Evidence map›Paper›PMID 34589619›Full record

ArticlePhysics and imaging in radiation oncology2021

Prostate specific membrane antigen positron emission tomography for lesion-directed high-dose-rate brachytherapy dose escalation.

Christopher W Smith, Ryan Alfano, Douglas Hoover, Kathleen Surry, David D'Souza, Jonathan Thiessen, Irina Rachinsky, John Butler, Jose A Gomez, Mena Gaed and 5 more

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In one paragraph

Article in Physics and imaging in radiation oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

15 authors.

Christopher W SmithBaines Imaging Research Laboratory, 790 Commissioners Rd E, London, ON N6A 5W9, Canada.
Ryan AlfanoBaines Imaging Research Laboratory, 790 Commissioners Rd E, London, ON N6A 5W9, Canada.
Douglas HooverLawson Health Research Institute, 750 Base Line Rd E, London, ON N6C 2R5, Canada.
Kathleen SurryLawson Health Research Institute, 750 Base Line Rd E, London, ON N6C 2R5, Canada.
David D'SouzaLawson Health Research Institute, 750 Base Line Rd E, London, ON N6C 2R5, Canada.
Jonathan ThiessenLawson Health Research Institute, 750 Base Line Rd E, London, ON N6C 2R5, Canada.
Irina RachinskyWestern University Department of Medical Imaging, 1151 Richmond St., London, ON N6A 3K7, Canada.
John ButlerLawson Health Research Institute, 750 Base Line Rd E, London, ON N6C 2R5, Canada.
Jose A GomezWestern University Department of Pathology and Laboratory Medicine, 1151 Richmond St., London, ON N6A 3K7, Canada.
Mena GaedWestern University Department of Pathology and Laboratory Medicine, 1151 Richmond St., London, ON N6A 3K7, Canada.
Madeleine MoussaWestern University Department of Pathology and Laboratory Medicine, 1151 Richmond St., London, ON N6A 3K7, Canada.
Joseph ChinWestern University Department of Surgery, 1151 Richmond St., London, ON N6A 3K7, Canada.
Stephen PautlerWestern University Department of Surgery, 1151 Richmond St., London, ON N6A 3K7, Canada.
Glenn S BaumanWestern University Department of Medical Biophysics, 1151 Richmond St., London, ON N6A 3K7, Canada.
Aaron D WardBaines Imaging Research Laboratory, 790 Commissioners Rd E, London, ON N6A 5W9, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeProstate specific membrane antigen positron emission tomography imaging (PSMA-PET) has demonstrated potential for intra-prostatic lesion localization. We leveraged our existing database of co-registered PSMA-PET imaging with cross sectional digitized pathology to model dose coverage of histologically-defined prostate cancer when tailoring brachytherapy dose escalation based on PSMA-PET imaging. MATERIALS AND

methodsUsing a previously-developed automated approach, we created segmentation volumes delineating underlying dominant intraprostatic lesions for ten men with co-registered pathology-imaging datasets. To simulate realistic high-dose-rate brachytherapy (HDR-BT) treatments, we registered the PSMA-PET-defined segmentation volumes and underlying cancer to 3D trans-rectal ultrasound images of HDR-BT cases where 15 Gray (Gy) was delivered. We applied dose/volume optimization to focally target the dominant intraprostatic lesion identified on PSMA-PET. We then compared histopathology dose for all high-grade cancer within whole-gland treatment plans versus PSMA-PET-targeted plans. Histopathology dose was analyzed for all clinically significant cancer with a Gleason score of 7or greater.

resultsThe standard whole-gland plans achieved a median [interquartile range] D98 of 15.2 [13.8-16.4] Gy to the histologically-defined cancer, while the targeted plans achieved a significantly higher D98 of 16.5 [15.0-19.0] Gy (p = 0.007).

conclusionThis study is the first to use digital histology to confirm the effectiveness of PSMA-PET HDR-BT dose escalation using automatically generated contours. Based on the findings of this study, PSMA-PET lesion dose escalation can lead to increased dose to the ground truth histologically defined cancer.

Indexed as

Dominant intraprostatic lesionHigh dose rate brachytherapyPositron emission tomographyProstate cancerTargeted radiation therapy

Identifiers

PMID34589619
PMCPMC8459608

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.