Volume 194, Issue 2, Pages (August 2015)

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Volume 194, Issue 2, Pages 364-370 (August 2015) Image Guided Focal Therapy for Magnetic Resonance Imaging Visible Prostate Cancer: Defining a 3-Dimensional Treatment Margin Based on Magnetic Resonance Imaging Histology Co-Registration Analysis Julien Le Nobin, Andrew B. Rosenkrantz, Arnauld Villers, Clément Orczyk, Fang-Ming Deng, Jonathan Melamed, Artem Mikheev, Henry Rusinek, Samir S. Taneja The Journal of Urology Volume 194, Issue 2, Pages 364-370 (August 2015) DOI: 10.1016/j.juro.2015.02.080 Copyright © 2015 American Urological Association Education and Research, Inc. Terms and Conditions

Figure 1 MRI lesion encompassed by histological lesion. Red outline indicates histological boundary. Small 2-headed arrows indicate HD. Large 2-headed arrows indicate Hausdorff Max. The Journal of Urology 2015 194, 364-370DOI: (10.1016/j.juro.2015.02.080) Copyright © 2015 American Urological Association Education and Research, Inc. Terms and Conditions

Figure 2 Focal treatment simulations using theoretical cylinders to define treatment zone. A, axial T2WI of prostate shows right posterolateral lesion corresponding to dominant tumor on radical prostatectomy (arrow). B, MRI lesion boundaries (blue overlay). C, MRI lesion (blue overlay) superimposed on histological lesion (red overlay). D, MRI lesion (inner overlay) encompassed by cylinder estimating MRI based treatment zone (outer overlay). E, superimposition of MRI lesion (inner overlay), histological lesion (middle overlay) and cylinder estimating treatment zone to achieve complete histological destruction (outer overlay). F, superimposition of MRI based (inner overlay) and histological based (outer overlay) treatment cylinders The Journal of Urology 2015 194, 364-370DOI: (10.1016/j.juro.2015.02.080) Copyright © 2015 American Urological Association Education and Research, Inc. Terms and Conditions

Figure 3 Maximum HD between MRI and registered histology stratified by tumor characteristics. Diam, lesion diameter. The Journal of Urology 2015 194, 364-370DOI: (10.1016/j.juro.2015.02.080) Copyright © 2015 American Urological Association Education and Research, Inc. Terms and Conditions

Figure 4 Maximum HD expressed as percent of MRI tumor diameter on T2WI. All data points fall within 9 mm curve. Each point represents 1 patient. Horizontal lines represent mean ± 95% CI of maximum HD. A, in all 46 lesions. Curves represent hypothetical treatment margins around lesion with given MRI diameter when applying 9, 5 and 1 mm treatment margins in cohort. B, in 32 lesions with high MRI SS of 4 or 5. Curve represents hypothetical treatment margins around lesion with given MRI diameter when applying 9 mm treatment margins in subset. The Journal of Urology 2015 194, 364-370DOI: (10.1016/j.juro.2015.02.080) Copyright © 2015 American Urological Association Education and Research, Inc. Terms and Conditions