Adeleke, Sola;
(2021)
Qualitative and quantitative whole-body MRI assessment of metastatic disease in patients with radio-recurrent prostate cancer.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
The thesis provides an overview of my research on the evaluation of whole-body magnetic resonance imaging (WB-MRI) as a single step imaging technique for assessment of metastasis in patients presenting with radio-recurrent prostate cancer (PCa). The work presented is the interim analysis of the LOCATE (localising occult prostate cancer metastasis with advanced imaging techniques) prospective clinical trial (study REC number: 15/LO/0776) Chapter 1 provides a literature review of available clinical and research imaging techniques for evaluation of metastatic disease in the radio-recurrent prostate cancer setting. It introduces the WB-MRI techniques employed in chapters 2-5, provides an overview of pathophysiological basis for WB-MRI signal changes and a review of current WB-MRI literature related to PCa. Chapter 2 presents the first part of my research, addressing the repeatability of lymph node and bone lesion size measurements conducted on various sequences on WB- MRI studies. This critical piece of work underpins the development of the reference standard applied for WB-MRI qualitative and quantitative analysis presented in chapters 3 and 4 respectively. Chapter 3 addresses quantitative imaging biomarkers namely signal fat fraction (sFF), apparent diffusion co-efficient (ADC) and signal enhancement ratio (SER) obtained from WB-MRI and assesses each as a classifier of nodal & bony metastatic disease status. Chapter 4 addresses the diagnostic accuracy of WB- MRI as a qualitative imaging modality evaluated by expert radiologists; compared against an enhanced reference standard (involving clinical and imaging 1-year follow-up). Sensitivity/specificity of WB- MRI is determined on a per-patient basis. Sensitivity/specificity analyses of conventional imaging is also provided. Finally, in this chapter, locked sequential read analysis for the whole-body MRI sequences is presented. Chapter 5 is a health economic analysis of imaging techniques evaluated in chapter 3. It was done in collaboration with the health economics team, in order to carry out a cost comparison analyses between whole body MRI and conventional imaging. Chapter 6 is a summary of main findings and discussions from chapters in this thesis. It also dwells on potential applications and future perspectives on some of the imaging techniques explored in this thesis.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Qualitative and quantitative whole-body MRI assessment of metastatic disease in patients with radio-recurrent prostate cancer |
| Event: | UCL(University College London) |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2021. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10119042 |
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