What references do you use for multi-parametric MRI delineation of the GTV in prostate cancer for prostate nodule?

Topics: Radiation Oncology • Genitourinary Cancers • Prostate Cancer

Specifically, in the TZ and PZ? What references do use for prostate nodule boost as done in FLAME trial?

Hypointensities are contoured on T2W MRI with corresponding abnormal DWI and ADC and high B-Val. Radiologists can also use DCE which may be difficult with the sequences given to the physician. Additionally, if there is a lenticular hypointense lesion in the AFMS or TZ with DWI changes, that is contoured.

Answer from: Radiation Oncologist at Academic Institution

In FLAME, the boost volume was the GTV on mpMRI as judged by the treating physician without any formal contouring guidelines (Kerkmeijer et al., PMID 33471548). There were differences in MRI protocols and physician judgement resulting in significant differences in tumor volumes between centers (van ...

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Radiation Oncologist at Lafayette Radiation Center
Been doing FLAME for 2 years. Prob 3-400. Agree wi...

Radiation Oncologist at RadiantCare
Very helpful. What dose/fx and expansion on GTV no...

Answer from: Radiation Oncologist at Academic Institution

This is an important question because FLAME did something quite remarkable in oncology: demonstrate a DFS benefit *without* increasing toxicity. We would, of course, want all eligible patients to benefit from this result and approach. But even radiologists need a lot of training to accurately identi...

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Radiation Oncologist at Sletten Center Radiation Therapy
In the community, we are looking for an MRI techni...

Radiation Oncologist at UC San Diego
Yes, good point. Foley is suboptimal for multiple ...

Radiation Oncologist at Sletten Center Radiation Therapy
Thanks very much. My question also arose out of th...

Radiation Oncologist at Anderson Regional Cancer Center
How would you approach a PIRADS 5 lesion that is d...

Radiation Oncologist at National Institutes of Health Clinical Center
I normally only boost MRI-visible lesions which I ...

Radiation Oncologist at Varian Medical Systems/Allegheny health network
A word of caution as NRG-GU010 allows SIB with hig...

Radiation Oncologist at UC San Diego
Like @Krishnan Patel, I do not try to boost MRI-in...

Radiation Oncologist at Sequoia Radiation Oncology Services, Inc
Does everyone recommend or use fiducials with a FL...

Radiation Oncologist at National Institutes of Health Clinical Center
There may be several appropriate fractionation sch...

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