MP7-19 IN VIVO MAGNETIC RESONANCE ELASTOGRAPHY TO IMAGE PROSTATE ANATOMY IN PATIENTS WITH PROSTATE CANCER: A FEASIBILITY STUDY

You have accessJournal of UrologyImaging/Radiology II1 Apr 2014MP7-19 IN VIVO MAGNETIC RESONANCE ELASTOGRAPHY TO IMAGE PROSTATE ANATOMY IN PATIENTS WITH PROSTATE CANCER: A FEASIBILITY STUDY Daniel Yelfimov, Phillip Rossman, Kevin Glaser, Matthew Tollefson, Akira Kawashima, David Woodrum, Richard Ehman, and Lance Mynderse Daniel YelfimovDaniel Yelfimov More articles by this author , Phillip RossmanPhillip Rossman More articles by this author , Kevin GlaserKevin Glaser More articles by this author , Matthew TollefsonMatthew Tollefson More articles by this author , Akira KawashimaAkira Kawashima More articles by this author , David WoodrumDavid Woodrum More articles by this author , Richard EhmanRichard Ehman More articles by this author , and Lance MynderseLance Mynderse More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.342AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Elasticity as a biomarker for prostate cancer is a promising field of research. Magnetic resonance elastography (MRE) applies a phase-contrast imaging sequence to detect the propagation of shear waves generated by a mechanical driver system in tissues to measure elasticity differences. Mechanical drivers applied externally to the skin have failed due to attenuation of shear waves by soft tissues and bones. Transurethral studies have been limited to ex vivo or non-human models. Our objective was to demonstrate the feasibility of prostate MRE using a transurethral actuator in human volunteers with a diagnosis of prostate cancer. METHODS This was a HIPPA-compliant, IRB-approved prospective study. Five patients with known prostate cancer were recruited. After acquisition of standard clinical multiparametric (mp) MRI using a 3-Tesla magnet and an endorectal coil, a transurethral catheter attached to an external pneumatic driver system translated longitudinal motion to the prostate at frequencies ranging from 150-233 Hz. Phase-contrast imaging sequences were utilized to detect the propagation of the resulting shear waves. Quantitative elastograms were generated by post-acquisition processing and compared to standard mpMRI. All patients proceeded with radical prostatectomy following the study. mpMRI and MRE images correlated with histopathology. RESULTS Gradient echo and echo-planar MRE images detected shear waves with peak motion amplitudes of up to +/- 5 um. Satisfactory MRE elastograms were generated from all 5 patients, and appear to show regions of increased elasticity in areas of known prostate cancer (Figure 1). All patients reported little discomfort from catheter placement or vibration amplitudes. There were no adverse events, patient discomfort or evidence of prostatic injury. CONCLUSIONS Prostate MRE utilizing a transurethral actuator is a safe and feasible imaging modality in human patients. The MRE sequences demonstrated satisfactory propagation of shear waves and post-processing elastograms. MRE showed increased tissue stiffness associated with prostate carcinoma. Further analysis remains, including normal prostate MRE and more detailed correlation of histopathology with MRE in a larger number of patients undergoing radical prostatectomy. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e73-e74 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Daniel Yelfimov More articles by this author Phillip Rossman More articles by this author Kevin Glaser More articles by this author Matthew Tollefson More articles by this author Akira Kawashima More articles by this author David Woodrum More articles by this author Richard Ehman More articles by this author Lance Mynderse More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...