To develop a prostate tumor habitat risk scoring (HRS) system based on multiparametric MRI (mpMRI) referenced to prostatectomy Gleason Score (GS) for automatic delineation of Gross Tumor Volumes (GTVs). A workflow for integration of HRS into radiotherapy (RT) boost volume dose escalation was developed in the framework of a Phase II randomized clinical trial (BLaStM).
An automated quantitative mpMRI based 10 point pixel by pixel method was optimized to prostatectomy GSs and volumes using referenced Dynamic Contrast Enhanced and Apparent Diffusion Coefficient sequences. The HRS contours were migrated to the planning CT for boost volume generation.
There were 51 regions of interest (ROIs) in 12 patients who underwent radical prostatectomy (RP) (26 with GS≥7 and 25 with GS6). The resultant heat maps showed inter- and intra-tumoral heterogeneity. The HRS6 level was significantly associated with RP ROIs (slope 1.09, r=0.767; p<.0001). For predicting the likelihood of cancer, GS≥7 and GS≥8, HRS6 AUCs were 0.718, 0.802 and 0.897, respectively. HRS was superior to the Prostate Imaging, Reporting and Diagnosis System 4/5 classification, wherein the AUCs were 0.62, 0.64 and 0.617, respectively (difference with HR6, p<.0001). HRS maps were created for the first 37 assessable patients on the BLaStM trial. There were an average of 1.38 habitat boost volumes per patient at a total boost volume average of 3.6 cc.
An automated quantitative mpMRI based method was developed to objectively guide dose escalation to high risk habitat volumes based on prostatectomy GS.
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 19 June 2018.
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