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2089094 3d Imaging Of Prostate Cancer Active Surveillance
Abstracts 2089094 3d Imaging Of Prostate Cancer Active Surveillance Robert Bard, Bard Cancer Center, New York, NY, United States Objectives: To show Doppler sonography vessel density imaging responses to antioxidant therapies. Methods: 111 patients treated with antioxidant supplement therapies composed of beta sitosterol, resveratrol, Co Q-10 and herbal antioxidants were followed over a four year period with prostate cancer were prospectively scanned with a GE Voluson unit 18 mhz probe employing conventional 3D/4D imaging uand glass body power Doppler image reconstruction. 88 patients had gleason 3, 23 had gleason 4. Follow up at 6, 12, 18, 24, 30 and 36 months was obtained. Vessel index was assessed on sonography by 3D histogram analysis and by DCE-MRI. Follow up biopsies were obtained shortly after imaging studies which occurred on a 6 month basis. Results: Gleason grade 3 (low grade): 72/88 patients had decreased vascular indices indicated positive response to the protocol. PSA lowering was noted. Gleason grade 4 (high grade): 10/23 patients had decreased vascular indices indicated positive response to the protocol. PSA lowering was noted. 5 patients were stable. 8 patients showed disease progression and PSA rise indicating negative response to the protocol. DCE-MRI confirmed all ultrasound tumor vascular findings. Biopsy correlation was good. Capsular erosion was present in 23/23 of gleason 4. Conclusions: Patients with capsular erosion demonstrated 3 x incidence of bone mets and 2x incidence of perirectal lymphadenopathy. Since bone metastases are difficult to image on some standard MRI protocols, DCE may highlight abnormal neovascularity. 70/72 patients responding to antioxidant therapies did not develop extracapsular disease. 2089097 Effect of Benign Calcifications Of Breast Masses On Shear Wave Elastography Adriana Gregory,1 Mohammad Mehrmohammadi,1,2 Max Denis,1 Mahdi Bayat,1 Mostafa Fatemi,1 Azra Alizad1,3 1 Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN, United States, 2Biomedical Engineering, Wayne State University, Detroit, MI, United States, 3Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN, United States Objectives: To quantify the bias generated by benign breast calcifications on shear-wave elastography images. Methods: The shear elasticity imaging technique used for our study was Focused Comb-push Ultrasound Shear Elastography (F-CUSE). We divided our study into 2 parts. The first part included 3 phantom experiments designed to evaluate the behavior of shear-waves in the presence of different configurations of calcifications. We used kidney stones to simulate benign breast calcifications, as their chemical composition is similar (calcium oxalate monohydrate). We used kidney stones in two forms: (a) intact, to simulate large calcifications, and (b) crushed, to simulate a cluster of microcalcifications. In part (b) we dispersed the crushed particles in volumes to obtain different concentrations. The kidney stones were imbedded in tissue-mimicking gel phantoms. The second part of our study included the data analysis from 6 different breast patients with benign masses where the initial B-mode ultrasound and mammography reports showed masses containing calcifications. Results: The phantom study showed that a single intact calcification with a radius greater than 1 mm is capable of generating significant shear-wave distortions in the form of areas with high shear wave speed (high stiffness) on and around the calcified area, and a single calcification with a radius of 1.5 mm or higher can produce stiffness value that reaches 192 KPa (8 m/s), which is the maximum of the display scale. The results of the study on crushed kidney stones (simulating microcalcification cluster) showed that the apparent Young’s modulus is higher for higher concentrations of microcalcifications.
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For three of the six patients with calcified masses, the results of F-CUSE imaging technique showed high Young’s modulus on and around the mass area, which could be classified as malignant lesions. Conclusions: The results from our study demonstrate that the presence of clustered and large or coarse calcifications in benign breast masses can induce the appearance of high stiffness regions when they are evaluated by shear-wave elastography methods, and consequently such masses can be misdiagnosed as malignant. More patient studies are necessary to validate our results. 2089103 Anatomy of The Optic Nerve Cribriform Plate Robert Bard, Bard Cancer Center, New York, NY, United States Objectives: determine normal depths and follow changes in progress of glaucoma. Irregularities of the cribriform plate at the optic nerve head occurs with glaucoma and have been documented with Optical Computed Tomography. Methods: 18 normals and 18 patients with glaucoma were prospectively scanned with a ge voluson 17 mhz 3D probe and 20 MHz linear probe with 0.1 mm axial resolution. Measurements were taken of the trilaminar structure. The plate had normal through transmission while optic nerve head Drusen showed shadowing consistent with calcification. Results: normal values; plate is 500 microns with center 200 microns. Abnormal center plate measured 100 microns and/or contour irregularities. The cribriform plate is an echogenic structure with a central echo poor region and may be mistaken for optic nerve head drusen. Conclusions: Glaucoma may produce changes in the cribriform plate at the optic nerve head. The plate may be differentiated from Drusen of the optic nerve by through transmission patterns. 2089110 The Epidermis In Health And Psoriasis Robert Bard, Bard Cancer Center, New York, NY, United States Objectives: determine normal depths and follow changes in progress of psoriasis. Methods: 68 patients with psoriasis were prospectively scanned with a ge voluson 17 mhz 3D probe and 20 MHz linear probe. Doppler imaging was performed. Results: normal values are presented by site anatomically. Epidermal thickening reflected healing. Doppler neovascularity decreased as healing progressed with interval epidermal thickening. Conclusions: Post treatment thickening was noted in healing psoriasis. Epidermal thickness, fibrosis and melanin content may affect certain laser treatments. 2089114 Vascular Mapping of Melanoma Locoregional Metastases Robert Bard, Bard Cancer Center, New York, NY, United States Objectives: To Compare The Accuracy Of 3d Power Doppler Sonography (3d-Pds) Mapping Of Malignant Melanoma/Adenopathy With Pet/Ct Methods: 99 Patients With Malignant Adenopathy Were Pre And Post Treatment Scanned With A 20 Mhz Linear Probe With 3d Doppler Image Reconstruction. Vascular Index Percentage Of Vessel Neovascularity Was Followed Using Computed Histogram Vessel Analysis. Patients Were Simultaneously Imaged By Dce-Mri And/Or Pet/Ct Scans. 18 Patients Had Malignant Melanoma With Locoregional Spread Results: Vascular Patterns Reflect Invasive Tumor Potential.
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For three of the six patients with calcified masses, the results of F-CUSE imaging technique showed high Young’s modulus on and around the mass area, which could be classified as malignant lesions. Conclusions: The results from our study demonstrate that the presence of clustered and large or coarse calcifications in benign breast masses can induce the appearance of high stiffness regions when they are evaluated by shear-wave elastography methods, and consequently such masses can be misdiagnosed as malignant. More patient studies are necessary to validate our results. 2089103 Anatomy of The Optic Nerve Cribriform Plate Robert Bard, Bard Cancer Center, New York, NY, United States Objectives: determine normal depths and follow changes in progress of glaucoma. Irregularities of the cribriform plate at the optic nerve head occurs with glaucoma and have been documented with Optical Computed Tomography. Methods: 18 normals and 18 patients with glaucoma were prospectively scanned with a ge voluson 17 mhz 3D probe and 20 MHz linear probe with 0.1 mm axial resolution. Measurements were taken of the trilaminar structure. The plate had normal through transmission while optic nerve head Drusen showed shadowing consistent with calcification. Results: normal values; plate is 500 microns with center 200 microns. Abnormal center plate measured 100 microns and/or contour irregularities. The cribriform plate is an echogenic structure with a central echo poor region and may be mistaken for optic nerve head drusen. Conclusions: Glaucoma may produce changes in the cribriform plate at the optic nerve head. The plate may be differentiated from Drusen of the optic nerve by through transmission patterns. 2089110 The Epidermis In Health And Psoriasis Robert Bard, Bard Cancer Center, New York, NY, United States Objectives: determine normal depths and follow changes in progress of psoriasis. Methods: 68 patients with psoriasis were prospectively scanned with a ge voluson 17 mhz 3D probe and 20 MHz linear probe. Doppler imaging was performed. Results: normal values are presented by site anatomically. Epidermal thickening reflected healing. Doppler neovascularity decreased as healing progressed with interval epidermal thickening. Conclusions: Post treatment thickening was noted in healing psoriasis. Epidermal thickness, fibrosis and melanin content may affect certain laser treatments. 2089114 Vascular Mapping of Melanoma Locoregional Metastases Robert Bard, Bard Cancer Center, New York, NY, United States Objectives: To Compare The Accuracy Of 3d Power Doppler Sonography (3d-Pds) Mapping Of Malignant Melanoma/Adenopathy With Pet/Ct Methods: 99 Patients With Malignant Adenopathy Were Pre And Post Treatment Scanned With A 20 Mhz Linear Probe With 3d Doppler Image Reconstruction. Vascular Index Percentage Of Vessel Neovascularity Was Followed Using Computed Histogram Vessel Analysis. Patients Were Simultaneously Imaged By Dce-Mri And/Or Pet/Ct Scans. 18 Patients Had Malignant Melanoma With Locoregional Spread Results: Vascular Patterns Reflect Invasive Tumor Potential.