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18. MRI-guided focused ultrasound focal therapy for patients with intermediate-risk prostate cancer: a phase 2b, multicentre study

Author

Ehdaie, Behfar, Tempany, Clare M, Holland, Ford, Sjoberg, Daniel D, Kibel, Adam S, Trinh, Quoc-Dien, Durack, Jeremy C, Akin, Oguz, Vickers, Andrew J, Scardino, Peter T, Sperling, Dan, Wong, Jeffrey Y C, Yuh, Bertram, Woodrum, David A, Mynderse, Lance A, Raman, Steven S, Pantuck, Allan J, Schiffman, Marc H, McClure, Timothy D, Sonn, Geoffrey A, and Ghanouni, Pejman

Published
2022
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19. Investigating MRI‐Associated Biological Aspects of Racial Disparities in Prostate Cancer for African American and White Men.

Author

Zabihollahy, Fatemeh, Miao, Qi, Naim, Sohaib, Sonni, Ida, Vangala, Sitaram, Kim, Harrison, Hsu, William, Sisk, Anthony, Reiter, Robert, Raman, Steven S., and Sung, Kyunghyun

Subjects
AFRICAN American men, RADICAL prostatectomy, GLEASON grading system, HEALTH equity, RACIAL inequality
Abstract

Background: Understanding the characteristics of multiparametric MRI (mpMRI) in patients from different racial/ethnic backgrounds is important for reducing the observed gaps in clinical outcomes. Purpose: To investigate the diagnostic performance of mpMRI and quantitative MRI parameters of prostate cancer (PCa) in African American (AA) and matched White (W) men. Study Type: Retrospective. Subjects: One hundred twenty‐nine patients (43 AA, 86 W) with histologically proven PCa who underwent mpMRI before radical prostatectomy. Field Strength/Sequence: 3.0 T, T2‐weighted turbo spin echo imaging, a single‐shot spin‐echo EPI sequence diffusion‐weighted imaging, and a gradient echo sequence dynamic contrast‐enhanced MRI with an ultrafast 3D spoiled gradient‐echo sequence. Assessment: The diagnostic performance of mpMRI in AA and W men was assessed using detection rates (DRs) and positive predictive values (PPVs) in zones defined by the PI‐RADS v2.1 prostate sector map. Quantitative MRI parameters, including Ktrans and ve of clinically significant (cs) PCa (Gleason score ≥ 7) tumors were compared between AA and W sub‐cohorts after matching age, prostate‐specific antigen (PSA), and prostate volume. Statistical Tests: Weighted Pearson's chi‐square and Mann–Whitney U tests with a statistically significant level of 0.05 were used to examine differences in DR and PPV and to compare parameters between AA and matched W men, respectively. Results: A total number of 264 PCa lesions were identified in the study cohort. The PPVs in the peripheral zone (PZ) and posterior prostate of mpMRI for csPCa lesions were significantly higher in AA men than in matched W men (87.8% vs. 68.1% in PZ, and 89.3% vs. 69.6% in posterior prostate). The Ktrans of index csPCa lesions in AA men was significantly higher than in W men (0.25 ± 0.12 vs. 0.20 ± 0.08 min−1; P < 0.01). Data Conclusion: This study demonstrated race‐related differences in the diagnostic performances and quantitative MRI measures of csPCa that were not reflected in age, PSA, and prostate volume. Evidence Level: 3 Technical Efficacy: Stage 2 [ABSTRACT FROM AUTHOR]

Published
2025
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30. Understanding Spatial Correlation Between Multiparametric MRI Performance and Prostate Cancer.

Author

Zabihollahy, Fatemeh, Naim, Sohaib, Wibulpolprasert, Pornphan, Reiter, Robert E., Raman, Steven S., and Sung, Kyunghyun

Subjects
RADICAL prostatectomy, PROSTATE cancer, GLEASON grading system, PROSTATE, MAGNETIC resonance imaging
Abstract

Background: Multiparametric MRI (mpMRI) has shown a substantial impact on prostate cancer (PCa) diagnosis. However, the understanding of the spatial correlation between mpMRI performance and PCa location is still limited. Purpose: To investigate the association between mpMRI performance and tumor spatial location within the prostate using a prostate sector map, described by Prostate Imaging Reporting and Data System (PI‐RADS) v2.1. Study Type: Retrospective. Subjects: One thousand one hundred forty‐three men who underwent mpMRI before radical prostatectomy between 2010 and 2022. Field Strength/Sequence: 3.0 T. T2‐weighted turbo spin‐echo, a single‐shot spin‐echo EPI sequence for diffusion‐weighted imaging, and a gradient echo sequence for dynamic contrast‐enhanced MRI sequences. Assessment: Integrated relative cancer prevalence (rCP), detection rate (DR), and positive predictive value (PPV) maps corresponding to the prostate sector map for PCa lesions were created. The relationship between tumor location and its detection/missing by radiologists on mpMRI compared to WMHP as a reference standard was investigated. Statistical Tests: A weighted chi‐square test was performed to examine the statistical differences for rCP, DR, and PPV of the aggregated sectors within the zone, anterior/posterior, left/right prostate, and different levels of the prostate with a statistically significant level of 0.05. Results: A total of 1665 PCa lesions were identified in 1143 patients, and from those 1060 lesions were clinically significant (cs)PCa tumors (any Gleason score [GS] ≥7). Our sector‐based analysis utilizing weighted chi‐square tests suggested that the left posterior part of PZ had a high likelihood of missing csPCa lesions at a DR of 67.0%. Aggregated sector analysis indicated that the anterior or apex locations in PZ had the significantly lowest csPCa detection at 67.3% and 71.5%, respectively. Data Conclusion: Spatial characteristics of the per‐lesion‐based mpMRI performance for diagnosis of PCa were studied. Our results demonstrated that there is a spatial correlation between mpMRI performance and locations of PCa on the prostate. Evidence Level: 4 Technical Efficacy: Stage 2 [ABSTRACT FROM AUTHOR]

Published
2024
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39. A 17-Gene Genomic Prostate Score Assay Provides Independent Information on Adverse Pathology in the Setting of Combined Multiparametric Magnetic Resonance Imaging Fusion Targeted and Systematic Prostate Biopsy

Author

Salmasi, Amirali, Said, Jonathan, Shindel, Alan W., Khoshnoodi, Pooria, Felker, Ely R., Sisk, Anthony E., Jr., Grogan, Tristan, McCullough, Debbie, Bennett, John, Bailey, Helen, Lawrence, H. Jeffrey, Elashoff, David A., Marks, Leonard S., Raman, Steven S., Febbo, Phillip G., and Reiter, Robert E.

Published
2018
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45. 3T Multiparametric MRI: Comparison of Performance With and Without Endorectal Coil for Prostate Cancer Detection, PI-RADSv2 Category and Staging with Whole Mount Histopathology Correlation in 429 Patients

Author

Afshari Mirak, Sohrab, Shakeri, Sepideh, Mohammadian Bajgiran, Amirhossein, Felker, Ely R., Sung, Kyung Hyun, Asvadi, Nazanin Hajarol, Khoshnoodi, Pooria, Markovic, Daniela, Ponzini, Danielle, Ahuja, Preeti, Sisk, Anthony, Reiter, Robert E., Lu, David, and Raman, Steven S.

Published
2018
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48. Endoportal Radiofrequency Ablation and Stent Placement in Patients with Portal Vein Tumor Thrombosis from Hepatocellular Carcinoma: A Study on Feasibility and Safety.

Author

Mizandari, Malkhaz, Gotsiridze, Elene, Keshavarz, Pedram, Nezami, Nariman, Azrumelashvili, Tamta, Nejati, Seyed Faraz, Habib, Nagy, Chiang, Jason, and Raman, Steven S.

Subjects
PATIENT portals, PORTAL vein, CATHETER ablation, THROMBOSIS, MULTIPLE tumors, RADIO frequency therapy, INTRAVASCULAR ultrasonography, HEPATOCELLULAR carcinoma
Abstract

Background: Hepatocellular carcinoma (HCC) is the most common type of liver cancer, with 10–40% of cases involving portal vein tumor thrombosis (PVTT), leading to poor outcomes and a short survival. The effectiveness of PVTT treatment in patients with HCC is still controversial. Methods: This prospective dual-center study cohort comprised 60 patients with HCC and PVTT who underwent PVR-EPRFA-ST using a novel intravascular radiofrequency system followed by vascular stent placement across the PVTT stenosed segment under fluoroscopy guidance. Results: PVR-EPRFA-ST was technically and clinically successful in 54/60 (90%) and 37/54 (68.5%) patients, respectively. The mean tumor size, PVTT length, post-ablation luminal diameter, and median duration of the recanalized PV patency were 8.6 ± 3.4 cm, 4.1 ± 2.1 cm, 10.3 ± 1.8 mm, and 13.4 months. Higher technical and clinical success rates were associated with a longer survival (177 ± 17.3 days, HR: 0.3, 95%CI 0.12–0.71, p = 0.04; and 233 ± 18.3 days, HR: 0.14, 0.07–0.27, p < 0.001). A shorter survival was associated with Child–Pugh C (HR: 2.7, p = 0.04), multiple tumors (HR: 1.81, p = 0.03), and PVTT length (HR: 1.16, p = 0.04). Conclusions: PVR-EPRFA-ST was feasible and effective for the treatment of selected patients with PVTT, especially in patients with Child–Pugh A/B, single tumors, or a shorter PVTT length. [ABSTRACT FROM AUTHOR]

Published
2024
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