Interactive Deformation Registration Of Endorectal Prostate MRI Using ITK Thin Plate Splines - Towards Personalized Prostate Cancer Radiotherapy

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology;  MRI / PET / Ultrasound;  Cancer / Oncology
Article Date: 11 Apr 2009 - 2:00 PDT

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UroToday.com - This current paper ⁽¹⁾ is part of the research aimied at developing more individualized and targeted prostate cancer radiotherapy.

Recent improvement in radiation treatment outcome of prostate cancer mainly comes from radiation dose escalation and combining radiation with hormonal treatment. However, dose response analysis projects significant hazard in normal tissue injury with further dose increase ^{(2, 3, 4)} . Targeting the treatment resistant areas within the prostate has the benefit of directing the radiation dose to the region needing the added dose while minimizing further collateral damage to normal tissue. The shape of the prostate changes daily as a result of varying rectal content. This daily variation in the prostate's shape poses a challenge for accurate calculation of dose and targeting, especially to the intraprostatic targets.

Algorithms are developed and being further refined to account for the organ deformation ⁽⁵⁾. Androgen ablation is associated with significant side effects. This generates the interest in finding more molecularly targeted radiation sensitizers. Preclinical data have demonstrated that anti-EGFR antibody augmented the radiation effect on prostate cancer ⁽⁶⁾. This may be tested in clinical trials in the future. Numerical simulation has shown that optical imaging may be combined with endorectal MRI to monitor the treatment response of prostate cancer ⁽⁷⁾. This may allow targeting the additional dose to the treatment-resistant areas while minimizing the dose to normal tissues.

This tool ⁽¹⁾ is part of an ensemble of interactive specialized prostate image registration (InSPIRE) algorithms being developed to allow high-resolution mapping of the treatment-resistant tumor from endorectal MRI onto the planning scans (MRI or CT) for radiation treatment.

References:
1. Cheung MR, Krishnan K. Interactive deformable registration of endorectal prostate MRI using ITK thin plate splines. Acad. Radiol. 16:351-7, 2009.
2. Cheung R, Tucker SL, Ye JS, Dong L, Liu H, Huang E, Mohan R, Kuban D. Characterization of rectal normal tissue complication probability after high-dose external beam radiotherapy for prostate cancer. Int J Radiat Oncol Biol Phys 58:1513-9, 2004.
3. Selek U, Cheung R, Lii M, Allen P, Steadham RE, Vantreese TR, Jr, Little DJ, Rosen, II, Kuban D. Erectile dysfunction and radiation dose to penile base structures: a lack of correlation. Int J Radiat Oncol Biol Phys 59:1039-46, 2004.
4. Cheung MR, Tucker SL, Dong L, deCrevoisier R, Lee AK, Frank S, Kudchadker RJ,Thames H, Mohan R, Kuban D. Investigation of bladder dose and volume factors influencing late urinary toxicity after external beam radiotherapy for prostate cancer. Int J Radiat Oncol Biol Phys 64:1059-65, 2007.
5. Wang H, Dong L, Lii MF, Lee AL, de Crevoisier R, Mohan R, Cox JD, Kuban DA, Cheung R. Implementation and validation of a three-dimensional deformable registration algorithm for targeted prostate cancer radiotherapy. Int J Radiat Oncol Biol Phys 61:725-35, 2005.
6. Wagener M, Zhang X, Villarreal HG, Levy L, Allen P, Shentu S, Fang B, Krishnan S, Chang JY, Cheung MR. Effect of combining anti-epidermal growth factor receptor antibody C225 and radiation on DU145 prostate cancer. Oncol Rep. 2008 May; 19(5):1071-7.
7. Li C, Liengsawangwong R, Choi H, Cheung R. Using a priori structural information from magnetic resonance imaging to investigate the feasibility of prostate diffuse optical tomography and spectroscopy: A simulation study. Med Phys 34:266-274, 2007.

Written by M. Rex Cheung, M.D., Ph.D as part of Beyond the Abstract on UroToday.com

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