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Simulated required accuracy of image registration tools for targeting high-grade cancer components with prostate biopsies

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Abstract

Objectives

To estimate the required spatial alignment accuracy for correctly grading 95 % of peripheral zone (PZ) prostate cancers using a system for multiparametric magnetic resonance (MR)-guided ultrasound (US) biopsies.

Methods

PZ prostate tumours were retrospectively annotated on multiparametric MR series using prostatectomy specimens as reference standard. Tumours were grouped based on homogeneous and heterogeneous apparent diffusion coefficient (ADC) values using an automated ADC texture analysis method. The proportion of heterogeneous tumours containing a distinct, high Gleason grade tumour focus yielding low ADC values was determined. Both overall tumour and high-grade focal volumes were calculated. All high-grade target volumes were then used in a simulated US biopsy system with adjustable accuracy to determine the hit rate.

Results

An ADC-determined high-grade tumour focus was found in 63 % of the PZ prostate tumours. The focal volumes were significantly smaller than the total tumour volumes (median volume of 0.3 ml and 1.1 ml respectively). To correctly grade 95 % of the aggressive tumour components the target registration error (TRE) should be smaller than 1.9 mm.

Conclusions

To enable finding the high Gleason grade component in 95 % of PZ prostate tumours with MR-guided US biopsies, a technical registration accuracy of 1.9 mm is required.

Key Points

• MRI can identify foci of prostatic cancer with reduced apparent diffusion coefficients

• Sixty-three per cent of prostatic peripheral zone tumours contain high-grade tumour low ADC foci

• The median volume of such foci is 0.3 ml

• Biopsy targets are significantly smaller than whole tumour volumes

• Simulated registration accuracy is 1.9 mm for correctly grading 95 % of tumours

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Abbreviations

ADC:

Apparent diffusion coefficient

DWI:

Diffusion-weighted imaging

MR:

Magnetic resonance

MRI:

Magnetic resonance imaging

PZ:

Peripheral zone

RMS:

Root mean square

TRE:

Target registration error

TRUS:

Transrectal ultrasound

US:

Ultrasound

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Acknowledgements

This work was funded by grant no. KUN 2007-3971 of the Dutch Cancer Society.

The cohort used in this article was previously reported by Hambrock et al. in Radiology (T. Hambrock, D.M. Somford, H.J. Huisman, I.M. van Oort, J.A. Witjes, C.A. Hulsbergen van de Kaa, T. Scheenen, and J.O. Barentsz. Relationship between apparent diffusion coefficients at 3.0-T MR imaging and Gleason grade in peripheral zone prostate cancer. Radiology, 259(2):453–461 2011.) This population was used in that article to assess whether there was a correlation between ADC and tumour aggressiveness. In our article we use this population to investigate the (focal) tumour volumes and estimate the required accuracy for MR-US fusion.

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Authors and Affiliations

  1. Department of Radiology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands

    Wendy J. M. van de Ven, Thomas Hambrock, Jelle O. Barentsz & Henkjan J. Huisman

  2. Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

    Christina A. Hulsbergen–van de Kaa

Authors
  1. Wendy J. M. van de Ven
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  2. Christina A. Hulsbergen–van de Kaa
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  3. Thomas Hambrock
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  5. Henkjan J. Huisman
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Correspondence to Wendy J. M. van de Ven.

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van de Ven, W.J.M., Hulsbergen–van de Kaa, C.A., Hambrock, T. et al. Simulated required accuracy of image registration tools for targeting high-grade cancer components with prostate biopsies. Eur Radiol 23, 1401–1407 (2013). https://doi.org/10.1007/s00330-012-2701-1

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  • DOI: https://doi.org/10.1007/s00330-012-2701-1

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