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Qualitative and quantitative whole-body MRI assessment of metastatic disease in patients with radio-recurrent prostate cancer

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). Green open access

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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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