Normalized periprostatic fat MRI measurements can predict prostate cancer aggressiveness in men undergoing radical prostatectomy for clinically localised disease

Figures

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  Figure 1. Schematic diagram explaining the concept of Normalised Periprostatic Fat Volume.

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  Figure 2. Sagittal and coronal images were used to identify the first slice at the level of the base of the prostate represented by the green lines. The yellow area represents the periprostatic fat, which was segmented from multiple sequential slices starting from this level to the prostate apex. P = Prostate gland; B = Bladder; R = Rectum; SV = Seminal Vesicle.

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  Figure 3. Segmentation technique to measure the volume of periprostatic fat (masked in yellow) from multiple sequential slices of axial T1 weighted MRIs. P = Prostate; B = Bladder; OI = Obturator internus muscle; R = Rectum; I = Ischiorectal fossa.

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  Figure 4. Measurement of subcutaneous fat thickness from the perpendicular distance between symphysis pubis and skin at the level of the superior pubic ramus on T1 weighted transverse pelvis MRI. P = Prostate gland; R = Rectum; S = Symphysis pubis; SF = Subcutaneous fat.

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  Figure 5. Abdominal fat area (masked in yellow) was measured from T1 weighted transverse abdominal MRI at the level of umbilicus using segmentation technique. L = Lumbar vertebral body; P = Psoas muscle; SF = Subcutaneous fat; U = Umbilicus; W = Abdominal wall muscles.

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  Figure 6. Prostate volume was measured from T2 weighted axial sequential images. The region of interest was marked manually from each slice using pencil starting from the level of the base of the prostate till the level of its apex. Subsequently the software automatically calculates the volume. P = Prostate gland; R = Rectum; I = Ischiorectal fossa; SP = Symphysis pubis.