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Naito H, Kato T, Ishikawa R, Tanaka K, Ueda N, Matsuoka Y, Miyauchi Y, Taoka R, Tsunemori H, Haba R, Nishiyama Y, Sugimoto M, Kakehi Y. The Impact of Histopathological Features of Prostate Cancerous Lesions on Multiparametric Magnetic Resonance Imaging Findings using PI-RADS Version 2. Urology 2020; 149:174-180. [PMID: 33285212 DOI: 10.1016/j.urology.2020.11.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 11/13/2020] [Accepted: 11/21/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To determine the square measure threshold of prostate cancer lesions in pathological specimens showing PI-RADS categories 3 to 5, and to identify the pathological characteristics of cancerous lesions over the threshold. METHODS Cancer foci detected in horizontal sections of specimens were defined as pathological cancerous lesions, in which square measure, lesion location (peripheral or transition zone), Gleason pattern (GP), GP4-5 component percentages, and GP 4 subtypes were assessed. A receiver operating characteristic curve was used to determine the threshold of the square measure of pathological specimens that distinguishes between lesions of PI-RADS categories 1 and 2 and those of 3 to 5. Univariable and multivariable analyses were performed to determine the histopathological features associated with PI-RADS categories 3 to 5. RESULTS A total of 100 consecutive patients underwent multiparametric magnetic resonance imaging before robotic-assisted laparoscopic prostatectomy. A total of 1366 pathological cancerous lesions were detected, 217 of which were classified as PI-RADS categories 3 to 5. A square measure of 40 mm2 on pathological specimens was the threshold for PI-RADS categories 3 to 5. Of the 415 lesions that were over 40 mm2, 211 lesions exhibited PI-RADS categories 1, 2 and 204 lesions exhibited PI-RADS categories 3 to 5. Multiple logistic regression analysis showed that square measure, fused glands, and cribriform glands were independently associated with PI-RADS categories 3 to 5. CONCLUSION Cancerous lesions over 40 mm2 showing PI-RADS categories 3 to 5 are associated with square measure, fused glands, and cribriform glands.
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Affiliation(s)
- Hirohito Naito
- Department of Urology, Faculty of Medicine, Kagawa University, Japan
| | - Takuma Kato
- Department of Urology, Faculty of Medicine, Kagawa University, Japan.
| | - Ryou Ishikawa
- Department of Diagnostic Pathology, Kagawa University Hospital, Japan
| | - Kenichi Tanaka
- Department of Radiology, Faculty of Medicine, Kagawa University, Japan
| | - Nobufumi Ueda
- Department of Urology, Faculty of Medicine, Kagawa University, Japan
| | - Yuki Matsuoka
- Department of Urology, Faculty of Medicine, Kagawa University, Japan
| | - Yasuyuki Miyauchi
- Department of Urology, Faculty of Medicine, Kagawa University, Japan
| | - Rikiya Taoka
- Department of Urology, Faculty of Medicine, Kagawa University, Japan
| | | | - Reiji Haba
- Department of Diagnostic Pathology, Kagawa University Hospital, Japan
| | | | - Mikio Sugimoto
- Department of Urology, Faculty of Medicine, Kagawa University, Japan
| | - Yoshiyuki Kakehi
- Department of Urology, Faculty of Medicine, Kagawa University, Japan
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Contrast-enhanced ultrasound with dispersion analysis for the localization of prostate cancer: correlation with radical prostatectomy specimens. World J Urol 2020; 38:2811-2818. [PMID: 32078707 DOI: 10.1007/s00345-020-03103-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 01/21/2020] [Indexed: 10/25/2022] Open
Abstract
PURPOSE To determine the value of two-dimensional (2D) contrast-enhanced ultrasound (CEUS) imaging and the additional value of contrast ultrasound dispersion imaging (CUDI) for the localization of clinically significant prostate cancer (csPCa). METHODS In this multicentre study, subjects scheduled for a radical prostatectomy underwent 2D CEUS imaging preoperatively. CUDI maps were generated from the CEUS recordings. Both CEUS recordings and CUDI maps were scored on the likelihood of presenting csPCa (any Gleason ≥ 4 + 3 and Gleason 3 + 4 larger than 0.5 mL) by five observers and compared to radical prostatectomy histopathology. An automated three-dimensional (3D) fusion protocol was used to match imaging with histopathology. Receiver operator curve (ROC) analysis was performed per observer and imaging modality. RESULTS 133 of 216 (62%) patients were included in the final analysis. Average area under the ROC for all five readers for CEUS, CUDI and the combination was 0.78, 0.79 and 0.78, respectively. This yields a sensitivity and specificity of 81 and 64% for CEUS, 83 and 56% for CUDI and 83 and 55% for the combination. Interobserver agreement for CEUS, CUDI and the combination showed kappa values of 0.20, 0.18 and 0.18 respectively. CONCLUSION The sensitivity and specificity of 2D CEUS and CUDI for csPCa localization are moderate. Despite compressing CEUS in one image, CUDI showed a similar performance to 2D CEUS. With a sensitivity of 83% at cutoff point 3, it could become a useful imaging procedure, especially with 4D acquisition, improved quantification and combination with other US imaging techniques such as elastography.
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Berg S, Hanske J, von Landenberg N, Noldus J, Brock M. Institutional Adoption and Apprenticeship of Fusion Targeted Prostate Biopsy: Does Experience Affect the Cancer Detection Rate? Urol Int 2020; 104:476-482. [PMID: 32036374 DOI: 10.1159/000505654] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 12/28/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION There are limited data on the learning curve of magnetic resonance imaging/transrectal ultrasound (MRI/TRUS)-fusion targeted prostate biopsies (tBx). OBJECTIVE The aim of this study was to investigate the difference in prostate cancer (PCa) detection rate between an experienced urologist and novice resident performing tBx. METHODS A total of 183 patients underwent tBx from 2012 to 2016 for a total of 518 tBx cores. Biopsies in this study were performed by an experienced urologist (investigator A) or a novice resident (investigator B). The outcome was the detection of PCa on tBx. Using a multivariable logistic regression model, we estimated odds ratios for the detection of PCa. Inverse probability treatment weighting (IPTW) was used to balance patients' baseline characteristics and compare detection rates of PCa. Before performance of tBx, all patients underwent MRI. RESULTS On multivariable logistic regression analysis, investigator experience was associated with a higher odds of detection of PCa (OR = 1.003; 95% confidence interval 1.002-1.006, p = 0.037). After IPTW adjustment, there was no significant difference between the detection rate of investigator A (23%) and investigator B (32%; p = 0.457). CONCLUSIONS Data revealed a positive association between investigator experience and the odds of PCa detection, although there was no difference in the detection rates of the investigators.
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Affiliation(s)
- Sebastian Berg
- Department of Urology and Neurourology, Marien Hospital Herne, Ruhr-University Bochum, Herne, Germany, .,Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA,
| | - Julian Hanske
- Department of Urology and Neurourology, Marien Hospital Herne, Ruhr-University Bochum, Herne, Germany
| | - Nicolas von Landenberg
- Department of Urology and Neurourology, Marien Hospital Herne, Ruhr-University Bochum, Herne, Germany
| | - Joachim Noldus
- Department of Urology and Neurourology, Marien Hospital Herne, Ruhr-University Bochum, Herne, Germany
| | - Marko Brock
- Department of Urology and Neurourology, Marien Hospital Herne, Ruhr-University Bochum, Herne, Germany
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Kam J, Yuminaga Y, Krelle M, Gavin D, Koschel S, Aluwihare K, Sutherland T, Skinner S, Brennan J, Wong LM, Louie-Johnsun M. Evaluation of the accuracy of multiparametric MRI for predicting prostate cancer pathology and tumour staging in the real world: an multicentre study. BJU Int 2019; 124:297-301. [DOI: 10.1111/bju.14696] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Jonathan Kam
- Gosford Hospital and Gosford Private Hospital; Gosford NSW Australia
- University of Newcastle; Newcastle NSW Australia
| | - Yuigi Yuminaga
- Gosford Hospital and Gosford Private Hospital; Gosford NSW Australia
| | | | | | | | | | | | | | - Janelle Brennan
- St Vincent's Hospital; Melbourne Vic. Australia
- Bendigo Hospital; Bendigo Vic. Australia
| | - Lih-Ming Wong
- St Vincent's Hospital; Melbourne Vic. Australia
- University of Melbourne; Melbourne Vic. Australia
| | - Mark Louie-Johnsun
- Gosford Hospital and Gosford Private Hospital; Gosford NSW Australia
- University of Newcastle; Newcastle NSW Australia
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Goldman H, Singh N, Harding C, McGirr J, Seal A, Duncan I, Sowter S. Accuracy of multiparametric magnetic resonance imaging to detect significant prostate cancer and index lesion location. ANZ J Surg 2018; 89:106-110. [DOI: 10.1111/ans.14754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 05/02/2018] [Accepted: 06/01/2018] [Indexed: 12/20/2022]
Affiliation(s)
- Hariette Goldman
- School of Medicine; The University of Notre Dame Australia; Sydney New South Wales Australia
- Rural Clinical School; The University of New South Wales; Wagga Wagga New South Wales Australia
| | - Neha Singh
- Rural Clinical School; The University of New South Wales; Wagga Wagga New South Wales Australia
- Wagga Wagga Base Hospital; Wagga Wagga New South Wales Australia
- Calvary Healthcare Regional Imaging; Wagga Wagga New South Wales Australia
| | - Catherine Harding
- School of Medicine; The University of Notre Dame Australia; Sydney New South Wales Australia
| | - Joe McGirr
- School of Medicine; The University of Notre Dame Australia; Sydney New South Wales Australia
| | - Alexa Seal
- School of Medicine; The University of Notre Dame Australia; Sydney New South Wales Australia
| | - Ian Duncan
- Calvary Healthcare Regional Imaging; Wagga Wagga New South Wales Australia
| | - Steven Sowter
- Rural Clinical School; The University of New South Wales; Wagga Wagga New South Wales Australia
- Wagga Wagga Base Hospital; Wagga Wagga New South Wales Australia
- Riverina Urology; Wagga Wagga New South Wales Australia
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A Single Center Evaluation of the Diagnostic Accuracy of Multiparametric Magnetic Resonance Imaging against Transperineal Prostate Mapping Biopsy: An Analysis of Men with Benign Histology and Insignificant Cancer following Transrectal Ultrasound Biopsy. J Urol 2018; 200:302-308. [DOI: 10.1016/j.juro.2018.02.072] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2018] [Indexed: 11/23/2022]
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Abedi I, Tavakkoli MB, Jabbari K, Amouheidari A, Yadegarfard G. Dosimetric and Radiobiological Evaluation of Multiparametric MRI-Guided Dose Painting in Radiotherapy of Prostate Cancer. JOURNAL OF MEDICAL SIGNALS AND SENSORS 2017; 7:114-121. [PMID: 28553585 PMCID: PMC5437763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Radiotherapy is one of the treatment options for locally advanced prostate cancer; however, with standard radiation doses, it is not always very effective. One of the strategies to improve the efficiency of radiotherapy is increasing the dose. In this study, to increase tumor local control rates, a new radiotherapy method, known as dose painting (DP), was investigated. To compare 3-dimensional conformal radiotherapy (3D-CRT) and intensity modulated radiotherapy (IMRT) plans with DP for prostate cancer. Twenty-four consecutive patients with locally advanced prostate cancer who underwent an multiparametric-magnetic resonance imaging (MP-MRI) (T2w, diffusion weighted image, dynamic contrast enhancement, and MRS) scan before a diagnostic biopsy from September 2015 to April 2016 were invited to take part in this study. The tumor local control probability (TCP) values for 3D-CRT, IMRT, and DP techniques were 45, 56, and 77%, respectively. The DP technique had a 37.5 and 71% higher TCP than IMRT and 3D-CRT, and these differences were statistically significant (P = 0.001). The mean normal tissue complication probability (NTCP) values of the organ at risks for 3D-CRT, IMRT, and DP showed that there were statistically significant differences among them in three plans (P = 0.01). DP by contours using MP-MRI is technically feasible. This study evaluated biological modeling based on both MP-MRI defined subvolumes and pathologically defined subvolumes. The MP-MRI-guided DP results in better TCP/NTCP than 3D-CRT and IMRT.
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Affiliation(s)
- Iraj Abedi
- Isfahan University of Medical Sciences, Isfahan, Iran
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Intraprostatic locations of tumor foci of higher grade missed by diagnostic prostate biopsy among potential candidates for active surveillance. Sci Rep 2016; 6:36781. [PMID: 27827421 PMCID: PMC5101522 DOI: 10.1038/srep36781] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 10/20/2016] [Indexed: 11/08/2022] Open
Abstract
To establish optimal biopsy scheme for selection of candidates for active surveillance (AS) among prostate cancer (PCa) patients, information on topographical distribution of tumor foci of higher grade missed by contemporary biopsy amongst potential candidates of AS would certainly be useful. Thus we analyzed topographic distribution of tumor foci by examining prostatectomy specimens in 444 patients who underwent radical prostatectomy for low risk PCa. Anterior and posterior prostate areas were demarcated by a horizontal line drawn at midpoint of prostatic urethra. Among 444 subjects, patients with upgrading showed relatively higher prevalence of index tumor foci in anterior prostate than those without upgrading, though not reaching statistical significance (p = 0.252). Meanwhile, among 135 (30.4%) patients with very low risk PCa, patients with upgrading showed significantly higher prevalence of index tumor foci in anterior prostate than those without upgrading (52.2% vs 33.8%; p = 0.031). In conclusions, tumor foci of higher grade missed by diagnostic biopsy were mostly located in anterior prostate among very low risk PCa patients. Such finding would be concrete evidence to support the notion that more efforts are needed to increase accuracy in detecting tumor foci in anterior prostate among potential candidates for AS.
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Toner L, Papa N, Perera M, Katelaris N, Weerakoon M, Chin K, Harewood L, Bolton DM, Lawrentschuk N. Multiparametric magnetic resonance imaging for prostate cancer—a comparative study including radical prostatectomy specimens. World J Urol 2016; 35:935-941. [DOI: 10.1007/s00345-016-1960-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 10/19/2016] [Indexed: 01/26/2023] Open
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Toner L, Bolton DM, Lawrentschuk N. Prevention of sepsis prior to prostate biopsy. Investig Clin Urol 2016; 57:94-9. [PMID: 26981590 PMCID: PMC4791668 DOI: 10.4111/icu.2016.57.2.94] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 02/26/2016] [Indexed: 11/19/2022] Open
Abstract
Purpose Urosepsis is the most feared complication of transrectal prostate biopsy. The incidence may be increasing from <1% to 2%–3% in contemporary series. Historically, fluoroquinolones have been effective antibiotic prophylaxis to prevent infective complications but antibiotic resistance is increasing. The increase in antibiotic resistance may contribute to reported increases in urosepsis and hospitalization after transrectal biopsy. This article will review other methods clinicians may employ to reduce the incidence of infective complications after prostate biopsy. Materials and Methods A systematic review of the literature was conducted using literature databases PubMed and Ovid MEDLINE in August 2015 in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) criteria. Results Effective strategies to reduce infective complications after transrectal prostate biopsy include augmented prophylaxis with other antibiotics, rectal swab culture directed antibiotic prophylaxis or a transperineal biopsy approach. Needle disinfection, minimizing the number of biopsy needles and rectal disinfectants may also be of use. These methods may be of particular utility in patients with risk factors for developing urosepsis such as recent antibiotic use and overseas travel. Conclusions The scientific literature describes various techniques designed to reduce infective complications caused by prostate biopsy. Clinicians should consider incorporating these novel techniques into their contemporary practice.
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Affiliation(s)
- Liam Toner
- Department of Surgery, Urology Unit, University of Melbourne, Melbourne, Australia
| | - Damien M Bolton
- Department of Surgery, Urology Unit, University of Melbourne, Melbourne, Australia
| | - Nathan Lawrentschuk
- Department of Surgery, Urology Unit, University of Melbourne, Melbourne, Australia.; Olivia Newton-John Cancer Research Institute, Austin Health, Melbourne, Australia.; Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.; School of Cancer Medicine, La Trobe University, Melbourne, Australia
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