Laser interstitial thermotherapy (LITT) is a relatively new focal therapy technique for the ablation of localized prostate cancer. In this study, for the first time, we are integrating ex vivo pathology and magnetic resonance imaging (MRI) to assess the imaging characteristics of prostate cancer and treatment changes following LITT.
Via a unique clinical trial, which gave us the availability of ex vivo histology and pre- and post-LITT MRIs, (1) we investigated the imaging characteristics of treatment effects and residual disease, and (2) evaluated treatment-induced feature changes in the ablated area relative to the residual disease First, a pathologist annotated the ablated area and the residual disease on the ex vivo histology Subsequently, we transferred the annotations to the post-LITT MRI using a semi-automatic elastic registration The pre- and post-LITT MRIs were registered and features were extracted A scoring metric based on the change in median pre- and post-LITT feature values was introduced, which allowed us to identify the most treatment responsive features Our results show that (1) image characteristics for treatment effects and residual disease are different, and (2) the change of feature values between pre- and post-LITT MRIs can be a quantitative biomarker for treatment response Finally, using feature change improved discrimination between the residual disease and treatment effects
Journal of medical imaging (Bellingham, Wash ) 2014 Oct 27 [Epub]
Geert J S Litjens, Henkjan J Huisman, Robin M Elliott, Natalie Nc Shih, Michael D Feldman, Satish Viswanath, Jurgen J Fütterer, Joyce G R Bomers, Anant Madabhushi
Radboud University Medical Center , Department of Radiology, Nijmegen 6525GA, The Netherlands , Radboud University Medical Center , Department of Radiology, Nijmegen 6525GA, The Netherlands , Case Western Reserve University , Department of Biomedical Engineering, Cleveland, Ohio 44106, United States , University of Pennsylvania , Department of Pathology and Laboratory Medicine, Philadelphia, Pennsylvania 19104, United States , University of Pennsylvania , Department of Pathology and Laboratory Medicine, Philadelphia, Pennsylvania 19104, United States , Case Western Reserve University , Department of Biomedical Engineering, Cleveland, Ohio 44106, United States , Radboud University Medical Center , Department of Radiology, Nijmegen 6525GA, The Netherlands ; University of Twente , Institute for Biomedical Technology and Technical Medicine, Enschede 7522NB, The Netherlands , Radboud University Medical Center , Department of Radiology, Nijmegen 6525GA, The Netherlands , Case Western Reserve University , Department of Biomedical Engineering, Cleveland, Ohio 44106, United States