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UCLA Prostate Imaging and Treatment

UCLA Prostate Imaging and Treatment

UCLA Prostate Imaging and Treatment
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UCLA Prostate Imaging and Treatment

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About Us

About Us

  • Case Studies
    • Radiation Therapy
    • Small Volume Low Grade Disease
    • Active Surveillance
    • Example of Change to Nerve Sparing
    • Extracapsular Extension and Seminal Vesicle Invasion
    • Dynamic Contrast-Enhancement for Biochemical Failure
    • MR-Guided Targeted Biopsy
    • Benign Disease (Infertility)
  • Clinical Trials
  • CME Course
  • Research Publications
  • Case Studies
  • Clinical Trials
  • CME Course
  • Research Publications
  • Radiation Therapy
  • Small Volume Low Grade Disease
  • Active Surveillance
  • Example of Change to Nerve Sparing
  • Extracapsular Extension and Seminal Vesicle Invasion
  • Dynamic Contrast-Enhancement for Biochemical Failure
  • MR-Guided Targeted Biopsy
  • Benign Disease (Infertility)
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Radiation Therapy

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History

  • 69 year-old, BPH gradual
  • PSA rise 1.6 → 4.8 ng/dl
  • Abnormal digital rectal exam → Biopsy: Gleason 5+4=9

Imaging


LEFT: T2-weighted image prior to treatment shows large, low-signal mass (yellow oval) on the right crossing midline anteriorly
RIGHT: Color perfusion map shows correspondingly increased perfusion (yellow-green pixels) with washout (red pixels)

 

 

 

 


Left: T2-weighted image after treatment shows normalization of T2 signal with reappearance of the normal peripheral-transitional zone border.
Right: Color perfusion map shows correspondingly decreased perfusion (blue pixels) consistent with response to treatment.

 

 

 

 

Example Report (Prior to Therapy) test

* Findings

No suspicious lymph nodes or bone lesions
Prostate measures 58 gm with mild prostatic hyperplasia
A single suspicious area is identified:

Location Bilateral anterior & right posterior
Size 2.8 cm
Capsule Involvement posterolaterally
T2 Asymmetric, ill-defined
Perfusion Abnormal
Overall suspicion High (4/5)

Seminal vesicles and neurovascular bundles appear normal

* Impression

  1. Technical quality: excellent
  2. Large right lesion crosses midline anteriorly and extends to capsule
  3. Organ-confined disease - no suspicious lymph nodes or bone lesions

Advantage: UCLA Prostate MRI

  • Although PSA remains the mainstay of treatment monitoring, MRI can add value when there is concern for residual disease
  • Removable table (GE HDxt or Siemens Skyra) allows for imaging after external patient mold is applied for registration with radiation planning.
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