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Rodríguez-Cabello MA, Méndez-Rubio S, Sanz-Miguelañez JL, Moraga-Sanz A, Aulló-González C, Platas-Sancho A. Prevalence and grade of malignancy differences with respect to the area of involvement in multiparametric resonance imaging of the prostate in the diagnosis of prostate cancer using the PI-RADS version 2 classification. World J Urol 2023; 41:2155-2163. [PMID: 37326654 DOI: 10.1007/s00345-023-04466-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 05/29/2023] [Indexed: 06/17/2023] Open
Abstract
PURPOSE The peripheral zone is histologically different from the transitional zone. The aim of this study is to analyze the differences between the prevalence and grade of malignancy of mpMRI-targeted biopsies that involve the TZ with respect to the PZ. METHODS A cross-sectional study of 597 men evaluated for PC screening between February 2016 and October 2022 was conducted. Exclusion criteria were prior BPH surgery, radiotherapy, 5-alpha-reductase inhibitors treatment, UTI, mixed involvement of PZ-TZ or doubts, and central-zone involvement. Hypothesis contrast test was used to study differences proportions of malignancy (ISUP > 0) and significant (ISUP > 1) and high-grade tumor (ISUP > 3) in PI-RADSv2 > 2-targeted biopsies in PZ with respect to TZ, and logistic regression and hypothesis contrast tests were used to study the influence of the area of exposure as an effect-modifying factor in the diagnosis of malignancy with respect to the PI-RADSv2 classification. RESULTS 473 patients were selected and 573 lesions biopsied (127 PI-RADS3, 346 PI-RADS4 and 100 PI-RADS5). A significant increase was described in the proportion of malignancy and significant and high-grade tumor in PZ compared to TZ (22.6%, 21.3%, and 8.7%, respectively). Significant increase in proportions and malignancy were described in cores targeted to PZ with respect to TZ, highlight the differences between PZ and TZ for ST (37.3%vs23.7% for PI-RADS4, 69.2%vs27.3% for PI-RADS5, respectively). Statistically significant linear trend was described increasing for malignancy, significant and high-grade tumors with respect to the PI-RADSv2 scores (change > 10%). CONCLUSION Although the prevalence and grade of malignancy in the TZ is lower than in the PZ, PI-RADS4 and 5-targeted biopsies should not be omitted in this location, but PI-RADS3 could be.
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Affiliation(s)
- Miguel Angel Rodríguez-Cabello
- Department of Urology, Hospital Universitario Sanitas La Moraleja. Avenida de Francisco Pi Y Margall 81, 28050, Madrid, Spain.
- Universidad Francisco de Vitoria. Carretera Pozuelo a, Av de Majadahonda, Km 1.800, 28223, Madrid, Spain.
| | - Santiago Méndez-Rubio
- Department of Urology, Hospital Universitario Sanitas La Moraleja. Avenida de Francisco Pi Y Margall 81, 28050, Madrid, Spain
- Universidad Francisco de Vitoria. Carretera Pozuelo a, Av de Majadahonda, Km 1.800, 28223, Madrid, Spain
| | - Juan Luis Sanz-Miguelañez
- Department of Urology, Hospital Universitario Sanitas La Moraleja. Avenida de Francisco Pi Y Margall 81, 28050, Madrid, Spain
- Universidad Francisco de Vitoria. Carretera Pozuelo a, Av de Majadahonda, Km 1.800, 28223, Madrid, Spain
| | - Alvaro Moraga-Sanz
- Department of Urology, Hospital Universitario Sanitas La Moraleja. Avenida de Francisco Pi Y Margall 81, 28050, Madrid, Spain
- Universidad Francisco de Vitoria. Carretera Pozuelo a, Av de Majadahonda, Km 1.800, 28223, Madrid, Spain
| | - Carolina Aulló-González
- Department of Radiology, Hospital Universitario Sanitas La Moraleja. Avenida de Francisco Pi Y Margall 81, 28050, Madrid, Spain
- Universidad Francisco de Vitoria. Carretera Pozuelo a, Av de Majadahonda, Km 1.800, 28223, Madrid, Spain
| | - Arturo Platas-Sancho
- Department of Urology, Hospital Universitario Sanitas La Moraleja. Avenida de Francisco Pi Y Margall 81, 28050, Madrid, Spain
- Universidad Francisco de Vitoria. Carretera Pozuelo a, Av de Majadahonda, Km 1.800, 28223, Madrid, Spain
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Santandreu-Morales I, Redondo-Cerezo E, Martín-Enguix D. [Non-obstructive jaundice as paraneoplastic syndrome of prostate carcinoma: Systematic review of published cases]. Med Clin (Barc) 2023; 160:206-212. [PMID: 36526448 DOI: 10.1016/j.medcli.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/29/2022] [Accepted: 11/02/2022] [Indexed: 12/23/2022]
Abstract
Stauffer syndrome is a paraneoplastic syndrome (PS) that involves liver disorders; it has been often related to renal tumors, but also to others such as adenocarcinoma of the prostate (ACP). Our objective was to carry out a systematic review of published cases associated with ACP. A total of 357 articles were accessed, 25 of which met the study's inclusion criteria. All published cases of Stauffer syndrome in patients diagnoses with ACP were in the metastatic stage. The PS resolved in 3 out of 4 patients when ACP-targeted therapy was implemented. The following were identified as poor prognosis factors: the diagnosis of ACP prior to that of SP, non-elevated levels of total bilirubin, and the non-resolution of SP at the start of treatment.
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Affiliation(s)
| | - Eduardo Redondo-Cerezo
- Departamento de Medicina, Universidad de Granada, Granada, España; Servicio de Aparato Digestivo, Hospital Universitario Virgen de las Nieves, Granada, España
| | - David Martín-Enguix
- Distrito Sanitario Granada Metropolitano, Centro de La Zubia, La Zubia, Granada, España.
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Utilidad de la biopsia guiada cognitivamente por resonancia magnética multiparamétrica para diagnosticar la lesión dominante del cáncer de próstata. RADIOLOGIA 2015; 57:428-33. [DOI: 10.1016/j.rx.2014.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 05/14/2014] [Accepted: 06/01/2014] [Indexed: 11/22/2022]
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Garcia Bennett J, Conejero Olesti A, Hurtado Salom C, Rebenaque E, Parada D, Serrano Alcalá E, Abreu De Con J. Usefulness of cognitive targeting in multiparametric MRI-guided biopsy to diagnose the dominant lesion in prostate cancer. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.rxeng.2015.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ghafoori M, Alavi M, Shakiba M, Hoseini K. The value of prostate MRI with endorectal coil in detecting seminal vesicle involvement in patients with prostate cancer. IRANIAN JOURNAL OF RADIOLOGY 2015; 12:e14556. [PMID: 25793086 PMCID: PMC4349101 DOI: 10.5812/iranjradiol.14556] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 09/14/2013] [Accepted: 09/24/2013] [Indexed: 11/16/2022]
Abstract
Background: In prostate cancer, detection of seminal vesicle involvement is important because it influences the treatment planning and prognosis of the patients. Objectives: The objective of this study was to determine the value of prostate MRI with endorectal coil in the detection of seminal vesicle involvement in patients with prostate cancer. Patients and Methods: A total number of 238 biopsy-proven prostate cancer patients were examined by 1.5 Tesla MRI with a combination of pelvic and endorectal coils to detect seminal vesicle involvement. After radical prostatectomy, the MRI results were compared with pathology results. Results: Seminal vesicle involvement was detected in 67 (28.1%) patients. Pathology confirmed the involvement of seminal vesicles by prostate cancer in 63 patients. In two patients, seminal vesicle involvement was diagnosed by pathology but not detected by MRI. The sensitivity was 0.97 [95% confidence interval = 0.89-0.99], the specificity was 0.98 [95% confidence interval = 0.94-0.99], the positive predictive value was 0.94 [95% confidence interval = 0.85-0.98], and the negative predictive value was 0.99 [95% confidence interval = 0.96-0.99]. Conclusions: MRI with endorectal coil is a valuable imaging technique with suitable accuracy in detecting seminal vesicle involvement in prostate cancer.
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Affiliation(s)
- Mahyar Ghafoori
- Department of Radiology, Hazrat Rasoul Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
| | - Manijeh Alavi
- Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
- Corresponding author: Manijeh Alavi, eputy of Research and Technology, Ministry of Health and Medical Education, No. 211, Azadi Avenue, 1419943471, Tehran, Iran. Tel: +98-2166509057, Fax: +98-2166517118, E-mail:
| | - Madjid Shakiba
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
| | - Kamal Hoseini
- Department of Urology, School of Medicine, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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Nieto-Morales M, Fernández-Ramos J, Pérez-Méndez L, Alventosa-Fernández E, Pastor-Santoveña M, Aguirre-Jaime A. Transrectal biopsy scheme can predict incorrect histological grading in prostate cancer. RADIOLOGIA 2014. [DOI: 10.1016/j.rxeng.2012.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Nieto-Morales ML, Fernández-Ramos J, Pérez-Méndez L, Alventosa-Fernández E, Pastor-Santoveña MS, Aguirre-Jaime A. [Transrectal biopsy scheme can predict incorrect histological grading in prostate cancer]. RADIOLOGIA 2012; 56:322-7. [PMID: 22940271 DOI: 10.1016/j.rx.2012.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Revised: 05/21/2012] [Accepted: 05/28/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To identify factors that might explain why a prostate with a Gleason score (GS) <7 in the biopsy specimen can turn out to have a GS ≥7 in the surgical specimen. MATERIAL AND METHODS We compared the GS of biopsy specimens with the GS of surgical specimens in 185 patients who underwent surgery for prostate cancer. We calculated the sensitivity, specificity, and predictive values for the GS of the biopsy specimens. We used Cohen's kappa to determine the degree of concordance between a GS of <7 and ≥7 for the biopsy specimen and the surgical specimen. Age, a family history of prostate cancer, total prostate-specific antigen (tPSA), digital rectal examination, prostate structure and volume, and the number of biopsy cores (biopsy scheme) were analyzed using multivariable logistic regression. RESULTS Histological study of biopsy specimens yielded high sensitivity (98%) but low specificity (49%) for GS ≤6 and low sensitivity (35, 26%) and high specificity (93, 99%) for GS=7 and GS ≥7, respectively. Cohen's kappa for the GS from the biopsy and surgical specimens was 0.43 (95% CI=30-56%). The biopsy scheme was the only predictor of discordance in the GS between the two techniques. Among the other variables included in the model, only tPSA showed a slightly significant association. Taking a scheme with less than 7 cores as a reference, we found no difference with 8 to 9 cores but we did find a difference with 10 to 11 cores and with 12 or more cores, with a prevalence ratio of 0.138 (95% CI=0.030-0.513) and 0.277 (95% CI=0.091-0.806), respectively. CONCLUSION The GS of the biopsy depends on the scheme. This factor must be taken into account when choosing a treatment option in patients with low tumor grade in biopsy specimens.
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Affiliation(s)
- M L Nieto-Morales
- Servicio de Radiodiagnóstico, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Islas Canarias, España.
| | - J Fernández-Ramos
- Servicio de Radiodiagnóstico, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Islas Canarias, España
| | - L Pérez-Méndez
- Enfermedades Respiratorias CIBER, Instituto Carlos III, Madrid, España; Unidad de Investigación, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Islas Canarias, España
| | - E Alventosa-Fernández
- Servicio de Radiodiagnóstico, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Islas Canarias, España
| | - M S Pastor-Santoveña
- Servicio de Radiodiagnóstico, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Islas Canarias, España
| | - A Aguirre-Jaime
- Unidad de Investigación, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Islas Canarias, España
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Rinaldi D, Fiocchi F, Ligabue G, Bianchi G, Torricelli P. Role of diffusion-weighted magnetic resonance imaging in prostate cancer evaluation. Radiol Med 2012; 117:1429-40. [DOI: 10.1007/s11547-012-0832-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2011] [Accepted: 07/06/2011] [Indexed: 12/14/2022]
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