Article Figures & Data
Figures
- FIGURE 1.
Flow diagram of image data, showing how planning CT was registered with simultaneously acquired dual-isotope 99mTc-labeled RBC SPECT and 111In-mAb RIS scans, enabling the projection of CTVRIS into the planning CT scan for assistance in modifying CTVpre to define CTVpost.
- FIGURE 2.
Axial images of planning CT showing the use of RIS in modifying the prostate-bed CTV. Normal structures: bladder (blue), and rectum (green). (A) The CTVpre (red) was entered before the RIS/CT fusion. CTVRIS (yellow) is the projection of the delineated uptake on the RIS scan into the planning CT. (B) CTVRIS was used to modify CTVpre to define CTVpost (aqua). In this case, CTVpost is the union of CTVpre and CTVRIS in A.
- FIGURE 3.
Dose volume histogram dosimetric endpoints for bladder and rectum. AUC = hatched area.
- FIGURE 4.
Kaplan–Meier curve displaying biochemical failure-free survival for the cohort.
Tables
Characteristic No. of patients* (n = 25) Race Caucasian 14 African-American 7 Hispanic 2 Other 2 Prostatectomy findings Pathologic T stage pT1/T2 6 pT3 16 pT4 2 pTx 1 Grade (Gleason Score) GS 6 5 GS 7 14 GS 8 2 GS 9 2 Uncharted 2 Margins Positive 12 Negative 11 Uncharted 2 Seminal vesicle invasion Positive 6 Negative 18 Uncharted 1 Extracapsular extension Yes 17 No 7 Uncharted 1 Pelvic lymph node involvement: Yes 0 No 23 Unsampled 2 Postprostatectomy course Postprostatectomy nadir (ng/mL) PSA ≤ 0.1 10 0.1 < PSA ≤ 0.2 2 0.2 < PSA ≤ 0.3 6 0.3 < PSA ≤ 0.5 1 0.5 < PSA ≤ 1.0 2 1.0 < PSA 1 Uncharted 3 Highest postprostatectomy PSA before RT consultation (ng/mL)† PSA ≤ 0.1 2 0.1 < PSA ≤ 0.2 3 0.2 < PSA ≤ 0.3 5 0.3 < PSA ≤ 0.5 3 0.5 < PSA ≤ 1.0 5 1.0 < PSA ≤ 2.0 5 2.0 < PSA 2 Uncharted 0 RIS findings Uptake only in prostate fossa 23 Prostate fossa and pelvic node uptake 2 Extrapelvic uptake 0 No uptake 0 Treatment information‡ Volume Whole pelvis initially 2 Prostate bed for entire duration 23 Prostate bed treatment technique 4-field 2 6-field 13 IMRT 10 Final dose (Gy)§ 64.0 2 64.8 1 65.0 1 66.0 18 66.4 1 68.0 2 Patient no. Treatment volume CTVpre (cm3) CTVpost (cm3) 1 24.3 16.1 2 47.8 107.8 3 38.6 34.2 4 25.6 41.5 5 39.8 59.6 6 20.6 38.4 7 23.8 42.6 8 33.2 14.2 9 24.5 9.9 10 35.8 45.5 11 10.7 22.0 12 38.8 51.8 13 17.5 17.2 14 28.1 49.3 15 24.2 31.3 16 19.1 15.5 17 15.1 16.8 18 18.1 28.0 19 14.5 23.6 20 13.4 35.1 21 25.5 38.8 22 28.6 53.3 23 15.6 24.9 24 21.7 48.6 25 6.2 8.0 Mean ± SD* 24.4 ± 10.2 35.0 ± 21.2 ↵* P = 0.032 and was obtained using a 2-tailed t-test.
Patient no. Rectum Bladder Volume (cm3) AUCpre (Gy × cm3) AUCpost (Gy × cm3) V60pre (cm3) V60post (cm3) Volume (cm3) AUCpre (Gy × cm3) AUCpost (Gy × cm3) V60pre (cm3) V60post (cm3) 1 226.1 5,834.3 3,182.8 36.8 9.5 81.6 2,683.7 3,034.3 16.5 24.9 2 207.1 3,674.6 10,219.8 17.6 101.2 123.5 4,081.0 6,815.7 29.1 76.1 3 191.1 8,538.0 5,527.0 69.7 35.5 153.5 5,859.4 2,964.2 39.7 17.1 4 78.2 2,102.0 3,552.8 5.5 26.7 86.7 2,933.6 3,927.9 15.9 28.0 5 155.6 7,049.1 8,572.3 52.0 88.0 180.5 7,880.4 8,580.0 61.8 73.5 6 148.2 5,097.7 7,209.3 40.1 73.3 106 4,385.3 5,709.1 32.1 58.3 7 167.9 4,923.9 7,235.9 42.8 81.6 147.9 5,522.3 7,797.8 41.9 73.4 8 114.5 4,972.6 3,816.7 39.7 27.7 57.1 2,998.4 2,901.2 29.5 28.8 9 147.7 6,505.1 2,333.1 52.6 7.5 287.8 6,929.2 4,429.0 42.3 25.3 10 121.6 6,234.0 6,254.2 58.5 58.5 106.9 4,883.3 5,239.2 37.3 46.7 11 75.4 3,603.2 3,879.1 35.9 41.7 155.5 5,981.6 6,724.9 42.1 55.1 12 73.2 5,008.7 6,160.2 45.4 71.8 106.5 7,474.2 8,223.0 58.7 77.7 13 104.9 2,478.9 2,983.8 21.9 22.5 155.9 2,677.9 4,990.1 13.2 37.4 14 71.4 2,483.4 3,168.9 18.5 21.7 162 6,452.6 8,146.0 47.1 78.0 15 83.2 4,491.9 4,568.5 43.1 45.7 118.2 5,116.9 5,278.7 39.8 43.6 16 30.7 1,552.5 1,586.0 15.7 16.5 165.3 5,680.7 5,546.3 40.0 31.7 17 61.4 2,571.8 3,121.8 27.1 31.6 75.4 3,072.0 3,423.4 24.5 23.9 18 53.7 1,455.8 2,762.8 12.6 28.3 146.1 4,674.1 6,800.2 30.0 55.8 19 101.5 3,590.4 3,867.2 28.0 36.3 175.3 4,955.1 5,048.9 32.3 33.9 20 60.4 2,473.4 2,526.8 25.8 27.9 151.6 5,200.4 5,204.1 40.3 40.0 21 107.2 4,389.9 4,783.3 30.2 31.6 121.3 3,360.6 4,358.7 14.1 35.4 22 114.5 3,943.4 4,937.5 30.5 32.3 96.9 4,254.6 4,507.4 29.3 35.8 23 84.4 3,352.9 4,290.6 26.3 37.7 116.8 3,178.3 4,775.7 22.3 36.9 24 89.2 3,421.1 4,951.8 33.2 54.8 188.3 6,623.0 9,864.5 47.3 94.3 25 24.9 921.4 1,409.6 8.3 15.9 147.2 2,688.6 4,753.8 19.2 32.9 Mean ± SD NA 4,026.8 ± 1,877.9 4,516.1 ± 2,150.9 32.7 ± 15.9 41.0 ± 25.1 NA 4,781.9 ± 1,583.6 5,561.0 ± 1,873.22 33.9 ± 13.0 46.6 ± 21.3 P* NA 0.396 0.168 NA 0.119 0.015 ↵* P values obtained using 2-tailed t-test.
AUCpre = AUC using PTVpre defined by the CTVpre; AUCpost = AUC using PTVpost; V60pre = V60 using PTVpre; V60post = V60 using PTVpost; NA = not applicable.
Toxicity Rectum Bladder Acute (n = 25) Late (n = 21) Acute (n = 25) Late (n = 21) Grade 0 10 (40%) 16 (76%) 10 (40%) 12 (57%) Grade 1 6 (24%) 2 (10%) 13 (52%) 5 (24%) Grade 2 9 (36%) 3 (14%) 2 (8%) 4 (19%) Grade 3 0 (0%) 0 (0%) 0 (0%) 0 (0%) Grade 4 0 (0%) 0 (0%) 0 (0%) 0 (0%) Grade 5 0 (0%) 0 (0%) 0 (0%) 0 (0%)
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