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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Cold spot mapping inferred from MRI at time of failure predicts biopsy-proven local failure after permanent seed brachytherapy in prostate cancer patients: Implications for focal salvage brachytherapy
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Cold spot mapping inferred from MRI at time of failure predicts biopsy-proven local failure after permanent seed brachytherapy in prostate cancer patients: Implications for focal salvage brachytherapy

机译：失败时通过MRI推断出的冷斑图预测了永久性种子近距离放射治疗对前列腺癌患者的活检证实的局部失败：对局部抢救近距离放射疗法的影响

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Background and purpose (1) To establish a method to evaluate dosimetry at the time of primary prostate permanent implant (pPPI) using MRI of the shrunken prostate at the time of failure (tf). (2) To compare cold spot mapping with sextant-biopsy mapping at tf. Material and methods Twenty-four patients were referred for biopsy-proven local failure (LF) after pPPI. Multiparametric MRI and combined-sextant biopsy with a central review of the pathology at tf were systematically performed. A model of the shrinking pattern was defined as a Volumetric Change Factor (VCF) as a function of time from time of pPPI (t0). An isotropic expansion to both prostate volume (PV) and seed position (SP) coordinates determined at t f was performed using a validated algorithm using the VCF. Results pPPI CT-based evaluation (at 4 weeks) vs. MR-based evaluation: Mean D90% was 145.23 ± 19.16 Gy [100.0-167.5] vs. 85.28 ± 27.36 Gy [39-139] (p = 0.001), respectively. Mean V100% was 91.6 ± 7.9% [70-100%] vs. 73.1 ± 13.8% [55-98%] (p = 0.0006), respectively. Seventy-seven per cent of the pathologically positive sextants were classified as cold. Conclusions Patients with biopsy-proven LF had poorer implantation quality when evaluated by MRI several years after implantation. There is a strong relationship between microscopic involvement at tf and cold spots.
机译：背景与目的（1）建立一种方法，用于评估在初次前列腺永久性植入物（pPPI）失效时（tf）使用缩小的前列腺MRI的剂量。 （2）比较tf时的冷点定位与六分点活检定位。材料和方法pPPI后，有24例因活检证实的局部衰竭（LF）被转诊。系统地进行了多参数MRI和组合式穿刺活检，并对tf的病理学进行了集中回顾。收缩模式的模型定义为体积变化因子（VCF），它是自pPPI（t0）开始的时间的函数。使用VCF使用经过验证的算法对在t f处确定的前列腺体积（PV）和种子位置（SP）坐标进行各向同性扩展。结果基于pPPI CT的评估（第4周）与基于MR的评估：平均D90％分别为145.23±19.16 Gy [100.0-167.5]和85.28±27.36 Gy [39-139]（p = 0.001）。平均V100％分别为91.6±7.9％[70-100％]与73.1±13.8％[55-98％]（p = 0.0006）。病理阳性的六分仪中有77％被归类为感冒。结论经活检证实的LF患者在植入后数年进行MRI检查时，其植入质量较差。 tf处的显微镜受累与冷点之间有很强的关系。

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