Planning CT and MRI scans were performed the same day, with as short a time as possible between scans. Patients were positioned within the scanners on a couch with a flat insert to mimic a radiotherapy couch top. CT scans were performed with patients supine with knee and footstock immobilisation on a Big Bore 16 slice scanner (Philips, Amsterdam, Netherlands), 30 min after drinking 500 mL of water and emptying their rectum (using micro-enema). Scans 2 mm wide were acquired with the Clarity TPUS probe (Elekta, Stockholm, Sweden) [11] (link), [12] (link), [13] (link) in position. To replicate this on the MRI scanner, patients were scanned in the same position with a ‘dummy’ probe constructed of compatible materials in position. At this stage patients had received three to four months of Luteinizing hormone-releasing hormone (LHRH) agonist therapy.
A Siemens 3 T Magnetom Skyra (Siemens Healthineers, Erlangen, Germany) was used for the MRI scans. Multi-parametric sequences were used to determine the location/presence of DILs within the prostate (a combination of anatomical and functional MRI sequences) as recommended in the ESUR prostate MRI guidelines 2012 [14] (link) and elsewhere including the FLAME study [6] (link).
A Siemens 3 T Magnetom Skyra (Siemens Healthineers, Erlangen, Germany) was used for the MRI scans. Multi-parametric sequences were used to determine the location/presence of DILs within the prostate (a combination of anatomical and functional MRI sequences) as recommended in the ESUR prostate MRI guidelines 2012 [14] (link) and elsewhere including the FLAME study [6] (link).