المؤلفون: Pagadala, Meghana S, Lynch, Julie, Karunamuni, Roshan, Alba, Patrick R, Lee, Kyung Min, Agiri, Fatai Y, Anglin, Tori, Carter, Hannah, Gaziano, J Michael, Jasuja, Guneet Kaur, Deka, Rishi, Rose, Brent S, Panizzon, Matthew S, Hauger, Richard L, Seibert, Tyler M

المصدر: Journal of the National Cancer Institute. 115(2)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Prevention, Prostate Cancer, Cancer, Urologic Diseases, Clinical Research, Genetics, Aging, Detection, screening and diagnosis, 4.1 Discovery and preclinical testing of markers and technologies, Good Health and Well Being, Humans, Male, Aged, Prostatic Neoplasms, Veterans, Retrospective Studies, Prostate-Specific Antigen, Cohort Studies, Early Detection of Cancer, Oncology & Carcinogenesis, Oncology and carcinogenesis

الوصف: BackgroundGenetic scores may provide an objective measure of prostate cancer risk and thus inform screening decisions. We evaluated whether a polygenic hazard score based on 290 genetic variants (PHS290) is associated with prostate cancer risk in a diverse population, including Black men, who have higher average risk of prostate cancer death but are often treated as a homogeneously high-risk group.MethodsThis was a retrospective analysis of the Million Veteran Program, a national, population-based cohort study of US military veterans conducted 2011-2021. Cox proportional hazards analyses tested for association of genetic and other risk factors (including self-reported race and ethnicity and family history) with age at death from prostate cancer, age at diagnosis of metastatic (nodal or distant) prostate cancer, and age at diagnosis of any prostate cancer.ResultsA total of 590 750 male participants were included. Median age at last follow-up was 69 years. PHS290 was associated with fatal prostate cancer in the full cohort and for each racial and ethnic group (P

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/3sz039dxTest

المؤلفون: Zhong, Allison Y, Lui, Asona J, Katz, Matthew S, Berlin, Alejandro, Kamran, Sophia C, Kishan, Amar U, Murthy, Vedang, Nagar, Himanshu, Seible, Daniel, Stish, Bradley J, Tree, Alison C, Seibert, Tyler M

المصدر: Radiation Oncology. 18(1)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Clinical Trials and Supportive Activities, Cancer, Clinical Research, Biomedical Imaging, Prostate Cancer, Urologic Diseases, Humans, Male, Magnetic Resonance Imaging, Prostate, Prostatic Neoplasms, Radiation Oncologists, Radiotherapy Dosage, United States, Prostate cancer, Radiotherapy, Focal boost, Tumor boost, Oncology & Carcinogenesis, Clinical sciences, Oncology and carcinogenesis

الوصف: BackgroundIn a recent phase III randomized control trial, delivering a focal radiotherapy (RT) boost to tumors visible on MRI was shown to improve disease-free survival and regional/distant metastasis-free survival for patients with prostate cancer-without increasing toxicity. The aim of this study was to assess how widely this technique is being applied in current practice, as well as physicians' perceived barriers toward its implementation.MethodsWe invited radiation oncologists to complete an online questionnaire assessing their use of intraprostatic focal boost in December 2022 and February 2023. To include perspectives from a broad range of practice settings, the invitation was distributed to radiation oncologists worldwide via email list, group text platform, and social media.Results263 radiation oncologist participants responded. The highest-represented countries were the United States (42%), Mexico (13%), and the United Kingdom (8%). The majority of participants worked at an academic medical center (52%) and considered their practice to be at least partially genitourinary (GU)-subspecialized (74%). Overall, 43% of participants reported routinely using intraprostatic focal boost. Complete GU-subspecialists were more likely to implement focal boost, with 61% reporting routine use. In both high-income and low-to-middle-income countries, less than half of participants routinely use focal boost. The most cited barriers were concerns about registration accuracy between MRI and CT (37%), concerns about risk of additional toxicity (35%), and challenges to accessing high-quality MRI (29%).ConclusionsTwo years following publication of a randomized trial of patient benefit without increased toxicity, almost half of the radiation oncologists surveyed are now routinely offering focal RT boost. Further adoption of this technique might be aided by increased access to high-quality MRI, better registration algorithms of MRI to CT simulation images, physician education on benefit-to-harm ratio, and training on contouring prostate lesions on MRI.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/6tt646dqTest

المؤلفون: Conlin, Christopher C, Feng, Christine H, Digma, Leonardino A, Rodríguez-Soto, Ana E, Kuperman, Joshua M, Rakow-Penner, Rebecca, Karow, David S, White, Nathan S, Seibert, Tyler M, Hahn, Michael E, Dale, Anders M

المصدر: Radiology Imaging Cancer. 5(1)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Prostate Cancer, Biomedical Imaging, Cancer, Urologic Diseases, Aging, Male, Humans, Aged, Prospective Studies, Bayes Theorem, Diffusion Magnetic Resonance Imaging, Magnetic Resonance Imaging, Prostatic Neoplasms, Bone Neoplasms, Bone Metastases, Diffusion Signal Model, Diffusion-weighted Imaging, Restriction Spectrum Imaging, Whole-Body MRI

الوصف: Purpose To develop a multicompartmental signal model for whole-body diffusion-weighted imaging (DWI) and apply it to study the diffusion properties of normal tissue and metastatic prostate cancer bone lesions in vivo. Materials and Methods This prospective study (ClinicalTrials.gov: NCT03440554) included 139 men with prostate cancer (mean age, 70 years ± 9 [SD]). Multicompartmental models with two to four tissue compartments were fit to DWI data from whole-body scans to determine optimal compartmental diffusion coefficients. Bayesian information criterion (BIC) and model-fitting residuals were calculated to quantify model complexity and goodness of fit. Diffusion coefficients for the optimal model (having lowest BIC) were used to compute compartmental signal-contribution maps. The signal intensity ratio (SIR) of bone lesions to normal-appearing bone was measured on these signal-contribution maps and on conventional DWI scans and compared using paired t tests (α = .05). Two-sample t tests (α = .05) were used to compare compartmental signal fractions between lesions and normal-appearing bone. Results Lowest BIC was observed from the four-compartment model, with optimal compartmental diffusion coefficients of 0, 1.1 × 10-3, 2.8 × 10-3, and >3.0 ×10-2 mm2/sec. Fitting residuals from this model were significantly lower than from conventional apparent diffusion coefficient mapping (P < .001). Bone lesion SIR was significantly higher on signal-contribution maps of model compartments 1 and 2 than on conventional DWI scans (P < .008). The fraction of signal from compartments 2, 3, and 4 was also significantly different between metastatic bone lesions and normal-appearing bone tissue (P ≤ .02). Conclusion The four-compartment model best described whole-body diffusion properties. Compartmental signal contributions from this model can be used to examine prostate cancer bone involvement. Keywords: Whole-Body MRI, Diffusion-weighted Imaging, Restriction Spectrum Imaging, Diffusion Signal Model, Bone Metastases, Prostate Cancer Clinical trial registration no. NCT03440554 Supplemental material is available for this article. © RSNA, 2023 See also commentary by Margolis in this issue.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/4t93276xTest

المؤلفون: Huynh-Le, Minh-Phuong, Karunamuni, Roshan, Fan, Chun Chieh, Asona, Lui, Thompson, Wesley K, Martinez, Maria Elena, Eeles, Rosalind A, Kote-Jarai, Zsofia, Muir, Kenneth R, Lophatananon, Artitaya, Schleutker, Johanna, Pashayan, Nora, Batra, Jyotsna, Grönberg, Henrik, Neal, David E, Nordestgaard, Børge G, Tangen, Catherine M, MacInnis, Robert J, Wolk, Alicja, Albanes, Demetrius, Haiman, Christopher A, Travis, Ruth C, Blot, William J, Stanford, Janet L, Mucci, Lorelei A, West, Catharine ML, Nielsen, Sune F, Kibel, Adam S, Cussenot, Olivier, Berndt, Sonja I, Koutros, Stella, Sørensen, Karina Dalsgaard, Cybulski, Cezary, Grindedal, Eli Marie, Menegaux, Florence, Park, Jong Y, Ingles, Sue A, Maier, Christiane, Hamilton, Robert J, Rosenstein, Barry S, Lu, Yong-Jie, Watya, Stephen, Vega, Ana, Kogevinas, Manolis, Wiklund, Fredrik, Penney, Kathryn L, Huff, Chad D, Teixeira, Manuel R, Multigner, Luc, Leach, Robin J, Brenner, Hermann, John, Esther M, Kaneva, Radka, Logothetis, Christopher J, Neuhausen, Susan L, De Ruyck, Kim, Ost, Piet, Razack, Azad, Newcomb, Lisa F, Fowke, Jay H, Gamulin, Marija, Abraham, Aswin, Claessens, Frank, Castelao, Jose Esteban, Townsend, Paul A, Crawford, Dana C, Petrovics, Gyorgy, van Schaik, Ron HN, Parent, Marie-Élise, Hu, Jennifer J, Zheng, Wei, Mills, Ian G, Andreassen, Ole A, Dale, Anders M, Seibert, Tyler M

المصدر: Prostate Cancer and Prostatic Diseases. 25(4)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Aging, Prostate Cancer, Cancer, Urologic Diseases, Prevention, Genetics, Good Health and Well Being, Male, Humans, Prostate-Specific Antigen, Prostatic Neoplasms, Early Detection of Cancer, Polymorphism, Single Nucleotide, Risk Factors, Risk Assessment, Genetic Predisposition to Disease, UKGPCS collaborators, APCB, NC-LA PCaP Investigators, IMPACT Study Steering Committee and Collaborators, Canary PASS Investigators, Profile Study Steering Committee, PRACTICAL Consortium, Urology & Nephrology, Clinical sciences, Oncology and carcinogenesis

الوصف: BackgroundProstate cancer risk stratification using single-nucleotide polymorphisms (SNPs) demonstrates considerable promise in men of European, Asian, and African genetic ancestries, but there is still need for increased accuracy. We evaluated whether including additional SNPs in a prostate cancer polygenic hazard score (PHS) would improve associations with clinically significant prostate cancer in multi-ancestry datasets.MethodsIn total, 299 SNPs previously associated with prostate cancer were evaluated for inclusion in a new PHS, using a LASSO-regularized Cox proportional hazards model in a training dataset of 72,181 men from the PRACTICAL Consortium. The PHS model was evaluated in four testing datasets: African ancestry, Asian ancestry, and two of European Ancestry-the Cohort of Swedish Men (COSM) and the ProtecT study. Hazard ratios (HRs) were estimated to compare men with high versus low PHS for association with clinically significant, with any, and with fatal prostate cancer. The impact of genetic risk stratification on the positive predictive value (PPV) of PSA testing for clinically significant prostate cancer was also measured.ResultsThe final model (PHS290) had 290 SNPs with non-zero coefficients. Comparing, for example, the highest and lowest quintiles of PHS290, the hazard ratios (HRs) for clinically significant prostate cancer were 13.73 [95% CI: 12.43-15.16] in ProtecT, 7.07 [6.58-7.60] in African ancestry, 10.31 [9.58-11.11] in Asian ancestry, and 11.18 [10.34-12.09] in COSM. Similar results were seen for association with any and fatal prostate cancer. Without PHS stratification, the PPV of PSA testing for clinically significant prostate cancer in ProtecT was 0.12 (0.11-0.14). For the top 20% and top 5% of PHS290, the PPV of PSA testing was 0.19 (0.15-0.22) and 0.26 (0.19-0.33), respectively.ConclusionsWe demonstrate better genetic risk stratification for clinically significant prostate cancer than prior versions of PHS in multi-ancestry datasets. This is promising for implementing precision-medicine approaches to prostate cancer screening decisions in diverse populations.

الوصول الحر: https://escholarship.org/uc/item/00p470cnTest

المؤلفون: Karunamuni, Roshan A, Huynh-Le, Minh-Phuong, Fan, Chun C, Thompson, Wesley, Lui, Asona, Martinez, Maria Elena, Rose, Brent S, Mahal, Brandon, Eeles, Rosalind A, Kote-Jarai, Zsofia, Muir, Kenneth, Lophatananon, Artitaya, Tangen, Catherine M, Goodman, Phyllis J, Thompson, Ian M, Blot, William J, Zheng, Wei, Kibel, Adam S, Drake, Bettina F, Cussenot, Olivier, Cancel-Tassin, Géraldine, Menegaux, Florence, Truong, Thérèse, Park, Jong Y, Lin, Hui-Yi, Taylor, Jack A, Bensen, Jeannette T, Mohler, James L, Fontham, Elizabeth TH, Multigner, Luc, Blanchet, Pascal, Brureau, Laurent, Romana, Marc, Leach, Robin J, John, Esther M, Fowke, Jay H, Bush, William S, Aldrich, Melinda C, Crawford, Dana C, Cullen, Jennifer, Petrovics, Gyorgy, Parent, Marie-Élise, Hu, Jennifer J, Sanderson, Maureen, Mills, Ian G, Andreassen, Ole A, Dale, Anders M, Seibert, Tyler M

المصدر: Prostate Cancer and Prostatic Diseases. 25(2)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Prostate Cancer, Prevention, Genetics, Cancer, Urologic Diseases, Black People, Case-Control Studies, Chromosomes, Human, Pair 8, Genetic Predisposition to Disease, Humans, Male, Multifactorial Inheritance, Polymorphism, Single Nucleotide, Prostatic Neoplasms, Risk Assessment, White People, UKGPCS Collaborators, PRACTICAL Consortium, Urology & Nephrology, Clinical sciences, Oncology and carcinogenesis

الوصف: BackgroundWe previously developed an African-ancestry-specific polygenic hazard score (PHS46+African) that substantially improved prostate cancer risk stratification in men with African ancestry. The model consists of 46 SNPs identified in Europeans and 3 SNPs from 8q24 shown to improve model performance in Africans. Herein, we used principal component (PC) analysis to uncover subpopulations of men with African ancestry for whom the utility of PHS46+African may differ.Materials and methodsGenotypic data were obtained from the PRACTICAL consortium for 6253 men with African genetic ancestry. Genetic variation in a window spanning 3 African-specific 8q24 SNPs was estimated using 93 PCs. A Cox proportional hazards framework was used to identify the pair of PCs most strongly associated with the performance of PHS46+African. A calibration factor (CF) was formulated using Cox coefficients to quantify the extent to which the performance of PHS46+African varies with PC.ResultsCF of PHS46+African was strongly associated with the first and twentieth PCs. Predicted CF ranged from 0.41 to 2.94, suggesting that PHS46+African may be up to 7 times more beneficial to some African men than others. The explained relative risk for PHS46+African varied from 3.6% to 9.9% for individuals with low and high CF values, respectively. By cross-referencing our data set with 1000 Genomes, we identified significant associations between continental and calibration groupings.ConclusionWe identified PCs within 8q24 that were strongly associated with the performance of PHS46+African. Further research to improve the clinical utility of polygenic risk scores (or models) is needed to improve health outcomes for men of African ancestry.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/73k820f8Test

المؤلفون: Martin, Richard M, Turner, Emma L, Young, Grace J, Metcalfe, Chris, Walsh, Eleanor I, Lane, J Athene, Sterne, Jonathan AC, Noble, Sian, Holding, Peter, Ben-Shlomo, Yoav, Williams, Naomi J, Pashayan, Nora, Bui, Mai Ngoc, Albertsen, Peter C, Seibert, Tyler M, Zietman, Anthony L, Oxley, Jon, Adolfsson, Jan, Mason, Malcolm D, Davey Smith, George, Neal, David E, Hamdy, Freddie C, Donovan, Jenny L, CAP Trial Group

مصطلحات موضوعية: Aged, Humans, Male, Middle Aged, Early Detection of Cancer, England, Follow-Up Studies, Mass Screening, Neoplasm Grading, Prostate-Specific Antigen, Prostatic Neoplasms, Wales, Ultrasonography, Image-Guided Biopsy

الوصف: IMPORTANCE: The Cluster Randomized Trial of PSA Testing for Prostate Cancer (CAP) reported no effect of prostate-specific antigen (PSA) screening on prostate cancer mortality at a median 10-year follow-up (primary outcome), but the long-term effects of PSA screening on prostate cancer mortality remain unclear. OBJECTIVE: To evaluate the effect of a single invitation for PSA screening on prostate cancer-specific mortality at a median 15-year follow-up compared with no invitation for screening. DESIGN, SETTING, AND PARTICIPANTS: This secondary analysis of the CAP randomized clinical trial included men aged 50 to 69 years identified at 573 primary care practices in England and Wales. Primary care practices were randomized between September 25, 2001, and August 24, 2007, and men were enrolled between January 8, 2002, and January 20, 2009. Follow-up was completed on March 31, 2021. INTERVENTION: Men received a single invitation for a PSA screening test with subsequent diagnostic tests if the PSA level was 3.0 ...

الإتاحة: https://doi.org/10.17863/cam.107668Test
https://www.repository.cam.ac.uk/handle/1810/366944Test

المؤلفون: Pagadala, Meghana S, Linscott, Joshua A, Talwar, James V, Seibert, Tyler M, Rose, Brent, Lynch, Julie, Panizzon, Matthew, Hauger, Richard, Hansen, Moritz H, Sammon, Jesse D, Hayn, Matthew H, Kader, Karim, Carter, Hannah, Ryan, Stephen T

المصدر: BMC Cancer. 22(1)

مصطلحات موضوعية: Epidemiology, Biomedical and Clinical Sciences, Health Sciences, Cancer, Genetics, Prevention, Aging, Prostate Cancer, Male, Humans, Genome-Wide Association Study, Genetic Predisposition to Disease, Polymorphism, Single Nucleotide, Prostatic Neoplasms, Risk Factors, Prostate Cancer Risk, Single nucleotide polymorphism, Ancestry, African, Polygenic Risk Score, Oncology and Carcinogenesis, Public Health and Health Services, Oncology & Carcinogenesis, Oncology and carcinogenesis

الوصف: BackgroundProstate cancer (PrCa) is one of the most genetically driven solid cancers with heritability estimates as high as 57%. Men of African ancestry are at an increased risk of PrCa; however, current polygenic risk score (PRS) models are based on European ancestry groups and may not be broadly applicable. The objective of this study was to construct an African ancestry-specific PrCa PRS (PRState) and evaluate its performance.MethodsAfrican ancestry group of 4,533 individuals in ELLIPSE consortium was used for discovery of African ancestry-specific PrCa SNPs. PRState was constructed as weighted sum of genotypes and effect sizes from genome-wide association study (GWAS) of PrCa in African ancestry group. Performance was evaluated using ROC-AUC analysis.ResultsWe identified African ancestry-specific PrCa risk loci on chromosomes 3, 8, and 11 and constructed a polygenic risk score (PRS) from 10 African ancestry-specific PrCa risk SNPs, achieving an AUC of 0.61 [0.60-0.63] and 0.65 [0.64-0.67], when combined with age and family history. Performance dropped significantly when using ancestry-mismatched PRS models but remained comparable when using trans-ancestry models. Importantly, we validated the PRState score in the Million Veteran Program (MVP), demonstrating improved prediction of PrCa and metastatic PrCa in individuals of African ancestry.ConclusionsAfrican ancestry-specific PRState improves PrCa prediction in African ancestry groups in ELLIPSE consortium and MVP. This study underscores the need for inclusion of individuals of African ancestry in gene variant discovery to optimize PRSs and identifies African ancestry-specific variants for use in future studies.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/4kc1t04qTest

المؤلفون: Digma, Leonardino A, Feng, Christine H, Conlin, Christopher C, Rodríguez-Soto, Ana E, Zhong, Allison Y, Hussain, Troy S, Lui, Asona J, Batra, Kanha, Simon, Aaron B, Karunamuni, Roshan, Kuperman, Joshua, Rakow-Penner, Rebecca, Hahn, Michael E, Dale, Anders M, Seibert, Tyler M

المصدر: Scientific Reports. 12(1)

مصطلحات موضوعية: Physical Sciences, Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Clinical Research, Cancer, Bioengineering, Biomedical Imaging, Artifacts, Bone Neoplasms, Diffusion Magnetic Resonance Imaging, Humans, Image Interpretation, Computer-Assisted, Male, Predictive Value of Tests, Prospective Studies, Prostatic Neoplasms, Reproducibility of Results, Whole Body Imaging

الوصف: Diffusion-weighted magnetic resonance imaging (DWI) of the musculoskeletal system has various applications, including visualization of bone tumors. However, DWI acquired with echo-planar imaging is susceptible to distortions due to static magnetic field inhomogeneities. This study aimed to estimate spatial displacements of bone and to examine whether distortion corrected DWI images more accurately reflect underlying anatomy. Whole-body MRI data from 127 prostate cancer patients were analyzed. The reverse polarity gradient (RPG) technique was applied to DWI data to estimate voxel-level distortions and to produce a distortion corrected DWI dataset. First, an anatomic landmark analysis was conducted, in which corresponding vertebral landmarks on DWI and anatomic T2-weighted images were annotated. Changes in distance between DWI- and T2-defined landmarks (i.e., changes in error) after distortion correction were calculated. In secondary analyses, distortion estimates from RPG were used to assess spatial displacements of bone metastases. Lastly, changes in mutual information between DWI and T2-weighted images of bone metastases after distortion correction were calculated. Distortion correction reduced anatomic error of vertebral DWI up to 29 mm. Error reductions were consistent across subjects (Wilcoxon signed-rank p

الوصول الحر: https://escholarship.org/uc/item/1c68h01hTest

المؤلفون: Huynh-Le, Minh-Phuong, Karunamuni, Roshan, Fan, Chun Chieh, Thompson, Wesley K, Muir, Kenneth, Lophatananon, Artitaya, Tye, Karen, Wolk, Alicja, Håkansson, Niclas, Mills, Ian G, Andreassen, Ole A, Dale, Anders M, Seibert, Tyler M

المصدر: Prostate Cancer and Prostatic Diseases. 24(3)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Oncology and Carcinogenesis, Urologic Diseases, Cancer, Prevention, Aging, Clinical Research, Prostate Cancer, 2.1 Biological and endogenous factors, Aetiology, Good Health and Well Being, Aged, Aged, 80 and over, Biomarkers, Tumor, Case-Control Studies, Follow-Up Studies, Genetic Predisposition to Disease, Humans, Longitudinal Studies, Male, Prognosis, Prostatic Neoplasms, Survival Rate, Sweden, PRACTICAL Consortium, Urology & Nephrology, Clinical sciences, Oncology and carcinogenesis

الوصف: BackgroundClinical variables-age, family history, genetics-are used for prostate cancer risk stratification. Recently, polygenic hazard scores (PHS46, PHS166) were validated as associated with age at prostate cancer diagnosis. While polygenic scores are associated with all prostate cancer (not specific for fatal cancers), PHS46 was also associated with age at prostate cancer death. We evaluated if adding PHS to clinical variables improves associations with prostate cancer death.MethodsGenotype/phenotype data were obtained from a nested case-control Cohort of Swedish Men (n = 3279; 2163 with prostate cancer, 278 prostate cancer deaths). PHS and clinical variables (family history, alcohol intake, smoking, heart disease, hypertension, diabetes, body mass index) were tested via univariable Cox proportional hazards models for association with age at prostate cancer death. Multivariable Cox models with/without PHS were compared with log-likelihood tests.ResultsMedian age at last follow-up/prostate cancer death was 78.0 (IQR: 72.3-84.1) and 81.4 (75.4-86.3) years, respectively. On univariable analysis, PHS46 (HR 3.41 [95% CI 2.78-4.17]), family history (HR 1.72 [1.46-2.03]), alcohol (HR 1.74 [1.40-2.15]), diabetes (HR 0.53 [0.37-0.75]) were each associated with prostate cancer death. On multivariable analysis, PHS46 (HR 2.45 [1.99-2.97]), family history (HR 1.73 [1.48-2.03]), alcohol (HR 1.45 [1.19-1.76]), diabetes (HR 0.62 [0.42-0.90]) all remained associated with fatal disease. Including PHS46 or PHS166 improved multivariable models for fatal prostate cancer (p

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/4255d4t4Test

المؤلفون: Feng, Christine H, Conlin, Christopher C, Batra, Kanha, Rodríguez‐Soto, Ana E, Karunamuni, Roshan, Simon, Aaron, Kuperman, Joshua, Rakow‐Penner, Rebecca, Hahn, Michael E, Dale, Anders M, Seibert, Tyler M

المصدر: Journal of Magnetic Resonance Imaging. 54(3)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Prostate Cancer, Clinical Research, Urologic Diseases, Aging, Cancer, Biomedical Imaging, Detection, screening and diagnosis, 4.2 Evaluation of markers and technologies, 4.1 Discovery and preclinical testing of markers and technologies, Diffusion Magnetic Resonance Imaging, Humans, Magnetic Resonance Imaging, Magnetic Resonance Spectroscopy, Male, Prostatic Neoplasms, ROC Curve, Retrospective Studies, prostate cancer, diffusion magnetic resonance imaging, restriction spectrum imaging, prostate cancer detection, Physical Sciences, Engineering, Medical and Health Sciences, Nuclear Medicine & Medical Imaging, Clinical sciences

الوصف: BackgroundDiffusion magnetic resonance imaging (MRI) is integral to detection of prostate cancer (PCa), but conventional apparent diffusion coefficient (ADC) cannot capture the complexity of prostate tissues and tends to yield noisy images that do not distinctly highlight cancer. A four-compartment restriction spectrum imaging (RSI4 ) model was recently found to optimally characterize pelvic diffusion signals, and the model coefficient for the slowest diffusion compartment, RSI4 -C1 , yielded greatest tumor conspicuity.PurposeTo evaluate the slowest diffusion compartment of a four-compartment spectrum imaging model (RSI4 -C1 ) as a quantitative voxel-level classifier of PCa.Study typeRetrospective.SubjectsForty-six men who underwent an extended MRI acquisition protocol for suspected PCa. Twenty-three men had benign prostates, and the other 23 men had PCa.Field strength/sequenceA 3 T, multishell diffusion-weighted and axial T2-weighted sequences.AssessmentHigh-confidence cancer voxels were delineated by expert consensus, using imaging data and biopsy results. The entire prostate was considered benign in patients with no detectable cancer. Diffusion images were used to calculate RSI4 -C1 and conventional ADC. Classifier images were also generated.Statistical testsVoxel-level discrimination of PCa from benign prostate tissue was assessed via receiver operating characteristic (ROC) curves generated by bootstrapping with patient-level case resampling. RSI4 -C1 was compared to conventional ADC for two metrics: area under the ROC curve (AUC) and false-positive rate for a sensitivity of 90% (FPR90 ). Statistical significance was assessed using bootstrap difference with two-sided α = 0.05.ResultsRSI4 -C1 outperformed conventional ADC, with greater AUC (mean 0.977 [95% CI: 0.951-0.991] vs. 0.922 [0.878-0.948]) and lower FPR90 (0.032 [0.009-0.082] vs. 0.201 [0.132-0.290]). These improvements were statistically significant (P

الوصول الحر: https://escholarship.org/uc/item/1nr8p2mzTest