Volume 58, Issue 2 pp. 237-243
Radiation Oncology—Original Article

MRI scans significantly change target coverage decisions in radical radiotherapy for prostate cancer

Joe H. Chang

Joe H. Chang

Radiation Oncology Centre, Austin Health, Melbourne, Victoria, Australia

Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia

University of Melbourne, Melbourne, Victoria, Australia

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Daryl Lim Joon

Daryl Lim Joon

Radiation Oncology Centre, Austin Health, Melbourne, Victoria, Australia

University of Melbourne, Melbourne, Victoria, Australia

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Brandon T. Nguyen

Brandon T. Nguyen

Radiation Oncology Centre, Austin Health, Melbourne, Victoria, Australia

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Chee-Yan Hiew

Chee-Yan Hiew

Department of Radiology, Austin Health, Melbourne, Victoria, Australia

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Stephen Esler

Stephen Esler

Department of Radiology, Austin Health, Melbourne, Victoria, Australia

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David Angus

David Angus

Department of Urology, Austin Health, Melbourne, Victoria, Australia

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Michael Chao

Michael Chao

Radiation Oncology Victoria, Melbourne, Victoria, Australia

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Morikatsu Wada

Morikatsu Wada

Radiation Oncology Centre, Austin Health, Melbourne, Victoria, Australia

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George Quong

George Quong

Radiation Oncology Victoria, Melbourne, Victoria, Australia

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Vincent Khoo

Corresponding Author

Vincent Khoo

Radiation Oncology Centre, Austin Health, Melbourne, Victoria, Australia

University of Melbourne, Melbourne, Victoria, Australia

Department of Clinical Oncology, Royal Marsden Hospital Trust & Institute of Cancer Research, London, UK

Correspondence

Dr Vincent Khoo, Department of Clinical Oncology, Royal Marsden Hospital and Institute of Cancer Research, London SW3 6JJ, UK.

Email: [email protected]

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First published: 29 August 2013
Citations: 31
JH Chang MBChB; D Lim Joon FRANZCR; BT Nguyen FRANZCR; C-Y Hiew FRANZCR; S Esler FRANZCR; D Angus FRACS; M Chao FRANZCR; M Wada FRANZCR; G Quong FRANZCR; V Khoo MD.
Conflict of interest: All authors have indicated that they do not have any conflicts of interest in relation to this work.

Abstract

Introduction

Conventional clinical staging for prostate cancer has many limitations. This study evaluates the impact of adding MRI scans to conventional clinical staging for guiding decisions about radiotherapy target coverage.

Methods

This was a retrospective review of 115 patients who were treated between February 2002 and September 2005 with radical radiotherapy for prostate cancer. All patients had MRI scans approximately 2 weeks before the initiation of radiotherapy. The T stage was assessed by both conventional clinical methods (cT-staging) as well as by MRI (mT-staging). The radiotherapy target volumes were determined first based on cT-staging and then taking the additional mT staging into account. The number of times extracapsular extension or seminal vesicle invasion was incorporated into target volumes was quantified based on both cT-staging and the additional mT-staging.

Results

Extracapsular extension was incorporated into target volumes significantly more often with the addition of mT-staging (46 patients (40%) ) compared with cT-staging alone (37 patients (32%) ) (P = 0.002). Seminal vesicle invasion was incorporated into target volumes significantly more often with the addition of mT-staging (21 patients (18%) ) compared with cT-staging alone (three patients (3%) ) (P < 0.001). A total of 23 patients (20%) had changes to their target coverage based on the mT-staging.

Conclusions

MRI scans can significantly change decisions about target coverage in radical radiotherapy for prostate cancer.

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