Patient specific modeling of palpation-based prostate cancer diagnosis: effects of pelvic cavity anatomy and intrabladder pressure.

Computational modeling has become a successful tool for scientific advances including understanding the behavior of biological and biomedical systems as well as improving clinical practice. In most cases, only general models are used without taking into account patient-specific features.

However, patient specificity has proven to be crucial in guiding clinical practice due to the disastrous consequences that can arise should the model be inaccurate. This paper proposes a framework for the computational modeling applied to the example of the male pelvic cavity for the purpose of prostate cancer diagnostics using palpation. The effects of patient specific structural features on palpation response are studied in three selected patients with very different pathophysiological conditions whose pelvic cavities are reconstructed from MRI scans. In particular, the role of intrabladder pressure in the outcome of digital rectal examination is investigated with the objective of providing guidelines to practitioners to enhance the effectiveness of diagnosis. Furthermore, the presence of the pelvic bone in the model is assessed to determine the pathophysiological conditions in which it has to be considered. The conclusions and suggestions of this work have potential use not only in clinical practice and also for biomechanical modeling where structural patient-specificity needs to be considered. This article is protected by copyright. All rights reserved.

Int J Numer Method Biomed Eng. 2015 Jul 16. doi: 10.1002/cnm.2734. [Epub ahead of print]

Palacio-Torralba J1, Jiménez Aguilar E2, Good DW3, Hammer S1, McNeill SA3,4, Stewart GD3,4, Reuben RL1, Chen Y1.

1 Institute of Mechanical, Process and Energy Engineering, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, EH14 4AS, UK.
2 Servicio de Oncología Médica, Hospital 12 de Octubre, Madrid, 28041, Spain.
3 Edinburgh Urological Cancer Group, Division of Pathology Laboratories, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Crewe Road South, Edinburgh, EH4 2XU, UK.
4 Department of Urology, NHS Lothian, Western General Hospital, Crewe Road South, Edinburgh, EH4 2XU, UK.