Photon-Counting Computed Tomography-Based Urethral Visualization Without Catheterization for Radiotherapy Planning: A Prospective Pilot Study Under ANTHEM (PURE-CT/ANTHEM)
In prostate cancer radiotherapy, it is important to accurately identify and protect healthy organs near the prostate. One of these structures is the urethra, the tube that carries urine from the bladder out of the body. If the urethra receives too much radiation, patients may experience urinary side effects.
Current CT scans used for treatment planning do not clearly show the urethra unless a urinary catheter is inserted. While a catheter can improve visibility, it may cause discomfort, increase the risk of infection, and slightly change the natural position of the urethra. MRI scans can also help visualize the urethra, but they are not always available and may not fit easily into all treatment workflows.
Photon-counting CT (PCCT) is a new type of CT scanner that produces higher-quality images with better detail. This technology may allow doctors to see the urethra without using a catheter.
The purpose of this pilot study is to investigate whether PCCT can reliably visualize the urethra in prostate cancer patients without the need for catheter insertion. If successful, this approach could make treatment planning more comfortable and less invasive while helping doctors better protect healthy tissues during radiotherapy.
調査の概要
研究の種類
入学 (推定)
連絡先と場所
研究連絡先
- 名前：Ciro Franzese, MD, Radiation Oncologist
- 電話番号：+39 0282247454
- メール：ciro.franzese@hunimed.eu
研究連絡先のバックアップ
- 名前：Laura Bonavita, Master degree
- 電話番号：+39 0282247026
- メール：laura.bonavita@humanitas.it
研究場所
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Milan
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Rozzano、Milan、イタリア、20089
- 募集
- Irccs Humanitas Research Hospital
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コンタクト：
- Ciro Franzese, MD, Radiation Oncologist
- 電話番号：+39 0282247454
- メール：ciro.franzese@hunimed.eu
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コンタクト：
- Laura Bonavita, Master degree
- 電話番号：+39 0282247026
- メール：laura.bonavita@humanitas.it
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-
参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- Prostate cancer candidate to radiotherapy
- Written informed consent.
- Eligibility for urethral catheter placement according to institutional practice
Exclusion Criteria:
- Active or suspected urinary tract infection.
- Known urethral stricture or recent urethral surgery
- Contraindication to catheter placement.
研究計画
研究はどのように設計されていますか？
デザインの詳細
この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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quality of imaging
時間枠：Day of TC acquisition
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Quantitative quality of prostatic urethra contouring on non-catheter photon-counting CT, assessed using spatial overlap and boundary agreement metrics, specifically the Dice similarity coefficient (DSC) and the 95th percentile Hausdorff distance (HD95), with corresponding confidence intervals.
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Day of TC acquisition
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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evaluate inter-observer agreement of urethral contours generated on non-catheter PCCT
時間枠：immediately after TC acquisition
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Inter-observer agreement assessed using spatial overlap and distance-based metrics (DSC and HD95).
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immediately after TC acquisition
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compare non-catheter urethral contours with catheter-based reference contours
時間枠：immediately after TC acquisition
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Agreement between non-catheter and catheter-based contours using spatial and geometric metrics (DSC and HD95).
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immediately after TC acquisition
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assess contouring confidence and contouring time across different PCCT reconstruction approaches
時間枠：immediately after TC acquisition
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Contour confidence score and contour time compared to standardized clinical times
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immediately after TC acquisition
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explore segmental urethral visualization along its anatomical course.
時間枠：immediately after TC acquisition
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evaluating segment-specific visualization quality through image quality parameters and artifacts affecting visualization
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immediately after TC acquisition
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Quantitative contour-derived parameters
時間枠：immediately after TC acquisition
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explore quantitative imaging and contour-derived parameters related to urethral conspicuity and reproducibility
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immediately after TC acquisition
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協力者と研究者
出版物と役立つリンク
一般刊行物
- Willemink MJ, Persson M, Pourmorteza A, Pelc NJ, Fleischmann D. Photon-counting CT: Technical Principles and Clinical Prospects. Radiology. 2018 Nov;289(2):293-312. doi: 10.1148/radiol.2018172656. Epub 2018 Sep 4.
- Shah KD, Zhou J, Roper J, Dhabaan A, Al-Hallaq H, Pourmorteza A, Yang X. Photon-counting CT in cancer radiotherapy: technological advances and clinical benefits. Phys Med Biol. 2025 May 16;70(10):10TR01. doi: 10.1088/1361-6560/add4ba.
- Yoshimura T, Okubo K, Takase Y, et al. Visualizing the urethra by magnetic resonance imaging without catheterization: Post-urination MRI technique. European Journal of Radiology Open. 2021 Jul;8:100382
- Ong WL, Allan Hupman M, Davidson M, Ruschin M, Detsky J, Liu S, Vesprini D, Loblaw A. Urethra contouring on computed tomography urethrogram versus magnetic resonance imaging for stereotactic body radiotherapy in prostate cancer. Clin Transl Radiat Oncol. 2023 Dec 30;45:100722. doi: 10.1016/j.ctro.2023.100722. eCollection 2024 Mar.
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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