Identification of treatment field of focal therapy for prostate cancer using MRI and biopsy

• Project/Area Number: 15K10578
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Urology
• Research Institution: Tokyo Medical and Dental University
• Principal Investigator: MATSUOKA YOH 東京医科歯科大学, 医学部附属病院, 講師 (90401380)
• Co-Investigator(Kenkyū-buntansha): 藤井 靖久 東京医科歯科大学, 大学院医歯学総合研究科, 教授 (70282754)
• Project Period (FY): 2015-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥4,810,000 (Direct Cost: ¥3,700,000、Indirect Cost: ¥1,110,000); Fiscal Year 2017: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000); Fiscal Year 2016: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000); Fiscal Year 2015: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
• Keywords: 前立腺癌 / MRI / 生検 / focal therapy

Outline of Final Research Achievements

The aim of our study is to identify appropriate candidates of focal therapy for prostate cancer and to establish how to design treatment field using multiparametric MRI and targeted/systematic biopsy. Firstly, we investigated the diagnostic performance of MRI and biopsy for clinically significant cancer and extraprostatic extension. The current MRI reporting and data system seemed to be useful to assess the eligibility for focal therapy because of its higher sensitivity for extraprostatic extension than previous system. Secondly, in a simulation study using prostatic phantoms, MRI/ultrasound image-fusion guidance enabled more accurate targeted sampling than transrectal ultrasound guidance. Clinical analysis demonstrated that treatment margin is needed in the treatment field planning of legion-targeted focal therapy.

Academic Significance and Societal Importance of the Research Achievements

高齢社会において前立腺癌の過剰治療削減は課題の一つである。近年の診断技術の進歩により、前立腺癌の低侵襲治療の開発が期待されている。病巣を選択的に治療するfocal therapyでは制癌効果と臓器/機能温存の両立を図るが、治療域縮小に伴う過少治療リスクに対して正確な病巣局在評価と治療域設定が必要である。本研究では、MRIおよび融合画像ガイド下生検の診断精度を明らかとし、その診断能に基づくfocal therapy治療域設定について解析を行った。focal therapyの治療計画基準を定めることで本治療の普及に貢献することが期待される。

Research Products

• [Journal Article] MRIと生検によるfocal therapyの症例選択と治療計画 (2018)
  • Author(s): 松岡 陽、齋藤一隆、木島敏樹、田中 宏、戸田一真、吉村亮一、藤井靖久
  • Journal Title: 泌尿器外科 Volume: 31 Pages: 717-719
• [Journal Article] Impact of the Prostate Imaging Reporting and Data System version 2 on MRI diagnosis for extracapsular extension of prostate cancer (2016)
  • Author(s): Yoh Matsuoka, Junichiro Ishioka, Hiroshi Tanaka, Tomo Kimura, Soichiro Yoshida, Kazutaka Saito, Yasuhisa Fujii, Kazunori Kihara
  • Journal Title: American Journal of Roentgenology Volume: 印刷中 Issue: 2 Pages: W76-W84
  • DOI: 10.2214/ajr.16.17163
  • Peer Reviewed
• [Presentation] 前立腺MRI-US fusion標的生検における系統的生検併用の有用性に関する立体画像解析 (2019)
  • Author(s): 松岡 陽、上原 翔、吉田宗一郎、田中 宏、木村 知、木島敏樹、横山みなと、石岡淳一郎、齋藤一隆、藤井靖久
  • Organizer: 日本泌尿器癌局所療法研究会
• [Presentation] Clinical significance of MRI-targeted biopsy in prediction of adverse pathological and oncological outcome after radical prostatectomy (2018)
  • Author(s): Matsuoka Y, Tanaka H, Kimura T, Waseda Y, Uehara S, Yasuda Y, Kijima T, Yoshida S, Yokoyama M, Ishioka J, Saito K, Kihara K, Fujii Y
  • Organizer: Annual Congress of the European Association of Urology
  • Int'l Joint Research
• [Presentation] Characteristics of global Gleason grading for MRI-targeted biopsy in comparison with systematic biopsy and prostatectomy grades (2018)
  • Author(s): Matsuoka Y, Tanaka H, Kimura T, Waseda Y, Uehara S, Yasuda Y, Kijima T, Yoshida S, Yokoyama M, Ishioka J, Saito K, Kihara K, Fujii Y
  • Organizer: Annual Congress of the European Association of Urology
  • Int'l Joint Research
• [Presentation] Predictive significance of MRI-targeted biopsy for pathological and oncological outcomes after radical prostatectomy (2018)
  • Author(s): Matsuoka Y, Tanaka H, Kimura T, Waseda Y, Uehara S, Yasuda Y, Kijima T, Yoshida S, Yokoyama M, Ishioka J, Saito K, Kihara K, Fujii Y
  • Organizer: International Symposium on Focal Therapy and Imaging in Prostate and Kidney Cancer
  • Int'l Joint Research
• [Presentation] Characteristics of MRI staging using PI-RADS version 2 and its predictive performance for biochemical recurrence after radical prostatectomy compared to PI-RADS version 1 (2017)
  • Author(s): Matsuoka Y, Ishioka J, Tanaka H, Kimura T, Inoue M, Ito M, Kijima T, Yoshida S, Yokoyama M, Saito K, Kihara K, Fujii Y
  • Organizer: Annual Congress of the European Association of Urology
  • Place of Presentation: ロンドン（イギリス）
  • Year and Date: 2017-03-24
  • Int'l Joint Research
• [Presentation] Risk assessment for undertreatment in focal therapy and its applicability to intermediate- and high-risk prostate cancer (2016)
  • Author(s): Matsuoka Y, Saito K, Numao N, Tanaka H, Inoue M, Ito M, Yoshida S, Yokoyama M, Ishioka J, Fujii Y, Kihara K
  • Organizer: International Symposium on Focal Therapy and Imaging in Prostate & Kidney Cancer
  • Place of Presentation: ダーラム（アメリカ）
  • Year and Date: 2016-06-23
  • Int'l Joint Research
• [Presentation] Applicability analysis of focal therapy to intermediate- and high-risk prostate cancer (2016)
  • Author(s): Matsuoka Y, Numao N, Saito K, Tanaka H, Inoue M, Ito M, Yoshida S, Yokoyama M, Ishioka J, Fujii Y, Kihara K
  • Organizer: Annual meeting of the American Urological Association
  • Place of Presentation: サンディエゴ（アメリカ）
  • Year and Date: 2016-05-06
  • Int'l Joint Research
• [Presentation] Impact of prebiopsy magnetic resonance imaging (MRI) on preoperative risk stratification for biochemical recurrence after radical prostatectomy (2016)
  • Author(s): Matsuoka Y, Ishioka J, Tanaka H, Nakayama T, Inoue M, Ito M, Yoshida S, Yokoyama M, Numao N, Saito K, Fujii Y, Kihara K
  • Organizer: Annual meeting of the American Urological Association
  • Place of Presentation: サンディエゴ（アメリカ）
  • Year and Date: 2016-05-06
  • Int'l Joint Research
• [Presentation] Impact of the Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) on the assessment of extracapsular extension in prostate cancer: A multireader study (2016)
  • Author(s): Matsuoka Y, Ishioka J, Tanaka H, Inoue M, Ito M, Yoshida S, Yokoyama M, Numao N, Saito K, Fujii Y, Kihara K
  • Organizer: Annual meeting of the American Urological Association
  • Place of Presentation: サンディエゴ（アメリカ）
  • Year and Date: 2016-05-06
  • Int'l Joint Research
• [Presentation] Impact of PI-RADS version 2 on MRI diagnosis for extracapsular extension of prostate cancer: A multireader study (2016)
  • Author(s): Matsuoka Y, Ishioka J, Tanaka H, Inoue M, Ito M, Yoshida S, Yokoyama M, Numao N, Saito K, Fujii F, Kihara K
  • Organizer: Annual Congress of the European Association of Urology
  • Place of Presentation: ミュンヘン（ドイツ）
  • Year and Date: 2016-03-11
  • Int'l Joint Research
• [Presentation] Eligibility analysis for focal therapy based on prostatectomy findings: Does intermediate-risk cancer have a higher likelihood of undertreatment than low-risk cancer? (2015)
  • Author(s): Matsuoka Y, Numao N, Saito K, Tanaka H, Ito M, Yoshida S, Yokoyama M, Ishioka J, Fujii Y, Kihara K
  • Organizer: International Symposium on Focal Therapy and Imaging in Prostate and Kidney Cancer
  • Place of Presentation: アムステルダム（オランダ）
  • Year and Date: 2015-06-21
  • Int'l Joint Research