title: B-mode and acoustic radiation force impulse (ARFI) imaging of prostate zonal anatomy: comparison with 3T T2-weighted MR imaging.
abstract: Prostate cancer (PCa) is the most common non-cutaneous malignancy among men in the United States and the second leading cause of cancer-related death. Multi-parametric magnetic resonance imaging (mpMRI) has gained recent popularity to characterize PCa. Acoustic Radiation Force Impulse (ARFI) imaging has the potential to aid PCa diagnosis and management by using tissue stiffness to evaluate prostate zonal anatomy and lesions. MR and B-mode/ARFI in vivo imaging datasets were compared with one another and with gross pathology measurements made immediately after radical prostatectomy. Images were manually segmented in 3D Slicer to delineate the central gland (CG) and prostate capsule, and 3D models were rendered to evaluate zonal anatomy dimensions and volumes. Both imaging modalities showed good correlation between estimated organ volume and gross pathologic weights. Ultrasound and MR total prostate volumes were well correlated (R(2) = 0.77), but B-mode images yielded prostate volumes that were larger (16.82% ± 22.45%) than MR images, due to overestimation of the lateral dimension (18.4% ± 13.9%), with less significant differences in the other dimensions (7.4% ± 17.6%, anterior-to-posterior, and -10.8% ± 13.9%, apex-to-base). ARFI and MR CG volumes were also well correlated (R(2) = 0.85). CG volume differences were attributed to ARFI underestimation of the apex-to-base axis (-28.8% ± 9.4%) and ARFI overestimation of the lateral dimension (21.5% ± 14.3%). B-mode/ARFI imaging yielded prostate volumes and dimensions that were well correlated with MR T2-weighted image (T2WI) estimates, with biases in the lateral dimension due to poor contrast caused by extraprostatic fat. B-mode combined with ARFI imaging is a promising low-cost, portable, real-time modality that can complement mpMRI for PCa diagnosis, treatment planning, and management.
authors: Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC, USA mark.palmeri@duke.edu.
authors: Mark L
authors: ML
authors: Palmeri
authors: Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC, USA.
authors: Zachary A
authors: ZA
authors: Miller
authors: Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC, USA.
authors: Tyler J
authors: TJ
authors: Glass
authors: Duke University School of Medicine, Durham, NC, USA.
authors: Kirema
authors: K
authors: Garcia-Reyes
authors: Department of Radiology, Duke University Medical Center, Durham, NC, USA.
authors: Rajan T
authors: RT
authors: Gupta
authors: Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC, USA.
authors: Stephen J
authors: SJ
authors: Rosenzweig
authors: Department of Radiology, Duke University Medical Center, Durham, NC, USA.
authors: Christopher
authors: C
authors: Kauffman
authors: Department of Surgery (Urology), Duke University Medical Center, Durham, NC, USA.
authors: Thomas J
authors: TJ
authors: Polascik
authors: Department of Pathology, Duke University Medical Center, Durham, NC, USA.
authors: Andrew
authors: A
authors: Buck
authors: Department of Pathology, Duke University Medical Center, Durham, NC, USA.
authors: Evan
authors: E
authors: Kulbacki
authors: Department of Pathology, Duke University Medical Center, Durham, NC, USA.
authors: John
authors: J
authors: Madden
authors: Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC, USA.
authors: Samantha L
authors: SL
authors: Lipman
authors: Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC, USA.
authors: Ned C
authors: NC
authors: Rouze
authors: Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC, USA.
authors: Kathryn R
authors: KR
authors: Nightingale
mesh_terms: D054459:Elasticity Imaging Techniques; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D009929:Organ Size; D011467:Prostate / Q000000981:diagnostic imaging* / Q000473:pathology
keywords: ARFI imaging; MR imaging; elasticity; image segmentation; prostate; tissue modeling; visualization