title: Dynamic contrast-enhanced MRI for automatic detection of foci ﻿of residual or recurrent disease after prostatectomy.
abstract: OBJECTIVE
  This study aimed to develop an automated procedure for identifying suspicious foci of residual/recurrent disease in the prostate bed using dynamic contrast-enhanced-MRI (DCE-MRI) in prostate cancer patients after prostatectomy.
  
  
  METHODS
  Data of 22 patients presenting for salvage radiotherapy (RT) with an identified gross tumor volume (GTV) in the prostate bed were analyzed retrospectively. An unsupervised pattern recognition method was used to analyze DCE-MRI curves from the prostate bed. Data were represented as a product of a number of signal-vs.-time patterns and their weights. The temporal pattern, characterized by fast wash-in and gradual wash-out, was considered the "tumor" pattern. The corresponding weights were thresholded based on the number (1, 1.5, 2, 2.5) of standard deviations away from the mean, denoted as DCE1.0, …, DCE2.5, and displayed on the T2-weighted MRI. The resultant four volumes were compared with the GTV and maximum pre-RT prostate-specific antigen (PSA) level. Pharmacokinetic modeling was also carried out.
  
  
  RESULTS
  Principal component analysis determined 2-4 significant patterns in patients' DCE-MRI. Analysis and display of the identified suspicious foci was performed in commercial software (MIM Corporation, Cleveland, OH, USA). In general, DCE1.0/DCE1.5 highlighted larger areas than GTV. DCE2.0 and GTV were significantly correlated (r = 0.60, p < 0.05). DCE2.0/DCA2.5 were also significantly correlated with PSA (r = 0.52, 0.67, p < 0.05). Ktransfor DCE2.5 was statistically higher than the GTV's Ktrans(p < 0.05), indicating that the automatic volume better captures areas of malignancy.
  
  
  CONCLUSIONS
  A software tool was developed for identification and visualization of the suspicious foci in DCE-MRI from post-prostatectomy patients and was integrated into the treatment planning system.
authors.affiliation: Department of Radiation Oncology, University of Miami Miller School of Medicine, 1121 NW 14th St, 33136, Miami, FL, USA.
authors.forename: N Andres
authors.initials: NA
authors.lastname: Parra
authors.affiliation: Department of Radiation Oncology, University of Miami Miller School of Medicine, 1121 NW 14th St, 33136, Miami, FL, USA.
authors.forename: Amber
authors.initials: A
authors.lastname: Orman
authors.affiliation: Department of Radiation Oncology, University of Miami Miller School of Medicine, 1121 NW 14th St, 33136, Miami, FL, USA.|Department of Radiology, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Kyle
authors.initials: K
authors.lastname: Padgett
authors.affiliation: Department of Radiology, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Victor
authors.initials: V
authors.lastname: Casillas
authors.affiliation: Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Sanoj
authors.initials: S
authors.lastname: Punnen
authors.affiliation: Department of Radiation Oncology, University of Miami Miller School of Medicine, 1121 NW 14th St, 33136, Miami, FL, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Abramowitz
authors.affiliation: Department of Radiation Oncology, University of Miami Miller School of Medicine, 1121 NW 14th St, 33136, Miami, FL, USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Pollack
authors.affiliation: Department of Radiation Oncology, University of Miami Miller School of Medicine, 1121 NW 14th St, 33136, Miami, FL, USA. RStoyanova@med.miami.edu.
authors.forename: Radka
authors.initials: R
authors.lastname: Stoyanova
mesh_terms: D000368:Aged; D000465:Algorithms; D003287:Contrast Media; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000517:prevention & control / Q000532:radiotherapy; D018365:Neoplasm, Residual; D017063:Outcome Assessment, Health Care / Q000379:methods; D010363:Pattern Recognition, Automated / Q000379:methods; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy / Q000601:surgery*; D018714:Radiotherapy, Adjuvant; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016879:Salvage Therapy; D012680:Sensitivity and Specificity; D012984:Software; D016896:Treatment Outcome; D047368:Tumor Burden
chemical_list: D003287:Contrast Media
keywords: Dynamic contrast enhanced (DCE-)MRI; Pattern recognition, automated; Prostate bed; Prostate cancer; Salvage radiotherapy