UCSF

Prostate cancer is extremely common. With recent advancements in cancer detection, an increasing number of men at a younger age face the difficult choice between delaying potentially life-saving interventions and seeking curative treatments, which are typically accompanied by a host of side effects. Non-invasive disease characterization is a promising step toward identifying patient-specific cancer management strategies. Due to the excellent performance of anatomic imaging and the ability to characterize physiologic properties via functional imaging modalities, multiparametic magnetic resonance imaging (mpMRI) has the potential to make a significant impact on the way prostate cancer is viewed by both patients and clinicians.

This thesis will introduce multiparametric MR imaging in the context of prostate anatomy. It will address the issues of aligning MR imaging to the whole-mount histopathology images (commonly regarded as a reference standard) and discuss characterization and stratification of prostatic lesions based on mpMR imaging. This work will also introduce a semi-automatic approach to lesion segmentation on histopathology and report on the prostate cancer composition in the radical prostatectomy population. Furthermore, this thesis will investigate the prevalence of “sparse” prostatic lesions, discussing their clinical significance and exploring mpMRI capabilities to detect these cancers. Finally, this work will examine the influence of prostate treatments, specifically 5-alpha reductase inhibitors (often used to treat benign prostatic hyperplasia), on the structure of prostatic tissues, their effect on the appearance of prostatic tissues on mpMRI, and what role such treatments play in our ability to properly detect malignancies post treatment.