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FIGURE 23 Volume models from 3D MRI scan of patient with prostate cancer. Models can be viewed from any angle of view and at any scale, with or without transparency, to study preoperatively the location of the cancer relative to other critical anatomic structures, such as the urethra, seminal vesicles, and neurovascular bundles. See also Plate 122.

FIGURE 24 Volume analysis of preferentially stained histological sections of prostate gland obtained from biopsy of patient with prostate cancer. This "3D assay" provides detailed information about microvessel patterns relative to glandular structures. In this case a marked difference of microvessel architecture is noted in the normal tissue (left) versus the cancerous tissue (right). See also Plate 123.

FIGURE 24 Volume analysis of preferentially stained histological sections of prostate gland obtained from biopsy of patient with prostate cancer. This "3D assay" provides detailed information about microvessel patterns relative to glandular structures. In this case a marked difference of microvessel architecture is noted in the normal tissue (left) versus the cancerous tissue (right). See also Plate 123.

FIGURE 25 Dynamic volume models of beating heart and coronary arteries at end-diastole and end-systole (left-right) seen from opposite (180°) viewpoints (top-bottom).

3D visualization can also be applied to histological sections that have been obtained from prostate biopsies [28]. Preliminary findings show that the ratio of gland volume to vessel length (as measured in 3D reconstructions of serial microscope sections) exhibits a twofold increase between benign and malignant tumors [28]. Shown in Fig. 24 is a comparison of 3D rendered biopsy specimens from two different sites within the prostate gland in a patient with prostate cancer. The normal tissue shows a very characteristic circumferential pattern of the microvessels relative to the glandular tissue. In the region containing the adenocarcinoma, the pattern of microvessels is tortuous and radically diffused throughout the glandular volume. The volume of tissue required for the analysis is similar to that obtained via needle biopsy [75]. Therefore, a procedure of image-guided stereo-tactic biopsy may be combined with 3D analysis of the biopsy sample to (1) provide a marker for presurgical stage and outcome, (2) improve patient population stratification and eliminate unnecessary surgeries, and (3) serve as high-accuracy location and extent information to improve the outcome of necessary surgeries. The use of preacquired 3D MRI images of the pelvis to guide needle biopsy will result in fewer needle insertions being required to reliably sample a suspicious tumor. The 3D tissue analysis may provide a reliable and sensitive marker of metastatic potential, improving the confidence of surgical decisions and potentially reducing the total number of prostatectomies, particularly in elderly patients.

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