Multiparametric MR imaging of the prostate at 1.5-T without endorectal coil using an 8 channel pelvic phased array: Is it still a viable option?

INTRODUCTION

The purpose of our work was to evaluate the feasibility of prostate multiparametric MR imaging at 1.5-T without endorectal coil using an 8 channel pelvic phased array coil.

MATERIAL AND METHODS

A total of 154 patients who underwent mp-MRI were retrospectively included. Patients received a standardized mp-MRI, compliant with 2012 European Society of Uro-Radiology guidelines, with 1·5 T magnetic field strength and an 8 channel pelvic phased-array coil. Two blinded readers graded the image quality of mp-MRI on a three-point scale and they scored the prostate lesions according to PI-RADS v2. All PI-RADS of 4 or 5 underwent biopsy. A third radiologist and a pathologist verified the correspondence between the MRI images and the results of the biopsy.

RESULTS

64 (41.6%) patients showed a Pi-rads of 4 or 5. At biopsy, 79.7% showed a Gleason score ≥7, 12.5% showed a Gleason score of 6 and 7.8% showed a negative biopsy. In the group of Pi-rads ≤ 3, 12 patients underwent a biopsy with the following results: negative biopsy in 33.3%, atypical Small Acinar Proliferation in 16.7%, prostatic intraepithelial neoplasia in 25% and indolent PCa 25%. Mp-MRI in the identification of clinically significant cancer provided a low percentage of false positive (7.8%) while in 79.7% of cases it was capable to detect clinically significant prostate cancer. In 92.2% of patients mp-MRI identified a prostate cancer with a Gleason score ≥6. The inter-reader agreement was excellent in defining both the quality of the examination and the PI-RADS category (k = 0.83 and k = 0.70, respectively).

CONCLUSIONS

mp-MRI at 1.5-T without endorectal coil using an 8 channel phased array is an appropriate tool for early detection of clinically significant prostate cancer.

IMPLICATIONS FOR PRACTICE

8 channel pelvic phased array is still an appropriate tool for early detection of clinically significant prostate cancer and for obtaining a reduction in overdiagnosis of indolent PCa.

Preliminary Report of a Multicentric Study on Environmental Risk Factors in Ta-T1 Transitional Cell Carcinoma of the Bladder

OBJECTIVE

The distribution of potential environmental risk factors among patients affected by superficial transitional cell carcinoma of the bladder (TCCB) has been analyzed.

METHODS

Patients affected by superficial TCCB underwent TUR and early intravesical chemotherapy. Detailed data about age, sex, residence, employment, active and passive cigarette smoking, water resource and hair dye use were centralized. Analysis has been conducted on 474 patients affected by Ta-T1 G1-2 TCCB at medium risk for recurrence. Patients with primary single Ta G1-2, Tis or T1G3 tumors were excluded from the present analysis.

RESULTS

Over 80% of the patients lived in urban areas, 22% were employed in industries presumed at risk for bladder cancer, 8% used hair dye and 75% were smokers. Bottled water was the only water resource in 42% of the patients. Employment in industry at risk (p = 0.01) and cigarette smoking (p = 0.04) resulted in being statistically related to tumor multiplicity. Moreover, the period of cigarette smoking was significantly longer in patients with recurrent tumors (p = 0.026). The municipal water supply represented the main water source in never-smokers (p = 0.01) rather than in smokers and in patients harboring T1 rather than Ta tumors (p = 0.03).

CONCLUSIONS

Employment in industry at risk and cigarette smoking resulted in being related to tumor multiplicity. The length of exposure to cigarette smoking was related to the natural history of the tumor. A drinkable water source emerged as a risk factor in absence of cigarette smoking.

Trattamento endoscopico della calcolosi ureterale

Non-invasive techniques have revolutionized the treatment of ureteral stones. We report the success rate and the complication rate of ureteral calculosis treatment with ureterorenoscopy. From November 1990 to April 1994 we have treated 121 patients with URS. In all cases we have used a 12.5 F. “Wolf” rigid ureteroscope. 85 patients (70.2%) were treated with ultrasonic lithotripsy; 36 (29.7%) with a Dormia basket; and in 16 cases a combined treatment of both procedures was employed. Complete stone removal was obtained in 96 patients (79.3%) but six of these required further endoscopic treatment. The complication rate was 7.4 per cent (9 patients) and two patients (1.6%) needed open surgery. In our experience ureteroscopy is a good approach to the treatment of ureteral stones.

[Immunotherapy of tumors: from the first experimental studies to the recent clinical applications. I. Passive immunotherapy]

After a short introduction on the rationale of cancer Immunotherapy (IT), the Authors analyse the experimental and clinical treatments. Very interesting the results of the clinical trials with cells, used with success never reached before with the standards treatments. Particular emphasis has been dedicated to Lymphokine Activated Killers in association with Interleukin2 (IL2) and Tumor Infiltrating Lymphocytes, which have shown a very strong and specific anticancer activity. The encouraging therapeutical possibilities of the association with cytokines and immunosuppressors are also underlined. Monoclonal antibodies are considered a promising therapeutical approach which did'nt receive an effective clinical application, although their use as immunoconjugates with toxines chemotherapeutical and radioactive agents is giving incouraging results. Yet some technical and immunological problems remain to be solved for them to be used in the clinical setting against solid tumors.