MRI scans significantly change target coverage decisions in radical radiotherapy for prostate cancer

Introduction Conventional clinical staging for prostate cancer has many limitations. This study evaluates the impact of adding MRI scans to conventional clinical staging for guiding decisions about radiotherapy target coverage. Methods This was a retrospective review of 115 patients who were treated...

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Bibliographic Details
Published in:Journal of medical imaging and radiation oncology 2014-04, Vol.58 (2), p.237-243
Main Authors: Chang, Joe H., Lim Joon, Daryl, Nguyen, Brandon T., Hiew, Chee-Yan, Esler, Stephen, Angus, David, Chao, Michael, Wada, Morikatsu, Quong, George, Khoo, Vincent
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Algorithms
Humans
Image Interpretation, Computer-Assisted - methods
magnetic resonance imaging
Male
Middle Aged
Neoplasm Staging
NMR
Nuclear magnetic resonance
Prostate cancer
Prostatic Neoplasms - pathology
Prostatic Neoplasms - radiotherapy
Radiation therapy
radiotherapy
Radiotherapy Dosage
Radiotherapy, Image-Guided - methods
Reproducibility of Results
Retrospective Studies
Sensitivity and Specificity
target volume delineation
Treatment Outcome
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Summary:Introduction Conventional clinical staging for prostate cancer has many limitations. This study evaluates the impact of adding MRI scans to conventional clinical staging for guiding decisions about radiotherapy target coverage. Methods This was a retrospective review of 115 patients who were treated between February 2002 and September 2005 with radical radiotherapy for prostate cancer. All patients had MRI scans approximately 2 weeks before the initiation of radiotherapy. The T stage was assessed by both conventional clinical methods (cT‐staging) as well as by MRI (mT‐staging). The radiotherapy target volumes were determined first based on cT‐staging and then taking the additional mT staging into account. The number of times extracapsular extension or seminal vesicle invasion was incorporated into target volumes was quantified based on both cT‐staging and the additional mT‐staging. Results Extracapsular extension was incorporated into target volumes significantly more often with the addition of mT‐staging (46 patients (40%) ) compared with cT‐staging alone (37 patients (32%) ) (P = 0.002). Seminal vesicle invasion was incorporated into target volumes significantly more often with the addition of mT‐staging (21 patients (18%) ) compared with cT‐staging alone (three patients (3%) ) (P 
ISSN:1754-9477
1754-9485
DOI:10.1111/1754-9485.12107