (BPH) and normal upper urinary tracts. Twelve consecutive patients with haematuria were included in the prospective study. All patients had prior imaging and cystoscopy to exclude other causes of haematuria. Patients prostate arteries were embolized with particles (200-500 μm), and they were followed up at 3, 12 and 18 months following the procedure. QOL questionnaires, IPSS, IIEF and clinical review were all employed to assess the success of the treatment. To allow useful comparison, patients were age- and prostate volume-matched and compared to patients treated with PAE for BPH without haematuria. All 12/12 cases were technically successful with bilateral PAE being performed. All cases of haematuria resolved by the 3-month follow-up (100%). There was one case of recurrence during the 12-month follow-up (overall clinical success at 18 months 92%). This was due to over anticoagulation and ceased once corrected. There was a reduction in lower urinary tract symptoms noted by improvements in QOL indices, IPSS and IIEF. There was continued success even if the patient was subsequently anticoagulated. There was no associated sexual dysfunction. There was more prostatic arterial branching and volume of embolic required to achieve stasis in BPH and haematuria than in BPH alone (p BPH allows a significant improvement in QOL.

  2. Prostate cancer risk prediction based on complete prostate cancer family history

    OpenAIRE

    Albright, Frederick; Stephenson, Robert A; Agarwal, Neeraj; Teerlink, Craig C; Lowrance, William T; Farnham, James M; Albright, Lisa A Cannon

    2014-01-01

    Background Prostate cancer (PC) relative risks (RRs) are typically estimated based on status of close relatives or presence of any affected relatives. This study provides RR estimates using extensive and specific PC family history. Methods A retrospective population-based study was undertaken to estimate RRs for PC based on complete family history of PC. A total of 635,443 males, all with ancestral genealogy data, were analyzed. RRs for PC were determined based upon PC rates estimated from ma...

  3. The use of nomograms in LDR-HDR prostate brachytherapy.

    Science.gov (United States)

    Pujades, Ma Carmen; Camacho, Cristina; Perez-Calatayud, Jose; Richart, José; Gimeno, Jose; Lliso, Françoise; Carmona, Vicente; Ballester, Facundo; Crispín, Vicente; Rodríguez, Silvia; Tormo, Alejandro

    2011-09-01

    The common use of nomograms in Low Dose Rate (LDR) permanent prostate brachytherapy (BT) allows to estimate the number of seeds required for an implant. Independent dosimetry verification is recommended for each clinical dosimetry in BT. Also, nomograms can be useful for dose calculation quality assurance and they could be adapted to High Dose Rate (HDR). This work sets nomograms for LDR and HDR prostate-BT implants, which are applied to three different institutions that use different implant techniques. Patients treated throughout 2010 till April 2011 were considered for this study. This example was chosen to be the representative of the latest implant techniques and to ensure consistency in the planning. A sufficient number of cases for both BT modalities, prescription dose and different work methodology (depending on the institution) were taken into account. The specific nomograms were built using the correlation between the prostate volume and some characteristic parameters of each BT modality, such as the source Air Kerma Strength, number of implanted seeds in LDR or total radiation time in HDR. For each institution and BT modality, nomograms normalized to the prescribed dose were obtained and fitted to a linear function. The parameters of the adjustment show a good agreement between data and the fitting. It should be noted that for each institution these linear function parameters are different, indicating that each centre should construct its own nomograms. Nomograms for LDR and HDR prostate brachytherapy are simple quality assurance tools, specific for each institution. Nevertheless, their use should be complementary to the necessary independent verification.

  4. Estimating tree bole volume using artificial neural network models for four species in Turkey.

    Science.gov (United States)

    Ozçelik, Ramazan; Diamantopoulou, Maria J; Brooks, John R; Wiant, Harry V

    2010-01-01

    Tree bole volumes of 89 Scots pine (Pinus sylvestris L.), 96 Brutian pine (Pinus brutia Ten.), 107 Cilicica fir (Abies cilicica Carr.) and 67 Cedar of Lebanon (Cedrus libani A. Rich.) trees were estimated using Artificial Neural Network (ANN) models. Neural networks offer a number of advantages including the ability to implicitly detect complex nonlinear relationships between input and output variables, which is very helpful in tree volume modeling. Two different neural network architectures were used and produced the Back propagation (BPANN) and the Cascade Correlation (CCANN) Artificial Neural Network models. In addition, tree bole volume estimates were compared to other established tree bole volume estimation techniques including the centroid method, taper equations, and existing standard volume tables. An overview of the features of ANNs and traditional methods is presented and the advantages and limitations of each one of them are discussed. For validation purposes, actual volumes were determined by aggregating the volumes of measured short sections (average 1 meter) of the tree bole using Smalian's formula. The results reported in this research suggest that the selected cascade correlation artificial neural network (CCANN) models are reliable for estimating the tree bole volume of the four examined tree species since they gave unbiased results and were superior to almost all methods in terms of error (%) expressed as the mean of the percentage errors. 2009 Elsevier Ltd. All rights reserved.

  5. Positive Response to Thermobalancing Therapy Enabled by Therapeutic Device in Men with Non-Malignant Prostate Diseases: BPH and Chronic Prostatitis.

    Science.gov (United States)

    Aghajanyan, Ivan Gerasimovich; Allen, Simon

    2016-04-18

    The most common types of non-malignant prostate diseases are benign prostatic hyperplasia (BPH) and chronic prostatitis (CP). The aim of this study was to find out whether thermobalancing therapy with a physiotherapeutic device is effective for BPH and CP. During a 2.5-year period, 124 men with BPH over the age of 55 were investigated. Clinical parameters were tested twice: via the International Prostate Symptom Score (IPSS) and via ultrasound measurement of prostate volume (PV) and uroflowmetry maximum flow rate (Q max ), before and after six months of therapy. In 45 men with CP under the age of 55, the dynamics of the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) were studied. The results of the investigated index tests in men with BPH confirmed a decrease in IPSS ( p BPH and the improvement in NIH-CPSI-QoL in patients with CP after using a physiotherapeutic device for six months as mono-therapy, support the view that thermobalancing therapy with the device can be recommended for these patients. Furthermore, the therapeutic device is free of side effects.

  6. Using LiDAR to Estimate Surface Erosion Volumes within the Post-storm 2012 Bagley Fire

    Science.gov (United States)

    Mikulovsky, R. P.; De La Fuente, J. A.; Mondry, Z. J.

    2014-12-01

    The total post-storm 2012 Bagley fire sediment budget of the Squaw Creek watershed in the Shasta-Trinity National Forest was estimated using many methods. A portion of the budget was quantitatively estimated using LiDAR. Simple workflows were designed to estimate the eroded volume's of debris slides, fill failures, gullies, altered channels and streams. LiDAR was also used to estimate depositional volumes. Thorough manual mapping of large erosional features using the ArcGIS 10.1 Geographic Information System was required as these mapped features determined the eroded volume boundaries in 3D space. The 3D pre-erosional surface for each mapped feature was interpolated based on the boundary elevations. A surface difference calculation was run using the estimated pre-erosional surfaces and LiDAR surfaces to determine volume of sediment potentially delivered into the stream system. In addition, cross sections of altered channels and streams were taken using stratified random selection based on channel gradient and stream order respectively. The original pre-storm surfaces of channel features were estimated using the cross sections and erosion depth criteria. Open source software Inkscape was used to estimate cross sectional areas for randomly selected channel features and then averaged for each channel gradient and stream order classes. The average areas were then multiplied by the length of each class to estimate total eroded altered channel and stream volume. Finally, reservoir and in-channel depositional volumes were estimated by mapping channel forms and generating specific reservoir elevation zones associated with depositional events. The in-channel areas and zones within the reservoir were multiplied by estimated and field observed sediment thicknesses to attain a best guess sediment volume. In channel estimates included re-occupying stream channel cross sections established before the fire. Once volumes were calculated, other erosion processes of the Bagley

  7. Analysis of Initial Baseline Clinical Parameters and Treatment Strategy Associated with Medication Failure in the Treatment of Benign Prostatic Hyperplasia in Korea

    Directory of Open Access Journals (Sweden)

    Hoon Choi

    2010-12-01

    Full Text Available Purpose To analyze the baseline clinical factors and medication treatment strategy used in cases with medication treatment failure of benign prostatic hyperplasia (BPH. Methods From January 2006 to December 2009, 677 BPH patients with at least 3 months of treatment with medication were enrolled. We analyzed clinical factors by medication failure (n=161 versus maintenance (n=516, by prostate size (less than 30 g, n=231; 30 to 50 g, n=244; greater than 50 g, n=202, and by prostate-specific antigen (PSA levels (less than 1.4 ng/mL, n=324; more than 1.4 ng/mL, n=353. Results Age, combination medication rate, PSA, and prostate volume were statistically different between the medication treatment failure and maintenance groups. By prostate size, the PSA and medication failure rates were relatively higher and the medication period was shorter in patients with a prostate size of more than 30 g. The combination medication rate was higher in patients with a prostate size of more than 50 g. The medication failure rate and prostate volume were higher in patients with a PSA level of more than 1.4 ng/mL. However, the combination treatment rate was not significantly different in patients with a PSA level lower than 1.4 ng/mL. Suggestive cutoffs for combination medication are a prostate volume of 34 g and PSA level of 1.9 ng/mL. Conclusions The clinical factors associated with medication failure were age, treatment type, and prostate volume. Combination therapy should be considered more in Korea in patients with a PSA level higher than 1.4 ng/mL and a prostate volume of between 30 and 50 g to prevent medication failure.

  8. High frequency of chronic bacterial and non-inflammatory prostatitis in infertile patients with prostatitis syndrome plus irritable bowel syndrome.

    OpenAIRE

    Enzo Vicari; Sandro La Vignera; Domenico Arcoria; Rosita Condorelli; Lucia O Vicari; Roberto Castiglione; Andrea Mangiameli; Aldo E Calogero

    2011-01-01

    Background Although prostatitis syndrome (PS) and irritable bowel syndrome (IBS) are common disorders, information on the prevalence of IBS in infertile patients with PS is relatively scanty. Therefore, this study was undertaken to estimate the frequency of PS and IBS and to evaluate the prevalence of the various diagnostic categories of prostatitis. Methodology/Principal Findings This study enrolled 152 patients with PS, diagnosed by the NIH-Chronic Prostatitis Symptom Index (NIH-CPSI) in an...

  9. A planning quality evaluation tool for prostate adaptive IMRT based on machine learning

    International Nuclear Information System (INIS)

    Zhu Xiaofeng; Ge Yaorong; Li Taoran; Thongphiew, Danthai; Yin Fangfang; Wu, Q Jackie

    2011-01-01

    Purpose: To ensure plan quality for adaptive IMRT of the prostate, we developed a quantitative evaluation tool using a machine learning approach. This tool generates dose volume histograms (DVHs) of organs-at-risk (OARs) based on prior plans as a reference, to be compared with the adaptive plan derived from fluence map deformation. Methods: Under the same configuration using seven-field 15 MV photon beams, DVHs of OARs (bladder and rectum) were estimated based on anatomical information of the patient and a model learned from a database of high quality prior plans. In this study, the anatomical information was characterized by the organ volumes and distance-to-target histogram (DTH). The database consists of 198 high quality prostate plans and was validated with 14 cases outside the training pool. Principal component analysis (PCA) was applied to DVHs and DTHs to quantify their salient features. Then, support vector regression (SVR) was implemented to establish the correlation between the features of the DVH and the anatomical information. Results: DVH/DTH curves could be characterized sufficiently just using only two or three truncated principal components, thus, patient anatomical information was quantified with reduced numbers of variables. The evaluation of the model using the test data set demonstrated its accuracy ∼80% in prediction and effectiveness in improving ART planning quality. Conclusions: An adaptive IMRT plan quality evaluation tool based on machine learning has been developed, which estimates OAR sparing and provides reference in evaluating ART.

  10. Real-time virtual sonography for navigation during targeted prostate biopsy using magnetic resonance imaging data

    International Nuclear Information System (INIS)

    Miyagawa, Tomoaki; Ishikawa, Satoru; Kimura, Tomokazu; Suetomi, Takahiro; Tsutsumi, Masakazu; Irie, Toshiyuki; Kondoh, Masanao; Mitake, Tsuyoshi

    2010-01-01

    The objective of this study was to evaluate the effectiveness of the medical navigation technique, namely, Real-time Virtual Sonography (RVS), for targeted prostate biopsy. Eighty-five patients with suspected prostate cancer lesions using magnetic resonance imaging (MRI) were included in this study. All selected patients had at least one negative result on the previous transrectal biopsies. The acquired MRI volume data were loaded onto a personal computer installed with RVS software, which registers the volumes between MRI and real-time ultrasound data for real-time display. The registered MRI images were displayed adjacent to the ultrasonographic sagittal image on the same computer monitor. The suspected lesions on T2-weighted images were marked with a red circle. At first suspected lesions were biopsied transperineally under real-time navigation with RVS and then followed by the conventional transrectal and transperineal biopsy under spinal anesthesia. The median age of the patients was 69 years (56-84 years), and the prostate-specific antigen level and prostate volume were 9.9 ng/mL (4.0-34.2) and 37.2 mL (18-141), respectively. Prostate cancer was detected in 52 patients (61%). The biopsy specimens obtained using RVS revealed 45/52 patients (87%) positive for prostate cancer. A total of 192 biopsy cores were obtained using RVS. Sixty-two of these (32%) were positive for prostate cancer, whereas conventional random biopsy revealed cancer only in 75/833 (9%) cores (P<0.01). Targeted prostate biopsy with RVS is very effective to diagnose lesions detected with MRI. This technique only requires additional computer and RVS software and thus is cost-effective. Therefore, RVS-guided prostate biopsy has great potential for better management of prostate cancer patients. (author)

  11. Rapid estimate of solid volume in large tuff cores using a gas pycnometer

    Energy Technology Data Exchange (ETDEWEB)

    Thies, C. [ed.; Geddis, A.M.; Guzman, A.G. [and others

    1996-09-01

    A thermally insulated, rigid-volume gas pycnometer system has been developed. The pycnometer chambers have been machined from solid PVC cylinders. Two chambers confine dry high-purity helium at different pressures. A thick-walled design ensures minimal heat exchange with the surrounding environment and a constant volume system, while expansion takes place between the chambers. The internal energy of the gas is assumed constant over the expansion. The ideal gas law is used to estimate the volume of solid material sealed in one of the chambers. Temperature is monitored continuously and incorporated into the calculation of solid volume. Temperature variation between measurements is less than 0.1{degrees}C. The data are used to compute grain density for oven-dried Apache Leap tuff core samples. The measured volume of solid and the sample bulk volume are used to estimate porosity and bulk density. Intrinsic permeability was estimated from the porosity and measured pore surface area and is compared to in-situ measurements by the air permeability method. The gas pycnometer accommodates large core samples (0.25 m length x 0.11 m diameter) and can measure solid volume greater than 2.20 cm{sup 3} with less than 1% error.

  12. Strategies for Online Organ Motion Correction for Intensity-Modulated Radiotherapy of Prostate Cancer: Prostate, Rectum, and Bladder Dose Effects

    International Nuclear Information System (INIS)

    Rijkhorst, Erik-Jan; Lakeman, Annemarie; Nijkamp, Jasper; Bois, Josien de; Herk, Marcel van; Lebesque, Joos V.; Sonke, Jan-Jakob

    2009-01-01

    Purpose: To quantify and evaluate the accumulated prostate, rectum, and bladder dose for several strategies including rotational organ motion correction for intensity-modulated radiotherapy (IMRT) of prostate cancer using realistic organ motion data. Methods and Materials: Repeat computed tomography (CT) scans of 19 prostate patients were used. Per patient, two IMRT plans with different uniform margins were created. To quantify prostate and seminal vesicle motion, repeat CT clinical target volumes (CTVs) were matched onto the planning CTV using deformable registration. Four different strategies, from online setup to full motion correction, were simulated. Rotations were corrected for using gantry and collimator angle adjustments. Prostate, rectum, and bladder doses were accumulated for each patient, plan, and strategy. Minimum CTV dose (D min ), rectum equivalent uniform dose (EUD, n = 0.13), and bladder surface receiving ≥78 Gy (S78), were calculated. Results: With online CTV translation correction, a 7-mm margin was sufficient (i.e., D min ≥ 95% of the prescribed dose for all patients). A 4-mm margin required additional rotational correction. Margin reduction lowered the rectum EUD(n = 0.13) by ∼2.6 Gy, and the bladder S78 by ∼1.9%. Conclusions: With online correction of both translations and rotations, a 4-mm margin was sufficient for 15 of 19 patients, whereas the remaining four patients had an underdosed CTV volume <1%. Margin reduction combined with online corrections resulted in a similar or lower dose to the rectum and bladder. The more advanced the correction strategy, the better the planned and accumulated dose agreed.

  13. Electromagnetic Transponders Indicate Prostate Size Increase Followed by Decrease During the Course of External Beam Radiation Therapy

    International Nuclear Information System (INIS)

    King, Benjamin L.; Butler, Wayne M.; Merrick, Gregory S.; Kurko, Brian S.; Reed, Joshua L.; Murray, Brian C.; Wallner, Kent E.

    2011-01-01

    Purpose: Real-time image guidance enables more accurate radiation therapy by tracking target movement. This study used transponder positions to monitor changes in prostate volume that may be a source of dosimetric and target inaccuracy. Methods and Materials: Twenty-four men with biopsy-proven T1c-T3a prostate cancer each had three electromagnetic transponders implanted transperineally. Their coordinates were recorded by the Calypso system, and the perimeter of the triangle formed by the transponders was used to calculate prostate volumes at sequential time points throughout the course of radiation therapy to a dose of 81 Gy in 1.8-Gy fractions. Results: There was a significant decrease in mean prostate volume of 10.9% from the first to the final day of radiation therapy. The volume loss did not occur monotonically but increased in most patients (75%) during the first several weeks to a median maximum on Day 7. The volume increased by a mean of 6.1% before decreasing by a mean maximum difference of 18.4% to nadir (p < 0.001 for both increase and decrease). Glandular shrinkage was asymmetric, with the apex to right base dimension varying more than twice that of the lateral dimension. For all dimensions, the mean change was <0.5 cm. Conclusion: Real-time transponder positions indicated a volume increase during the initial days of radiation therapy and then significant and asymmetric shrinkage by the final day. Understanding and tracking volume fluctuations of the prostate during radiation therapy can help real-time imaging technology perform to its fullest potential.

  14. Seed displacements after permanent brachytherapy for prostate cancer in dependence on the prostate level

    Energy Technology Data Exchange (ETDEWEB)

    Pinkawa, M.; Gagel, B.; Asadpour, B.; Piroth, M.D.; Klotz, J.; Eble, M.J. [Dept. of Radiotherapy, RWTH Aachen (Germany); Borchers, H.; Jakse, G. [Dept. of Urology, RWTH Aachen (Germany)

    2008-10-15

    Purpose: to evaluate seed displacements after permanent prostate brachytherapy considering different prostate levels. Patients and methods: in 61 patients, postimplant CT scans were performed 1 day and 1 month after an implant with stranded seeds. Seed and prostate surface displacements were determined relative to pelvic bones. Four groups of seed locations were selected: seeds at the base (n = 305; B), at the apex (n = 305; A), close to the urethra (n = 306; U), and close to the rectal wall (n = 204; R). The length of two strands (always containing four seeds) per patient was measured in all CT scans and compared. Results: the largest inferior seed displacements were found at the base: mean 5.3 mm (B), 2.2 mm (A), 2.7 mm (U), 3.3 mm (R; p < 0.001). Posterior displacements predominated both at the base and the central region: mean 2.2 mm (B), 2.0 mm (U), 0.8 mm (A), -0.6 mm (R; p < 0.001). With a decreasing edema between day 1 and 30 (mean prostate volume of 51 cm{sup 3} vs. 41 cm{sup 3}; p < 0.001), a mean caudal prostate base displacement of 3.9 mm was found, whereas the mean inward displacement ranged from 1.2 to 1.6 mm at the remaining borders (lateral, anterior, posterior, apical). The analysis of the strand lengths revealed an implant compression between day 1 and 30 (mean 1.7 mm; p < 0.001). Conclusion: the largest prostate tissue and seed displacements were observed at the prostate base, associated with an implant compression. Predominantly inferior and posterior displacements implicate consequential smaller preplanning margins at the apex and the posterior prostate. (orig.)

  15. The value of MSCT on prostate disease

    International Nuclear Information System (INIS)

    Li Xi

    2009-01-01

    Objective: To analyze the CT signs of BPH, and to investigate the value of diagnosis and differential diagnosis of BPH by MSCT. Methods: Multi-phase CT scanning including plain scan, arterial phase (35sec), venous phase (65sec), parenchymal phase (95sec), lag period (180sec) scan after giving contrast medium was performed in 22 cases with BPH proven pathologically and clinically. CT signs of plain scan and dynamic scan were analyzed. Results: Morphology of prostatic hyperplasia was: chestnuts like in lightly hyperplasia with normal or slightly increased volume; round in obviously hyperplasia with enlarged volume; all the hyperplasia prostate impressed to the base of bladder, even with lobulated incisure of bladder neck. Symphyso-cyst of prostate, bladder stone, bladder diverticulum, vesicocele, hydronephrosis, etc may be combined. BPH located in the central of prostate. Uniform density showed in plain scan. CT value was 35.7 ± 3.5HU; average CT value was 50.7 ± 10.4HU in arterial phase, 67.2 ± 12.3HU in venous phase, 70.1 ± 7HU in parenchymal phase and 68.8 ± 8.2HU in lag period scan, Densr-time-curve of BPH was slow-flatbed pattern. Conclusion: MSCT is of important value in diagnosis and differential diagnosis of BPH for the morphologic characteristics and development of BPH can be evaluated thoroughly by it. (authors)

  16. Genus Zero Graph Segmentation: Estimation of Intracranial Volume

    DEFF Research Database (Denmark)

    Jensen, Rasmus Ramsbøl; Thorup, Signe Strann; Paulsen, Rasmus Reinhold

    2013-01-01

    The intracranial volume (ICV) in children with premature fusion of one or more sutures in the calvaria is of interest due to the risk of increased intracranial pressure. Challenges for automatic estimation of ICV include holes in the skull e.g. the foramen magnum and fontanelles. In this paper, we...

  17. Genus zero graph segmentation: Estimation of intracranial volume

    DEFF Research Database (Denmark)

    Jensen, Rasmus Ramsbøl; Thorup, Signe Strann; Paulsen, Rasmus Reinhold

    2014-01-01

    The intracranial volume (ICV) in children with premature fusion of one or more sutures in the calvaria is of interest due to the risk of increased intracranial pressure. Challenges for automatic estimation of ICV include holes in the skull e.g. the foramen magnum and fontanelles. In this paper, w...

  18. SU-G-TeP1-01: A Simulation Study to Investigate Maximum Allowable Deformations of Implant Geometry Before Plan Objectives Are Violated in Prostate HDR Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Babier, A [Department of Physics, Engineering Physics and Astronomy, Queens University, Kingston, Ontario (Canada); Joshi, C [Department of Physics, Engineering Physics and Astronomy, Queens University, Kingston, Ontario (Canada); Cancer Center of Southeastern Ontario, Kingston General Hospital, Kingston, Ontario (Canada)

    2016-06-15

    Purpose: In prostate HDR brachytherapy dose distributions are highly sensitive to changes in prostate volume and catheter displacements. We investigate the maximum deformations in implant geometry before planning objectives are violated. Methods: A typical prostate Ir-192 HDR brachytherapy reference plan was calculated on the Oncentra planning system, which used CT images from a tissue equivalent prostate phantom (CIRS Model 053S) embedded inside a pelvis wax phantom. The prostate was deformed and catheters were displaced in simulations using a code written in MATLAB. For each deformation dose distributions were calculated, based on TG43 methods, using the MATLAB code. The calculations were validated through comparison with Oncentra calculations for the reference plan, and agreed within 0.12%SD and 0.3%SD for dose and volume, respectively. Isotropic prostate volume deformations of up to +34% to −27% relative to its original volume, and longitudinal catheter displacements of 7.5 mm in superior and inferior directions were simulated. Planning objectives were based on American Brachytherapy Society guidelines for prostate and urethra volumes. A plan violated the planning objectives when less than 90% of the prostate volume received the prescribed dose or higher (V{sub 100}), or the urethral volume receiving 125% of prescribed dose or higher was more than 1 cc (U{sub 125}). Lastly, the dose homogeneity index (DHI=1-V{sub 150}/V{sub 100}) was evaluated; a plan was considered sub-optimal when the DHI fell below 0.62. Results and Conclusion: Planning objectives were violated when the prostate expanded by 10.7±0.5% or contracted by 11.0±0.2%; objectives were also violated when catheters were displaced by 4.15±0.15 mm and 3.70±0.15 mm in the superior and inferior directions, respectively. The DHI changes did not affect the plan optimality, except in the case of prostate compression. In general, catheter displacements have a significantly larger impact on plan

  19. TU-F-CAMPUS-T-05: Dose Escalation to Biological Tumor Volumes of Prostate Cancer Patients Using Gold Nanoparticles

    Energy Technology Data Exchange (ETDEWEB)

    Jermoumi, M; Ngwa, W [Department of Physics and Applied Physics, Medical Physics Program, University of Massachusetts Lowell (United States); Department of Radiation Oncology, Dana Farber Cancer Insitute, Brigham and Women’s Hospital, Harvard Medical, Boston, MA (United States); Sajo, E [Department of Physics and Applied Physics, Medical Physics Program, University of Massachusetts Lowell (United States); Houari, K [Department of Radiation Oncology, Dana Farber Cancer Insitute, Brigham and Women’s Hospital, Harvard Medical, Boston, MA (United States)

    2015-06-15

    Purpose: Studies have shown that radiation boosting could help reduce prostate cancer (PCa) recurrence. Biological tumor volumes (BTV) are a high priority for such radiation boosting. The purpose of this study is to investigate the potential of radiation boosting of real patient BTVs using gold nanoparticles (GNP) released from gold-loaded brachytherapy spacers (GBS) during brachytherapy. Methods: The BTVs of 12 patients having prostate adenocarcinoma identified with positron emission tomography (PET) and CT scanner using C-11 labeled tracer [11C]acetate were investigated. The initial GNP concentration and time to achieve a dose enhancement effect (DEF) of 2 was simulated using the freely downloadable software RAID APP. The investigations were carried out for low dose rate (LDR) brachytherapy sources (BTS) described in AAPM Task Group report 43: Cs-131, I-125, and Pd-103. In first case, we used 7 mg/g and 18 mg/g of GNP initial concentrations to estimate the time needed for released GNP to achieve a DEF of 2 for the different BTS, and compare with clinically relevant treatment times. In second case, we calculated the initial concentration of GNPs needed to achieve a DEF of 2 during the time the BTS would typically deliver 50%, 70% and 90% of the total dose. Results: For an initial concentration of 18 mg/g, when using Cs-131, and Pd-103, a DEF of 2 could only be achieved for BTV of 3.3 cm3 and 1 cm3 respectively. Meanwhile a DEF of 2 could be achieved for all 12 BTVs when using I-125. To achieve a DEF of 2 for all patients using Cs-131 and Pd-103, much higher initial concentrations would have to be used than have been typically employed in pre-clinical studies. Conclusion: The I-125 is the most viable BTS that can be employed with GBS to guide dose painting treatment planning for localized PCa.

  20. MRI to predict prostate growth and development in children, adolescents and young adults.

    Science.gov (United States)

    Ren, Jing; Liu, Huijia; Wang, He; Wen, Didi; Huang, Xufang; Ren, Fang; Huan, Yi

    2015-02-01

    The purpose of this study was to investigate the use of MRI in predicting prostate growth and development. A total of 1,500 healthy male volunteers who underwent MRI of the pelvis were included in this prospective study. Subjects were divided into five groups according to age (group A, 2-5 years; group B, 6-10 years; group C, 11-15 years; group D, 16-20 years; group E, 21-25 years). Total prostate volume (TPV) as well as prostate central zone (CZ) and peripheral zone (PZ) were measured and evaluated on MRI. Data of the different groups were compared using variance analysis, Scheffé's method, Kruskal-Wallis H-test, and Pearson's correlation. Statistical significance was inferred at P development scores were 0.08, 0.69, 1.56, 2.38, and 2.74, respectively. Both TPVs and zonal anatomy scores varied significantly among the five groups (P = 0.000). TPV and zonal anatomy score increased with increasing age. MRI provides a reliable quantitative reference for prostate growth and development. • When and how the prostate develops after birth remains unclear. • Prostate volume increases rapidly after the age of 10 years. • MRI provides a reliable objective and quantitative reference for prostate growth and development.

  1. Right ventricular volume estimation with cine MRI

    International Nuclear Information System (INIS)

    Sawachika, Takashi

    1993-01-01

    To quantitate right ventricular (RV) volumes easily using cine MRI, we developed a new method called 'modified area-length method (MOAL method)'. To validate this method, we compared it to the conventional Simpson's rule. Magnetom H15 (Siemens) was used and 6 normal volunteers and 21 patients with various RV sizes were imaged with ECG triggered gradient echo method (FISP, TR 50 ms, TE 12 ms, slice thickness 9 mm). For Simpson's rule transverse images of 12 sequential views which cover whole heart were acquired. For the MOAL method, two orthogonal views were imaged. One was the sagittal view which includes RV outflow tract and the other was the coronal view defined from the sagittal image to cover the whole RV. From these images the area (As, Ac) of RV and the longest distance between RV apex and pulmonary valve (Lmax) were determined. By correlating RV volumes measured by Simpson's rule to As*Ac/Lmax the RV volume could be estimated as follows: V=0.85*As*Ac/Lmax+4.55. Thus the MOAL method demonstrated excellent accuracy to quantitate RV volume and the acquisition time abbreviated to one fifth compared with Simpson's rule. This should be a highly promising method for routine clinical application. (author)

  2. Are strict vegetarians protected against prostate cancer?1

    Science.gov (United States)

    Knutsen, Synnove F; Knutsen, Raymond; Jacobsen, Bjarne K; Fan, Jing; Beeson, W Lawrence; Sabate, Joan; Hadley, David; Jaceldo-Siegl, Karen; Penniecook, Jason; Herring, Patti; Butler, Terry; Bennett, Hanni; Fraser, Gary

    2016-01-01

    Background: According to the American Cancer Society, prostate cancer accounts for ∼27% of all incident cancer cases among men and is the second most common (noncutaneous) cancer among men. The relation between diet and prostate cancer is still unclear. Because people do not consume individual foods but rather foods in combination, the assessment of dietary patterns may offer valuable information when determining associations between diet and prostate cancer risk. Objective: This study aimed to examine the association between dietary patterns (nonvegetarian, lacto-ovo-vegetarian, pesco-vegetarian, vegan, and semi-vegetarian) and prostate cancer incidence among 26,346 male participants of the Adventist Health Study-2. Design: In this prospective cohort study, cancer cases were identified by matching to cancer registries. Cox proportional hazards regression analysis was performed to estimate HRs by using age as the time variable. Results: In total, 1079 incident prostate cancer cases were identified. Around 8% of the study population reported adherence to the vegan diet. Vegan diets showed a statistically significant protective association with prostate cancer risk (HR: 0.65; 95% CI: 0.49, 0.85). After stratifying by race, the statistically significant association with a vegan diet remained only for the whites (HR: 0.63; 95% CI: 0.46, 0.86), but the multivariate HR for black vegans showed a similar but nonsignificant point estimate (HR: 0.69; 95% CI: 0.41, 1.18). Conclusion: Vegan diets may confer a lower risk of prostate cancer. This lower estimated risk is seen in both white and black vegan subjects, although in the latter, the CI is wider and includes the null. PMID:26561618

  3. Development of Interpretable Predictive Models for BPH and Prostate Cancer.

    Science.gov (United States)

    Bermejo, Pablo; Vivo, Alicia; Tárraga, Pedro J; Rodríguez-Montes, J A

    2015-01-01

    Traditional methods for deciding whether to recommend a patient for a prostate biopsy are based on cut-off levels of stand-alone markers such as prostate-specific antigen (PSA) or any of its derivatives. However, in the last decade we have seen the increasing use of predictive models that combine, in a non-linear manner, several predictives that are better able to predict prostate cancer (PC), but these fail to help the clinician to distinguish between PC and benign prostate hyperplasia (BPH) patients. We construct two new models that are capable of predicting both PC and BPH. An observational study was performed on 150 patients with PSA ≥3 ng/mL and age >50 years. We built a decision tree and a logistic regression model, validated with the leave-one-out methodology, in order to predict PC or BPH, or reject both. Statistical dependence with PC and BPH was found for prostate volume (P-value BPH prediction. PSA and volume together help to build predictive models that accurately distinguish among PC, BPH, and patients without any of these pathologies. Our decision tree and logistic regression models outperform the AUC obtained in the compared studies. Using these models as decision support, the number of unnecessary biopsies might be significantly reduced.

  4. MR-perfusion (MRP) and diffusion-weighted imaging (DWI) in prostate cancer: quantitative and model-based gadobenate dimeglumine MRP parameters in detection of prostate cancer.

    Science.gov (United States)

    Scherr, M K; Seitz, M; Müller-Lisse, U G; Ingrisch, M; Reiser, M F; Müller-Lisse, U L

    2010-12-01

    Various MR methods, including MR-spectroscopy (MRS), dynamic, contrast-enhanced MRI (DCE-MRI), and diffusion-weighted imaging (DWI) have been applied to improve test quality of standard MRI of the prostate. To determine if quantitative, model-based MR-perfusion (MRP) with gadobenate dimeglumine (Gd-BOPTA) discriminates between prostate cancer, benign tissue, and transitional zone (TZ) tissue. 27 patients (age, 65±4 years; PSA 11.0±6.1 ng/ml) with clinical suspicion of prostate cancer underwent standard MRI, 3D MR-spectroscopy (MRS), and MRP with Gd-BOPTA. Based on results of combined MRI/MRS and subsequent guided prostate biopsy alone (17/27), biopsy and radical prostatectomy (9/27), or sufficient negative follow-up (7/27), maps of model-free, deconvolution-based mean transit time (dMTT) were generated for 29 benign regions (bROIs), 14 cancer regions (cROIs), and 18 regions of transitional zone (tzROIs). Applying a 2-compartment exchange model, quantitative perfusion analysis was performed including as parameters: plasma flow (PF), plasma volume (PV), plasma mean transit time (PMTT), extraction flow (EFL), extraction fraction (EFR), interstitial volume (IV) and interstitial mean transit time (IMTT). Two-sided T-tests (significance level pMRP with Gd-BOPTA discriminates between prostate cancer and benign tissue with several parameters. However, distinction of prostate cancer and TZ does not appear to be reliable. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  5. Abdominal fat volume estimation by stereology on CT: a comparison with manual planimetry

    Energy Technology Data Exchange (ETDEWEB)

    Manios, G.E.; Mazonakis, M.; Damilakis, J. [University of Crete, Department of Medical Physics, Faculty of Medicine, Heraklion, Crete (Greece); Voulgaris, C.; Karantanas, A. [University of Crete, Department of Radiology, Faculty of Medicine, Heraklion, Crete (Greece)

    2016-03-15

    To deploy and evaluate a stereological point-counting technique on abdominal CT for the estimation of visceral (VAF) and subcutaneous abdominal fat (SAF) volumes. Stereological volume estimations based on point counting and systematic sampling were performed on images from 14 consecutive patients who had undergone abdominal CT. For the optimization of the method, five sampling intensities in combination with 100 and 200 points were tested. The optimum stereological measurements were compared with VAF and SAF volumes derived by the standard technique of manual planimetry on the same scans. Optimization analysis showed that the selection of 200 points along with the sampling intensity 1/8 provided efficient volume estimations in less than 4 min for VAF and SAF together. The optimized stereology showed strong correlation with planimetry (VAF: r = 0.98; SAF: r = 0.98). No statistical differences were found between the two methods (VAF: P = 0.81; SAF: P = 0.83). The 95 % limits of agreement were also acceptable (VAF: -16.5 %, 16.1 %; SAF: -10.8 %, 10.7 %) and the repeatability of stereology was good (VAF: CV = 4.5 %, SAF: CV = 3.2 %). Stereology may be successfully applied to CT images for the efficient estimation of abdominal fat volume and may constitute a good alternative to the conventional planimetric technique. (orig.)

  6. Comparison of rectal volume definition techniques and their influence on rectal toxicity in patients with prostate cancer treated with 3D conformal radiotherapy: a dose-volume analysis

    International Nuclear Information System (INIS)

    Onal, Cem; Topkan, Erkan; Efe, Esma; Yavuz, Melek; Sonmez, Serhat; Yavuz, Aydin

    2009-01-01

    To evaluate the impact of four different rectum contouring techniques and rectal toxicities in patients with treated with 3D conformal radiotherapy (3DCRT). Clinical and dosimetric data were evaluated for 94 patients who received a total dose 3DCRT of 70 Gy, and rectal doses were compared in four different rectal contouring techniques: the prostate-containing CT sections (method 1); 1 cm above and below the planning target volume (PTV) (method 2); 110 mm starting from the anal verge (method 3); and from the anal verge to the sigmoid flexure (method 4). The percentage of rectal volume receiving RT doses (30–70 Gy) and minimum, mean rectal doses were assessed. Median age was 69 years. Percentage of rectal volume receiving high doses (≥ 70 Gy) were higher with the techniques that contoured smaller rectal volumes. In methods 2 and 3, the percentage of rectal volume receiving ≥ 70 Gy was significantly higher in patients with than without rectal bleeding (method 2: 30.8% vs. 22.5%, respectively (p = 0.03); method 3: 26.9% vs. 18.1%, respectively (p = 0.006)). Mean rectal dose was significant predictor of rectal bleeding only in method 3 (48.8 Gy in patients with bleeding vs. 44.4 Gy in patients without bleeding; p = 0.02). Different techniques of rectal contouring significantly influence the calculation of radiation doses to the rectum and the prediction of rectal toxicity. Rectal volume receiving higher doses (≥ 70 Gy) and mean rectal doses may significantly predict rectal bleeding for techniques contouring larger rectal volumes, as was in method 3

  7. Shifting paradigms in the estimation of survival for castration-resistant prostate cancer: A tertiary academic center experience.

    Science.gov (United States)

    Afshar, Mehran; Evison, Felicity; James, Nicholas D; Patel, Prashant

    2015-08-01

    Castration-resistant prostate cancer (CRPC) has retained a guarded prognosis, with historical survival estimates of 18 to 24 months. However, the landscape of available therapy has changed, and the emphasis has altered from supportive to active treatment. Few large series from real-world populations exist in the contemporary era with fully mature survival data to confirm the indication based on clinical trials that patients with CRPC are surviving far longer than the historical estimates. We aim to review a large patient cohort with CRPC and provide mature survival data. Using the electronic histopathology database at Queen Elizabeth Hospital, Birmingham, UK, all prostate-specific antigentest results between April 2006 and September 2007 were extracted, and patients satisfying the American Society for Radiation Oncology (ASTRO) definition of hormone failure were identified. Electronic records were reviewed and variables were collected, including survival, treatment, biochemistry, histopathology, and demographics. Probability of survival, and of developing metastasis or CRPC, was determined using the Kaplan-Meier method. Patients were stratified into 3 groups, namely, D0--no metastasis at diagnosis but later appearance, D1--no metastasis at diagnosis or at last follow-up, and D2--metastasis at diagnosis. From 8,062 patient-prostate-specific antigen episodes, we identified 447 patients meeting the criteria. A notes review revealed 147 patients with CRPC. Median overall survival (OS) from diagnosis was 84.7 months (95% CI: 73-89), and 129 deaths had occurred (88%). Median OS from diagnosis for D0, D1, and D2 patients was 100.4, 180.1, and 58.9 months, respectively (Pdata benefit clinicians and patients in understanding prognosis and treatment choices. Importantly, our patients were diagnosed before the current wave of novel therapeutics for CRPC, so survival for men diagnosed today may be more than our findings. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Automated detection of a prostate Ni-Ti stent in electronic portal images

    OpenAIRE

    Carl, Jesper; Nielsen, Henning; Nielsen, Jane; Lund, Bente; Larsen, Erik Hoejkjaer

    2006-01-01

      Udgivelsesdato: DEC  Planning target volumes (PTV) in fractionated radiotherapy still have to be outlined with wide margins to the clinical target volume due to uncertainties arising from daily shift of the prostate position. A recently proposed new method of visualization of the prostate is based on insertion of a thermo-expandable Ni-Ti stent. The current study proposes a new detection algorithm for automated detection of the Ni-Ti stent in electronic portal images. The algorithm is ba...

  9. Tamsulosin reduces nighttime urine production in benign prostatic hyperplasia patients with nocturnal polyuria: a prospective open-label long-term study using frequency-volume chart.

    Science.gov (United States)

    Kojima, Yoshiyuki; Sasaki, Shoichi; Imura, Makoto; Kubota, Yasue; Hayashi, Yutaro; Kohri, Kenjiro

    2012-01-01

    The effects of tamsulosin treatment on changes in frequency-volume chart (FVC) data, especially nighttime urine production, over time were assessed, and the mechanisms underlying the improvement of nocturia in benign prostatic hyperplasia (BPH) patients with nocturnal polyuria (NP) are discussed. A total of 104 patients with lower urinary tract symptoms secondary to BPH were enrolled. After enrollment in the study, the patients were treated with tamsulosin (0.2 mg) once daily. Visits were scheduled every 4 weeks until week 12 (month 3) after study entry, and then every 12 weeks subsequently. All patients completed the International Prostate Symptom Score (IPSS), quality of life (QOL) index, and 3-day FVC, and underwent uroflowmetry at enrollment and on each visit. Eighty-two patients (mean age: 70.9 ± 7.1 years) were analyzed for 24 months after treatment. Patients were divided into two groups, NP and nonNP, based on FVC outcome. The IPSS, QOL index, and maximum flow rate improved during the 24-month period after treatment in both groups. Mean daytime urine volume significantly increased in the NP group, but no changes were detected in the nonNP group. Mean nighttime urine frequency significantly decreased in the NP group over a 24-month period, and was associated with a significant decrease in nighttime urine volume that was not found in the nonNP group. Maximum voided volume increased most months after treatment in both groups. The present long-term prospective study using FVC demonstrated that tamsulosin reduced nighttime urine production in BPH patients with NP. Copyright © 2011 Wiley Periodicals, Inc.

  10. Estimation of fetal volume by magnetic resonance imaging and stereology.

    Science.gov (United States)

    Roberts, N; Garden, A S; Cruz-Orive, L M; Whitehouse, G H; Edwards, R H

    1994-11-01

    The current methods to monitor fetal growth in utero are based on ultrasound image measurements which, lacking a proper sampling methodology, may be biased to unknown degrees. The Cavalieri method of stereology guarantees the accurate estimation of the volume of an arbitrary object from a few systematic sections. Non-invasive scanning methods, and magnetic resonance imaging (MRI) in particular, are valuable tools to provide the necessary sections, and therefore offer interesting possibilities for unbiased quantification. This paper describes how to estimate fetal volume in utero with a coefficient of error of less than 5% in less than 5 min, from three or four properly sampled MRI scans. MRI was chosen because it does not use ionizing radiations on the one hand, and it offers a good image quality on the other. The impact of potential sources of bias such as fetal motion, chemical shift and partial voluming artefacts is discussed. The methods are illustrated on four subjects monitored between weeks 28 and 40 of gestation.

  11. The american brachytherapy society recommendations for permanent prostate brachytherapy postimplant dosimetric analysis

    International Nuclear Information System (INIS)

    Nag, Subir; Bice, William; Wyngaert, Keith de; Prestidge, Bradley; Stock, Richard; Yu Yan

    2000-01-01

    Purpose: The purpose of this report is to establish guidelines for postimplant dosimetric analysis of permanent prostate brachytherapy. Methods: Members of the American Brachytherapy Society (ABS) with expertise in prostate dosimetry evaluation performed a literature review and supplemented with their clinical experience formulated guidelines for performing and analyzing postimplant dosimetry of permanent prostate brachytherapy. Results: The ABS recommends that postimplant dosimetry should be performed on all patients undergoing permanent prostate brachytherapy for optimal patient care. At present, computed tomography (CT)-based dosimetry is recommended, based on availability cost and the ability to image the prostate as well as the seeds. Additional plane radiographs should be obtained to verify the seed count. Until the ideal postoperative interval for CT scanning has been determined, each center should perform dosimetric evaluation of prostate implants at a consistent postoperative interval. This interval should be reported. Isodose displays should be obtained at 50%, 80%, 90%, 100%, 150%, and 200% of the prescription dose and displayed on multiple cross-sectional images of the prostate. A dose-volume histogram (DVH) of the prostate should be performed and the D 90 (dose to 90% of the prostate gland) reported by all centers. Additionally, the D 80, D 100, the fractional V 80, V 90, V 100, V 150, and V 200, (i.e., the percentage of prostate volume receiving 80%, 90%, 100%, 150%, and 200% of the prescribed dose, respectively), the rectal, and urethral doses should be reported and ultimately correlated with clinical outcome in the research environment. On-line real-time dosimetry, the effects of dose heterogeneity, and the effects of tissue heterogeneity need further investigation. Conclusion: It is essential that postimplant dosimetry should be performed on all patients undergoing permanent prostate brachytherapy. Guidelines were established for the performance

  12. SU-F-J-167: Use of MR for Permanent Prostate Implant Preplanning

    Energy Technology Data Exchange (ETDEWEB)

    Narayana, V; McLaughlin, P [Assarian Cancer Center, Novi, MI (United States); University of Michigan, Ann Arbor, MI (United States); Yao, B [Assarian Cancer Center, Novi, MI (United States)

    2016-06-15

    Purpose: To study the feasibility using MR imaging to improve target definition on ultrasound during permanent prostate implants and aid in source strength determination for treatment planning in the OR. Methods: Patients who receive permanent prostate implants undergo MR and CT imaging prior to the implant procedure to determine the volume of the prostate, bony restriction to the procedure, bladder extension, external sphincter length and neurovascular bundle. The volume of the prostate is generally used to order seeds for the procedure. In 10 patients, the MR was used as the preplanning study with the PTV defined as a 2 mm expansion of the MR prostate in all directions except the posterior. Various dose volume parameters for the MR prostate and the PTV were compared to the actual preplan developed and executed in the OR. In addition, there parameters were compared to the post implant dosimetry performed 3 weeks after the implant procedure. Results: The results show that the number of seeds used using MR and US (ultrasound) planning was generally with 2 seeds and the maximum difference was 7 seeds. There is no significant difference between any of the dose index parameters of V100, V150, V200, D99 and D90 parameters between MR planning, US planning and postimplant evaluation There was a significant difference between planned D99 (avg of 105%) and achieved D99 (avg 91%). Conclusion: MR imaging is an invaluable tool to improve target definition for permanent prostate implants. Use of MR images for preplanning improves the confidence with which source can be ordered for the procedure that is OR planned. Ordering a maximum of 10 seeds more than planned would be sufficient to deliver a plan in the OR using US. Moving ahead to non-rigid registration between MR ad US images could further increase the confidence level of MR planning.

  13. Improved robotic stereotactic body radiation therapy plan quality and planning efficacy for organ-confined prostate cancer utilizing overlap-volume histogram-driven planning methodology

    International Nuclear Information System (INIS)

    Wu, Binbin; Pang, Dalong; Lei, Siyuan; Gatti, John; Tong, Michael; McNutt, Todd; Kole, Thomas; Dritschilo, Anatoly; Collins, Sean

    2014-01-01

    Background and purpose: This study is to determine if the overlap-volume histogram (OVH)-driven planning methodology can be adapted to robotic SBRT (CyberKnife Robotic Radiosurgery System) to further minimize the bladder and rectal doses achieved in plans manually-created by clinical planners. Methods and materials: A database containing clinically-delivered, robotic SBRT plans (7.25 Gy/fraction in 36.25 Gy) of 425 patients with localized prostate cancer was used as a cohort to establish an organ’s distance-to-dose model. The OVH-driven planning methodology was refined by adding the PTV volume factor to counter the target’s dose fall-off effect and incorporated into Multiplan to automate SBRT planning. For validation, automated plans (APs) for 12 new patients were generated, and their achieved dose/volume values were compared to the corresponding manually-created, clinically-delivered plans (CPs). A two-sided, Wilcoxon rank-sum test was used for statistical comparison with a significance level of p < 0.05. Results: PTV’s V(36.25 Gy) was comparable: 95.6% in CPs comparing to 95.1% in APs (p = 0.2). On average, the refined approach lowered V(18.12 Gy) to the bladder and rectum by 8.2% (p < 0.05) and 6.4% (p = 0.14). A physician confirmed APs were clinically acceptable. Conclusions: The improvements in APs could further reduce toxicities observed in SBRT for organ-confined prostate cancer

  14. Clinical stage T1c prostate cancer: evaluation with endorectal MR imaging and MR spectroscopic imaging.

    Science.gov (United States)

    Zhang, Jingbo; Hricak, Hedvig; Shukla-Dave, Amita; Akin, Oguz; Ishill, Nicole M; Carlino, Lauren J; Reuter, Victor E; Eastham, James A

    2009-11-01

    To assess the diagnostic accuracy of endorectal magnetic resonance (MR) imaging and MR spectroscopic imaging for prediction of the pathologic stage of prostate cancer and the presence of clinically nonimportant disease in patients with clinical stage T1c prostate cancer. The institutional review board approved-and waived the informed patient consent requirement for-this HIPAA-compliant study involving 158 patients (median age, 58 years; age range, 40-76 years) who had clinical stage T1c prostate cancer, had not been treated preoperatively, and underwent combined 1.5-T endorectal MR imaging-MR spectroscopic imaging between January 2003 and March 2004 before undergoing radical prostatectomy. On the MR images and combined endorectal MR-MR spectroscopic images, two radiologists retrospectively and independently rated the likelihood of cancer in 12 prostate regions and the likelihoods of extracapsular extension (ECE), seminal vesicle invasion (SVI), and adjacent organ invasion by using a five-point scale, and they determined the probability of clinically nonimportant prostate cancer by using a four-point scale. Whole-mount step-section pathology maps were used for imaging-pathologic analysis correlation. Receiver operating characteristic curves were constructed and areas under the curves (AUCs) were estimated nonparametrically for assessment of reader accuracy. At surgical-pathologic analysis, one (0.6%) patient had no cancer; 124 (78%) patients, organ-confined (stage pT2) disease; 29 (18%) patients, ECE (stage pT3a); two (1%) patients, SVI (stage pT3b); and two (1%) patients, bladder neck invasion (stage pT4). Forty-six (29%) patients had a total tumor volume of less than 0.5 cm(3). With combined MR imaging-MR spectroscopic imaging, the two readers achieved 80% accuracy in disease staging and AUCs of 0.62 and 0.71 for the prediction of clinically nonimportant cancer. Clinical stage T1c prostate cancers are heterogeneous in pathologic stage and volume. MR imaging may

  15. Nuclear androgen receptors in human prostatic tissue. Extraction with heparin and estimation of the number of binding sites with different methods

    International Nuclear Information System (INIS)

    Foekens, J.A.; Bolt-de Vries, J.; Mulder, E.; Blankenstein, M.A.; Schroeder, F.H.; Molen, H.J. van der

    1981-01-01

    A procedure for the estimation of nuclear androgen receptors in benign prostatic hyperplastic tissue is described, which employs extraction of receptors from nuclei with buffers containing heparin. Extraction of a nuclear pellet with a heparin-containing (1 g/l) buffer appeared to have definite advantages over 0.4 mol/l KCl extraction. Heparin appeared to be twice as efficient in extracting androgen receptors. In addition aggregated receptor proteins, formed after storage at -80 0 C, were partly deaggregated by heparin. Specific isolation of the androgen receptor was performed using either agar gel electrophoresis, protamine sulphate precipitation or LH-20 gel filtration. A comparison was made between the amounts of estimated receptors with these different techniques. Protamine sulphate precipitation resulted in the highest estimates of receptor-bound 5α-[ 3 H]dihydrotestosterone ( 3 H-DHT). Treatment of the labelled nuclear extracts with a charcoal suspension prior to the receptor assay resulted in lower amounts of estimated androgen receptors. A method for routine evaluation of nuclear androgen receptors in prostatic tissue has been evaluated, which involves extraction of nuclear pellets with a heparin-containing (1 g/l) buffer, exchange labelling of the nuclear extracts for 20 h at 10 0 C and quantification of the receptors with protamine sulphate precipitation. (Auth.)

  16. Evaluation of atlas-based auto-segmentation software in prostate cancer patients

    International Nuclear Information System (INIS)

    Greenham, Stuart; Dean, Jenna; Fu, Cheuk Kuen Kenneth; Goman, Joanne; Mulligan, Jeremy; Tune, Deanna; Sampson, David; Westhuyzen, Justin; McKay, Michael

    2014-01-01

    The performance and limitations of an atlas-based auto-segmentation software package (ABAS; Elekta Inc.) was evaluated using male pelvic anatomy as the area of interest. Contours from 10 prostate patients were selected to create atlases in ABAS. The contoured regions of interest were created manually to align with published guidelines and included the prostate, bladder, rectum, femoral heads and external patient contour. Twenty-four clinically treated prostate patients were auto-contoured using a randomised selection of two, four, six, eight or ten atlases. The concordance between the manually drawn and computer-generated contours were evaluated statistically using Pearson's product–moment correlation coefficient (r) and clinically in a validated qualitative evaluation. In the latter evaluation, six radiation therapists classified the degree of agreement for each structure using seven clinically appropriate categories. The ABAS software generated clinically acceptable contours for the bladder, rectum, femoral heads and external patient contour. For these structures, ABAS-generated volumes were highly correlated with ‘as treated’ volumes, manually drawn; for four atlases, for example, bladder r = 0.988 (P < 0.001), rectum r = 0.739 (P < 0.001) and left femoral head r = 0.560 (P < 0.001). Poorest results were seen for the prostate (r = 0.401, P < 0.05) (four atlases); however this was attributed to the comparison prostate volume being contoured on magnetic resonance imaging (MRI) rather than computed tomography (CT) data. For all structures, increasing the number of atlases did not consistently improve accuracy. ABAS-generated contours are clinically useful for a range of structures in the male pelvis. Clinically appropriate volumes were created, but editing of some contours was inevitably required. The ideal number of atlases to improve generated automatic contours is yet to be determined

  17. Presence of PSA auto-antibodies in men with prostate abnormalities (prostate cancer/benign prostatic hyperplasia/prostatitis).

    Science.gov (United States)

    Lokant, M T; Naz, R K

    2015-04-01

    Prostate-specific antigen (PSA), produced by the prostate, liquefies post-ejaculate semen. PSA is detected in semen and blood. Increased circulating PSA levels indicate prostate abnormality [prostate cancer (PC), benign prostatic hyperplasia (BPH), prostatitis (PTIS)], with variance among individuals. As the prostate has been proposed as an immune organ, we hypothesise that variation in PSA levels among men may be due to presence of auto-antibodies against PSA. Sera from healthy men (n = 28) and men having prostatitis (n = 25), BPH (n = 30) or PC (n = 29) were tested for PSA antibody presence using enzyme-linked immunosorbent assay (ELISA) values converted to standard deviation (SD) units, and Western blotting. Taking ≥2 SD units as cut-off for positive immunoreactivity, 0% of normal men, 0% with prostatitis, 33% with BPH and 3.45% with PC demonstrated PSA antibodies. One-way analysis of variance (anova) performed on the mean absorbance values and SD units of each group showed BPH as significantly different (P prostatitis. All others were nonsignificant (P prostate abnormalities, especially differentiating BPH from prostate cancer and prostatitis. © 2014 Blackwell Verlag GmbH.

  18. Brachytherapy in early prostate cancer--early experience.

    Science.gov (United States)

    Jose, B O; Bailen, J L; Albrink, F H; Steinbock, G S; Cornett, M S; Benson, D C; Schmied, W K; Medley, R N; Spanos, W J; Paris, K J; Koerner, P D; Gatenby, R A; Wilson, D L; Meyer, R

    1999-01-01

    Use of brachytherapy with radioactive seeds in the management of early prostate cancer is commonly used in the United States. The early experience has been reported from the prostate treatment centers in Seattle for the last 10 years. In this manuscript we are reporting our early experience of 150 radioactive seed implantations in early stage prostate cancer using either Iodine 125 or Palladium 103 seeds. The average age of the patient is 66 years and the median Gleason score is 5.4 with a median PSA of 6. A brief description of the evolution of the treatment of prostate cancer as well as the preparation for the seed implantation using the volume study with ultrasound of the prostate, pubic arch study using CT scan of the pelvis and the complete planning using the treatment planning computers are discussed. We also have described the current technique which is used in our experience based on the Seattle guidelines. We plan a follow-up report with the results of the studies with longer follow-up.

  19. The Development of Prostate Palpation Skills through Simulation Training May Impact Early Detection of Prostate Abnormalities and Early Management

    Science.gov (United States)

    2011-05-01

    has a high incidence rate (one in six for men in the U.S.), with an estimated 192,280 new cases in 2009. When diagnosed in an early and less...converges in a vector toward the nipple . Study results indicate that use of the vertical strip leads to an increased detection of abnormalities [10], [16...Palpation, Clinical prostate examination. Prostate cancer is one of the most common causes of death in American men , with an estimated 189,280 new cases

  20. A theoretical approach to the problem of dose-volume constraint estimation and their impact on the dose-volume histogram selection

    International Nuclear Information System (INIS)

    Schinkel, Colleen; Stavrev, Pavel; Stavreva, Nadia; Fallone, B. Gino

    2006-01-01

    This paper outlines a theoretical approach to the problem of estimating and choosing dose-volume constraints. Following this approach, a method of choosing dose-volume constraints based on biological criteria is proposed. This method is called ''reverse normal tissue complication probability (NTCP) mapping into dose-volume space'' and may be used as a general guidance to the problem of dose-volume constraint estimation. Dose-volume histograms (DVHs) are randomly simulated, and those resulting in clinically acceptable levels of complication, such as NTCP of 5±0.5%, are selected and averaged producing a mean DVH that is proven to result in the same level of NTCP. The points from the averaged DVH are proposed to serve as physical dose-volume constraints. The population-based critical volume and Lyman NTCP models with parameter sets taken from literature sources were used for the NTCP estimation. The impact of the prescribed value of the maximum dose to the organ, D max , on the averaged DVH and the dose-volume constraint points is investigated. Constraint points for 16 organs are calculated. The impact of the number of constraints to be fulfilled based on the likelihood that a DVH satisfying them will result in an acceptable NTCP is also investigated. It is theoretically proven that the radiation treatment optimization based on physical objective functions can sufficiently well restrict the dose to the organs at risk, resulting in sufficiently low NTCP values through the employment of several appropriate dose-volume constraints. At the same time, the pure physical approach to optimization is self-restrictive due to the preassignment of acceptable NTCP levels thus excluding possible better solutions to the problem

  1. Photoacoustic-based sO2 estimation through excised bovine prostate tissue with interstitial light delivery.

    Science.gov (United States)

    Mitcham, Trevor; Taghavi, Houra; Long, James; Wood, Cayla; Fuentes, David; Stefan, Wolfgang; Ward, John; Bouchard, Richard

    2017-09-01

    Photoacoustic (PA) imaging is capable of probing blood oxygen saturation (sO 2 ), which has been shown to correlate with tissue hypoxia, a promising cancer biomarker. However, wavelength-dependent local fluence changes can compromise sO 2 estimation accuracy in tissue. This work investigates using PA imaging with interstitial irradiation and local fluence correction to assess precision and accuracy of sO 2 estimation of blood samples through ex vivo bovine prostate tissue ranging from 14% to 100% sO 2 . Study results for bovine blood samples at distances up to 20 mm from the irradiation source show that local fluence correction improved average sO 2 estimation error from 16.8% to 3.2% and maintained an average precision of 2.3% when compared to matched CO-oximeter sO 2 measurements. This work demonstrates the potential for future clinical translation of using fluence-corrected and interstitially driven PA imaging to accurately and precisely assess sO 2 at depth in tissue with high resolution.

  2. 'Compromise position' image alignment to accommodate independent motion of multiple clinical target volumes during radiotherapy: A high risk prostate cancer example

    International Nuclear Information System (INIS)

    Rosewall, Tara; Alasti, Hamideh; Bayley, Andrew; Yan, Jing

    2017-01-01

    Inclusion of multiple independently moving clinical target volumes (CTVs) in the irradiated volume causes an image guidance conundrum. The purpose of this research was to use high risk prostate cancer as a clinical example to evaluate a 'compromise' image alignment strategy. The daily pre-treatment orthogonal EPI for 14 consecutive patients were included in this analysis. Image matching was performed by aligning to the prostate only, the bony pelvis only and using the 'compromise' strategy. Residual CTV surrogate displacements were quantified for each of the alignment strategies. Analysis of the 388 daily fractions indicated surrogate displacements were well-correlated in all directions (r 2 = 0.95 (LR), 0.67 (AP) and 0.59 (SI). Differences between the surrogates displacements (95% range) were −0.4 to 1.8 mm (LR), −1.2 to 5.2 mm (SI) and −1.2 to 5.2 mm (AP). The distribution of the residual displacements was significantly smaller using the 'compromise' strategy, compared to the other strategies (p 0.005). The 'compromise' strategy ensured the CTV was encompassed by the PTV in all fractions, compared to 47 PTV violations when aligned to prostate only. This study demonstrated the feasibility of a compromise position image guidance strategy to accommodate simultaneous displacements of two independently moving CTVs. Application of this strategy was facilitated by correlation between the CTV displacements and resulted in no geometric excursions of the CTVs beyond standard sized PTVs. This simple image guidance strategy may also be applicable to other disease sites that concurrently irradiate multiple CTVs, such as head and neck, lung and cervix cancer.

  3. Dose-escalated simultaneous integrated-boost treatment of prostate cancer patients via helical tomotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Geier, M.; Astner, S.T.; Duma, M.N.; Putzhammer, J.; Winkler, C.; Molls, M.; Geinitz, H. [Technische Univ. Muenchen (Germany). Klinik und Poliklinik fuer Strahlentherapie und Radiologische Onkologie; Jacob, V. [Universitaetsklinikum Freiburg (Germany). Klinik fuer Strahlenheilkunde; Nieder, C. [Nordland Hospital, Bodoe (Norway). Dept. of Oncology and Palliative Care; Tromsoe Univ. (Norway). Inst. of Clinical Medicine

    2012-05-15

    The goal of this work was to assess the feasibility of moderately hypofractionated simultaneous integrated-boost intensity-modulated radiotherapy (SIB-IMRT) with helical tomotherapy in patients with localized prostate cancer regarding acute side effects and dose-volume histogram data (DVH data). Acute side effects and DVH data were evaluated of the first 40 intermediate risk prostate cancer patients treated with a definitive daily image-guided SIB-IMRT protocol via helical tomotherapy in our department. The planning target volume including the prostate and the base of the seminal vesicles with safety margins was treated with 70 Gy in 35 fractions. The boost volume containing the prostate and 3 mm safety margins (5 mm craniocaudal) was treated as SIB to a total dose of 76 Gy (2.17 Gy per fraction). Planning constraints for the anterior rectal wall were set in order not to exceed the dose of 76 Gy prescribed to the boost volume. Acute toxicity was evaluated prospectively using a modified CTCAE (Common Terminology Criteria for Adverse Events) score. SIB-IMRT allowed good rectal sparing, although the full boost dose was permitted to the anterior rectal wall. Median rectum dose was 38 Gy in all patients and the median volumes receiving at least 65 Gy (V65), 70 Gy (V70), and 75 Gy (V75) were 13.5%, 9%, and 3%, respectively. No grade 4 toxicity was observed. Acute grade 3 toxicity was observed in 20% of patients involving nocturia only. Grade 2 acute intestinal and urological side effects occurred in 25% and 57.5%, respectively. No correlation was found between acute toxicity and the DVH data. This institutional SIB-IMRT protocol using daily image guidance as a precondition for smaller safety margins allows dose escalation to the prostate without increasing acute toxicity. (orig.)

  4. Association of anorectal dose-volume histograms and impaired fecal continence after 3D conformal radiotherapy for carcinoma of the prostate

    International Nuclear Information System (INIS)

    Vordermark, Dirk; Schwab, Michael; Ness-Dourdoumas, Rhea; Sailer, Marco; Flentje, Michael; Koelbl, Oliver

    2003-01-01

    Purpose: The late toxicity of fecal incontinence after pelvic radiotherapy is now frequently recognized but the etiology poorly understood. We therefore investigated associations between dose-volume histogram (DVH) parameters of the rectum and the anal canal with fecal continence as measured by an established 10-item questionnaire. Methods and materials: Forty-four patients treated for carcinoma of the prostate with 58-72 Gy of 3D conformal radiotherapy between 1995 and 1999 who completed the questionnaire formed the study population. Total continence scores of treated patients obtained 1.5 years (median) after radiotherapy were compared to a control group of 30 patients before radiotherapy. Median, mean, minimum and maximum doses as well as the volume (% and ml) treated to 40, 50, 60 and 70 Gy were determined separately for anal canal and rectum. DVH parameters were correlated with total continence score (Spearman rank test) and patients grouped according to observed continence were compared regarding DVH values (Mann-Whitney U-test). Results: Median fecal continence scores were significantly worse in the irradiated than in the control group (31 vs. 35 of a maximum 36 points). In treated patients, 59%/27%/14% were classified as fully continent, slightly incontinent and severely incontinent. Continence was similar in the 58-to-62-Gy, 66-Gy and 68-to-72-Gy dose groups. No DVH parameter was significantly correlated with total continence score, but severely incontinent patients had a significantly higher minimum dose to the anal canal than fully continent/slightly incontinent, accompanied by portals extending significantly further inferiorly with respect to the ischial tuberosities. Conclusions: Excluding the inferior part of the anal canal from the treated volume in 3D conformal therapy for carcinoma of the prostate appears to be a promising strategy to prevent radiation-induced fecal incontinence

  5. Rapid estimation of the vertebral body volume: a combination of the Cavalieri principle and computed tomography images

    International Nuclear Information System (INIS)

    Odaci, Ersan; Sahin, Buenyamin; Sonmez, Osman Fikret; Kaplan, Sueleyman; Bas, Orhan; Bilgic, Sait; Bek, Yueksel; Erguer, Hayati

    2003-01-01

    Objective: The exact volume of the vertebral body is necessary for the evaluation, treatment and surgical application of related vertebral body. Thereby, the volume changes of the vertebral body are monitored, such as infectious diseases of vertebra and traumatic or non-traumatic fractures and deformities of the spine. Several studies have been conducted for the assessment of the vertebral body size based on the evaluation of the different criteria of the spine using different techniques. However, we have not found any detailed study in the literature describing the combination of the Cavalieri principle and vertebral body volume estimation. Materials and methods: In the present study we describe a rapid, simple, accurate and practical technique for estimating the volume of vertebral body. Two specimens were taken from the cadavers including ten lumbar vertebras and were scanned in axial, sagittal and coronal section planes by a computed tomography (CT) machine. The consecutive sections in 5 and 3 mm thicknesses were used to estimate the total volume of the vertebral bodies by means of the Cavalieri principle. Furthermore, to evaluate inter-observer differences the volume estimations were carried out by three performers. Results: There were no significant differences between the performers' estimates and real volumes of the vertebral bodies (P>0.05) and also between the performers' volume estimates (P>0.05). The section thickness and the section plains did not affect the accuracy of the estimates (P>0.05). A high correlation was seen between the estimates of performers and the real volumes of the vertebral bodies (r=0.881). Conclusion: We concluded that the combination of CT scanning with the Cavalieri principle is a direct and accurate technique that can be safely applied to estimate the volume of the vertebral body with the mean of 5 min and 11 s workload per vertebra

  6. SU-E-J-232: Feasibility of MRI-Based Preplan On Low Dose Rate Prostate Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Y; Tward, J; Rassiah-Szegedi, P; Zhao, H; Sarkar, V; Huang, L; Szegedi, M; Kokeny, K; Salter, B [University of Utah Huntsman Cancer Institute, Salt Lake City, UT (United States)

    2015-06-15

    Purpose: To investigate the feasibility of using MRI-based preplan for low dose rate prostate brachytherapy. Methods: 12 patients who received transrectal ultrasound (TRUS) guided prostate brachytherapy with Pd-103 were retrospectively studied. Our care-standard of the TRUS-based preplan served as the control. One or more prostate T2-weighted wide and/or narrow-field of view MRIs obtained within the 3 months prior to the implant were imported into the MIM Symphony software v6.3 (MIM Software Inc., Cleveland, OH) for each patient. In total, 37 MRI preplans (10 different image sequences with average thickness of 4.8mm) were generated. The contoured prostate volume and the seed counts required to achieve adequate dosimetric coverage from TRUS and MRI preplans were compared for each patient. The effects of different MRI sequences and image thicknesses were also investigated statistically using Student’s t-test. Lastly, the nomogram from the MRI preplan and TRUS preplan from our historical treatment data were compared. Results: The average prostate volume contoured on the TRUS and MRI were 26.6cc (range: 12.6∼41.3cc), and 27.4 cc (range: 14.3∼50.0cc), respectively. Axial MRI thicknesses (range: 3.5∼8.1mm) did not significantly affect the contoured volume or the number of seeds required on the preplan (R2 = 0.0002 and 0.0012, respectively). Four of the MRI sequences (AX-T2, AX-T2-Whole-Pelvis, AX-T2-FSE, and AXIALT2- Hi-Res) showed statistically significant better prostate volume agreement with TRUS than the other seven sequences (P <0.01). Nomogram overlay between the MRI and TRUS preplans showed good agreement; indicating volumes contoured on MRI preplan scan reliably predict how many seeds are needed for implant. Conclusion: Although MRI does not allow for determination of the actual implant geometry, it can give reliable volumes for seed ordering purposes. Our future work will investigate if MRI is sufficient to reliably replace TRUS preplanning in patients

  7. Dosimetric implications of residual seminal vesicle motion in fiducial-guided intensity-modulated radiotherapy for prostate cancer

    International Nuclear Information System (INIS)

    Stenmark, Matthew H.; Vineberg, Karen; Ten Haken, Randall K.; Hamstra, Daniel A.; Feng, Mary

    2012-01-01

    To determine whether residual interfraction seminal vesicle (SV) displacement necessitates specific planning target volume (PTV) margins during fiducial-guided intensity modulated radiation therapy (IMRT) of the prostate. A planning computed tomography (CT) scan and 2 subsequent CT scans were prospectively obtained for 20 prostate cancer patients with intraprostatic fiducial markers. After CT registration, SV displacement relative to the prostate was quantified as a function of margin size for both the proximal (1 cm) SV (PSV) and the full SV (FSV). Two IMRT plans were simulated for each patient (prostate + PSV and prostate + FSV) both with a uniform 5-mm PTV margin. Minimum clinical target volume (CTV) dose (D min ) and the volume of SV receiving 95% of the prescription dose (V 95% ) were assessed during treatment and compared with the initial plan. In all cases, SV displacement with respect to the prostate was greater for the FSV compared with the PSV. To ensure at least 95% geometrical coverage of the CTV for 90% of patients, margins of 5 and 8 mm were required for the PSV and FSV, respectively. Dosimetrically, residual SV displacement had minimal impact on PSV coverage compared with FSV coverage. For the PSV D min was ≥95% of the prescribed dose in 90% of patients with an overall mean V 95% of 99.6 ± 0.8%; for the FSV D min was ≥95% of the prescribed dose in only 45% of patients with a mean V 95% of 97.9 ± 2.4%. The SVs move differentially from the prostate and exhibit greater variation with increasing distance from the prostate. For plans targeting just the prostate and PSVs, 5-mm PTV expansions are adequate. However, despite daily localization of the prostate, larger PTV margins are required for cases where the intent is to completely cover the FSV.

  8. Enucleation ratio efficacy might be a better predictor to assess learning curve of holmium laser enucleation of the prostate

    Directory of Open Access Journals (Sweden)

    Chang Wook Jeong

    2012-06-01

    Full Text Available PURPOSE: To appraise the evaluation methods for learning curve and to analyze the non-mentor-aided learning curve and early complications following the holmium laser enucleation of the prostate. MATERIALS AND METHODS:One-hundred and forty (n=140 consecutive patients who underwent HoLEP from July 2008 to July 2010 by a single surgeon (SJO were enrolled. Perioperative clinical variables, including enucleation time, morcellation time, enucleation ratio (enucleation weight/transitional zone volume, enucleation efficacy (enucleated weight/enucleation time, enucleation ratio efficacy (enucleation ratio/enucleation time, and early complication rate were analyzed. RESULTS: Mean prostate volume was 62.7 mL (range 21-162 and preoperative International Prostate Symptom Score (IPSS was 19.0 (4-35. Mean enucleation time and morcellation time were 49.9±23.8 (S.D. min and 11.0±9.7 min, respectively. Median duration of postoperative indwelling catheter was 1 (1-7 day and median hospital stay was 1 (1-6 day. There were a total of 31 surgery-related complications in 27 patients (19.3%, and all were manageable. There was an increasing trend of enucleation efficacy in the first 50 cases. However, enucleation efficacy was linearly correlated with the prostate size (correlation coefficients, R=0.701, p<0.001. But, enucleation ratio efficacy could eliminate the confounding effect of the prostate size (R=-0.101, p=0.233. The plateau of enucleation ratio efficacy was reached around the twenty-fifth case. CONCLUSIONS: Our results demonstrated that the operative learning curve plateau is reached after about 25 cases. We propose that a more appropriate parameter for estimating the operative learning curve is enucleation ratio efficacy, rather than enucleation efficacy.

  9. Use of benchmark dose-volume histograms for selection of the optimal technique between three-dimensional conformal radiation therapy and intensity-modulated radiation therapy in prostate cancer

    International Nuclear Information System (INIS)

    Luo Chunhui; Yang, Claus Chunli; Narayan, Samir; Stern, Robin L.; Perks, Julian; Goldberg, Zelanna; Ryu, Janice; Purdy, James A.; Vijayakumar, Srinivasan

    2006-01-01

    Purpose: The aim of this study was to develop and validate our own benchmark dose-volume histograms (DVHs) of bladder and rectum for both conventional three-dimensional conformal radiation therapy (3D-CRT) and intensity-modulated radiation therapy (IMRT), and to evaluate quantitatively the benefits of using IMRT vs. 3D-CRT in treating localized prostate cancer. Methods and Materials: During the implementation of IMRT for prostate cancer, our policy was to plan each patient with both 3D-CRT and IMRT. This study included 31 patients with T1b to T2c localized prostate cancer, for whom we completed double-planning using both 3D-CRT and IMRT techniques. The target volumes included prostate, either with or without proximal seminal vesicles. Bladder and rectum DVH data were summarized to obtain an average DVH for each technique and then compared using two-tailed paired t test analysis. Results: For 3D-CRT our bladder doses were as follows: mean 28.8 Gy, v60 16.4%, v70 10.9%; rectal doses were: mean 39.3 Gy, v60 21.8%, v70 13.6%. IMRT plans resulted in similar mean dose values: bladder 26.4 Gy, rectum 34.9 Gy, but lower values of v70 for the bladder (7.8%) and rectum (9.3%). These benchmark DVHs have resulted in a critical evaluation of our 3D-CRT techniques over time. Conclusion: Our institution has developed benchmark DVHs for bladder and rectum based on our clinical experience with 3D-CRT and IMRT. We use these standards as well as differences in individual cases to make decisions on whether patients may benefit from IMRT treatment rather than 3D-CRT

  10. Market projections of cellulose nanomaterial-enabled products-- Part 2: Volume estimates

    Science.gov (United States)

    John Cowie; E.M. (Ted) Bilek; Theodore H. Wegner; Jo Anne Shatkin

    2014-01-01

    Nanocellulose has enormous potential to provide an important materials platform in numerous product sectors. This study builds on previous work by the same authors in which likely high-volume, low-volume, and novel applications for cellulosic nanomaterials were identified. In particular, this study creates a transparent methodology and estimates the potential annual...

  11. Estrogen receptors in the human male prostatic urethra and prostate in prostatic cancer and benign prostatic hyperplasia

    DEFF Research Database (Denmark)

    Bødker, A; Bruun, J; Balslev, E

    1999-01-01

    Estrogen receptors (ERs) in the prostate and prostatic urethra were examined in 33 men with benign prostatic hyperplasia (BPH) and in 11 with prostate cancer (PC). The Abbot monoclonal ER-ICA assay was used for immunohistochemical investigation. In the BPH group, ERs were revealed in the prostatic...... demonstrated in the prostatic stroma and/or prostatic urethra in 6 out of 11 cases. In both BPH and PC patients, immunoreactivity was weak and confined to few cells, indicating low ER content in the prostate as well as in the prostatic urethra. Dextran-coated charcoal (DCC) analysis was used for detection...... and quanticization of cytosolic and nuclear ERs. In the BPH group, ERs were detected once in the prostate and prostatic urethra in the nuclear and cytosol, and additionally in the prostatic urethra in the cytosol fraction in three cases. In all cases, ER content was low, ranging from 10-15 fmol/mg protein. In the PC...

  12. Block volume estimation from the discontinuity spacing measurements of mesozoic limestone quarries, Karaburun Peninsula, Turkey.

    Science.gov (United States)

    Elci, Hakan; Turk, Necdet

    2014-01-01

    Block volumes are generally estimated by analyzing the discontinuity spacing measurements obtained either from the scan lines placed over the rock exposures or the borehole cores. Discontinuity spacing measurements made at the Mesozoic limestone quarries in Karaburun Peninsula were used to estimate the average block volumes that could be produced from them using the suggested methods in the literature. The Block Quality Designation (BQD) ratio method proposed by the authors has been found to have given in the same order of the rock block volume to the volumetric joint count (J(v)) method. Moreover, dimensions of the 2378 blocks produced between the years of 2009 and 2011 in the working quarries have been recorded. Assuming, that each block surfaces is a discontinuity, the mean block volume (V(b)), the mean volumetric joint count (J(vb)) and the mean block shape factor of the blocks are determined and compared with the estimated mean in situ block volumes (V(in)) and volumetric joint count (J(vi)) values estimated from the in situ discontinuity measurements. The established relations are presented as a chart to be used in practice for estimating the mean volume of blocks that can be obtained from a quarry site by analyzing the rock mass discontinuity spacing measurements.

  13. Block Volume Estimation from the Discontinuity Spacing Measurements of Mesozoic Limestone Quarries, Karaburun Peninsula, Turkey

    Directory of Open Access Journals (Sweden)

    Hakan Elci

    2014-01-01

    Full Text Available Block volumes are generally estimated by analyzing the discontinuity spacing measurements obtained either from the scan lines placed over the rock exposures or the borehole cores. Discontinuity spacing measurements made at the Mesozoic limestone quarries in Karaburun Peninsula were used to estimate the average block volumes that could be produced from them using the suggested methods in the literature. The Block Quality Designation (BQD ratio method proposed by the authors has been found to have given in the same order of the rock block volume to the volumetric joint count (Jv method. Moreover, dimensions of the 2378 blocks produced between the years of 2009 and 2011 in the working quarries have been recorded. Assuming, that each block surfaces is a discontinuity, the mean block volume (Vb, the mean volumetric joint count (Jvb and the mean block shape factor of the blocks are determined and compared with the estimated mean in situ block volumes (Vin and volumetric joint count (Jvi values estimated from the in situ discontinuity measurements. The established relations are presented as a chart to be used in practice for estimating the mean volume of blocks that can be obtained from a quarry site by analyzing the rock mass discontinuity spacing measurements.

  14. [Bushen Huoxue Fang promotes the apoptosis of epithelial cells in the prostatic ductal system of rats with benign prostatic hyperplasia].

    Science.gov (United States)

    Sun, Jie; Li, Qiu-Fen; Tian, Dai-Zhi; Jiang, Shao-Bo; Wu, Xian-De; Qiu, Shun-An; Ren, Xiao-Gang; Li, Yu-Bing

    2014-09-01

    To investigate the effects of Bushen Huoxue Fang (BSHX) on the apoptosis of epithelial cells in the prostatic ductal system of rats with benign prostatic hyperplasia (BPH) and its possible action mechanism. One hundred 3- month-old male Wistar rats were randomly divided into four groups of equal number (control, castrated, BPH model, and BSHX). BPH models were made by subcutaneous injection of testosterone following castration; the rats in the BSHX group were treated intragastrically with BSHX at 2.34 g/ml after modeling, while those in the other two groups with equal volume of saline, all for 37 days. On the 38th day, all the rats were sacrificed and their prostates harvested for detection of the distribution of TGF-beta1 and alpha-actin and the count of positive cells in the prostatic ductal system by immunohistochemical staining. The apoptosis rate of epithelial cells in the prostatic ductal system was determined by TUNEL assay. The expression of TGF-beta1 was significantly increased in the rats of the BSHX group as compared with the BPH models in both the proximal prostatic duct ([15.28 +/- 4.30]% vs [36.42 +/- 8.10]%, P epithelial cells in the proximal prostatic duct ([39.42 +/- 9.20]% vs [3.86 +/- 1.34]%, P epithelial cells in the prostatic ductal system was significantly higher in the BSHX-treated rats than in the BPH models (P epithelial cells, and thus effectively inhibit benign prostatic hyperplasia.

  15. Estimation of Apple Volume and Its Shape Indentation Using Image Processing Technique and Neural Network

    Directory of Open Access Journals (Sweden)

    M Jafarlou

    2014-04-01

    Full Text Available Physical properties of agricultural products such as volume are the most important parameters influencing grading and packaging systems. They should be measured accurately as they are considered for any good system design. Image processing and neural network techniques are both non-destructive and useful methods which are recently used for such purpose. In this study, the images of apples were captured from a constant distance and then were processed in MATLAB software and the edges of apple images were extracted. The interior area of apple image was divided into some thin trapezoidal elements perpendicular to longitudinal axis. Total volume of apple was estimated by the summation of incremental volumes of these elements revolved around the apple’s longitudinal axis. The picture of half cut apple was also captured in order to obtain the apple shape’s indentation volume, which was subtracted from the previously estimated total volume of apple. The real volume of apples was measured using water displacement method and the relation between the real volume and estimated volume was obtained. The t-test and Bland-Altman indicated that the difference between the real volume and the estimated volume was not significantly different (p>0.05 i.e. the mean difference was 1.52 cm3 and the accuracy of measurement was 92%. Utilizing neural network with input variables of dimension and mass has increased the accuracy up to 97% and the difference between the mean of volumes decreased to 0.7 cm3.

  16. Economic evaluation of diagnostic localization following biochemical prostate cancer recurrence.

    Science.gov (United States)

    Barocas, Daniel A; Bensink, Mark E; Berry, Kristin; Musa, Zahra; Bodnar, Carolyn; Dann, Robert; Ramsey, Scott D

    2014-10-01

    The aim of this study was to assess potential cost-effectiveness of using a prostate cancer specific functional imaging technology capable of identifying residual localized disease versus small volume metastatic disease for asymptomatic men with low but detectable prostate specific antigen (PSA) elevation following radical prostatectomy. Markov modeling was used to estimate the incremental impact on healthcare system costs (2012 USD) and quality-adjusted life-years (QALYs) of two alternative strategies: (i) using the new diagnostic to guide therapy versus (ii) current usual care-using a combination of computed tomography, magnetic resonance imaging, and bone scan to guide therapy. Costs were based on estimates from literature and Medicare reimbursement. Prostate cancer progression, survival, utilities, and background risk of all-cause mortality were obtained from literature. Base-case diagnostic sensitivity (75 percent), specificity (90 percent), and cost (USD 2,500) were provided by our industry partner GE Healthcare. The new diagnostic strategy provided an average gain of 1.83 (95 percent uncertainty interval [UI]: 1.24-2.64) QALYs with added costs of USD 15,595 (95 percent UI: USD -6,330-44,402) over 35 years. The resulting incremental cost-effectiveness ratio was USD 8,516/QALY (95 percent UI: USD -2,947-22,372). RESULTS were most influenced by the utility discounting rate and test performance characteristics; however, the new diagnostic provided clinical benefits over a wide range of sensitivity and specificity. This analysis suggests a diagnostic technology capable of identifying whether men with biochemical recurrence after radical prostatectomy have localized versus metastatic disease would be a cost-effective alternative to current standard work-up. The results support additional investment in development and validation of such a diagnostic.

  17. A Bayesian nonrigid registration method to enhance intraoperative target definition in image-guided prostate procedures through uncertainty characterization

    International Nuclear Information System (INIS)

    Pursley, Jennifer; Risholm, Petter; Fedorov, Andriy; Tuncali, Kemal; Fennessy, Fiona M.; Wells, William M. III; Tempany, Clare M.; Cormack, Robert A.

    2012-01-01

    variation in the shape and volume of the segmented prostate in diagnostic and intraprocedural images. The probabilistic method allowed us to convey registration results in terms of posterior distributions, with the dispersion providing a patient-specific estimate of the registration uncertainty. The median of the predictive distance distribution between the deformed prostate boundary and the segmented boundary was ⩽3 mm (95th percentiles within ±4 mm) for all ten patients. The accuracy and precision of the internal deformation was evaluated by comparing the posterior predictive distance distribution for the CZ-PZ interface for each patient, with the median distance ranging from −0.6 to 2.4 mm. Posterior predictive distances between naturally occurring landmarks showed registration errors of ⩽5 mm in any direction. The uncertainty was not a global measure, but instead was local and varied throughout the registration region. Registration uncertainties were largest in the apical region of the prostate. Conclusions: Using a Bayesian nonrigid registration method, the authors determined the posterior distribution on deformations between diagnostic and intraprocedural MR images and quantified the uncertainty in the registration results. The feasibility of this approach was tested and results were positive. The probabilistic framework allows us to evaluate both patient-specific and location-specific estimates of the uncertainty in the registration result. Although the framework was tested on MR-guided procedures, the preliminary results suggest that it may be applied to TRUS-guided procedures as well, where the addition of diagnostic MR information may have a larger impact on target definition and clinical guidance.

  18. Prostate-specific antigen density: correlation with histological diagnosis of prostate cancer, benign prostatic hyperplasia and prostatitis

    NARCIS (Netherlands)

    van Iersel, M. P.; Witjes, W. P.; de la Rosette, J. J.; Oosterhof, G. O.

    1995-01-01

    To assess the additional value of prostate-specific antigen density in the diagnosis of prostate cancer in patients who undergo prostate biopsies. The study comprised 376 patients with symptoms of prostatism who were undergoing prostate biopsy. Digital rectal examination (DRE) and transrectal

  19. Optimal needle arrangement for intraoperative planning in permanent I-125 prostate implants

    International Nuclear Information System (INIS)

    Thompson, S.A.; Fung, A.Y.C.; Zaider, M.

    2002-01-01

    One limitation of intraoperative planning of permanent prostate implants is that needles must already be in the gland before planning images are acquired. Improperly placed needles often restrict the capability of generating optimal seed placement. We developed guiding principles for the proper layout of needles within the treatment volume. The Memorial Sloan-Kettering Cancer Center planning system employs a genetic algorithm to find the optimal seed implantation pattern consistent with pre-assigned constraints (needle geometry, uniformity, conformity and the avoidance of high doses to urethra and rectum). Ultrasound volumes for twelve patients with I-125 implants were used to generate six plans per patient (total 72 plans) with different needle arrangements. The plans were evaluated in terms of V100 (percentage prostate volume receiving at least the prescription dose), U135 (percentage urethra volume receiving at least 135% of prescription dose), and CI (conformity index, the ratio of treatment volume to prescription dose volume.) The method termed POSTCTR, in which needles were placed on the periphery of the largest ultrasound slice and posterior central needles were placed as needed, consistently gave superior results for all prostate sizes. Another arrangement, labelled POSTLAT, where the needles were placed peripherally with additional needles in the posterior lateral lobes, also gave satisfactory results. We advocate two needle arrangements, POSTCTR and POSTLAT, with the former giving better results. (author)

  20. Optimal needle arrangement for intraoperative planning in permanent I-125 prostate implants

    Energy Technology Data Exchange (ETDEWEB)

    Thompson, S.A. [Department of Medical Physics, North Shore-Long Island Jewish Health System, Manhassett, NY (United States); Fung, A.Y.C.; Zaider, M. [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

    2002-08-21

    One limitation of intraoperative planning of permanent prostate implants is that needles must already be in the gland before planning images are acquired. Improperly placed needles often restrict the capability of generating optimal seed placement. We developed guiding principles for the proper layout of needles within the treatment volume. The Memorial Sloan-Kettering Cancer Center planning system employs a genetic algorithm to find the optimal seed implantation pattern consistent with pre-assigned constraints (needle geometry, uniformity, conformity and the avoidance of high doses to urethra and rectum). Ultrasound volumes for twelve patients with I-125 implants were used to generate six plans per patient (total 72 plans) with different needle arrangements. The plans were evaluated in terms of V100 (percentage prostate volume receiving at least the prescription dose), U135 (percentage urethra volume receiving at least 135% of prescription dose), and CI (conformity index, the ratio of treatment volume to prescription dose volume.) The method termed POSTCTR, in which needles were placed on the periphery of the largest ultrasound slice and posterior central needles were placed as needed, consistently gave superior results for all prostate sizes. Another arrangement, labelled POSTLAT, where the needles were placed peripherally with additional needles in the posterior lateral lobes, also gave satisfactory results. We advocate two needle arrangements, POSTCTR and POSTLAT, with the former giving better results. (author)

  1. A 3D global-to-local deformable mesh model based registration and anatomy-constrained segmentation method for image guided prostate radiotherapy

    International Nuclear Information System (INIS)

    Zhou Jinghao; Kim, Sung; Jabbour, Salma; Goyal, Sharad; Haffty, Bruce; Chen, Ting; Levinson, Lydia; Metaxas, Dimitris; Yue, Ning J.

    2010-01-01

    Purpose: In the external beam radiation treatment of prostate cancers, successful implementation of adaptive radiotherapy and conformal radiation dose delivery is highly dependent on precise and expeditious segmentation and registration of the prostate volume between the simulation and the treatment images. The purpose of this study is to develop a novel, fast, and accurate segmentation and registration method to increase the computational efficiency to meet the restricted clinical treatment time requirement in image guided radiotherapy. Methods: The method developed in this study used soft tissues to capture the transformation between the 3D planning CT (pCT) images and 3D cone-beam CT (CBCT) treatment images. The method incorporated a global-to-local deformable mesh model based registration framework as well as an automatic anatomy-constrained robust active shape model (ACRASM) based segmentation algorithm in the 3D CBCT images. The global registration was based on the mutual information method, and the local registration was to minimize the Euclidian distance of the corresponding nodal points from the global transformation of deformable mesh models, which implicitly used the information of the segmented target volume. The method was applied on six data sets of prostate cancer patients. Target volumes delineated by the same radiation oncologist on the pCT and CBCT were chosen as the benchmarks and were compared to the segmented and registered results. The distance-based and the volume-based estimators were used to quantitatively evaluate the results of segmentation and registration. Results: The ACRASM segmentation algorithm was compared to the original active shape model (ASM) algorithm by evaluating the values of the distance-based estimators. With respect to the corresponding benchmarks, the mean distance ranged from -0.85 to 0.84 mm for ACRASM and from -1.44 to 1.17 mm for ASM. The mean absolute distance ranged from 1.77 to 3.07 mm for ACRASM and from 2.45 to

  2. Estimation of the volume and percent uptake of the liver and spleen by SPECT

    International Nuclear Information System (INIS)

    Yamagata, Atushi

    1988-01-01

    The volume and percent uptake of the liver and spleen were estimated with single photon emission computed tomography (SPECT) using 99m Tc-phytate. Clinical usefulness of these parameters was evaluated by comparison with other liver function tests in 87 patients including 25 normal controls, 24 liver cirrhosis and 16 other chronic liver diseases. SPECT images were obtained by Maxi Camera 400T. Cut-off level for reconstruction of images and relationship between counts and activity (mCi) were obtained from phantom studies. Volumes estimated using SPECT and computed tomography were compared in 16 patients. Results obtained were as follows. 1) Optimal cut-off level for measurement of volumes for the liver was 37 % and for the spleen was 42 %. 2) Correlation between organ volumes estimated with CT and SPECT was good (r = 0.92 for the liver and r = 0.96 for the spleen), although volumes measured with SPECT were larger than those with CT. 3) Significant differences of percent uptake were observed between normal controls and liver cirrhosis. 4) Better correlation between spleen volumes and uptake was recognized in cases without liver cirrhosis than in cases with liver cirrhosis. The spleen uptake in liver cirrhosis was higher than those in others in comparison with the volume. 5) The liver/spleen ratio of 99m Tc-phytae uptake could most clearly differentiate liver cirrhosis from others. 6) Negative correlation was observed between liver volume or uptake and ICG (R 15 ). Estimation of volume and uptake of the liver and spleen could be a useful procedure to assess liver function, probably related with effective hepatic blood flow in liver cirrhosis. (author)

  3. Simulating intrafraction prostate motion with a random walk model.

    Science.gov (United States)

    Pommer, Tobias; Oh, Jung Hun; Munck Af Rosenschöld, Per; Deasy, Joseph O

    2017-01-01

    Prostate motion during radiation therapy (ie, intrafraction motion) can cause unwanted loss of radiation dose to the prostate and increased dose to the surrounding organs at risk. A compact but general statistical description of this motion could be useful for simulation of radiation therapy delivery or margin calculations. We investigated whether prostate motion could be modeled with a random walk model. Prostate motion recorded during 548 radiation therapy fractions in 17 patients was analyzed and used for input in a random walk prostate motion model. The recorded motion was categorized on the basis of whether any transient excursions (ie, rapid prostate motion in the anterior and superior direction followed by a return) occurred in the trace and transient motion. This was separately modeled as a large step in the anterior/superior direction followed by a returning large step. Random walk simulations were conducted with and without added artificial transient motion using either motion data from all observed traces or only traces without transient excursions as model input, respectively. A general estimate of motion was derived with reasonable agreement between simulated and observed traces, especially during the first 5 minutes of the excursion-free simulations. Simulated and observed diffusion coefficients agreed within 0.03, 0.2 and 0.3 mm 2 /min in the left/right, superior/inferior, and anterior/posterior directions, respectively. A rapid increase in variance at the start of observed traces was difficult to reproduce and seemed to represent the patient's need to adjust before treatment. This could be estimated somewhat using artificial transient motion. Random walk modeling is feasible and recreated the characteristics of the observed prostate motion. Introducing artificial transient motion did not improve the overall agreement, although the first 30 seconds of the traces were better reproduced. The model provides a simple estimate of prostate motion during

  4. Temporal validation for landsat-based volume estimation model

    Science.gov (United States)

    Renaldo J. Arroyo; Emily B. Schultz; Thomas G. Matney; David L. Evans; Zhaofei Fan

    2015-01-01

    Satellite imagery can potentially reduce the costs and time associated with ground-based forest inventories; however, for satellite imagery to provide reliable forest inventory data, it must produce consistent results from one time period to the next. The objective of this study was to temporally validate a Landsat-based volume estimation model in a four county study...

  5. Pubertal development and prostate cancer risk

    DEFF Research Database (Denmark)

    Bonilla, Carolina; Lewis, Sarah J; Martin, Richard M

    2016-01-01

    , 0.91-1.00) and prostate cancer-specific mortality (hazard ratio amongst cases, per tertile: 0.94; 95 % CI, 0.90-0.98), but not with disease grade. CONCLUSIONS: Older age at sexual maturation is causally linked to a reduced risk of later prostate cancer, especially aggressive disease.......BACKGROUND: Epidemiological studies have observed a positive association between an earlier age at sexual development and prostate cancer, but markers of sexual maturation in boys are imprecise and observational estimates are likely to suffer from a degree of uncontrolled confounding. To obtain...... to a difference of one Tanner stage between pubertal boys of the same age) was associated with a 77 % (95 % CI, 43-91 %) reduced odds of high Gleason prostate cancer. In PRACTICAL, the puberty genetic score was associated with prostate cancer stage (OR of advanced vs. localized cancer, per tertile: 0.95; 95 % CI...

  6. A semiautomatic tool for prostate segmentation in radiotherapy treatment planning

    International Nuclear Information System (INIS)

    Schulz, Jörn; Skrøvseth, Stein Olav; Tømmerås, Veronika Kristine; Marienhagen, Kirsten; Godtliebsen, Fred

    2014-01-01

    Delineation of the target volume is a time-consuming task in radiotherapy treatment planning, yet essential for a successful treatment of cancers such as prostate cancer. To facilitate the delineation procedure, the paper proposes an intuitive approach for 3D modeling of the prostate by slice-wise best fitting ellipses. The proposed estimate is initialized by the definition of a few control points in a new patient. The method is not restricted to particular image modalities but assumes a smooth shape with elliptic cross sections of the object. A training data set of 23 patients was used to calculate a prior shape model. The mean shape model was evaluated based on the manual contour of 10 test patients. The patient records of training and test data are based on axial T1-weighted 3D fast-field echo (FFE) sequences. The manual contours were considered as the reference model. Volume overlap (Vo), accuracy (Ac) (both ratio, range 0-1, optimal value 1) and Hausdorff distance (HD) (mm, optimal value 0) were calculated as evaluation parameters. The median and median absolute deviation (MAD) between manual delineation and deformed mean best fitting ellipses (MBFE) was Vo (0.9 ± 0.02), Ac (0.81 ± 0.03) and HD (4.05 ± 1.3)mm and between manual delineation and best fitting ellipses (BFE) was Vo (0.96 ± 0.01), Ac (0.92 ± 0.01) and HD (1.6 ± 0.27)mm. Additional results show a moderate improvement of the MBFE results after Monte Carlo Markov Chain (MCMC) method. The results emphasize the potential of the proposed method of modeling the prostate by best fitting ellipses. It shows the robustness and reproducibility of the model. A small sample test on 8 patients suggest possible time saving using the model

  7. Careful assessment key in managing prostatitis.

    Science.gov (United States)

    Gujadhur, Rahul; Aning, Jonathan

    2015-04-01

    Prostatitis is a common condition estimated to affect up to 30% of men in their lifetime, it is most prevalent in men aged between 35 and 50. Prostatitis is subclassified into: acute bacterial prostatitis, chronic bacterial prostatitis, chronic pelvic pain and asymptomatic inflammatory prostatitis. Acute bacterial prostatitis presents with acute onset pelvic pain which may or may not be related to voiding, lower urinary tract symptoms, sometimes haematuria or haematospermia and systemic symptoms such as fever and rigors. A documented history of recurrent urinary tract infections is the key feature of chronic bacterial prostatitis. Duration of symptoms > 3 months defines chronicity. The key symptom of chronic pelvic pain syndrome is pain. Patients may describe pain during or after ejaculation as their predominant symptom. Clinical assessment includes a thorough history and examination. A digital rectal examination should be performed after a midstream urine (MSU) sample has been collected for urine dipstick, microscopy and culture. The prostate should be checked for nodules. In acute bacterial prostatitis the MSU is the only laboratory investigation required. Chronic pelvic pain syndrome may be multifactorial and part of a more generalised pain disorder. Pelvic floor muscle abnormalities, altered neuroendocrine pathways, chemically induced inflammation, bacterial infection, autoimmune processes, dysfunctional voiding as well intraprostatic ductal reflux mechanisms have all been identified in men with chronic pelvic pain syndrome.

  8. Percutaneous transperineal placement of gold 198 seeds for treatment of carcinoma of the prostate

    Energy Technology Data Exchange (ETDEWEB)

    Crusinberry, R.A.; Kramolowsky, E.V.; Loening, S.A.

    1987-01-01

    Thirty-one patients have been treated for carcinoma of the prostate with /sup 198/Au seeds placed transperineally using transrectal ultrasonic guidance. Twenty patients have been followed postoperatively for periods ranging from 3 to 31 months, with an average follow-up time of 12 months. Cumulative dose of radiation to the prostate calculated by dosimetry was either 9000 rads or 15,000 rads. Serial transrectal ultrasound examinations performed on these patients showed a decrease in prostate size in all patients within 6 months of treatment, with a statistically significant decrease observed between the third and sixth months. No significant difference in amount or rate of tumor regression was noted when tumor stage and grade were correlated to volume decrease after treatment. Patients who received the larger doses of radiation (15,000 rads) showed a significantly greater rate of decline in prostatic volume than those who received 9000 rads. Seven patients underwent prostate biopsy between 12 and 18 months after treatment; six biopsies showed residual tumor. Complications after treatment included urinary retention because of prostatic edema (three), radiation urethritis (three), and rectal ulceration (one). Transperineal placement of /sup 198/Au is well tolerated and offers an alternative to external beam radiation for treatment of carcinoma of the prostate.

  9. Suggestion for the prostatic fossa clinical target volume in adjuvant or salvage radiotherapy after a radical prostatectomy

    International Nuclear Information System (INIS)

    Park, Jun Su; Park, Won; Pyo, Hong Ryull; Park, Byung Kwan; Park, Sung Yoon; Choi, Han Yong; Lee, Hyun Moo; Jeon, Seong Soo; Seo, Seong Il; Jeong, Byong Chang; Jeon, Hwang Gyun

    2014-01-01

    Background and purpose: To assess the location of recurrent tumors and suggest the optimal target volume in adjuvant or salvage radiotherapy (RT) after a radical prostatectomy (RP). Material and methods: From January 2000 to December 2012, 113 patients had been diagnosed with suspected recurrent prostate cancer by MRI scan and received salvage RT in the Samsung Medical Center. This study assessed the location of the suspected tumor recurrences and used the inferior border of the pubic symphysis as a point of reference. Results: There were 118 suspect tumor recurrences. The most common site of recurrence was the anastomotic site (78.8%), followed by the bladder neck (15.3%) and retrovesical area (5.9%). In the cranial direction, 106 (87.3%) lesions were located within 30 mm of the reference point. In the caudal direction, 12 lesions (10.2%) were located below the reference point. In the transverse plane, 112 lesions (94.9%) were located within 10 mm of the midline. Conclusions: A MRI scan acquired before salvage RT is useful for the localization of recurrent tumors and the delineation of the target volume. We suggest the optimal target volume in adjuvant or salvage RT after RP, which includes 97% of suspected tumor recurrences

  10. Estrogen receptors in the human male prostatic urethra and prostate in prostatic cancer and benign prostatic hyperplasia

    DEFF Research Database (Denmark)

    Bødker, A; Bruun, J; Balslev, E

    1999-01-01

    Estrogen receptors (ERs) in the prostate and prostatic urethra were examined in 33 men with benign prostatic hyperplasia (BPH) and in 11 with prostate cancer (PC). The Abbot monoclonal ER-ICA assay was used for immunohistochemical investigation. In the BPH group, ERs were revealed in the prostatic...... stroma in eight cases and in the glandular epithelium in one. In four cases ERs were seen in the prostatic stroma and in the glandular epithelium. In the prostatic urethra, ERs were found in 19 cases located in the urothelium, lamina propria and/or periurethral glands. In the PC group, ERs were...... demonstrated in the prostatic stroma and/or prostatic urethra in 6 out of 11 cases. In both BPH and PC patients, immunoreactivity was weak and confined to few cells, indicating low ER content in the prostate as well as in the prostatic urethra. Dextran-coated charcoal (DCC) analysis was used for detection...

  11. Early diagnostic role of PSA combined miR-155 detection in prostate cancer.

    Science.gov (United States)

    Guo, T; Wang, X-X; Fu, H; Tang, Y-C; Meng, B-Q; Chen, C-H

    2018-03-01

    As a kind of malignant tumor in the male genitourinary system, prostate cancer exhibits significantly increased occurrence. Prostate-specific antigen (PSA) expression can be seen in the prostate cancer, prostatitis, and other diseases, therefore, lack of diagnostic specificity. The miR-155 expression is abnormally increased in the tumors. Therefore, this study aims to explore the clinical significance of PSA combined miR-155 detection in the early diagnosis of prostate cancer. A total of 86 patients diagnosed with prostate cancer were enrolled in this study. PSA and miR-155 gene expression in tumor tissue were detected by using Real-time PCR. The serum levels of PSA were measured by using enzyme-linked immunosorbent assay (ELISA). The correlation of PSA and miR-155 expression with age, body mass index (BMI), tumor volume, tumor-node-metastasis (TNM) stage, lymph node metastasis (LNM), and other clinicopathological features were analyzed, respectively. Serum PSA expression and PSA gene in tumor tissue were significantly higher compared to that in adjacent tissues (pPSA gene and protein increased significantly with the clinical stage of TNM and decreased following the increase of grade (pPSA and miR-155 expressions were positively correlated with TNM stage, tumor volume, and LNM, and negatively correlated with grade (pPSA and miR-155 were closely related to the clinicopathological features of prostate cancer. Combined detection is helpful for the early diagnosis of prostate cancer.

  12. PREVALENCE OF BENIGN PROSTATIC HYPERPLASIA AND PROSTATE CANCER IN AFRICANS AND AFRICANS IN THE DIASPORA.

    Science.gov (United States)

    Yeboah, E D

    2016-01-01

    There have been several publications on population or community prevalence of benign prostatic hyperplasia and prostate cancer from various countries and races but few reports are from Africa on Africans. A review on the prevalence of benign prostatic hyperplasia and prostate cancer in Africans and other races. The current literature on prevalence of benign prostatic hyperplasia (BPH), prostate cancer (PC), and benign prostatic hyperplasia co-existing with prostate cancer in Africans and other races is reviewed. Benign prostatic hyperplasia (BPH) prevalence in Ghana is responsible for 60% acute retention of urine and 28.6% of haematuria. Worldwide prevalence of BPH varies from 20 - 62% in men over 50 years and this includes USA, UK, Japan and Ghana. Reports from South Africa indicate prevalence of over 50% in adult males of 60 years. BPH co-existing with PC - Reports from USA, UK and Japan and Ghana reveal moderate association of BPH and PC. The co-existence of PC in patients being treated for BPH is 3 - 20% Prostate Cancer prevalence - There is high prevalence in USA, Scandinavian Countries, African Americans (AA) and Caribbean blacks. Ghana, Trinidad & Tobago have reported high prevalence of 6 -10% in men aged 50 years and above but others reported low prevalence in Africans from Africa. The low reporting from Africa of 10 - 40:100,000 is attributable to under reporting, absence of PSA screening/testing, lack of reliable cancer registries and poor medical facilities. Economic Costs of BPH and PC: BPH in the USA national direct costs are estimated at U$4Billion and individual costs of US$1536 annually. In Ghana, individual costs for BPH medications range from US$300 - 550 per year and cost for simple prostatectomy/TURP is estimated at US$1100. For prostate cancer, individual direct costs from Europe range from 6,575 - 12,000 euros, £2818.00 UK and over U$12,000 - 20,000 in USA per annum. In Ghana, individual direct costs ranges, for radical prostatectomy and

  13. Acute Bacterial Prostatitis: Diagnosis and Management.

    Science.gov (United States)

    Coker, Timothy J; Dierfeldt, Daniel M

    2016-01-15

    Acute bacterial prostatitis is an acute infection of the prostate gland that causes pelvic pain and urinary tract symptoms, such as dysuria, urinary frequency, and urinary retention, and may lead to systemic symptoms, such as fevers, chills, nausea, emesis, and malaise. Although the true incidence is unknown, acute bacterial prostatitis is estimated to comprise approximately 10% of all cases of prostatitis. Most acute bacterial prostatitis infections are community acquired, but some occur after transurethral manipulation procedures, such as urethral catheterization and cystoscopy, or after transrectal prostate biopsy. The physical examination should include abdominal, genital, and digital rectal examination to assess for a tender, enlarged, or boggy prostate. Diagnosis is predominantly made based on history and physical examination, but may be aided by urinalysis. Urine cultures should be obtained in all patients who are suspected of having acute bacterial prostatitis to determine the responsible bacteria and its antibiotic sensitivity pattern. Additional laboratory studies can be obtained based on risk factors and severity of illness. Radiography is typically unnecessary. Most patients can be treated as outpatients with oral antibiotics and supportive measures. Hospitalization and broad-spectrum intravenous antibiotics should be considered in patients who are systemically ill, unable to voluntarily urinate, unable to tolerate oral intake, or have risk factors for antibiotic resistance. Typical antibiotic regimens include ceftriaxone and doxycycline, ciprofloxacin, and piperacillin/tazobactam. The risk of nosocomial bacterial prostatitis can be reduced by using antibiotics, such as ciprofloxacin, before transrectal prostate biopsy.

  14. Xanthogranulomatous Prostatitis, a Rare Prostatic Entity

    Directory of Open Access Journals (Sweden)

    Alejandro Noyola

    2017-01-01

    Full Text Available There are several benign prostatic pathologies that can clinically mimic a prostate adenocarcinoma. Xanthogranulomatous prostatitis is a benign inflammatory condition of the prostate and a rare entity. A 47-year old male, with 3 years of lower urinary tract symptoms, with a palpable hypogastric tumor, digital rectal examination: solid prostate, of approximately 60 g. Initial PSA was 0.90 ng/mL. He underwent surgical excision of the lower abdominal nodule and prostatectomy. Histopathology showed xanthogranulomatous prostatitis, without malignancy. Xanthogranulomatous prostatitis is an extremely rare entity that can simulate prostate adenocarcinoma, therefore having a correct histopathological diagnosis is essential.

  15. Effects of organ motion on proton prostate treatments, as determined from analysis of daily CT imaging for patient positioning.

    Science.gov (United States)

    Maeda, Yoshikazu; Sato, Yoshitaka; Shibata, Satoshi; Bou, Sayuri; Yamamoto, Kazutaka; Tamamura, Hiroyasu; Fuwa, Nobukazu; Takamatsu, Shigeyuki; Sasaki, Makoto; Tameshige, Yuji; Kume, Kyo; Minami, Hiroki; Saga, Yusuke; Saito, Makoto

    2018-05-01

    .0, 7.6, 6.0), (11.8, 8.4, 7.8, 5.2, 6.3), and (9.9, 7.5, 7.8, 5.2, 6.3). PRB matching showed the smallest positional deviations at all portions except for the anterior portion of the prostate and was able to markedly reduce the positional deviations at the posterior portion. The averaged WEL variations at the distal and proximal sides of planning target volumes were estimated 7-9 mm and 4-6 mm, respectively, and showed the increasing of a few millimeters in PC and PRB matching compared to bone matching. In the treatment planning simulation, the DVH values of the rectum in PRB matching were reduced compared to those obtained with other matching strategies. The positional deviations for the prostate on the posterior side and the SVs were smaller by PRB matching than the other strategies and effectively reduced the rectal dose. 3D dose calculations indicate that PRB matching with CT image guidance may do a better job relative to other positioning methods to effectively reduce the rectal complications. The WEL variation was quite large, and the appropriate margin (approx. 10 mm) must be adapted to the proton range in an initial planning to maintain the coverage of target volumes throughout entire treatment. © 2018 American Association of Physicists in Medicine.

  16. Dose-volume analysis of predictors for chronic rectal toxicity after treatment of prostate cancer with adaptive image-guided radiotherapy

    International Nuclear Information System (INIS)

    Vargas, Carlos; Martinez, Alvaro; Kestin, Larry L.; Yan Di; Grills, Inga; Brabbins, Donald S.; Lockman, David M.; Liang Jian; Gustafson, Gary S.; Chen, Peter Y.; Vicini, Frank A.; Wong, John W.

    2005-01-01

    Purpose We analyzed our experience treating localized prostate cancer with image-guided off-line correction with adaptive high-dose radiotherapy (ART) in our Phase II dose escalation study to identify factors predictive of chronic rectal toxicity. Materials and Methods From 1999-2002, 331 patients with clinical stage T1-T3N0M0 prostate cancer were prospectively treated in our Phase II 3D conformal dose escalation ART study to a median dose of 75.6 Gy (range, 63.0-79.2 Gy), minimum dose to confidence limited-planning target volume (cl-PTV) in 1.8 Gy fractions (median isocenter dose = 79.7 Gy). Seventy-four patients (22%) also received neoadjuvant/adjuvant androgen deprivation therapy. A patient-specific cl-PTV was constructed using 5 computed tomography scans and 4 sets of electronic portal images by applying an adaptive process to assure target accuracy and minimize PTV margin. For each case, the rectum (rectal solid) was contoured from the sacroiliac joints or rectosigmoid junction (whichever was higher) to the anal verge or ischial tuberosities (whichever was lower), with a median volume of 81.2 cc. The rectal wall was defined using the rectal solid with an individualized 3-mm wall thickness (median volume = 29.8 cc). Rectal wall dose-volume histogram was used to determine the prescribed dose. Toxicity was quantified using the National Cancer Institute Common Toxicity Criteria 2.0. Multiple dose-volume endpoints were evaluated for their association with chronic rectal toxicity. Results Median follow-up was 1.6 years. Thirty-four patients (crude rate 10.3%) experienced Grade 2 chronic rectal toxicity at a median interval of 1.1 years. Nine patients (crude rate = 2.7%) experienced Grade ≥3 chronic rectal toxicity (1 was Grade 4) at a median interval of 1.2 years. The 3-year rates of Grade ≥2 and Grade ≥3 chronic rectal toxicity were 20% and 4%, respectively. Acute toxicity predicted for chronic: Acute Grade 2-3 rectal toxicity (p 40% respectively. The volume

  17. Hematuria following stereotactic body radiation therapy (SBRT) for clinically localized prostate cancer

    International Nuclear Information System (INIS)

    Gurka, Marie K; Chen, Leonard N; Bhagat, Aditi; Moures, Rudy; Kim, Joy S; Yung, Thomas; Lei, Siyuan; Collins, Brian T; Krishnan, Pranay; Suy, Simeng; Dritschilo, Anatoly; Lynch, John H; Collins, Sean P

    2015-01-01

    Hematuria following prostate radiotherapy is a known toxicity that may adversely affect a patient’s quality of life. Given the higher dose of radiation per fraction using stereotactic body radiation therapy (SBRT) there is concern that post-SBRT hematuria would be more common than with alternative radiation therapy approaches. Herein, we describe the incidence and severity of hematuria following stereotactic body radiation therapy (SBRT) for prostate cancer at our institution. Two hundred and eight consecutive patients with prostate cancer treated with SBRT monotherapy with at least three years of follow-up were included in this retrospective analysis. Treatment was delivered using the CyberKnife® (Accuray) to doses of 35–36.25 Gy in 5 fractions. Toxicities were scored using the CTCAE v.4. Hematuria was counted at the highest grade it occurred in the acute and late setting for each patient. Cystoscopy findings were retrospectively reviewed. Univariate and multivariate analyses were performed. Hematuria-associated bother was assessed via the Expanded Prostate Index Composite (EPIC)-26. The median age was 69 years with a median prostate volume of 39 cc. With a median follow-up of 48 months, 38 patients (18.3%) experienced at least one episode of hematuria. Median time to hematuria was 13.5 months. In the late period, there were three grade 3 events and five grade 2 events. There were no grade 4 or 5 events. The 3-year actuarial incidence of late hematuria ≥ grade 2 was 2.4%. On univariate analysis, prostate volume (p = 0.022) and history of prior procedure(s) for benign prostatic hypertrophy (BPH) (p = 0.002) were significantly associated with hematuria. On multivariate analysis, history of prior procedure(s) for BPH (p < 0.0001) and α 1A antagonist use (p = 0.008) were significantly associated with the development of hematuria. SBRT for prostate cancer was well tolerated with hematuria rates comparable to other radiation modalities. Patients factors

  18. ICPP tank farm closure study. Volume III: Cost estimates, planning schedules, yearly cost flowcharts, and life-cycle cost estimates

    International Nuclear Information System (INIS)

    1998-02-01

    This volume contains information on cost estimates, planning schedules, yearly cost flowcharts, and life-cycle costs for the six options described in Volume 1, Section 2: Option 1 -- Total removal clean closure; No subsequent use; Option 2 -- Risk-based clean closure; LLW fill; Option 3 -- Risk-based clean closure; CERCLA fill; Option 4 -- Close to RCRA landfill standards; LLW fill; Option 5 -- Close to RCRA landfill standards; CERCLA fill; and Option 6 -- Close to RCRA landfill standards; Clean fill. This volume is divided into two portions. The first portion contains the cost and planning schedule estimates while the second portion contains life-cycle costs and yearly cash flow information for each option

  19. Elevated insulin and reduced insulin like growth factor binding protein-3/prostate specific antigen ratio with increase in prostate size in Benign Prostatic Hyperplasia.

    Science.gov (United States)

    Sreenivasulu, Karli; Nandeesha, Hanumanthappa; Dorairajan, Lalgudi Narayanan; Rajappa, Medha; Vinayagam, Vickneshwaran

    2017-06-01

    Insulin and insulin like growth factor-1 (IGF-1) have growth promoting effects, while insulin like growth factor binding protein-3 (IGFBP-3) has growth inhibitory effects. The present study was designed to assess the concentrations of insulin, IGF-1, IGFBP-3 and their association with prostate size in patients with BPH. Ninety 90 BPH cases and 90 controls were enrolled in the study. Insulin, IGF-1, IGFBP-3, PSA, testosterone and estradiol were estimated in both the groups. Insulin, IGF-1 and estradiol were increased and IGFBP-3/PSA was decreased in BPH cases when compared with controls. Insulin (r=0.64, p=0.001) and IGF-1 (r=0.22, p=0.03) were positively correlated and IGFBP-3/PSA (r=-0.316, p=0.002) were negatively correlated with prostate size in BPH. Multivariate analysis showed that insulin (p=0.001) and IGFBP-3/PSA (p=0.004) predicts the prostate size in patients with BPH. Insulin was increased and IGFBP-3/PSA was reduced in BPH patients with increased prostate size. At a cutoff concentration of 527.52, IGFBP-3/PSA ratio was found to differentiate benign growth of prostate from normal prostate with 96% sensitivity and 96% specificity. Insulin is elevated and IGFBP-3/PSA is reduced with increase prostate size in BPH cases. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Classification of tubulo-papillary renal cortical tumours using estimates of nuclear volume

    DEFF Research Database (Denmark)

    Brooks, B; Sørensen, Flemming Brandt; Olsen, S

    1993-01-01

    The classification of renal cortical tumours is problematic, with no clear division of benign from malignant tumours. Unbiased stereological estimates of volume-weighted nuclear volume (nuclear vv) were obtained by point sampling of nuclear intercepts in a retrospective study of 36 variably sized...

  1. Prostate carcinoma (PC) - an organ-related specific pathological neoplasm

    International Nuclear Information System (INIS)

    Massmann, J.; Funk, A.; Altwein, J.; Praetorius, M.

    2003-01-01

    The organ- and tumour-related specific characteristics of prostate carcinoma (PC) are presented in an overview under various aspects. It is the key for understanding pathological changes, including PC, to consider the subdivision of the prostate into anatomically and functionally distinguishable zones, especially the transitional zone (TZ) and the peripheral zone (PZ). The pseudoneoplastic hyperplasia of the TZ, combined with inflammatory consequences and age-related changes, forms a differential diagnostic challenge to both clinico-radiological diagnosis and macroscopic and microscopic examination. High-degree prostatic intra-epithelial neoplasia (PIN III) and atypical adenomatous hyperplasia (AAH) are presented as precursor lesions of PC with varying significance and assessment. Moreover, there are discussed the following characteristic features of PC: localisation types, focality, volume, progression, double-graduation according to Gleason, tumour stage, and prognosis. The most important prognosis factors of PC (category I) include the categories of the TNM system, such as stage, surgical marginal situation, degree and also the preoperative PSA level as a (poor) substitute for the tumour volume. Potential prognosis parameters (category II) show the tumour volume and the DNS ploidy, while there continues to exist a large number of non-established parameters (category III). The prognostic validity of the pathological examinations depends, on the one hand, on the tissue extent (needle biopsy, transurethral resection (TURP), so-called simple prostatectomy, radical prostatectomy (RPE)) and the prostate zones covered. On the other hand, the prognostic certainty also depends on the tumour-adequate macroscopic and microscopic assessment of an RPE that can only be a partial or complete handling in transversal large-area sections. (orig.) [de

  2. Effect of Foley catheters on seed positions and urethral dose in 125I and 103Pd prostate implants

    International Nuclear Information System (INIS)

    Brezovich, Ivan A.; Pareek, Prem N.; Duan, Jun; Fiveash, John

    2001-01-01

    Purpose: To estimate the perturbation of seed position and urethral dose, subsequent to withdrawal of urethral catheters. Methods and Materials: A mathematical model based on the volume incompressibility of tissues was used to compute seed positions and doses following removal of the Foley. The model assumed that the central axis of the urethra remains stationary, and that prostate tissue and seeds move radially toward the center of the urethra to fill the void left by the catheter. Seed motion has also been measured using transrectal ultrasound. Results: Based on the computations, seeds located originally close to the urethra travel relatively large distances toward the urethra upon Foley removal, whereas seeds located further away move substantially less. This seed motion leads to higher urethral doses than shown in a standard treatment plan. Dose enhancements increase with catheter size, decrease with increasing prostate volume, are more pronounced for 103 Pd than for 125 I, and range between 3.5% and 32.4%. Postimplant dosimetry is equally affected if images are taken with urethral catheters in place, showing lower urethral doses than actually delivered. Preliminary ultrasound based measurements of seed motion agree with the theory. Conclusion: During the implantation procedure, 12 fr or smaller urethral catheters are preferable to larger diameter catheters if urine drainage is sufficient. Treatment planners should avoid planning seeds at 5 mm or closer from the urethra. Special caution is indicated in prostates having about 20 cm 3 or smaller volumes, and when 103 Pd is used. Postimplant dosimetry is susceptible to the same errors

  3. FOXP3+ regulatory T cells in normal prostate tissue, postatrophic hyperplasia, prostatic intraepithelial neoplasia, and tumor histological lesions in men with and without prostate cancer.

    Science.gov (United States)

    Davidsson, Sabina; Andren, Ove; Ohlson, Anna-Lena; Carlsson, Jessica; Andersson, Swen-Olof; Giunchi, Francesca; Rider, Jennifer R; Fiorentino, Michelangelo

    2018-01-01

    The tumor promoting or counteracting effects of the immune response to cancer development are thought to be mediated to some extent by the infiltration of regulatory T cells (T regs ). In the present study we evaluated the prevalence of T reg populations in stromal and epithelial compartments of normal, post atrophic hyperplasia (PAH), prostatic intraepithelial neoplasia (PIN), and tumor lesions in men with and without prostate cancer. Study subjects were 102 men consecutively diagnosed with localized prostate cancer undergoing radical prostatectomy and 38 men diagnosed with bladder cancer undergoing cystoprostatectomy without prostate cancer at the pathological examination. Whole mount sections from all patients were evaluated for the epithelial and stromal expression of CD4 + T regs and CD8 + T regs in normal, PAH, PIN, and tumor lesions. A Friedmańs test was used to investigate differences in the mean number of T regs across histological lesions. Logistic regression was used to estimate crude and adjusted odds ratios (OR) for prostate cancer for each histological area. In men with prostate cancer, similarly high numbers of stromal CD4 + T regs were identified in PAH and tumor, but CD4 + T regs were less common in PIN. Greater numbers of epithelial CD4+ T regs in normal prostatic tissue were positively associated with both Gleason score and pT-stage. We observed a fourfold increased risk of prostate cancer in men with epithelial CD4 + T regs in the normal prostatic tissue counterpart. Our results may suggest a possible pathway through which PAH develops directly into prostate cancer in the presence of CD4 + T regs and indicate that transformation of the anti-tumor immune response may be initiated even before the primary tumor is established. © 2017 The Authors. The Prostate Published by Wiley Periodicals Inc.

  4. Dosimetric comparison between VMAT and RC3D techniques: case of prostate treatment

    Science.gov (United States)

    Chemingui, Fatima Zohra; Benrachi, Fatima; Bali, Mohamed Saleh; Ladjal, Hamid

    2017-09-01

    Considered as the second men cancer in Algeria, prostate cancer is treated in 70% by radiation. That's why radiation therapy is therapeutic weapon for prostate cancer. Conformational Radiotherapy in 3D is the most common technique [1-5]. The use of conventionally optimized treatment plans was compared at case scenario of optimized treatment plans VMAT for prostate cancer. The evaluation of the two optimizations strategies focused on the resulting plans ability to retain dose objectives under the influence of patient set up. Dose Volume Histogram in the Planning Target Volume and dose in the Organs At Risks were used to calculate the conformity index, and evaluation ratio of irradiated volume which represent the main tool of comparison [6,7]. The situation was analysed systematically. The 14% dose increase in the target leads to a decrease in the dose in adjacent organs with 39% in the bladder. Therefore, the criterion for better efficacy and less toxicity reveal that VMAT is the best choice.

  5. Dosimetric comparison between VMAT and RC3D techniques: case of prostate treatment

    Directory of Open Access Journals (Sweden)

    Chemingui Fatima Zohra

    2017-01-01

    Full Text Available Considered as the second men cancer in Algeria, prostate cancer is treated in 70% by radiation. That's why radiation therapy is therapeutic weapon for prostate cancer. Conformational Radiotherapy in 3D is the most common technique [1−5]. The use of conventionally optimized treatment plans was compared at case scenario of optimized treatment plans VMAT for prostate cancer. The evaluation of the two optimizations strategies focused on the resulting plans ability to retain dose objectives under the influence of patient set up. Dose Volume Histogram in the Planning Target Volume and dose in the Organs At Risks were used to calculate the conformity index, and evaluation ratio of irradiated volume which represent the main tool of comparison [6,7]. The situation was analysed systematically. The 14% dose increase in the target leads to a decrease in the dose in adjacent organs with 39% in the bladder. Therefore, the criterion for better efficacy and less toxicity reveal that VMAT is the best choice.

  6. The impact of postimplant edema on the urethral dose in prostate brachytherapy

    International Nuclear Information System (INIS)

    Waterman, Frank M.; Dicker, Adam P.

    2000-01-01

    Purpose: The objective of this work is to determine the effect of timing of the postimplant CT scan on the assessment of the urethral dose. Methods and Materials: A preimplant CT scan and two postimplant CT scans were obtained on 50 patients who received I-125 prostate seed implants. The first postimplant CT scan was obtained on the day of the implant; the second usually 4 to 9 weeks later (mean: 46 no. +-no. 23 days; range: 27-135 days). The urethra was localized in each postimplant CT scan and a dose-volume histogram (DVH) of the urethral dose was compiled from each CT study. The relative decrease in the prostate volume between the first and second postimplant CT scans was determined by contouring the prostate in each CT scan. Results: The prostate volume decreased by 27 no. +-no. 9% (mean no. +-no. SD) between the first and second postimplant CT scans. As a result, the averaged urethral dose derived from the second CT scan was about 30% higher. In terms of dose, the D 10 , D 25 , D 50 , D 75 , and D 90 urethral doses derived from the second CT scan were 90 no. +-no. 56 Gy, 81 no. +-no. 49 Gy, 67 no. +-no. 42 Gy, 49 no. +-no. 44 Gy, and 40 no. +-no. 46 Gy higher, respectively. The increase in the urethral dose is correlated with the decrease in the prostate volume (R = 0.57, no. rhono. 10 dose derived from the CT scans obtained at 46 no. +-no. 23 days postimplant was 90 no. +-no. 56 Gy higher than that derived from the CT scans obtained on the day of the implant. Because of this large difference, the timing of the postimplant CT scan needs to be specified when specifying dose thresholds for urethral morbidity

  7. Changes in atheroma volume estimated from digitized femoral arteriograms

    International Nuclear Information System (INIS)

    Nilsson, S.; Erikson, U.

    1990-01-01

    To evaluate the effects of treatment in patients with cardiovascular risk factors, valid and reproducible methods for assessing changes in atheroma volume are required. We postulated that these changes could be accurately estimated by repeat measurement of the lumen volume of the artery to be studied. With a computer-based technique, the lumen volume of a 20 cm segment of the femoral artery was measured in arteriograms from 107 patients with hypercholesterolemia. Films were digitized with use of a high-resolution scanner, cross-sectional areas were calculated with a slice thickness of 150 μm and the lumen volume was obtained by their integration. The validity of the method was demonstrated in model experiments. An automatic algorithm to correct for changes due to patient positioning was developed and validated in a model experiment. With repeat measurment 10 min and 11 to 13 months apart the coefficients of variation were 2.9% (N=107) and 6.1% (N=29), respectively. (orig.)

  8. Comparison of prostate contours between conventional stepping transverse imaging and Twister-based sagittal imaging in permanent interstitial prostate brachytherapy.

    Science.gov (United States)

    Kawakami, Shogo; Ishiyama, Hiromichi; Satoh, Takefumi; Tsumura, Hideyasu; Sekiguchi, Akane; Takenaka, Kouji; Tabata, Ken-Ichi; Iwamura, Masatsugu; Hayakawa, Kazushige

    2017-08-01

    To compare prostate contours on conventional stepping transverse image acquisitions with those on twister-based sagittal image acquisitions. Twenty prostate cancer patients who were planned to have permanent interstitial prostate brachytherapy were prospectively accrued. A transrectal ultrasonography probe was inserted, with the patient in lithotomy position. Transverse images were obtained with stepping movement of the transverse transducer. In the same patient, sagittal images were also obtained through rotation of the sagittal transducer using the "Twister" mode. The differences of prostate size among the two types of image acquisitions were compared. The relationships among the difference of the two types of image acquisitions, dose-volume histogram (DVH) parameters on the post-implant computed tomography (CT) analysis, as well as other factors were analyzed. The sagittal image acquisitions showed a larger prostate size compared to the transverse image acquisitions especially in the anterior-posterior (AP) direction ( p transverse image acquisitions was correlated to DVH parameters such as D 90 ( R = 0.518, p = 0.019), and V 100 ( R = 0.598, p = 0.005). There were small but significant differences in the prostate contours between the transverse and the sagittal planning image acquisitions. Furthermore, our study suggested that the differences between the two types of image acquisitions might correlated to dosimetric results on CT analysis.

  9. Visualizing the prostate gland by MR imaging in young and old mice.

    Directory of Open Access Journals (Sweden)

    Murali Ravoori

    Full Text Available Prostate imaging requires optimization in young and old mouse models. We tested which MR sequences and field strengths best depict the prostate gland in young and old mice; and, whether prostate MR signal, size, and architecture change with age.Magnetic resonance imaging (MRI of the prostate of young (2 months and old (18 months male nude mice (n = 6 was performed at 4.7 and 7 T and SCID mice (n = 6 at 7 T field strengths, using T1, fat suppressed T1, DWI, T2, fat suppressed T2, as well as T2-based- and proton density-based Dixon "water only" sequences. Images were ranked for best overall sequence for prostate visualization, prostate delineation, and quality of fat suppression. Prostate volume and signal characteristics were compared and histology was performed.T2-based-Dixon "water only" images ranked best overall for prostate visualization and delineation as well as fat suppression (n = 6, P<0.001 at both 4.7 T and 7 T in nude and 7T in SCID mice. Evaluated in nude mice, T2-based Dixon "water only" had greater prostate CNR and lower fat SNR at 7 T than 4.7 T (P<0.001. Prostate volume was less in older than younger mice (n = 6, P<0.02 nude mice; n = 6, P<0.002 SCID mice. Prostate T2 FSE as well as proton density-based and T2-based-Dixon "water only" signal intensity was higher in younger than older mice (P<0.001 nude mice; P<0.01 SCID mice both at 4.7 and 7 T. This corresponded to an increase in glandular hyperplasia in older mice by histology (P<0.01, n = 6.T2-based Dixon "water only" images best depict the mouse prostate in young and old nude mice at 4.7 and 7 T. The mouse prostate decreases in size with age. The decrease in T2 and T2-based Dixon "water only" signal with age corresponds with glandular hyperplasia. Findings suggest age should be an important determinant when choosing models of prostate biology and disease.

  10. Can finasteride reverse the progress of benign prostatic hyperplasia? A two-year placebo-controlled study. The Scandinavian BPH Study Group

    DEFF Research Database (Denmark)

    Andersen, J T; Ekman, P; Wolf, H

    1995-01-01

    rate, prostate volume, postvoiding residual urinary volume, and serum concentrations of prostate-specific antigen together with laboratory safety parameters were measured at entry and at months 12 and 24. Interim physical and laboratory examinations were performed when indicated clinically. RESULTS......OBJECTIVES. To study if placebo-induced improvement in men with symptomatic benign prostatic hyperplasia (BPH) is maintained over 2 years, and to study the efficacy and safety from intervention with finasteride 5 mg for 24 months. METHODS. This was a multicenter, double-blind, placebo....... The maximum urinary flow rate decreased in the placebo group, but improved in the finasteride group, resulting in a between-group difference of 1.8 mL/s at 24 months (P prostate volume was +12% in the placebo group versus -19% in the finasteride-treated group (P

  11. Impact of knee support and shape of tabletop on rectum and prostate position

    International Nuclear Information System (INIS)

    Steenbakkers, Roel; Duppen, Joop C.; Betgen, Anja; Lotz, Heidi; Remeijer, Peter; Fitton, Isabelle; Nowak, Peter; Herk, Marcel van; Rasch, Coen

    2004-01-01

    Purpose: To evaluate the impact of different tabletops with or without a knee support on the position of the rectum, prostate, and bulb of the penis; and to evaluate the effect of these patient-positioning devices on treatment planning. Methods and materials: For 10 male volunteers, five MRI scans were made in four different positions: on a flat tabletop with knee support, on a flat tabletop without knee support, on a rounded tabletop with knee support, and on a rounded tabletop without knee support. The fifth scan was in the same position as the first. With image registration, the position differences of the rectum, prostate, and bulb of the penis were measured at several points in a sagittal plane through the central axis of the prostate. A planning target volume was generated from the delineated prostates with a margin of 10 mm in three dimensions. A three-field treatment plan with a prescribed dose of 78 Gy to the International Commission on Radiation Units and Measurements point was automatically generated from each planning target volume. Dose-volume histograms were calculated for all rectal walls. Results: The shape of the tabletop did not affect the rectum and prostate position. Addition of a knee support shifted the anterior and posterior rectal walls dorsally. For the anterior rectal wall, the maximum dorsal shift was 9.9 mm (standard error of the mean [SEM] 1.7 mm) at the top of the prostate. For the posterior rectal wall, the maximum dorsal shift was 10.2 mm (SEM 1.5 mm) at the middle of the prostate. Therefore, the rectal filling was pushed caudally when a knee support was added. The knee support caused a rotation of the prostate around the left-right axis at the apex (i.e., a dorsal rotation) by 5.6 deg (SEM 0.8 deg ) and shifts in the caudal and dorsal directions of 2.6 mm (SEM 0.4 cm) and 1.4 mm (SEM 0.6 mm), respectively. The position of the bulb of the penis was not influenced by the use of a knee support or rounded tabletop. The volume of the

  12. Updated Drainable Interstitial Liquid Volume Estimates for 119 Single Shell Tanks (SST) Declared Stabilized

    International Nuclear Information System (INIS)

    FIELD, J.G.

    2000-01-01

    This document assesses the volume of drainable interstitial liquid (DIL) and pumpable liquid remaining in 119 single-shell tanks (SSTs) that were previously stabilized. Based on the methodology and assumptions presented, the DIL exceeded the stabilization criterion of less than 50,000 gal in two of the 119 SSTs. Tank 241-C-102 had an estimated DIL of 62,000 gal, and the estimated DIL for tank 241-BY-103 was 58,000 gal. In addition, tanks 241-BX-103, 241-T-102, and 241-T-112 appear to exceed the stabilization criterion of 5,000 gal supernatant. An assessment of the source of the supernatant in these tanks is beyond the scope of this document. The actual DIL and pumpable liquid remaining volumes for each tank may vary significantly from estimated volumes as a result of specific tank waste characteristics that are not currently measured or defined. Further refinement to the pumpable liquid and DIL volume estimates may be needed as additional tank waste information is obtained

  13. Effect of various methods for rectum delineation on relative and absolute dose-volume histograms for prostate IMRT treatment planning

    Energy Technology Data Exchange (ETDEWEB)

    Kusumoto, Chiaki [Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Ohira, Shingo [Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita (Japan); Miyazaki, Masayoshi [Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Ueda, Yoshihiro [Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Department of Radiation Oncology, Graduate School of Medicine, Osaka University, Suita (Japan); Isono, Masaru [Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Teshima, Teruki, E-mail: teshima-te@mc.pref.osaka.jp [Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan)

    2016-07-01

    Several reports have dealt with correlations of late rectal toxicity with rectal dose-volume histograms (DVHs) for high dose levels. There are 2 techniques to assess rectal volume for reception of a specific dose: relative-DVH (R-DVH, %) that indicates relative volume for a vertical axis, and absolute-DVH (A-DVH, cc) with its vertical axis showing absolute volume of the rectum. The parameters of DVH vary depending on the rectum delineation method, but the literature does not present any standardization of such methods. The aim of the present study was to evaluate the effects of different delineation methods on rectal DVHs. The enrollment for this study comprised 28 patients with high-risk localized prostate cancer, who had undergone intensity-modulated radiation therapy (IMRT) with the prescription dose of 78 Gy. The rectum was contoured with 4 different methods using 2 lengths, short (Sh) and long (Lg), and 2 cross sections, rectum (Rec) and rectal wall (Rw). Sh means the length from 1 cm above the seminal vesicles to 1 cm below the prostate and Lg the length from the rectosigmoid junction to the anus. Rec represents the entire rectal volume including the rectal contents and Rw the rectal volume of the area with a wall thickness of 4 mm. We compared dose-volume parameters by using 4 rectal contour methods for the same plan with the R-DVHs as well as the A-DVHs. For the high dose levels, the R-DVH parameters varied widely. The mean of V{sub 70} for Sh-Rw was the highest (19.4%) and nearly twice as high as that for Lg-Rec (10.4%). On the contrary, only small variations were observed in the A-DVH parameters (4.3, 4.3, 5.5, and 5.5 cc for Sh-Rw, Lg-Rw, Sh-Rec, and Lg-Rec, respectively). As for R-DVHs, the parameters of V{sub 70} varied depending on the rectal lengths (Sh-Rec vs Lg-Rec: R = 0.76; Sh-Rw vs Lg-Rw: R = 0.85) and cross sections (Sh-Rec vs Sh-Rw: R = 0.49; Lg-Rec vs Lg-Rw: R = 0.65). For A-DVHs, however, the parameters of Sh rectal A-DVHs hardly changed

  14. CT-based postimplant dosimetry of prostate brachytherapy. Comparison of 1-mm and 5-mm section CT

    International Nuclear Information System (INIS)

    Tanaka, Osamu; Hayashi, Shinya; Kanematsu, Masayuki; Matsuo, Masayuki; Hoshi, Hiroaki; Nakano, Masahiro; Maeda, Sanaho; Deguchi, Takashi; Hoshi, Hiroaki

    2007-01-01

    The aim of this study was to compare the outcomes between 1-mm and 5-mm section computed tomography (CT)-based postimplant dosimetry. A series of 21 consecutive patients underwent permanent prostate brachytherapy. The postimplant prostate volume was calculated using 1-mm and 5-mm section CT. One radiation oncologist contoured the prostate on CT images to obtain the reconstructed prostate volume (pVol), prostate V 100 (percent of the prostate volume receiving at least the full prescribed dose), and prostate D 90 (mean dose delivered to 90% of the prostate gland). The same radiation oncologist performed the contouring three times to evaluate intraobserver variation and subjectively scored the quality of the CT images. The mean ±1 standard deviation (SD) postimplant pVol was 20.17±6.66 cc by 1-mm section CT and 22.24±8.48 cc by 5-mm section CT; the difference in the mean values was 2.06 cc (P 100 was 80.44%±7.06% by 1-mm section CT and 77.33%±10.22% by 5-mm section CT. The mean postimplant prostate D 90 was 83.28%±10.81% by 1-mm section CT and 78.60%±15.75% by 5-mm section CT. In the evaluation of image quality, 5-mm section CT was assigned significantly higher scores than 1-mm section CT. In regard to intraobserver variation, 5-mm section CT revealed less intraobserver variation than 1-mm section CT. Our current results suggested that the outcomes of postimplant dosimetry using 1-mm section CT did not improved the results over those obtained using 5-mm section CT in terms of the quality of the CT image or reproducibility. (author)

  15. [Technique of intraoperative planning in prostatic brachytherapy with permanent implants of 125I or 103Pd].

    Science.gov (United States)

    Prada Gómez, Pedro José; Juan Rijo, Germán; Hevia Suarez, Miguel; Abascal García, José María; Abascal García, Ramón

    2002-12-01

    Prostatic brachytherapy with permanent 125I or 123Pd seeds implantation is a therapeutic option for organ-confined prostate cancer. We analyze the technique based on previous planning, our current intraoperative planning procedure and the reasons that moved us to introduce this change. Changes in prostate volume and spatial localization observed between previous planning and intraoperative images, and possible difficulties for seed implantation due to pubic arch interference are some of the reasons that induce us to change technique. Before the operation, we calculate the prostatic volume by transrectal ultrasound; with this information we determine the total implant activity following Wu's nomogram, and per-seed activity; therefore, it is an individual process for each patient. We perform a peripheral implant, placing 75-80% of the seeds within the peripheral prostatic zone, generally through 12-15 needles, the rest of the seeds are placed in the central prostatic zone using a maximum of 3-4 needles in high volume prostates. The day of intervention, after positioning and catheter insertion, volumetry is re-checked. Ultrasound images (from base to apex every 5 mm) are transferred to the planner were a suitable seed distribution is determined. Implantation is then performed placing all needles unloaded, and then intraoperative post-planning to allow us to check implant precision is performed after cistoscopically check that there is no urethral or bladder penetration by any needle. We finish with the insertion of seeds into the prostate. Total time for the procedure is around 90 minutes. Intraoperative planning is an additional step for the treatment of prostate cancer with permanent seeds brachytherapy, which avoids the disadvantages of previous planning and improves tumor inclusion in the ideal irradiation dose area, which will translate into better local disease control.

  16. Dosimetric effects of edema in permanent prostate seed implants: a rigorous solution

    International Nuclear Information System (INIS)

    Chen Zhe; Yue Ning; Wang Xiaohong; Roberts, Kenneth B.; Peschel, Richard; Nath, Ravinder

    2000-01-01

    Purpose: To derive a rigorous analytic solution to the dosimetric effects of prostate edema so that its impact on the conventional pre-implant and post-implant dosimetry can be studied for any given radioactive isotope and edema characteristics. Methods and Materials: The edema characteristics observed by Waterman et al (Int. J. Rad. Onc. Biol. Phys, 41:1069-1077; 1998) was used to model the time evolution of the prostate and the seed locations. The total dose to any part of prostate tissue from a seed implant was calculated analytically by parameterizing the dose fall-off from a radioactive seed as a single inverse power function of distance, with proper account of the edema-induced time evolution. The dosimetric impact of prostate edema was determined by comparing the dose calculated with full consideration of prostate edema to that calculated with the conventional dosimetry approach where the seed locations and the target volume are assumed to be stationary. Results: A rigorous analytic solution on the relative dosimetric effects of prostate edema was obtained. This solution proved explicitly that the relative dosimetric effects of edema, as found in the previous numerical studies by Yue et. al. (Int. J. Radiat. Oncol. Biol. Phys. 43, 447-454, 1999), are independent of the size and the shape of the implant target volume and are independent of the number and the locations of the seeds implanted. It also showed that the magnitude of relative dosimetric effects is independent of the location of dose evaluation point within the edematous target volume. It implies that the relative dosimetric effects of prostate edema are universal with respect to a given isotope and edema characteristic. A set of master tables for the relative dosimetric effects of edema were obtained for a wide range of edema characteristics for both 125 I and 103 Pd prostate seed implants. Conclusions: A rigorous analytic solution of the relative dosimetric effects of prostate edema has been

  17. New Strategy for Prostate Cancer Prevention Based on Selenium Suppression of Androgen Receptor Signaling

    Science.gov (United States)

    2010-04-01

    combination in prostate cancer chemoprevention. Emodin is a phytochemical that has been shown to induce AR degradation (18). We hypothesize that the...Since the induction of PSA screening , the majority of the prostate cancers diagnosed are asymptomatic, early-stage, small volume diseases. Current

  18. Unbiased estimation of the eyeball volume using the Cavalieri principle on computed tomography images.

    Science.gov (United States)

    Acer, Niyazi; Sahin, Bunyamin; Ucar, Tolga; Usanmaz, Mustafa

    2009-01-01

    The size of the eyeball has been the subject of a few studies. None of them used stereological methods to estimate the volume. In the current study, we estimated the volume of eyeball in normal men and women using the stereological methods. Eyeball volume (EV) was estimated using the Cavalieri principle as a combination of point-counting and planimetry techniques. We used computed tomography scans taken from 36 participants (15 men and 21 women) to estimate the EV. The mean (SD) EV values obtained by planimetry method were 7.49 (0.79) and 7.06 (0.85) cm in men and women, respectively. By using point-counting method, the mean (SD) values were 7.48 (0.85) and 7.21 (0.84) cm in men and women, respectively. There was no statistically significant difference between the findings from the 2 methods (P > 0.05). A weak correlation was found between the axial length of eyeball and the EV estimated by point counting and planimetry (P eyeball.

  19. Ablative efficiency of lithium triborate laser vaporization and conventional transurethral resection of the prostate: a comparison using transrectal three-dimensional ultrasound volumetry

    Science.gov (United States)

    Gross, Oliver; Sulser, Tullio; Hefermehl, Lukas J.; Strebel, Daniel D.; Largo, Remo; Mortezavi, Ashkan; Poyet, Cédric; Eberli, Daniel; Zimmermann, Matthias; Müller, Alexander; Michel, Maurice S.; Müntener, Michael; Seifert, Hans-Helge; Hermanns, Thomas

    2011-03-01

    Introduction and objectives: It is unknown if tissue ablation following 120W lithium triborate (LBO) laser vaporization (LV) of the prostate is comparable to that following transurethral resection of the prostate (TURP). Therefore, transrectal 3D-ultrasound volumetry of the prostate was performed to compare the efficiency of tissue ablation between LBO-LV and TURP. Methods: Between 03/2008 and 03/2010 110 patients underwent routine LBO-LV (n=61) or TURP (n=49). Transrectal 3D-ultrasound with planimetric volumetry of the prostate was performed pre-operatively, after catheter removal, 6 weeks and 6 months. Results: Median prostate volume was 52.5ml in the LV group and 46.9ml in the TURP group. After catheter removal, median absolute volume reduction (LV: 7.05ml, TURP: 15.8ml) and relative volume reduction (15.9% vs. 34.2%) were significantly lower in the LV group (p<0.001). After 6 weeks/ 6 months, the relative volume reduction but not the absolute remained significantly lower in the LV group. Conclusions: LBO-LV is an efficient procedure evidenced by an absolute tissue ablation not significantly different to that after TURP. However, TURP seems to be superior due to a higher relative tissue ablation. The differences in tissue ablation had no impact on the early clinical outcome. Delayed volume reduction indicates that prostatic swelling occurs early after LV and then decreases subsequently.

  20. Reappraisal of the application of total and free PSA estimation for diagnosis of prostate cancer in Chinese

    International Nuclear Information System (INIS)

    Chu, L.S.; Liu, R.S.; Yang, C.S.; Chen, G.K.; Liao, S.Q.

    2002-01-01

    Objectives: Prostate-specific antigen (PSA) test has become one of the most cost effective tools for detecting early prostate cancer. In general, a diagnosis of prostate cancer is uncommon at serum levels of total PSA (TPSA) at or below 4 ng/mL and is common at levels above 10 ng/mL. The diagnostic gray zone is between 4.0 and 10.0 ng/mL, where the differential diagnosis of prostate cancer is most difficult. For such patients ratio of free-to-total PSA (F/TPSA) can be useful in differentiating prostate cancer from benign prostate hypertrophy (BPH). However, screen for prostate cancer with PSA remains controversial. Thirty-five percent of the patients with clinically localized prostate cancer present with serum PSA levels below 4 ng/mL. What is the optimal 'reflex' total PSA at which we should implement use of the F/T PSA? The purpose of this study is to assess the usefulness of F/TPSA in patients with TPSA less than 4 ng/mL. Methods: A total of 101 high-risk patients of prostate cancer underwent transrectal ultrasonography and biopsy or transurethral resection of prostate were studied. Sixty-eight patients were proved to have BPH only and 33 patients were proved to have prostate cancer. TPSA and F/TPSA were determined using a immunoradiometric assay (PSA-RIACT, FPSA-RIACT, CIS). The appropriate cut-off value of F/TPSA in diagnosis of prostate cancer determined by receiver-operating characteristic (ROC) curve was 0.19. Results: The TPSA value of the subjects ranged from 0 to 15 ng/mL. Seventeen cases (26%) of prostate cancer were disclosed in 65 patients with TPSA > 4 ng/mL. Thirty-six patients had TPSA 0.19 were proved to have prostate cancer. Conclusion: Thirty-nine per cent of high-risk patients with TPSA < 4.0 ng/mL and F/T PSA < 0.19 was found to have prostate cancer. F/T PSA should be determined in Chinese patients with TPSA < 10 ng/mL instead of the algorithm of combined use of F/T PSA and TPSA between 4-10 ng/mL