Your Donations in Action: Asona Lui, MD, PhD

Recent level I evidence has revealed that adding a radiation boost to tumors visible on MRI improves disease-free and metastasis-free prostate cancer survival without added toxicity.

However, identifying prostate tumors on MRI presents a new and difficult challenge for radiation oncologists, limiting the adoption of intraprostatic tumor radiotherapy boost for patients. A diffusion MRI biomarker called the Restriction Spectrum Imaging restriction score (RSIrs) can improve radiologists’ identification of clinically significant prostate cancer.

For her 2021 Philips/RSNA Research Resident Grant project, Asona Lui, MD, PhD, assistant professor, radiation medicine and applied sciences at UC San Diego Health, and colleagues sought to determine if RSIrs would improve the accuracy of radiation oncologist target volumes.

For the multi-institutional, international, prospective study, 44 radiation oncologists (participants) contoured prostate tumors, producing 1604 participant volumes on 39 total patient cases, using conventional MRI with or without RSIrs maps.

When compared to consensus expert volumes, 40 of 44 participants completely missed at least one expert-defined target lesion without RSIrs, compared to 13 of 44 with RSIrs maps. On conventional MRI alone, 134 of 762 contour attempts failed, compared to 18 of 842 with RSIrs maps.

Dr. Lui noted that the study confirms radiation oncologists have difficulty accurately identifying prostate tumors on conventional MRI, likely due to lack of training in this new technique. “Use of RSIrs maps fills that knowledge gap and makes it easier to deliver the oncologic benefits of focal tumor boost to all eligible patients,” she said.

The Foundation grant provided Dr. Lui with an opportunity to expand her research repertoire into imaging science and gain the experience of running a large international multi-institutional clinical study.

“This work has been presented at several conferences, won an award at the American College of Radiation Oncologists (ACRO) Summit 2023, and has been published in several top radiation oncology journals,” she said. “The funding was also critical to securing a junior faculty position as a physician scientist. I look forward to applying these new skills in my translational research lab at UC San Diego, set to open in Fall 2024.”

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Read our previous Your Donations in Action story.