Multiparametric bone MRI targeting aides lesion selection for CT-guided sclerotic bone biopsies in metastatic castrate resistant prostate cancer
Abstract Background Bone biopsies in metastatic castrate-resistant prostate cancer (mCRPC) patients can be challenging. This study’s objective was to prospectively validate a multiparametric bone MRI (mpBMRI) algorithm to facilitate target lesion selection in mCRPC patients with sclerotic bone disea...
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | Cancer Imaging |
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| Online Access: | https://doi.org/10.1186/s40644-023-00644-w |
| _version_ | 1797388136080211968 |
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| author | Ricardo Donners Ines Figueiredo Daniel Westaby Dow-Mu Koh Nina Tunariu Suzanne Carreira Johann S. de Bono Nicos Fotiadis |
| author_facet | Ricardo Donners Ines Figueiredo Daniel Westaby Dow-Mu Koh Nina Tunariu Suzanne Carreira Johann S. de Bono Nicos Fotiadis |
| author_sort | Ricardo Donners |
| collection | DOAJ |
| description | Abstract Background Bone biopsies in metastatic castrate-resistant prostate cancer (mCRPC) patients can be challenging. This study’s objective was to prospectively validate a multiparametric bone MRI (mpBMRI) algorithm to facilitate target lesion selection in mCRPC patients with sclerotic bone disease for subsequent CT-guided bone biopsies. Methods 20 CT-guided bone biopsies were prospectively performed between 02/2021 and 11/2021 in 17 mCRPC patients with only sclerotic bone disease. Biopsy targets were selected based on MRI, including diffusion-weighted (DWI) and T1-weighted VIBE Dixon MR images, allowing for calculation of the apparent diffusion coefficient (ADC) and the relative fat-fraction (rFF), respectively. Bone marrow with high DWI signal, ADC < 1100 µm2/s and rFF < 20% was the preferred biopsy target. Tumor content and NGS-feasibility was assessed by a pathologist. Prognostic routine laboratory blood parameters, target lesion size, biopsy tract length, visual CT density, means of HU, ADC and rFF were compared between successful and unsuccessful biopsies (p < 0.05 = significant). Results Overall, 17/20 (85%) biopsies were tumor-positive and next-generation genomic sequencing (NGS) was feasible in 13/18 (72%) evaluated samples. Neither laboratory parameters, diameter, tract length nor visual CT density grading showed significant differences between a positive versus negative or NGS feasible versus non-feasible biopsy results (each p > 0.137). Lesion mean HU was 387 ± 187 HU in NGS feasible and 493 ± 218 HU in non-feasible biopsies (p = 0.521). For targets fulfilling all MRI selection algorithm criteria, 13/14 (93%) biopsies were tumor-positive and 10/12 (83%) provided NGS adequate tissue. Conclusions Multiparametric bone MRI can facilitate target lesion selection for subsequent CT-guided bone biopsy in mCPRC patients with sclerotic metastases. Trial registration Committee for Clinical Research of the Royal Marsden Hospital registration number SE1220. |
| first_indexed | 2024-03-08T22:35:24Z |
| format | Article |
| id | doaj.art-76c557085ee14e639a41f169264874dd |
| institution | Directory Open Access Journal |
| issn | 1470-7330 |
| language | English |
| last_indexed | 2024-03-08T22:35:24Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Cancer Imaging |
| spelling | doaj.art-76c557085ee14e639a41f169264874dd2023-12-17T12:28:53ZengBMCCancer Imaging1470-73302023-12-012311910.1186/s40644-023-00644-wMultiparametric bone MRI targeting aides lesion selection for CT-guided sclerotic bone biopsies in metastatic castrate resistant prostate cancerRicardo Donners0Ines Figueiredo1Daniel Westaby2Dow-Mu Koh3Nina Tunariu4Suzanne Carreira5Johann S. de Bono6Nicos Fotiadis7Department of Radiology, Royal Marsden HospitalThe Institute of Cancer ResearchThe Institute of Cancer ResearchDepartment of Radiology, Royal Marsden HospitalDepartment of Radiology, Royal Marsden HospitalThe Institute of Cancer ResearchThe Institute of Cancer ResearchDepartment of Interventional Radiology, Royal Marsden HospitalAbstract Background Bone biopsies in metastatic castrate-resistant prostate cancer (mCRPC) patients can be challenging. This study’s objective was to prospectively validate a multiparametric bone MRI (mpBMRI) algorithm to facilitate target lesion selection in mCRPC patients with sclerotic bone disease for subsequent CT-guided bone biopsies. Methods 20 CT-guided bone biopsies were prospectively performed between 02/2021 and 11/2021 in 17 mCRPC patients with only sclerotic bone disease. Biopsy targets were selected based on MRI, including diffusion-weighted (DWI) and T1-weighted VIBE Dixon MR images, allowing for calculation of the apparent diffusion coefficient (ADC) and the relative fat-fraction (rFF), respectively. Bone marrow with high DWI signal, ADC < 1100 µm2/s and rFF < 20% was the preferred biopsy target. Tumor content and NGS-feasibility was assessed by a pathologist. Prognostic routine laboratory blood parameters, target lesion size, biopsy tract length, visual CT density, means of HU, ADC and rFF were compared between successful and unsuccessful biopsies (p < 0.05 = significant). Results Overall, 17/20 (85%) biopsies were tumor-positive and next-generation genomic sequencing (NGS) was feasible in 13/18 (72%) evaluated samples. Neither laboratory parameters, diameter, tract length nor visual CT density grading showed significant differences between a positive versus negative or NGS feasible versus non-feasible biopsy results (each p > 0.137). Lesion mean HU was 387 ± 187 HU in NGS feasible and 493 ± 218 HU in non-feasible biopsies (p = 0.521). For targets fulfilling all MRI selection algorithm criteria, 13/14 (93%) biopsies were tumor-positive and 10/12 (83%) provided NGS adequate tissue. Conclusions Multiparametric bone MRI can facilitate target lesion selection for subsequent CT-guided bone biopsy in mCPRC patients with sclerotic metastases. Trial registration Committee for Clinical Research of the Royal Marsden Hospital registration number SE1220.https://doi.org/10.1186/s40644-023-00644-wNeoplasmsImage-guided biopsyComputer tomographyGenomicsBone marrow |
| spellingShingle | Ricardo Donners Ines Figueiredo Daniel Westaby Dow-Mu Koh Nina Tunariu Suzanne Carreira Johann S. de Bono Nicos Fotiadis Multiparametric bone MRI targeting aides lesion selection for CT-guided sclerotic bone biopsies in metastatic castrate resistant prostate cancer Cancer Imaging Neoplasms Image-guided biopsy Computer tomography Genomics Bone marrow |
| title | Multiparametric bone MRI targeting aides lesion selection for CT-guided sclerotic bone biopsies in metastatic castrate resistant prostate cancer |
| title_full | Multiparametric bone MRI targeting aides lesion selection for CT-guided sclerotic bone biopsies in metastatic castrate resistant prostate cancer |
| title_fullStr | Multiparametric bone MRI targeting aides lesion selection for CT-guided sclerotic bone biopsies in metastatic castrate resistant prostate cancer |
| title_full_unstemmed | Multiparametric bone MRI targeting aides lesion selection for CT-guided sclerotic bone biopsies in metastatic castrate resistant prostate cancer |
| title_short | Multiparametric bone MRI targeting aides lesion selection for CT-guided sclerotic bone biopsies in metastatic castrate resistant prostate cancer |
| title_sort | multiparametric bone mri targeting aides lesion selection for ct guided sclerotic bone biopsies in metastatic castrate resistant prostate cancer |
| topic | Neoplasms Image-guided biopsy Computer tomography Genomics Bone marrow |
| url | https://doi.org/10.1186/s40644-023-00644-w |
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