1
|
Malvezzi M, Bosetti C, Negri E, La Vecchia C, Decarli A. Cancer Mortality in Italy, 1970–2002. TUMORI JOURNAL 2018; 94:640-57. [DOI: 10.1177/030089160809400502] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Aims and background To update previous work on Italian cancer mortality. Methods WHO data were used to calculate death rates for 30 cancer sites for 2002. Trends were analyzed with joinpoint regression over the 1970–2002 period. Results Total cancer deaths for 2002 in Italy were 163,070 (93,398 men, 69,672 women). Male cancer mortality rose until 1988 and since then has had a 1.4% yearly fall. The first cause of cancer death in males was lung cancer, accounting for 28% of deaths. The decrease in mortality from male lung cancer came about the end of the 1980's (estimated annual percentage change, EAPC, −1.26 from 1989 to 1993 and −2.32 thereafter) and was the main reason for the favorable trends in total male cancer mortality, reflecting the change in smoking prevalence in Italian males. Female total cancer mortality trends have also been favorable, with an overall yearly drop of 1.1% since 1992. The most frequent causes of cancer deaths in females were breast and colorectal cancers, accounting for 16% and 14% of cancer deaths, and both showed declining trends (EAPC, −1.80 since 1992 and −1.51 from 1993 for breast and colorectal cancers, respectively). Female lung cancer has been on the rise (EAPC, 0.82 since 1987) for the last decades due to the rise in cigarette smoking since the 1970's in Italian females. Discussion Mortality from the most common cancers in Italy showed a favorable trend over recent years, the maintenance and potential improvement of which would require a strategy focusing on the control of tobacco and alcohol consumption, nutrition and diet. Early diagnosis for selected neoplasms can also have a relevant impact, together with advancements in treatments.
Collapse
Affiliation(s)
- Matteo Malvezzi
- Istituto di Ricerche Farmacologiche “Mario Negri”, Milan, Italy
- Istituto di Statistica Medica e Biometria “GA Maccacaro”, Università degli Studi di Milano, Milan, Italy
| | | | - Eva Negri
- Istituto di Ricerche Farmacologiche “Mario Negri”, Milan, Italy
| | - Carlo La Vecchia
- Istituto di Ricerche Farmacologiche “Mario Negri”, Milan, Italy
- Istituto di Statistica Medica e Biometria “GA Maccacaro”, Università degli Studi di Milano, Milan, Italy
| | - Adriano Decarli
- Istituto di Statistica Medica e Biometria “GA Maccacaro”, Università degli Studi di Milano, Milan, Italy
- Unità di Statistica Medica e Biometria, Fondazione IRCSS Istituto Nazionale Tumori, Milan, Italy
| |
Collapse
|
2
|
Chen Z, Zheng Y, Ji G, Liu X, Li P, Cai L, Guo Y, Yang J. Accuracy of dynamic contrast-enhanced magnetic resonance imaging in the diagnosis of prostate cancer: systematic review and meta-analysis. Oncotarget 2017; 8:77975-77989. [PMID: 29100440 PMCID: PMC5652829 DOI: 10.18632/oncotarget.20316] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 08/04/2017] [Indexed: 01/23/2023] Open
Abstract
The goals of this meta-analysis were to assess the effectiveness of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in patients with prostate carcinoma (PCa) and to explore the risk profiles with the highest benefit. Systematic electronic searched were conducted in database. We used patient-based and biopsy-based pooled weighted estimates of the sensitivity, specificity, and a summary receiver operating characteristic (SROC) curve for assessing the diagnostic performance of DCE. We performed direct and indirect comparisons of DCE and other methods of imaging. A total of 26 articles met the inclusion criteria for the analysis. DCE-MRI pooled sensitivity was 0.53 (95% CI 0.39 to 0.67), with a specificity of 0.88 (95% CI 0.83 to 0.92) on whole gland. The peripheral zone pooled sensitivity was 0.70 (95% CI 0.46 to 0.86), with a specificity of 0.88 (95% CI 0.76 to 0.94). Compared with T2-weighted imaging (T2WI), DCE was statistically superior to T2. In conclusion, DCE had relatively high specificity in detecting PCa but relatively low sensitivity as a complementary functional method. DCE-MRI might help clinicians exclude cases of normal tissue and serve as an adjunct to conventional imaging when seeking to identify tumor foci in patients with PCa.
Collapse
Affiliation(s)
- Zhiqiang Chen
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
- Radiology Department of The General Hospital, Ningxia Medical University, Yinchuan 750004, Ningxia, China
| | - Yi Zheng
- Radiology Department of The General Hospital, Ningxia Medical University, Yinchuan 750004, Ningxia, China
| | - Guanghai Ji
- Radiology Department of The General Hospital, Ningxia Medical University, Yinchuan 750004, Ningxia, China
| | - Xinxin Liu
- Department of Diagnostic Imaging, Honghui Hospital, Health Science Center of Xi'an Jiaotong University, Xi'an 750004, Shaanxi, China
| | - Peng Li
- Radiology Department of The General Hospital, Ningxia Medical University, Yinchuan 750004, Ningxia, China
| | - Lei Cai
- Radiology Department of The General Hospital, Ningxia Medical University, Yinchuan 750004, Ningxia, China
| | - Yulin Guo
- Radiology Department of The General Hospital, Ningxia Medical University, Yinchuan 750004, Ningxia, China
| | - Jian Yang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
| |
Collapse
|
3
|
Golabek T, Powroźnik J, Chłosta P, Dobruch J, Borówka A. The impact of nutrition in urogenital cancers. Arch Med Sci 2015; 11:411-8. [PMID: 25995760 PMCID: PMC4424258 DOI: 10.5114/aoms.2015.50973] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 03/05/2013] [Accepted: 03/24/2013] [Indexed: 01/09/2023] Open
Abstract
Prostate, bladder and kidney cancers remain the most common cancers of the urinary tract. Despite improved primary prevention, detection and treatment, the incidence of age-related cancers of the urinary tract is likely to rise as a result of global population ageing. An association of diet with prostate, bladder and kidney carcinogenesis is plausible since the majority of metabolites, including carcinogens, are excreted through the urinary tract. Moreover, large regional differences in incidence rates of urologic tumours exist throughout the world. These rates change when people relocate to different geographic areas, which is suggestive of a strong environmental influence. As a result of these observations, numerous studies have been conducted to assess the effects of diet and nutritional status in kidney, bladder and prostate carcinogenesis. Here, we review the literature assessing the effect of diet and nutritional status on urological cancer risk, which has attracted the most interest.
Collapse
Affiliation(s)
- Tomasz Golabek
- Department of Urology, Jagiellonian University Medical College, Krakow, Poland
| | - Jan Powroźnik
- 1 Department of Urology of the Postgraduate Medical Education Centre, the European Health Centre, Otwock, Poland
| | - Piotr Chłosta
- Department of Urology, Jagiellonian University Medical College, Krakow, Poland
| | - Jakub Dobruch
- 1 Department of Urology of the Postgraduate Medical Education Centre, the European Health Centre, Otwock, Poland
| | - Andrzej Borówka
- 1 Department of Urology of the Postgraduate Medical Education Centre, the European Health Centre, Otwock, Poland
| |
Collapse
|
4
|
Basiri A, Shakhssalim N, Jalaly NY, Miri HH, Partovipour E, Panahi MH. Difference in the Incidences of the Most Prevalent Urologic Cancers from 2003 to 2009 in Iran. Asian Pac J Cancer Prev 2014; 15:1459-63. [DOI: 10.7314/apjcp.2014.15.3.1459] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
5
|
Min BD, Kim WT, Cho BS, Kim YJ, Yun SJ, Lee SC, Kim WJ. Usefulness of a combined approach of t1-weighted, t2-weighted, dynamic contrast-enhanced, and diffusion-weighted imaging in prostate cancer. Korean J Urol 2012; 53:830-5. [PMID: 23301126 PMCID: PMC3531635 DOI: 10.4111/kju.2012.53.12.830] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 09/20/2012] [Indexed: 11/18/2022] Open
Abstract
Purpose We evaluated the value of a combined approach of T1-weighted (T1W) imaging, T2-weighted (T2W) imaging, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), and diffusion-weighted imaging (DWI) for the detection of prostate cancer and extracapsular extension (ECE) in patients with prostate cancer by using pathologic data after radical prostatectomy. Materials and Methods From April 2009 to December 2011, 126 patients who underwent radical prostatectomy and prostate MRI for prostate cancer were analyzed retrospectively. The MRI findings were compared with the pathologic findings of the radical prostatectomy specimens in each patient. The sensitivity, specificity, and accuracy of the detection of prostate cancer and extracapsular extension were analyzed. Results The prostate cancer detection rate by use of T1W and T2W imaging, DCE-MRI, and their combination was 65.1%, 69.0%, and 80.2%, respectively (p=0.023). The detection rate using T1W and T2W imaging, DCE-MRI, DWI, and their combination was 57.7%, 65.4%, 67.3%, and 80.8%, respectively (p=0.086). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of combination MRI (T1W, T2W, and DCE-MRI) for ECE were 46.4%, 91.4%, 83.9%, and 68.1%, respectively. The sensitivity of combination MRI (T1W, T2W, and DCE-MRI) for ECE tended to increase as the prostate-specific antigen level rose (p=0.010). The sensitivity, specificity, PPV, and NPV of combination MRI (T1W, T2W, DCE-MRI, and DWI) for ECE were 65.0%, 87.5%, 76.5%, and 80.0%, respectively. Conclusions A combined approach of T1W, T2W, and DCE-MRI with DWI demonstrated an accurate detection rate of prostate cancer. Also, combination approaches showed a high specificity for predicting ECE, although sensitivity was relatively lower. Therefore, these methods are reliable for predicting prostate cancer. However, a new protocol is necessary to enhance the sensitivity for predicting ECE.
Collapse
Affiliation(s)
- Byung Dal Min
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Korea
| | | | | | | | | | | | | |
Collapse
|
6
|
Lee JY, Chang IH, Moon YT, Kim KD, Myung SC, Kim TH, Lee JB. Effect of Prostate Biopsy Hemorrhage on MRDW and MRS Imaging. Korean J Urol 2011; 52:674-80. [PMID: 22087361 PMCID: PMC3212661 DOI: 10.4111/kju.2011.52.10.674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Accepted: 08/02/2011] [Indexed: 11/24/2022] Open
Abstract
Purpose To retrospectively evaluate the effect of post-prostate-biopsy hemorrhage on the interpretation of magnetic resonance diffusion-weighted (MRDW) and magnetic resonance spectroscopic (MRS) imaging in the detection of prostate cancer. We also investigated the optimal timing for magnetic resonance examination after prostate biopsy. Materials and Methods We reviewed the records of 135 men. All patients underwent prostate magnetic resonance imaging (MRI). The prostate was divided into eight regions according to the biopsy site. Subsequently, we measured hemorrhage on apparent diffusion coefficient (ADC) values and (choline+creatinine)/citrate ([Cho+Cr]/Cit) ratios in the same regions on the MRI. We investigated the effect of hemorrhage at ADC values and (Cho+Cr)/Cit ratios on MRI and the relationship between prostate biopsy results and MRI findings. Results The mean patient age was 68.7 years and the mean time between biopsy and MRI was 23.5 days. The total hemorrhagic score demonstrated no significant associations with intervals from biopsy to MRI. Higher hemorrhagic scores were associated with higher ADC values, prostate cancer, and noncancer groups, respectively (p<0.001). ADC values were lower in tumors than in normal tissue (p<0.001), and ADC values were inversely correlated with tumor Gleason score in biopsy cores (p<0.001). However, (Cho+Cr)/Cit ratios did not exhibit any association with prostate biopsy results and hemorrhage. Conclusions Hemorrhage had no significant associations with the interval from biopsy to MRI. ADC values may help to detect prostate cancer and predict the aggressiveness of cancer; however, it is important to consider the bias effect of hemorrhage on the interpretation of MRDW imaging given that hemorrhage affects ADC values.
Collapse
Affiliation(s)
- Jong Yeon Lee
- Department of Urology, Chung-Ang University College of Medicine, Seoul, Korea
| | | | | | | | | | | | | |
Collapse
|
7
|
Choi MS, Choi YS, Yoon BI, Kim SJ, Cho HJ, Hong SH, Lee JY, Hwang TK, Kim SW. The Clinical Value of Performing an MRI before Prostate Biopsy. Korean J Urol 2011; 52:572-7. [PMID: 21927706 PMCID: PMC3162225 DOI: 10.4111/kju.2011.52.8.572] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Accepted: 07/14/2011] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Prostate cancer foci have a characteristic feature in magnetic resonance imaging (MRI). We aimed to assess the clinical value of MRI before prostate biopsy in prostate cancer detection. MATERIALS AND METHODS From March 2009 to June 2010, 154 patients were enrolled in this study. A total of 51 patients with a clinical suspicion of prostate cancer underwent prostate MRI by a 3T scanner before transrectal ultrasound (TRUS)-guided biopsies. A total of 103 patients with a clinical suspicion of prostate cancer underwent prostate MRI after biopsies. The sensitivity, specificity, and positive predictive value (PPV) were evaluated. In addition, tumor location of pathologic findings and ADC mapping on MRI were matched and compared. RESULTS The sensitivity of MRI before and after biopsy was 84.8% and 92.4%, respectively. The PPV of MRI before and after biopsy was 75.7% and 92.4%, respectively. The MRI location match percentage before and after biopsy was 89.3% and 94.1%, respectively. CONCLUSIONS Compared with other previous reports, our results show that the prostate cancer detection sensitivity of MRI is on the rise. Furthermore, MRI before prostate biopsy can provide more information by which to identify prostate cancer during prostate biopsy and thus reduce the false-negative rate.
Collapse
Affiliation(s)
- Myung Sun Choi
- Department of Urology, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Trends in Mortality From Urologic Cancers in Europe, 1970–2008. Eur Urol 2011; 60:1-15. [DOI: 10.1016/j.eururo.2011.03.047] [Citation(s) in RCA: 129] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Accepted: 03/25/2011] [Indexed: 12/31/2022]
|
9
|
Malvezzi M, Arfé A, Bertuccio P, Levi F, La Vecchia C, Negri E. European cancer mortality predictions for the year 2011. Ann Oncol 2011; 22:947-956. [DOI: 10.1093/annonc/mdq774] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
10
|
Ondrusova M, Ondrus D, Karabinos J, Muzik J, Kliment J, Gulis G. Trends in Prostate Cancer Incidence and Mortality before and after the Introduction of PSA Testing in the Slovak and Czech Republics. TUMORI JOURNAL 2011; 97:149-55. [DOI: 10.1177/030089161109700203] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and background As two neighboring countries in central Europe with national cancer registries, the Slovak (SR) and Czech Republics (CR) are countries with a medium global rate in the occurrence of prostate cancer. This paper analyzes the incidence of prostate cancer and mortality before and after the introduction of PSA testing in the two Republics and the possible reasons for any differences discovered and compares the results with selected regions and countries of the world. Study design and results In the Slovak Republic, prostate cancer incidence (age-adjusted to the world standard population) has risen from 14.6/100, 000 in 1968 (95% CI, ±1.5772) to 36.2/100, 000 in 2005 (95% CI, ±2.0678). The estimated annual increase in the incidence during the period 1968–1991 (before nationwide PSA testing) was 0.421; from 1991 (when nationwide PSA testing began) to up to 2003 it was 0.941. Mortality rates grew from 7.3/100, 000 in 1968 to 14.9/100, 000 in 2005. In spite of the geographic proximity of the two countries, the increase in incidence occurred faster in the Czech than in the Slovak Republic, from 15.8/100, 000 in 1977 (95% CI, ±0.9748) to 59.5/100, 000 in 2005 (95% CI, ±1.7187). The estimated annual increase in incidence in the Czech Republic for the period of 1977–1991 was 0.581. From 1991 (when national PSA testing began) until 2003, it was 1.981. In the period before 1991, mortality rose more sharply in the Czech than in the Slovak Republic, whereas after the introduction of PSA testing mortality stabilized more quickly in the Czech than in the Slovak Republic. In the Slovak Republic, a significant reduction in mortality was observed after 2002 and has continued to the present and probably is not affected only by the results connected with the increase in PSA testing. Conclusions The difference in the incidence and mortality of prostate cancer in the Slovak and the Czech Republics results from a difference in the intensity of PSA testing as well as from the introduction of complex, more effective treatment in advanced clinical stages.
Collapse
Affiliation(s)
- Martina Ondrusova
- Cancer Research Institute, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Dalibor Ondrus
- 1st Department of Oncology, Comenius University, Faculty of Medicine, St. Elisabeth Cancer Institute, Bratislava, Slovak Republic
| | - Juraj Karabinos
- Faculty of Mathematics, Physics and Informatics, Comenius University, Bratislava, Slovak Republic
| | - Jan Muzik
- Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science of the Masaryk University, Brno, Czech Republic
| | - Jan Kliment
- Department of Urology, Comenius University, Jessenius Faculty of Medicine, Martin, Slovak Republic
| | - Gabriel Gulis
- Unit for Health Promotion Research, Institute of Public Health, University of Southern Denmark, Esbjerg, Denmark
| |
Collapse
|
11
|
|
12
|
MR Imaging of Prostate Cancer: Diffusion Weighted Imaging and (3D) Hydrogen 1 (H) MR Spectroscopy in Comparison with Histology. Radiol Res Pract 2010; 2011:616852. [PMID: 22091382 PMCID: PMC3198606 DOI: 10.1155/2011/616852] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2009] [Accepted: 05/10/2010] [Indexed: 11/18/2022] Open
Abstract
Purpose. To evaluate retrospectively the impact of diffusion weighted imaging (DWI) and (3D) hydrogen 1 (1H) MR-spectroscopy (MRS) on the detection of prostatic cancer in comparison to histological examinations. Materials and Methods: 50 patients with suspicion of prostate cancer underwent a MRI examination at a 1.5T scanner. The prostate was divided into sextants. Regions of interest were placed in each sextant to evaluate the apparent diffusion coefficient (ADC)-values. The results of the DWI as well as MRS were compared retrospectively with the findings of the histological examination. Sensitivity and specificity of ADC and metabolic ratio (MET)—both separately and in combination—for identification of tumor tissue was computed for variable discrimination thresholds to evaluate its receiver operator characteristic (ROC). An association between ADC, MET and Gleason score was tested by the non-parametric Spearman ρ-test. Results. The average ADC-value was 1.65 ± 0.32mm2/s × 10−3 in normal tissue and 0.96±0.24 mm2/s × 10−3 in tumor tissue (mean ± 1 SD). MET was 0.418 ± 0.431 in normal tissue and 2.010 ± 1.649 in tumor tissue. The area under the ROC curve was 0.966 (95%-confidence interval 0.941–0.991) and 0.943 (0.918–0.968) for DWI and MRS, respectively. There was a highly significant negative correlation between ADC-value and the Gleason score in the tumor-positive tissue probes (n = 62, ρ = −0.405, P = .001). MRS did not show a significant correlation with the Gleason score (ρ = 0.117, P = .366). By using both the DWI and MRS, the regression model provided sensitivity and specificity for detection of tumor of 91.9% and 98.3%, respectively. Conclusion. The results of our study showed that both DWI and MRS should be considered as an additional and complementary tool to the T2-weighted MRI for detecting prostate cancer.
Collapse
|
13
|
La Vecchia C, Bosetti C, Lucchini F, Bertuccio P, Negri E, Boyle P, Levi F. Cancer mortality in Europe, 2000-2004, and an overview of trends since 1975. Ann Oncol 2009; 21:1323-1360. [PMID: 19948741 DOI: 10.1093/annonc/mdp530] [Citation(s) in RCA: 300] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND To update the pattern of cancer mortality in Europe. MATERIALS AND METHODS We analysed cancer mortality in 34 European countries during 2000-2004, with an overview of trends in 1975-2004 using data from the World Health Organization. RESULTS From 1990-1994 to 2000-2004, overall cancer mortality in the European Union declined from 185.2 to 168.0/100 000 (world standard, -9%) in men and from 104.8 to 96.9 (-8%) in women, with larger falls in middle age. Total cancer mortality trends were favourable, though to a variable degree, in all major European countries, including Russia, but not in Romania. The major determinants of these favourable trends were the decline of lung (-16%) and other tobacco-related cancers in men, together with the persistent falls in gastric cancer, and the recent appreciable falls in colorectal cancer. In women, relevant contributions came from the persistent decline in cervical cancer and the recent falls in breast cancer mortality, particularly in northern and western Europe. Favourable trends were also observed for testicular cancer, Hodgkin lymphomas, leukaemias, and other neoplasms amenable to treatment, though the reductions were still appreciably smaller in eastern Europe. CONCLUSION This updated analysis of cancer mortality in Europe showed a persistent favourable trend over the last years.
Collapse
Affiliation(s)
- C La Vecchia
- Department of Epidemiology, Istituto di Ricerche Farmacologiche 'Mario Negri'; Institute of Medical Statistics and Biometry 'G.A. Maccacaro', Università degli Studi di Milano, Milan, Italy
| | - C Bosetti
- Department of Epidemiology, Istituto di Ricerche Farmacologiche 'Mario Negri'.
| | - F Lucchini
- Cancer Epidemiology Unit and Cancer Registries of Vaud and Neuchâtel, Institut de médecine sociale et préventive, Centre Hospitalier Universitaire Vaudois et Université de Lausanne, Lausanne, Switzerland
| | - P Bertuccio
- Department of Epidemiology, Istituto di Ricerche Farmacologiche 'Mario Negri'
| | - E Negri
- Department of Epidemiology, Istituto di Ricerche Farmacologiche 'Mario Negri'
| | - P Boyle
- International Prevention Research Institute, Lyon, France
| | - F Levi
- Cancer Epidemiology Unit and Cancer Registries of Vaud and Neuchâtel, Institut de médecine sociale et préventive, Centre Hospitalier Universitaire Vaudois et Université de Lausanne, Lausanne, Switzerland
| |
Collapse
|
14
|
Peripheral zone prostate cancer. Pre-treatment evaluation with MR and 3D ¹H MR spectroscopic imaging: correlation with pathologic findings. ACTA ACUST UNITED AC 2009; 35:757-63. [PMID: 19756851 DOI: 10.1007/s00261-009-9577-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2009] [Accepted: 08/31/2009] [Indexed: 10/20/2022]
Abstract
The purpose of this study was to retrospectively characterize benign and malignant prostate peripheral zone tissue by using endorectal MRI and 3D ¹H MRS. Fifty-two men with untreated biopsy-proven prostate cancer underwent combined endorectal MRI and MRSI. Whole-mount step-section histopathologic analysis constituted the reference standard. Biopsy correctly detected 74 locations; MRI correctly detected 72 locations; MRS correctly detected 72 locations; MRI + MRS correctly detected 78 locations. Cohen's test showed that biopsy had a lower degree of agreement with histology than MRI + MRS combined. The ratio of [(Cho + Cr)]/Cit correlates with the pathologic Gleason score. The addition of 3D¹H MRSI to MRI can improve diagnosis of prostate cancer contributing indirectly to improve local staging. In addition, the correlation between metabolic 3D¹H MRSI data with pathological Gleason grade may offer a non-invasive means to better predict prostate cancer aggressiveness.
Collapse
|
15
|
Grabe M, Bjartell A, Wullt B. PROQUR: a tool for quality control, epidemiological surveillance, patient follow-up and clinical research activities related to prostate cancer. Acta Oncol 2009; 44:628-32. [PMID: 16165922 DOI: 10.1080/02841860510029932] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Prostate cancer is a leading cancer in Western Europe and epidemiological surveillance is essential to better understand the disease and its treatment. A database for quality control starting with the diagnostic procedure transrectal ultrasound guided core biopsy of the prostate was designed with the aim of monitoring side-events to the procedure, direct printing of reports and forms related to the diagnostic procedure, the National Cancer Registry and the National Prostate Cancer Quality Registry. The programme is flexible, and new folders related to specific research activities can be attached. The programme is easy to handle and aimed at facilitating the daily work of the urologist, epidemiological surveillance and disease progression. We suggest the programme should become a common tool and platform for a standardised approach in diagnostic, therapeutic, administrative reporting to the National Cancer Registry and National Prostate Cancer Quality Registry, and research on prostate diseases in the urologic community in Sweden and eventually abroad.
Collapse
Affiliation(s)
- Magnus Grabe
- Department of Urology, Malmö University Hospital, Malmö, Sweden.
| | | | | |
Collapse
|
16
|
Sakko AJ, Butler MS, Byers S, Reinboth BJ, Stahl J, Kench JG, Horvath LG, Sutherland RL, Stricker PD, Henshall SM, Marshall VR, Tilley WD, Horsfall DJ, Ricciardelli C. Immunohistochemical level of unsulfated chondroitin disaccharides in the cancer stroma is an independent predictor of prostate cancer relapse. Cancer Epidemiol Biomarkers Prev 2008; 17:2488-97. [PMID: 18768520 DOI: 10.1158/1055-9965.epi-08-0204] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The glycosaminoglycan chondroitin sulfate is significantly increased in the peritumoral stroma of prostate tumors compared with normal stroma and is an independent predictor of prostate-specific antigen (PSA) relapse following radical prostatectomy. In this study, we determined whether specific alterations in the sulfation pattern of glycosaminoglycan chains in clinically organ-confined prostate cancer are associated with PSA relapse. Immunoreactivity to distinct glycosaminoglycan disaccharide epitopes was assessed by manually scoring the staining intensity in prostate tissues from patients with benign prostatic hyperplasia (n = 19), early-stage cancer (cohort 1, n = 55 and cohort 2, n = 275), and advanced-stage cancer (n = 20). Alterations to glycosaminoglycans in benign and malignant prostate tissues were determined by cellulose acetate chromatography and high-pressure liquid chromatography. Glycosaminoglycan disaccharide epitopes were localized to the peritumoral stroma of clinically localized prostate cancer. The level of immunostaining for unsulfated disaccharides (C0S) in the peritumoral stroma, but not for 4-sulfated (C4S) or 6-sulfated disaccharides (C6S), was significantly associated with the rate of PSA relapse following radical prostatectomy. High levels of C0S immunostaining were determined to be an independent predictor of PSA relapse (1.6-fold, P = 0.020). Advanced-stage prostate cancer tissues exhibited reduced electrophoretic mobility for chondroitin sulfate and increased unsulfated disaccharides when compared with benign prostatic hyperplasia tissues, whereas the sulfated disaccharide levels were unaffected. The level of C0S immunostaining in the peritumoral stroma is an independent determinant of PSA failure in clinically localized prostate cancer. Specific alterations to chondroitin sulfate side chains occurring during tumor development may be a crucial step for disease progression in prostate cancer.
Collapse
Affiliation(s)
- Andrew J Sakko
- Discipline of Obstetrics and Gynaecology, Research Centre for Reproductive Health, University of Adelaide, Adelaide, SA, Australia
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Bouchardy C, Fioretta G, Rapiti E, Verkooijen HM, Rapin CH, Schmidlin F, Miralbell R, Zanetti R. Recent trends in prostate cancer mortality show a continuous decrease in several countries. Int J Cancer 2008; 123:421-429. [DOI: 10.1002/ijc.23520] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
18
|
Bosetti C, Bertuccio P, Levi F, Lucchini F, Negri E, La Vecchia C. Cancer mortality in the European Union, 1970-2003, with a joinpoint analysis. Ann Oncol 2008; 19:631-40. [PMID: 18281267 DOI: 10.1093/annonc/mdm597] [Citation(s) in RCA: 118] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Cancer mortality peaked in the European Union (EU) in the late 1980s and declined thereafter. MATERIALS AND METHODS We analyzed EU cancer mortality data provided by the World Health Organization in 1970-2003, using join point analysis. RESULTS Overall, cancer mortality levelled off in men since 1988 and declined in 1993-2003 (annual percent change, APC = -1.3%). In women, a steady decline has been observed since the early 1970s. The decline in male cancer mortality has been driven by lung cancer, which levelled off since the late 1980s and declined thereafter (APC = 2.7% in 1997-2003). Recent decreases were also observed for other tobacco-related cancers, as oral cavity/pharynx, esophagus, larynx and bladder, as well as for colorectal (APC = -0.9% in 1992-2003) and prostate cancers (APC = -1.0% in 1994-2003). In women, breast cancer mortality levelled off since the early 1990s and declined thereafter (APC = -1.0% in 1998-2003). Female mortality declined through the period 1970-2003 for colorectal and uterine cancer, while it increased over the last three decades for lung cancer (APC = 4.6% in 2001-2003). In both sexes, mortality declined in 1970-2003 for stomach cancer and for a few cancers amenable to treatment. CONCLUSION This update analysis of the mortality from cancer in the EU shows favorable patterns over recent years in both sexes.
Collapse
Affiliation(s)
- C Bosetti
- Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy.
| | | | | | | | | | | |
Collapse
|
19
|
Abstract
The objective of this analysis was to predict average world age-standardized mortality rates per person-years (100,000 person-years) and numbers of prostate cancer deaths in Ireland for the years 2005, 2010 and 2015. Poisson linear and log-linear regression models of Irish prostate cancer mortality data for the years 1950-2002 were used to predict trends for the whole population, for men aged 0-64 and 50-74 years. The prostate cancer world age-standardized mortality rate in 2015 is predicted to remain unchanged from the average recorded in 1998-2002, while, because of population growth, the number of deaths is predicted to increase. In persons under 65 years of age, the world age-standardized mortality rate is expected to increase, but the number of deaths in this age group is expected to nearly double between 2002 and 2015. Similarly, the world age-standardized mortality rate for men aged 50-74 years is predicted to rise with the number of deaths in this age group expected to increase sharply. The historical evidence predicts a small increase of age-adjusted prostate cancer mortality rates in Ireland and only in the age groups of 0-64 and 50-74 years in the next 10 years, along with a continuing marked increase in number of deaths due to demographic change.
Collapse
|
20
|
Abstract
Prostate cancer is one of the most important cancers in men. With a worldwide incidence of 25.3 per 100,000 it is the second most common cancer in men, with large differences between countries. Important clues on risk factors remain to be found. Age, genetic factors and environmental influences have been studied. Incidence has been increasing over the last few decades, largely due to early detection procedures. The mortality rate of 8.1 per 100,000 mainly affects men at older ages; increases in this rate over time and differences between countries are markedly smaller than for incidence. For the future, prostate cancer will remain an important and--through evolutions in incidence and demography--growing health problem.
Collapse
Affiliation(s)
- Vera Nelen
- Public Health Department, Provinciaal Instituut voor Hygiëne, Antwerp, Belgium
| |
Collapse
|
21
|
Wannenes F, Ciafré SA, Niola F, Frajese G, Farace MG. Vector-based RNA interference against vascular endothelial growth factor-A significantly limits vascularization and growth of prostate cancer in vivo. Cancer Gene Ther 2006; 12:926-34. [PMID: 15956982 DOI: 10.1038/sj.cgt.7700862] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
RNA interference technology is emerging as a very potent tool to obtain a cellular knockdown of a desired gene. In this work we used vector-based RNA interference to inhibit vascular endothelial growth factor (VEGF) expression in prostate cancer in vitro and in vivo. We demonstrated that transduction with a plasmid carrying a small interfering RNA targeting all isoforms of VEGF, dramatically impairs the expression of this growth factor in the human prostate cancer cell line PC3. As a consequence, PC3 cells loose their ability to induce one of the fundamental steps of angiogenesis, namely the formation of a tube-like network in vitro. Most importantly, our "therapeutic" vector is able to impair tumor growth rate and vascularization in vivo. We show that a single injection of naked plasmid in developing neoplastic mass significantly decreases microvessel density in an androgen-refractory prostate xenograft and is able to sustain a long-term slowing down of tumor growth. In conclusion, our results confirm the basic role of VEGF in the angiogenic development of prostate carcinoma, and suggest that the use of our vector-based RNA interference approach to inhibit angiogenesis could be an effective tool in view of future gene therapy applications for prostate cancer.
Collapse
Affiliation(s)
- Francesca Wannenes
- Department of Experimental Medicine and Biochemical Sciences, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | | | | | | | | |
Collapse
|
22
|
Pekmezovic T, Baade P. Trends and patterns in prostate cancer mortality in Belgrade, Serbia: a join-point analysis. Eur J Cancer Prev 2006; 15:51-6. [PMID: 16374230 DOI: 10.1097/01.cej.0000195707.89998.0c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The objective of this analysis was to examine recent changes in prostate cancer mortality among the male population of Belgrade, Serbia, during the period 1975-2002. Mortality data (official death certificates) for prostate cancer were gathered from published and unpublished material of the Municipal Institute of Statistics in Belgrade. Mortality rates were standardized according to the European standard population. Trends in mortality rates were assessed using join-point analysis. During the period from 1975 to 2002 in the population of Belgrade the average age-adjusted mortality rate from prostate cancer during this period was 17.5/100,000 (95% confidence interval, 15.4-19.6), ranging from 8.2/100,000 in 1984 to 31.2/100,000 in 2002. Since 1986 mortality rates among men aged 50 years and over have risen by nearly 6% per year, with the increases being slightly higher among older men (70 years and over 8% per year) compared to younger men (50-69 years, 4% per year). Mortality due to prostate cancer is rising quickly among men in Belgrade. This level of increase is the highest of any reported increase internationally and contrasts sharply with the widespread decrease in prostate cancer mortality in many developed countries.
Collapse
Affiliation(s)
- Tatjana Pekmezovic
- Institute of Epidemiology, School of Medicine, University of Belgrade, Serbia and Montenegro.
| | | |
Collapse
|
23
|
O'Reilly T, McSheehy PMJ, Wenger F, Hattenberger M, Muller M, Vaxelaire J, Altmann KH, Wartmann M. Patupilone (epothilone B, EPO906) inhibits growth and metastasis of experimental prostate tumors in vivo. Prostate 2005; 65:231-40. [PMID: 15948135 DOI: 10.1002/pros.20289] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Microtubule agents appear promising for the treatment of prostate cancer. Patupilone (epothilone B), a highly potent non-taxane microtubule stabilizing agent, was evaluated in models of androgen-independent prostate cancer. METHODS Patupilone was administered to athymic mice bearing human prostate cancer xenografts (subcutaneous DU 145 and PC-3M, orthotopic PC-3M). RESULTS One 4 mg/kg patupilone administration produced transient regression of DU 145 tumors, while two weekly administrations of 2.5 mg/kg produced stable disease followed by protracted regression, however with more pronounced body weight loss. Taxol (15 mg/kg every other day) weakly inhibited tumor growth, but with less body weight loss. Patupilone (5 mg/kg) produced protracted growth inhibition of subcutaneous PC-3M tumors, with transient body weight loss. In mice with orthotopic PC-3M tumors, 4 or 5 mg/kg/week patupilone impaired primary tumor growth, abrogated metastases and enhanced survival, with only transient body weight loss. CONCLUSIONS These data suggest that patupilone holds promise for prostate cancer treatment.
Collapse
Affiliation(s)
- Terence O'Reilly
- Novartis Institutes for BioMedical Research, Oncology Research, Basel, Switzerland
| | | | | | | | | | | | | | | |
Collapse
|
24
|
Kalkner KM, Acosta S, Thorsson O, Frederiksen H, Nilsson A, Gustavsson B, Elingsbo M, Stridsberg M, Abrahamsson PA. Octreotide scintigraphy and Chromogranin A do not predict clinical response in patients with octreotide acetate-treated hormone-refractory prostate cancer. Prostate Cancer Prostatic Dis 2005; 9:92-8. [PMID: 16231013 DOI: 10.1038/sj.pcan.4500843] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In this pilot study, the predictive value of Octreotide scintigraphy (Octreoscan) and/or Chromogranin-A (CgA) was investigated in patients with hormone-refractory prostate cancer treated with Octreotide acetate. In total, 20 patients with progressive disease and bone metastases entered the trial. At baseline Octreoscan, CgA, PSA, alkaline phosphates (ALP) and two self-administered questionnaires (EORTC QLQ C-30 (v3) and brief pain index) were performed and a diary of the pharmaceutical was started. The treatment consisted of Octreotide (Sandostatin LAR) acetate 30 mg intramuscular injection every month. The blood samples and questionnaires were repeated every month until 3 months. Clinical responder was defined as a patient with increased global health score more than 10 units and stable or decreased pain score without an increase in analgesic. In all, 17 patients were treated per protocol, and four were assessed as clinical responders. Six patients developed a reduction in ALP (median -26%, range -5 to -78%). All patients increased in PSA. At baseline, three patients had a negative Octreoscan and the patients with positive lesions, demonstrated uptake of low intensity. At baseline the CgA was elevated above the normal range in 15 of the patients, and during treatment five patients decreased their CgA to the normal range. Neither baseline Octreoscan nor CgA could identify the clinical reponders. A minority of patients improves their health-related quality of life. The decrease and normalization of CgA levels in five patients during therapy indicates therapeutic activity but Octreoscan and CgA could not identify clinical responders.
Collapse
Affiliation(s)
- K M Kalkner
- Department of Oncology and Pathology, Radiumhemmet, Karolinska University Hospital, Stockholm, Sweden.
| | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Morote J, Esquena S, Orsola A, Salvador C, Trilla E, Cecchini L, Raventós CX, Planas J, Catalán R, Reventós J. Effect of androgen deprivation therapy in the thyroid function test of patients with prostate cancer. Anticancer Drugs 2005; 16:863-6. [PMID: 16096434 DOI: 10.1097/01.cad.0000173474.82486.74] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We have assessed the effect of androgen deprivation therapy (ADT) in the thyroid function test in prostate cancer patients. Serum levels of tri-iodothyronine (T3), thyroxine (T4), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) were determined in a cross-sectional study that included 279 patients diagnosed with prostate cancer. A subset of 96 patients free of prostate-specific antigen relapse after radical prostatectomy became a control group and 183 patients under continuous ADT formed the study group. Sixty-four patients out of the study group were treated with luteinizing hormone-releasing hormone (LHRH) agonist and 119 with LHRH agonist plus bicalutamide. The average time of ADT was 42.5 months (3-218). Results were as follows. Mean T3 level was 122.7 ng/dl (72.6-213.0) in the control group and 123.8 ng/dl (64.4-228.2) in patients under ADT, p=0.472. Mean T4 level was 7.66 (1.81-4.30) and 7.66 microg/dl (3.60-13.30), respectively, p=0.884. Mean TSH level was 1.58 (0.44-11.70) and 1.81 mU/dl (0.15-6.58), respectively, p=0.007. Mean FT4 level was 1.24 (0.80-1.90) and 1.18 ng/dl (0.80-1.90), respectively, p=0.018. No statistically significant differences between the T3, T4, TSH and FT4 serum levels were detected according to the modality of ADT. The serum level of TSH was higher than 5 mU/l in six patients (2.1%); however, all cases had a normal FT4 serum level. This mild hypothyroidism was detected in two of the 96 patients of the control group (2.1%) and in four of the 183 under ADT (2.2%). Our data show that ADT seems to alter the thyroid function test. A statistically significant increase in TSH serum level and a decrease in FT4 serum level were detected in patients under ADT. However, only a mild hypothyroidism was detected in about 2% of the patients with prostate cancer, independently of ADT.
Collapse
Affiliation(s)
- Juan Morote
- Departments of Urology, Vall d'Hebron Hospital, Autònoma University of Barcelona, Barcelona, Spain.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Chen Z, Trotman LC, Shaffer D, Lin HK, Dotan ZA, Niki M, Koutcher JA, Scher HI, Ludwig T, Gerald W, Cordon-Cardo C, Pandolfi PP. Crucial role of p53-dependent cellular senescence in suppression of Pten-deficient tumorigenesis. Nature 2005; 436:725-30. [PMID: 16079851 PMCID: PMC1939938 DOI: 10.1038/nature03918] [Citation(s) in RCA: 1521] [Impact Index Per Article: 80.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2005] [Accepted: 06/15/2005] [Indexed: 02/07/2023]
Abstract
Cellular senescence has been theorized to oppose neoplastic transformation triggered by activation of oncogenic pathways in vitro, but the relevance of senescence in vivo has not been established. The PTEN and p53 tumour suppressors are among the most commonly inactivated or mutated genes in human cancer including prostate cancer. Although they are functionally distinct, reciprocal cooperation has been proposed, as PTEN is thought to regulate p53 stability, and p53 to enhance PTEN transcription. Here we show that conditional inactivation of Trp53 in the mouse prostate fails to produce a tumour phenotype, whereas complete Pten inactivation in the prostate triggers non-lethal invasive prostate cancer after long latency. Strikingly, combined inactivation of Pten and Trp53 elicits invasive prostate cancer as early as 2 weeks after puberty and is invariably lethal by 7 months of age. Importantly, acute Pten inactivation induces growth arrest through the p53-dependent cellular senescence pathway both in vitro and in vivo, which can be fully rescued by combined loss of Trp53. Furthermore, we detected evidence of cellular senescence in specimens from early-stage human prostate cancer. Our results demonstrate the relevance of cellular senescence in restricting tumorigenesis in vivo and support a model for cooperative tumour suppression in which p53 is an essential failsafe protein of Pten-deficient tumours.
Collapse
Affiliation(s)
- Zhenbang Chen
- Cancer Biology and Genetics Program, Memorial Sloan-Kettering Cancer Center, Sloan-Kettering Institute, 1275 York Avenue, New York, New York 10021, USA
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Wetter A, Hübner F, Lehnert T, Fliessbach K, Vorbuchner M, Roell S, Zangos S, Luboldt W, Vogl TJ. Three-dimensional 1H-magnetic resonance spectroscopy of the prostate in clinical practice: technique and results in patients with elevated prostate-specific antigen and negative or no previous prostate biopsies. Eur Radiol 2004; 15:645-52. [PMID: 15627189 DOI: 10.1007/s00330-004-2562-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2004] [Revised: 10/04/2004] [Accepted: 10/11/2004] [Indexed: 12/01/2022]
Abstract
To assess the benefit of routinely used three-dimensional 1H-spectroscopy of the prostate combined with magnetic resonance imaging in patients with elevated prostate-specific antigen (PSA) levels and negative or no previous prostate biopsies. Fifty-four patients were examined with our combined imaging protocol, which consisted of transversal, coronal and sagittal T2-weighted fast spin echo sequences. For spectroscopy, we used a three-dimensional chemical shift imaging spin echo (3D-CSI-SE) sequence. The study population consisted of patients with elevated PSA levels and histologically proven prostate carcinoma and patients with elevated PSA levels and negative or no previous prostate biopsies. Examination time was 31 min, a time feasible for routine use. Eighty-eight tumour voxels and 67 control voxels of 27 patients with histologically proven prostate carcinoma were analysed. Ratios of (choline + creatine)/citrate [(Cho + Crea)/Cit] below 0.6 were classified as normal and above 0.6 as pathological. Applying this classification to 20 patients with tumour-suspicious lesions of the prostate and negative or no previous prostate biopsies, we could obtain a sensitivity and specificity for tumour detection of 100% and 69%, respectively. Our combined imaging protocol is feasible for routine use and can add valuable information for the diagnostic management of patients with negative or no previous prostate biopsies.
Collapse
Affiliation(s)
- Axel Wetter
- Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe-University of Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|