Development of radiation therapy treatment planning techniques for prostate cancer with non-invasive urethra visualization method using MRI

• Project/Area Number: 18K15577
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 52040:Radiological sciences-related
• Research Institution: Hokkaido University
• Principal Investigator: Yoshimura Takaaki 北海道大学, 保健科学研究院, 助教 (70807742)
• Project Period (FY): 2018-04-01 – 2022-03-31
• Project Status: Completed (Fiscal Year 2021)
• Budget Amount: ¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000); Fiscal Year 2021: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000); Fiscal Year 2020: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000); Fiscal Year 2019: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000); Fiscal Year 2018: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
• Keywords: MRI / 放射線治療計画 / 前立腺癌 / 尿道 / スポットスキャニング陽子線治療 / TCP/NTCP / 動体追跡陽子線治療 / 治療プロセス / 医学物理 / NTCPモデル

Outline of Final Research Achievements

Urethra-sparing radiation therapy for localized prostate cancer can reduce the risk of radiation-induced genitourinary toxicity by intentionally underdosing the periurethral transitional zone. We proposed a method using post-urination high resolution T2-weighted 3.0 T MRI (PU-MRI) in urethra-sparing treatment planning. Our results demonstrated that the inter-operator prostatic urinary tract Region of Interest (ROI) matched with a high accuracy, not only in CT with a urethral catheter, but also in PU-MRI. Thus, PU-MRI is useful in identifying the urethra non-invasively, without using a urethral catheter. Moreover, compared with the conventional clinically applied plans, urethra-sparing proton therapy have potential clinical advantages and may reduce the risk of genitourinary toxicities, while maintaining the same tumor control probability and normal tissue complication probability in the rectum and bladder. And there were expectations for the promotion of future research.

Academic Significance and Societal Importance of the Research Achievements

本研究では、トイレで排尿直後にMRIを撮影することによって、従来の侵襲的に尿道カテーテルを挿入することによる尿道同定法における課題であった感染リスクや患者の心理的負担を取り除くことができる非侵襲的な尿道同定法を提案した。さらに、本研究で提案した尿道同定法で同定された尿道に対する線量を下げた治療計画をシミュレーションすることにより、現在臨床で用いられている治療計画と同等の腫瘍制御確率、直腸と膀胱の正常組織障害発生確率を維持しながら、尿道の障害発生確率のみを有意に低減できることを示した。本研究の成果は、患者の負担が少ない放射線治療法として普及することが期待され、社会的意義あるものであったと考える。

Research Products

• [Journal Article] Visualizing the urethra by magnetic resonance imaging without usage of a catheter for radiotherapy of prostate cancer (2021)
  • Author(s): Yoshimura Takaaki、Nishioka Kentaro、Hashimoto Takayuki、Fujiwara Taro、Ishizaka Kinya、Sugimori Hiroyuki、Kogame Shoki、Seki Kazuya、Tamura Hiroshi、Tanaka Sodai、Matsuo Yuto、Dekura Yasuhiro、Kato Fumi、Aoyama Hidefumi、Shimizu Shinichi
  • Journal Title: Physics and Imaging in Radiation Oncology Volume: 18 Pages: 1-4
  • DOI: 10.1016/j.phro.2021.03.002
  • Peer Reviewed / Open Access
• [Journal Article] A treatment planning study of urethra-sparing intensity-modulated proton therapy for localized prostate cancer (2021)
  • Author(s): Yoshimura Takaaki、Nishioka Kentaro、Hashimoto Takayuki、Seki Kazuya、Kogame Shouki、Tanaka Sodai、Kanehira Takahiro、Tamura Masaya、Takao Seishin、Matsuura Taeko、Kobashi Keiji、Kato Fumi、Aoyama Hidefumi、Shimizu Shinichi
  • Journal Title: Physics and Imaging in Radiation Oncology Volume: 20 Pages: 23-29
  • DOI: 10.1016/j.phro.2021.09.006
  • Peer Reviewed / Open Access
• [Journal Article] Are simple verbal instructions sufficient to ensure that bladder volume does not deteriorate prostate position reproducibility during spot scanning proton therapy? (2021)
  • Author(s): Nishioka Kentaro、Gotoh Kento、Hashimoto Takayuki、Abe Takashige、Osawa Takahiro、Matsumoto Ryuji、Yokota Isao、Katoh Norio、Kinoshita Rumiko、Yasuda Koichi、Yakabe Toshiaki、Yoshimura Takaaki、Takao Seishin、Shinohara Nobuo、Aoyama Hidefumi、Shimizu Shinichi、Shirato Hiroki
  • Journal Title: BJR|Open Volume: 3 Issue: 1
  • DOI: 10.1259/bjro.20210064
  • NAID: 120007171672
  • Peer Reviewed / Open Access
• [Journal Article] Quantitative analysis of treatments using real‐time image gated spot‐scanning with synchrotron‐based proton beam therapy system log data (2020)
  • Author(s): Yoshimura Takaaki、Shimizu Shinichi、Hashimoto Takayuki、Nishioka Kentaro、Katoh Norio、Taguchi Hiroshi、Yasuda Koichi、Matsuura Taeko、Takao Seishin、Tamura Masaya、Tanaka Sodai、Ito Yoichi M.、Matsuo Yuto、Tamura Hiroshi、Horita Kenji、Umegaki Kikuo、Shirato Hiroki
  • Journal Title: Journal of Applied Clinical Medical Physics Volume: 21 Issue: 12 Pages: 10-19
  • DOI: 10.1002/acm2.13029
  • Peer Reviewed / Open Access
• [Journal Article] The urethral position may shift due to urethral catheter placement in the treatment planning for prostate radiation therapy (2019)
  • Author(s): Dekura Yasuhiro、Nishioka Kentaro、Hashimoto Takayuki、Miyamoto Naoki、Suzuki Ryusuke、Yoshimura Takaaki、Matsumoto Ryuji、Osawa Takahiro、Abe Takashige、Ito Yoichi M.、Shinohara Nobuo、Shirato Hiroki、Shimizu Shinichi
  • Journal Title: Radiation Oncology Volume: 14 Issue: 1 Pages: 226-226
  • DOI: 10.1186/s13014-019-1424-8
  • Peer Reviewed / Open Access
• [Journal Article] Analysis of treatment process time for real‐time‐image gated‐spot‐scanning proton‐beam therapy (RGPT) system (2019)
  • Author(s): Yoshimura Takaaki、Shimizu Shinichi、Hashimoto Takayuki、Nishioka Kentaro、Katoh Norio、Inoue Tetsuya、Taguchi Hiroshi、Yasuda Koichi、Matsuura Taeko、Takao Seishin、Tamura Masaya、Ito Yoichi M.、Matsuo Yuto、Tamura Hiroshi、Horita Kenji、Umegaki Kikuo、Shirato Hiroki
  • Journal Title: Journal of Applied Clinical Medical Physics Volume: 21 Issue: 2 Pages: 38-49
  • DOI: 10.1002/acm2.12804
  • Peer Reviewed / Open Access
• [Presentation] The Impact of Daily Urinary Volume Variations and Prostate Volume on Prostate Position During Radiotherapy. (2021)
  • Author(s): Nishioka K, Hashimoto T, Yokota I, Katoh N, Kinoshita R, Yasuda K, Takao S, Yoshimura T, Aoyama T, Shimizu S
  • Organizer: The 80th Annual meeting of the Japan Radiological Society
• [Presentation] Dosimetric impact of the adaptive planning frequency for IMPT of prostate cancer using daily in-room CT images (2021)
  • Author(s): Tamura H, Maeda Y, Nishioka K, Yoshimura T, Hashimoto T, Shimizu S, Sasaki M, Yamamoto K, Tamamura H, Aoyama H, Shirato H
  • Organizer: The 9th Korea-Japan Joint Meeting on Medical Physics
  • Int'l Joint Research
• [Presentation] Urethra-sparing intensity modulated proton therapy for localized prostate cancer woith non-invassive urethra visualization method (2021)
  • Author(s): Yoshimura T
  • Organizer: The 5th FHS International Conference
  • Int'l Joint Research / Invited
• [Presentation] Preliminary study of methods for estimating Gleason score using deep learning (2021)
  • Author(s): Manabe K, Yoshimura T, Yamada T, Asammi Y, Sugimori H
  • Organizer: The 5th FHS International Conference
  • Int'l Joint Research
• [Presentation] Deep learning を用いた前立腺がん検出の精度向上に関する基礎的検討 (2021)
  • Author(s): Manabe K, Yoshimura T, Yamada T, Asami Y, Sugimori H
  • Organizer: 第49回日本放射線技術学会秋季学術大会
• [Presentation] Evaluation of visualizing the prostatic urinary tract in MRI with a super resolution deep learning model for urethra sparing radiotherapy (2021)
  • Author(s): Yoshimura T, Nishioka K, Hashimoto T, Kogame S, Seki K, Sugimori H, Yamashina H, Kato F, Aoyama H, Kudo K, Shimizu S
  • Organizer: The 63rd Annual meeting for American Society for Radiation Oncology (ASTRO)
  • Int'l Joint Research
• [Presentation] Urethra Sparing Intensity Modulated Proton Therapy for Localized Prostate Cancer: A simulation study (2021)
  • Author(s): Seki K, Yoshimura T, Nishioka K, Hashimoto T, Kogame S, Tanaka S, Kanehira T, Tamura M, Takao S, Matsuura T, Kobashi K, Kato F, Aoyama H, Shimizu S
  • Organizer: 日本放射線腫瘍学会第34回学術大会
• [Presentation] Dose Volume Statistics of daily adaptive IMPT for prostate cancer using daily in-room CT images (2021)
  • Author(s): Tamura H, Maeda Y, Nishioka K, Kobashi K, Yoshimrua T, Hashimoto T, Shimizu S, Sasaki M, yamamoto K, Tamamura H, Aoyama H, Shirato H
  • Organizer: Dose Volume Statistics of daily adaptive IMPT for prostate cancer using daily in-room CT images. 日本放射線腫瘍学会第34回学術大会
• [Presentation] Visualizing the prostatic urinary tract with post-urination MRI: Inter-operator contouring accuracy (2020)
  • Author(s): Yoshimura T, Nishioka K, Hashimoto T, Fujiwara T, Ishizaka K, Sugimori H, Kogame S, Seki K, Tamura H, Tanaka S, Matsuo Y, Dekura Y, Kato F, Aoyama H, Shimizu S
  • Organizer: 第33回日本放射線腫瘍学会
• [Presentation] Quantitative analysis of treatment process flow using real-time-image gated-spot-scanning proton-beam delivery log system (2019)
  • Author(s): Yoshimura T, Tanaka S, Shimizu S, Hashimoto T, Katoh N, Matsuura T, Takao S, Matsuo Y, Tamura H, Shirato H
  • Organizer: 58th Annual Meeting for the Particle Therapy Co-operative Group (PTCOG)
  • Int'l Joint Research
• [Presentation] 北海道大学病院における強度変調陽子線治療(IMPT)の経験 (2018)
  • Author(s): Yoshimura T, Shimizu S, Hashimoto T, NIshioka K, Katoh N, Yasuda K, Matsuura T, Takao S, Tamura M, Matsuo Y, Horita K, Nannkumo J, Tamura H, Umegaki K, Shirato H
  • Organizer: 第15回日本粒子線治療臨床研究会
• [Presentation] Analysis of Beam Delivery Times and Dose Rates for the Treatment of Mobile Tumors Using Real Time Image Gated Spot-Scanning Proton Beam Therapy (2018)
  • Author(s): Shimizu S, Yoshimura T, Katoh N, Inoue T, Hashimoto T, Nishioka K, Takao S, Matsuura T, Miyamoto N, Ito M. Y, Umegaki K, Shirato H
  • Organizer: The 60th Annual meeting for American Society for Radiation Oncology (ASTRO)
  • Int'l Joint Research
• [Presentation] Big Data Analysis of Treatment Process Time for the Real-time-image Gated-spot-scanning Proton-beam Therapy (RGPT) System (2018)
  • Author(s): Yoshimura T, Shimizu S, Hashimoto T, Katoh N, Inoue T, Nishioka K, Matsuura T, Takao S, Tamumra M, Tamura H, Horita K, Umegaki K, Shirato H
  • Organizer: The 60th Annual meeting for American Society for Radiation Oncology (ASTRO)
  • Int'l Joint Research