Image Guided Prostate Cancer Treatments

Image-Guided Prostate Cancer Treatments is a comprehensive reference and practical guide on the technology and application of ultrasound and MRI in the male pelvis, with special attention to the prostate. The book is organized into three main sections, the first of which is devoted to general aspects of imaging and image-guided treatments. The second section provides a systematic overview of the application of ultrasound and MRI to the diagnosis and treatment of diseases of the lower urinary tract. Performance of the ultrasound and MRI studies is explained, and the normal and abnormal pathological anatomy is reviewed. Correlation with the ultrasound in the same plane is provided to assist in understanding the MRI sequences. Biopsy and interventional procedures, ultrasound-MRI fusion techniques, and image-guided therapies, including focused ultrasound, photodynamic therapy, microwave and laser ablation, are all fully covered. The third section focuses on securing treatment effectiveness and the use of follow-up imaging to ensure therapeutic success and detect tumor recurrence at an early stage, which is vital given that prompt focal treatment of recurrence is very successful. Here, particular attention is paid to the role of Doppler ultrasound and DCE-MRI technologies. This book, containing a wealth of high-quality illustrations based on high-end equipment, will acquaint beginners with the basics of prostate ultrasound and MRI, while more advanced practitioners will learn new skills, means of avoiding pitfalls, and ways of effectively relating the imaging and image-guided treatments to the clinical situation. The information provided will permit a tailored approach in dealing with specific pathologic issues.

Prominent physicians review past, current, and future applications of the many powerful imaging techniques now used in the diagnosis, staging, treatment, and outcomes assessment of cancers of the prostate, central nervous system (CNS), and breast. Topics range from the use of screening mammography and approaches to breast cancer detection using MRI to improved visualization of the prostate gland from transrectal ultrasound and MRI, to MRI-guided resection of neoplasms.

Intensity-modulated radiation therapy (IMRT), one of the most important developments in radiation oncology in the past 25 years, involves technology to deliver radiation to tumors in the right location, quantity and time. Unavoidable irradiation of surrounding normal tissues is distributed so as to preserve their function. The achievements and future directions in the field are grouped in the three sections of the book, each suitable for supporting a teaching course. Part 1 contains topical reviews of the basic principles of IMRT, part 2 describes advanced techniques such as image-guided and biologically based approaches, and part 3 focuses on investigation of IMRT to improve outcome at various cancer sites.

Modern medical imaging and radiation therapy technologies are so complex and computer driven that it is difficult for physicians and technologists to know exactly what is happening at the point-of-care. Medical physicists responsible for filling this gap in knowledge must stay abreast of the latest advances at the intersection of medical imaging and radiation therapy. This book provides medical physicists and radiation oncologists current and relevant information on Adaptive Radiation Therapy (ART), a state-of-the-art approach that uses a feedback process to account for patient-specific anatomic and/or biological changes, thus delivering highly individualized radiation therapy for cancer patients. The book should also benefit medical dosimetrists and radiation therapists. Adaptive Radiation Therapy describes technological and methodological advances in the field of ART, as well as initial clinical experiences using ART for selected anatomic sites. Divided into three sections (radiobiological basis, current technologies, and clinical applications), the book covers: Morphological and biological biomarkers for patient-specific planning Design and optimization of treatment plans Delivery of IMRT and IGRT intervention methodologies of ART Management of intrafraction variations, particularly with respiratory motion Quality assurance needed to ensure the safe delivery of ART ART applications in several common cancer types / anatomic sites The technology and methodology for ART have advanced significantly in the last few years and accumulated clinical data have demonstrated the need for ART in clinical settings, assisted by the wide application of intensity modulated radiation therapy (IMRT) and image-guided radiation therapy (IGRT). This book shows the real potential for supplying every patient with individualized radiation therapy that is maximally accurate and precise.

This book constitutes the refereed proceedings of the International Workshop on Prostate Cancer Imaging, held in conjunction with MICCAI 2011, in Toronto, Canada, in September 2011. The 15 revised full papers presented together with 2 invited talks were carefully reviewed and selected from 19 submissions. The papers cover the clinical areas of radiology, radiation oncology, and image guided intervention, addressing topics such as prostate segmentation, multi-modal prostate registration, and computer-aided diagnosis and classification of prostate cancer.

This book provides detailed, state-of-the-art information and guidelines on the latest developments, innovations, and clinical procedures in image-guided and adaptive radiation therapy. The first section discusses key methodological and technological issues in image-guided and adaptive radiation therapy, including use of implanted fiducial markers, management of respiratory motion, image-guided stereotactic radiosurgery and stereotactic body radiation therapy, three-dimensional conformal brachytherapy, target definition and localization, and PET/CT and biologically conformal radiation therapy. The second section provides practical clinical information on image-guided adaptive radiation therapy for cancers at all common anatomic sites and for pediatric cancers. The third section offers practical guidelines for establishing an effective image-guided adaptive radiation therapy program.

This text encompass an up-to-date, comprehensive review of the state-of-the-art for gland preserving therapies. Fully updated and revised, this text evaluates the scientific evidence for the evolving trend to treat intermediate risk, clinically localized prostate cancer in a focally ablative manner with novel gland-preserving, focal therapy methods. Various ablative devices such as high intensity focused ultrasound, irreversible electroporation, photodynamic therapy, cryotherapy and laser ablation, among others, is discussed in regard to their strengths and limitations as a therapeutic modality. Emphasis is placed on patient selection and outcomes utilizing both advanced imaging techniques and pathologic evaluation. Current and new approaches to image cancer foci within the prostate (multiparametric ultrasonography, multiparametric magnetic resonance image, etc) are presented along with various biopsy techniques, including robotics to map prostate cancer. Patient selection based on imaging and genomic classification, adjuvants to enhance therapy, treatment strategy, outcomes and patient centered concerns is discussed, providing an acceptable balance between cancer control and improved quality of life for patients. Written by experts in the field and lavishly illustrated with detailed line-art and photographs, Imaging and Focal Therapy of Early Prostate Cancer, Second Edition is designed as a comprehensive resource for urologists, radiation oncologists, medical oncologists, radiologists, uropathologists, molecular biologists, biomedical engineers, other clinicians –- residents, fellows, nurses and allied professionals -- and researchers with an interest in the diagnosis and novel treatment of prostate cancer. It will provide insight into the latest research and clinical applications of image-guided diagnosis and minimally invasive focal, gland-preserving treatment for prostate cancer.

Radiation oncology for physicians and residents needing a multidisciplinary, treatment-focused resource; this updated edition provides the latest knowledge in this consistently growing field. You will broaden your understanding of the basic biology of disease processes, and access updated treatment algorithms, information on techniques, and state-of-the-art modalities.

This is a story of relationships. I have not told it to make anyone feel sorry for me and it certainly was not my intention to elicit tears or sadness. It is a story of mother and daughter, and how family members can support each other as they confront the worst blow ever dealt to them. It is a story also, I hope, of communication. The renowned Dr. Elizabeth Kubler-Ross, whose life study concerned the dying, believed and often said that the dying have unfinished business and cannot properly prepare to leave this world until it is done. As we try to help those who are terminally ill, we find that they may have, conversely, helped us. Thus, this is a story of incredible bravery and strength. If you are going through this now, or watching someone you love go through it, I hope you will find something in here to make those last days more meaningful.

The treatment of prostate cancer continues to be problematic owing to serious side-effects, including erectile dysfunction and urinary incontinence. Robotic radiosurgery offers a novel, rapid, non-invasive outpatient treatment option that combines robotics, advanced image-guided spatial positioning, and motion detection with submillimeter precision. This book examines all aspects of the treatment of prostate cancer with robotic radiosurgery. It explains how image-guided robotic radiosurgery overcomes the problem of patient motion during radiation therapy by continuously identifying the precise location of the prostate tumor throughout the course of treatment. Hypofractionated radiation delivery by means of robotic radiosurgery systems is also discussed in detail. The book closes by examining other emerging genitourinary applications of robotic radiosurgery. All of the authors are experts in their field who present a persuasive case for this fascinating technique.

Image-Guided Cancer Therapy: A Multidisciplinary Approach provides clinicians with in-depth coverage of the growing, dynamic field of interventional oncology. Combining the knowledge of expert editors and authors into one powerhouse reference, this book looks at tumor ablation, HIFU, embolic therapies, emerging technologies, and radiation therapy throughout the body (liver, bone, breast, gynecologic and prostate cancers, to name just a few) , and includes discussion of different imaging modalities. In the words of Peter Mueller, MD, author of the book’s Foreword: “... The senior authors are all world renowned experts in interventional oncology, which is another example of the high quality authorship and experience that is brought to this book. The later chapters discuss therapies that are simply not covered in any other source. Everyone who is doing or wants to do ablation therapies and interventional oncology will face a time when they will be asked to use their expertise in less used and less investigated areas. There is nowhere else where the reader can get information on the prostate, breast, and gynecologic areas, and especially pediatrics....This book is an outstanding contribution to the literature and will become a ‘must read’ for all physicians who are interested in Interventional Oncology.”

This book covers novel strategies and state of the art approaches for automated non-invasive systems for early prostate cancer diagnosis. Prostate cancer is the most frequently diagnosed malignancy after skin cancer and the second leading cause of cancer related male deaths in the USA after lung cancer. However, early detection of prostate cancer increases chances of patients’ survival. Generally, The CAD systems analyze the prostate images in three steps: (i) prostate segmentation; (ii) Prostate description or feature extraction; and (iii) classification of the prostate status. Explores all of the latest research and developments in state-of-the art imaging of the prostate from world class experts. Contains a comprehensive overview of 2D/3D Shape Modeling for MRI data. Presents a detailed examination of automated segmentation of the prostate in 3D imaging. Examines Computer-Aided-Diagnosis through automated techniques. There will be extensive references at the end of each chapter to enhance further study.

Prominent physicians review past, current, and future applications of the many powerful imaging techniques now used in the diagnosis, staging, treatment, and outcomes assessment of cancers of the prostate, central nervous system (CNS), and breast. Topics range from the use of screening mammography and approaches to breast cancer detection using MRI to improved visualization of the prostate gland from transrectal ultrasound and MRI, to MRI-guided resection of neoplasms.

Image-Guided Radiation Therapy presents key image-guided radiation treatment (IGRT) technologies for external beam radiotherapy. The book explores the decades-long technological developments that have occurred in the realm of image-guided conformal, customized radiation treatment. Expert authors, all of whom have actively participated in the development or implementation of IGRT, imaging, and enabling technologies, share their first-hand experiences on the science, clinical uses, and impact of these technologies. They describe kilovoltage and megavoltage imaging as well as radiological, ultrasound, and optical technologies for determining and validating target and patient positioning. The book examines how anatomical and biological imaging using CT and PET has contributed to the understanding of target volume boundaries and biological behavior. It also explores such innovations as 4D PET/CT and digital tomosynthesis. Advancing patient care, this book focuses on a wealth of hybrid IGRT technologies and devices for coupled imaging and treatment inside the radiation treatment room. It thoroughly covers the modalities, software tools, and imaging treatment geometries that constitute IGRT.