Clinical translation of VERDICT MRI biomarkers for Prostate Cancer characterisation.
Doctoral thesis (Ph.D), UCL (University College London).
Access restricted to UCL open access staff until 1 June 2023.
Prostate Cancer is the second most common cancer worldwide and the second most common cause of cancer death among men in the UK. The introduction of multiparametric magnetic resonance imaging (mpMRI) in the diagnostic pathway in the last 10 years has helped reduce the over-diagnosis of clinically insignificant prostate cancer whilst still detecting clinically significant cancer (csPCa). However, mpMRI is not a perfect test and has important shortcomings. The specificity of mpMRI is modest at 37% due to indeterminate appearances caused by benign pathologies. This causes men to undergo unnecessary invasive biopsies that are negative for cancer. Therefore, there is a need for biomarkers that can aid the assessment of MRI for prostate cancer.
In this thesis, I evaluate whether quantitative imaging biomarkers (QIBs) derived from VERDICT MRI (Vascular, Extracellular and Restricted Diffusion for Cytometry in Tumours) can add more value in classifying which men have csPCa when compared to biomarkers derived from mpMRI in a cohort of men suspected to have prostate cancer.
I first analyse the performance of the current diagnostic pathway in a prospective cohort and identify in which participants there is a need for additional biomarkers. I then compare the diagnostic accuracy of VERDICT QIBs to mpMRI QIBs in differentiating men with csPCa to those without in men who underwent biopsy in the prospective cohort. I also assess the image quality and inter-reader agreement of the most promising VERDICT parameter map when qualitatively assessed by radiologists.
Finally, I identify whether there is a clinical need for biomarkers in monitoring response to hormonal and radiotherapy in patients with locally aggressive prostate cancer. Subsequently, I study the changes in VERDICT QIBs after hormonal and radiotherapy in men with biopsy-proven prostate cancer.
|Title:||Clinical translation of VERDICT MRI biomarkers for Prostate Cancer characterisation|
|Additional information:||Copyright © The Author 2022. 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.|
|Keywords:||Prostate Cancer, MRI, VERDICT MRI, Prostate Biopsy|
|UCL classification:||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
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
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