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Sample records for biopsy related prostate

  1. Post-radiotherapy prostate biopsies reveal heightened apex positivity relative to other prostate regions sampled

    International Nuclear Information System (INIS)

    Background and purpose: Prostate biopsy positivity after radiotherapy (RT) is a significant determinant of eventual biochemical failure. We mapped pre- and post-treatment tumor locations to determine if residual disease is location-dependent. Materials and methods: There were 303 patients treated on a randomized hypofractionation trial. Of these, 125 underwent prostate biopsy 2-years post-RT. Biopsy cores were mapped to a sextant template, and 86 patients with both pre-/post-treatment systematic sextant biopsies were analyzed. Results: The pretreatment distribution of positive biopsy cores was not significantly related to prostate region (base, mid, apex; p = 0.723). Whereas all regions post-RT had reduced positive biopsies, the base was reduced to the greatest degree and the apex the least (p = 0.045). In 38 patients who had a positive post-treatment biopsy, there was change in the rate of apical positivity before and after treatment (76 vs. 71%; p = 0.774), while significant reductions were seen in the mid and base. Conclusion: In our experience, persistence of prostate tumor cells after RT increases going from the base to apex. MRI was used in planning and image guidance was performed daily during treatment, so geographic miss of the apex is unlikely. Nonetheless, the pattern observed suggests that attention to apex dosimetry is a priority

  2. Prostate biopsy

    Science.gov (United States)

    ... from the prostate through the scope. Perineal - through perineum (the skin between the anus and the scrotum). ... pain. A small cut is made in the perineum. A needle is inserted to collect prostate tissue.

  3. Detection of Xenotropic Murine Leukemia Virus-Related Virus in Prostate Biopsy Samples

    International Nuclear Information System (INIS)

    Objective: To determine the association of Xenotropic murine leukemia virus related virus (XMRV) infection with prostate cancer and compare it with benign prostate hyperplasia. Study Design: Case control study. Place and Duration of Study: Department of Histopathology and Molecular Pathology, Dow University of Health Sciences, Karachi, from January 2009 to December 2012. Methodology: XMRV was screened in 50 prostate cancer and 50 benign prostatic hyperplasia biopsies using conventional end-point PCR. Other studied variables were family history of prostate cancer, patients age and Gleason score. Results: XMRV was detected in 4 (8%) of the 50 prostate cancer biopsy specimens compared to none in biopsies with benign prostatic hyperplasia. However, there was no significant statistical association of XMRV infection with the other variables. Conclusion: A low frequency of XMRV infection was found in this case-control study. Men, who harbor XMRV infection, may be at increased risk of prostate cancer but this needs to be investigated further at a larger scale. (author)

  4. Optimizing prostate biopsy for repeat transrectal prostate biopsies patients

    Institute of Scientific and Technical Information of China (English)

    Xiaojun Deng; Jianwei Cao; Feng Liu; Weifeng Wang; Jidong Hao; Jiansheng Wan; Hui Liu

    2014-01-01

    Objective:Diagnosis of patients with negative prostate biopsy and persistent suspicion of prostate cancer re-mains a serious problem. In this study, we investigated the application of optimizing prostate biopsy for patients who need repeat prostate biopsy. Methods:In this prospective, non-randomized phase-I clinical trial, the prostate cancer detection rate of initial detection scheme was compared with optimizing prostate biopsy scheme. The number of punctures of initial detection scheme was the same as that of optimizing prostate biopsy scheme. The puncture direction of optimizing prostate biopsy was a 45° angle to the sagittal plane from front, middle, and back. The two cores from each lateral lobe were horizontal y inwardly inclined 45°. Results:A total of 45 patients with initial negative biopsy for cancer were received the optimizing prostate biopsy scheme. The cancer detection rate was 17.8%(8/45), and prostate intraepithelial neoplasm (PIN) was 6.7%(3/45). The pa-tients receiving repeat transrectal prostate biopsies were pathological y diagnosed as lower Gleason grade prostate cancers. Conclusion:The cancer detection rate of repeat biopsy prostate cancer is lower than that of initial biopsy. Our study showed that the optimizing prostate biopsy is important to improve the detection rate of repeat transrectal prostate biopsies patients.

  5. Ultrasound- and MRI-Guided Prostate Biopsy

    Science.gov (United States)

    ... Index A-Z Ultrasound- and MRI-Guided Prostate Biopsy Ultrasound- and MRI-guided prostate biopsy uses imaging ... Biopsy? What is Ultrasound- and MRI-guided Prostate Biopsy? Ultrasound- and MRI-guided prostate biopsies are performed ...

  6. Methods for Prostate Biopsy

    Directory of Open Access Journals (Sweden)

    M. Ghafoori

    2008-01-01

    Full Text Available Prostate cancer is currently the most prevalent form of cancer in men and the second leading cause of can-cer death in the United States, and the third most common cancer in men worldwide. Increasing mor-tality rates due to prostate carcinoma have been ob-served worldwide. This disease usually progresses im-perceptibly; thus, patients are unlikely to seek medi-cal help during the early stages. For these reasons, screening programs aimed at early detection have been developed. The prostate-specific antigen (PSA test is among the best screening tools available in medicine today and is recognized as the best marker for its early detection. Prostate cancers detected by DRE method alone are clinically localized only 50% to 60% of the time, whereas PSA-detected tumors are clinically localized 90% of the time and pathologi-cally confined to the prostate as determined at prostatectomy about two thirds of the time. Recently, the detection of localized prostate cancers has improved, owing to the development of various new biopsy methods. However, a standard biopsy method, including number of cores, has not yet been established at present. When screening results indi-cate the possibility of prostate cancer, a pathologic diagnosis may be pursued by ultrasound guided trans-rectal needle biopsy. Prostate biopsy is usually ad-vised if serum PSA is >4 ng/mL, and this procedure remains the gold standard for prostate cancer diagno-sis. Fine needle biopsy is less painful than core bi-opsy, but also less diagnostically accurate. Systematic biopsy protocols: In 1989, Hodge et al. coined the sextant biopsy method that is still the standard of reference in prostate cancer detection. The prostate is bilaterally divided into three regions (apex, midgland, and base, all of which are system-atically biopsied once. Although Hodge et al. first proposed sextant biopsy under transrectal ultrasound guidance, some recent reports have indicated that systematic sextant biopsy

  7. Prostate cancer detection upon transrectal ultrasound-guided biopsy in relation to digital rectal examination and prostate-specific antigen level: what to expect in the Chinese population?

    Directory of Open Access Journals (Sweden)

    Jeremy YC Teoh

    2015-01-01

    Full Text Available We investigated the prostate cancer detection rates upon transrectal ultrasound (TRUS-guided biopsy in relation to digital rectal examination (DRE and prostate-specific antigen (PSA, and risk factors of prostate cancer detection in the Chinese population. Data from all consecutive Chinese men who underwent first TRUS-guided prostate biopsy from year 2000 to 2013 was retrieved from our database. The prostate cancer detection rates with reference to DRE finding and PSA level of 50 ng ml−1 were investigated. Multivariate logistic regression analyses were performed to investigate for potential risk factors of prostate cancer detection. A total of 2606 Chinese men were included. In patients with normal DRE, the cancer detection rates were 8.6%, 13.4%, 21.8%, 41.7% and 85.2% in patients with PSA 50 ng ml−1 respectively. In patients with abnormal DRE, the cancer detection rates were 12.4%, 30.2%, 52.7%, 80.6% and 96.4% in patients with PSA 50 ng ml−1 respectively. Older age, smaller prostate volume, larger number of biopsy cores, presence of abnormal DRE finding and higher PSA level were associated with increased risk of prostate cancer detection upon multivariate logistic regression analyses (P < 0.001. Chinese men appeared to have lower prostate cancer detection rates when compared to the Western population. Taking the different risk factors into account, an individualized approach to the decision of TRUS-guided biopsy can be adopted.

  8. Methods for Prostate Biopsy

    OpenAIRE

    M. Ghafoori

    2008-01-01

    Prostate cancer is currently the most prevalent form of cancer in men and the second leading cause of can-cer death in the United States, and the third most common cancer in men worldwide. Increasing mor-tality rates due to prostate carcinoma have been ob-served worldwide. This disease usually progresses im-perceptibly; thus, patients are unlikely to seek medi-cal help during the early stages. For these reasons, screening programs aimed at early detection have been developed. The prostate-spe...

  9. Strategies for prevention of ultrasound-guided prostate biopsy infections

    OpenAIRE

    Lu DD; Raman JD

    2016-01-01

    Diane D Lu, Jay D Raman Division of Urology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA Abstract: Prostate cancer is the most common cancer in male patients and the second leading cause of cancer-related mortality in males. To confirm the diagnosis of prostate cancer, an ultrasound-guided needle biopsy is necessary to obtain prostate tissue sufficient for histologic analysis by pathologists. Ultrasound-guided prostate needle biopsy can be accomplished via a transperine...

  10. Strategies for prevention of ultrasound-guided prostate biopsy infections

    OpenAIRE

    Raman, Jay,

    2016-01-01

    Diane D Lu, Jay D Raman Division of Urology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA Abstract: Prostate cancer is the most common cancer in male patients and the second leading cause of cancer-related mortality in males. To confirm the diagnosis of prostate cancer, an ultrasound-guided needle biopsy is necessary to obtain prostate tissue sufficient for histologic analysis by pathologists. Ultrasound-guided prostate needle biopsy can be accomplished via a transpe...

  11. SATURATION BIOPSY OF THE PROSTATE (REVIEW

    Directory of Open Access Journals (Sweden)

    A. V. Sadchenko

    2014-07-01

    Full Text Available Prostate biopsy is the principal method of diagnois of prostate cancer, allowing to start the adequate treatment. The tactics of the patients, which have negative initial biopsy, is a subject of discussion. Saturation biopsy is a “gold standard„ of diagnostics of PCA with repeat biopsy. Saturation biopsy of the prostate is not a primary procedure, usually apply in patients with negative biopsies in anamnesis, patients with multifocal PIN and ASAP. Saturation biopsy allows to more precisely predict the volume and degree of malignancy of PCA, that can be used for planning tactics of active surveillance and focal therapy.

  12. Different Methods for Prostate Biopsy and Biopsy Protocols

    Directory of Open Access Journals (Sweden)

    Mahyar Ghafoori

    2011-05-01

    Full Text Available Prostate carcinoma is one of the most common"nmalignancies among men. Increasing mortality rates due"nto prostate carcinoma have been observed worldwide."nThis disease usually progresses imperceptibly, for this"nreason; screening programs aimed at early detection"nhave been developed. The prostate specific antigen"n(PSA test is among the best screening tools available"nin medicine today because it is recognized as the best"nmarker for its early detection."nIn case of abnormal rise in PSA, the patient usually"nrefers for prostate biopsy under the guide of trans"nrectal ultrasonography (TRUS. Different methods are"nrecognized for prostate biopsy that may be divided"ninto two main categories namely, systematic biopsy"nand targeted biopsy."nIn systematic biopsy we divide the prostate gland"nrandomly to different sections and obtain biopsy"nspecimens from each section.The protocol of systematic biopsy is different among"ndifferent institutions. The number of biopsy specimens"ncould be started from less than 6 to more than 20"nbiopsies in some institutions. Increasing the number"nof biopsy specimens increases the detection rate for"nprostate cancer increasing the complications such"nas post biopsy prostatitis and septicemia, which are"nthe most important, as well. In scheduling a biopsy"nprotocol with high number of biopsies it is preferred"nto hospitalize the patient and prescribe intravenous"nantibiotics."nTargeted biopsy of the prostate means obtaining biopsy"nspecimens from a pathologic lesion that is suspicious"nfor prostate cancer. Different modalities could be"nused for detecting prostate cancer within the prostate"ngland. Transrectal ultrasonography, ultrasonography"nwith the use of ultrasound contrast agents, MRI of the"nprostate with the use of endorectal coil, dynamic MR"nstudy with contrast agent, diffusion weighted imaging"nof the prostate and MR spectroscopy all could help"nin the detection of a suspicious tumoral mass in the

  13. Biopsy of the prostate guided by transrectal ultrasound: relation between warfarin use and incidence of bleeding complications

    Energy Technology Data Exchange (ETDEWEB)

    Ihezue, C.U. [Department of Radiology, Southampton General Hospital (United Kingdom); Smart, J. [Department of Radiology, Southampton General Hospital (United Kingdom); Dewbury, K.C. [Department of Radiology, Southampton General Hospital (United Kingdom)]. E-mail: keith.dewbury@suht.swest.nhs.uk; Mehta, R. [Department of Radiology, Southampton General Hospital (United Kingdom); Burgess, L. [Department of Radiology, Southampton General Hospital (United Kingdom)

    2005-04-01

    AIM: To determine the relation between warfarin use and the frequency of bleeding complications after biopsy of the prostate guided by transrectal ultrasound (TRUS). METHODS: Overall, 1022 consecutive patients with suspected prostatic disease were followed after biopsy. Warfarin and aspirin use was determined on the day of the procedure. A TRUS-guided biopsy was performed and patients were offered a questionnaire to complete 10 days after the procedure, to determine any immediate or delayed bleeding complications. Follow-up telephone calls were made to those who had not replied within the stipulated period. RESULTS: Of the 1000 patients who replied, 49 were receiving warfarin, 220 were receiving aspirin and 731 were not receiving any anticoagulant drugs. Of the 49 subjects reporting current use of warfarin, 18 (36.7%) experienced haematuria, compared with 440 (60.2%) of the patients receiving no anti-coagulant drugs who reported haematuria. This was statistically significant (p=0.001). Of the group receiving warfarin, 4 (8.2%) experienced haematospermia whereas 153 (21%) of the group receiving no anticoagulant medication reported haematospermia. This difference also was statistically significant (p=0.030). Rectal bleeding was experienced by 7 (14.3%) of the group receiving warfarin compared with 95 (13%) in the group without anticoagulant medication, but this was not statistically significant (p=0.80). We also demonstrated that there was no statistically significant association between the severity of the bleeding complications and medication with warfarin. CONCLUSION: None of the group receiving warfarin experienced clinically important bleeding complications. Our results suggest that the frequency and severity of bleeding complications were no worse in the warfarin group than in the control group and that discontinuing anticoagulation medication before prostate biopsy may be unnecessary.

  14. Strategies for prevention of ultrasound-guided prostate biopsy infections

    Directory of Open Access Journals (Sweden)

    Lu DD

    2016-07-01

    Full Text Available Diane D Lu, Jay D Raman Division of Urology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA Abstract: Prostate cancer is the most common cancer in male patients and the second leading cause of cancer-related mortality in males. To confirm the diagnosis of prostate cancer, an ultrasound-guided needle biopsy is necessary to obtain prostate tissue sufficient for histologic analysis by pathologists. Ultrasound-guided prostate needle biopsy can be accomplished via a transperineal or transrectal approach. The latter biopsy technique involves placing an ultrasound probe into the rectum, visualizing the prostate located just anterior to it, and then obtaining 12–14 biopsies. Each biopsy core requires piercing of the rectal mucosa which can inherently contribute to infection. The increasing infectious risk of prostate needle biopsy requires refinement and re-evaluation of the process in which the technique is performed. Such processes include (but are not limited to prebiopsy risk stratification, antibiotic prophylaxis, use of rectal preparations, and equipment processing. In the subsequent review, we highlight the current available information on different strategies to reduce the risk of infection following prostate needle biopsy. Keywords: prostate cancer, prostate biopsy, urinary tract infection, sepsis, complications

  15. A Prospective Randomized Trial of Two Different Prostate Biopsy Schemes

    Science.gov (United States)

    2016-07-03

    Prostate Cancer; Local Anesthesia; Prostate-Specific Antigen/Blood; Biopsy/Methods; Image-guided Biopsy/Methods; Prostatic Neoplasms/Diagnosis; Prostate/Pathology; Prospective Studies; Humans; Male; Ultrasonography, Interventional/Methods

  16. Strategies for prevention of ultrasound-guided prostate biopsy infections

    Science.gov (United States)

    Lu, Diane D; Raman, Jay D

    2016-01-01

    Prostate cancer is the most common cancer in male patients and the second leading cause of cancer-related mortality in males. To confirm the diagnosis of prostate cancer, an ultrasound-guided needle biopsy is necessary to obtain prostate tissue sufficient for histologic analysis by pathologists. Ultrasound-guided prostate needle biopsy can be accomplished via a transperineal or transrectal approach. The latter biopsy technique involves placing an ultrasound probe into the rectum, visualizing the prostate located just anterior to it, and then obtaining 12–14 biopsies. Each biopsy core requires piercing of the rectal mucosa which can inherently contribute to infection. The increasing infectious risk of prostate needle biopsy requires refinement and re-evaluation of the process in which the technique is performed. Such processes include (but are not limited to) prebiopsy risk stratification, antibiotic prophylaxis, use of rectal preparations, and equipment processing. In the subsequent review, we highlight the current available information on different strategies to reduce the risk of infection following prostate needle biopsy. PMID:27468242

  17. Prostate biopsy tracking with deformation estimation

    CERN Document Server

    Baumann, Michael; Daanen, Vincent; Troccaz, Jocelyne

    2011-01-01

    Transrectal biopsies under 2D ultrasound (US) control are the current clinical standard for prostate cancer diagnosis. The isoechogenic nature of prostate carcinoma makes it necessary to sample the gland systematically, resulting in a low sensitivity. Also, it is difficult for the clinician to follow the sampling protocol accurately under 2D US control and the exact anatomical location of the biopsy cores is unknown after the intervention. Tracking systems for prostate biopsies make it possible to generate biopsy distribution maps for intra- and post-interventional quality control and 3D visualisation of histological results for diagnosis and treatment planning. They can also guide the clinician toward non-ultrasound targets. In this paper, a volume-swept 3D US based tracking system for fast and accurate estimation of prostate tissue motion is proposed. The entirely image-based system solves the patient motion problem with an a priori model of rectal probe kinematics. Prostate deformations are estimated with ...

  18. External validation of extended prostate biopsy nomogram

    OpenAIRE

    Hrbáček, Jan; Minárik, Ivo; Sieger, Tomáš; Babjuk, Marek

    2015-01-01

    Introduction Historical nomograms for the prediction of cancer on prostate biopsy, developed in the sextant biopsy era are no more accurate today. The aim of this study was an independent external validation of a 10-core biopsy nomogram by Chun et al. (2007). Material and methods A total of 322 patients who presented for their initial biopsy in a tertiary care center and had all the necessary data available were included in the retrospective analysis. To validate the nomogram, receiver operat...

  19. Systemic Blastomycosis Diagnosed by Prostate Needle Biopsy

    OpenAIRE

    Neal, Peter M.; Nikolai, Anne

    2008-01-01

    A healthy 51-year-old man presented with a 1-month history of lower urinary tract irritative symptoms. Urinalysis was suggestive of infection, and the patient was treated with multiple antibiotics without relief of symptoms.A urological exam demonstrated abnormal induration of the prostate gland. Biopsy of the prostate gland revealed Blastomyces dermatitidis. In areas where Blastomyces dermatitidis is endemic, clinicians should be aware of the presence of this fungus and possible sites of inf...

  20. [Prostate biopsy under magnetic resonance imaging guidance].

    Science.gov (United States)

    Kuplevatskiy, V I; CherkashiN, M A; Roshchin, D A; Berezina, N A; Vorob'ev, N A

    2016-01-01

    Prostate cancer (PC) is one of the most important problems in modern oncology. According to statistical data, PC ranks second in the cancer morbidity structure in the Russian Federation and developed countries and its prevalence has been progressively increasing over the past decade. A need for early diagnosis and maximally accurate morphological verification of the diagnosis in difficult clinical cases (inconvenient tumor location for standard transrectal biopsy; gland scarring changes concurrent with prostatitis and hemorrhage; threshold values of prostate-specific antigen with unclear changes in its doubling per unit time; suspicion of biochemical recurrence or clinical tumor progression after special treatment) leads to revised diagnostic algorithms and clinically introduced new high-tech invasive diagnostic methods. This paper gives the first analysis of literature data on Russian practice using one of the new methods to verify prostate cancer (transrectal prostate cancer under magnetic resonance imaging (MRI) guidance). The have sought the 1995-2015 data in the MEDLINE and Pubmed. PMID:27192773

  1. Study of prostate biopsy robot system

    Institute of Scientific and Technical Information of China (English)

    ZHANG Yong-de; ZHANG Long; ZHAO Yan-jiang; ZHANG Yan-hua

    2009-01-01

    A system for prostate biopsy with robot assistance was proposed. The system consists of Motoman robot, needle insertion mechanism, and control software. A experiment was held with this software, and it proved that the whole system is simple, reliable and good application.

  2. The Results after Transrectal Prostate Biopsy with 12 Biopsy Cores Taken

    OpenAIRE

    Knežević, Marina; Galić, Josip; Tucak, Antun; Ebling, Zdravko

    2004-01-01

    This report describes the clinical value of transrectal prostate biopsy during which 12 biopsy cores are taken in comparison to the classical sextant method. There were 106 patients included in the study, who had transrectal prostate biopsy (TRB) due to abnormal finding after digitorectal examination (DRE) and/or values of PSA > 4 ng/ml in the period from 4 October 2001 till 14 August 2002. There were 117 biopsies with 12 biopsy cores taken, 6 cores from each lobe. Prostate can...

  3. Preparation and management of complications in prostate biopsies

    Directory of Open Access Journals (Sweden)

    Chiang Jeng Tyng

    2013-12-01

    Full Text Available Transrectal ultrasonography-guided biopsy plays a key role in prostate sampling for cancer detection. Among interventional procedures, it is one of the most frequent procedures performed by radiologists. Despite the safety and low morbidity of such procedure, possible complications should be promptly assessed and treated. The standardization of protocols and of preprocedural preparation is aimed at minimizing complications as well as expediting their management. The authors have made a literature review describing the possible complications related to transrectal ultrasonography-guided prostate biopsy, and discuss their management and guidance to reduce the incidence of such complications.

  4. [Optimization of prostate biopsy strategy in diagnosis of prostate cancer].

    Science.gov (United States)

    Kimura, Go

    2016-01-01

    The prostate gland is the sole organ that uses not targeted but systematic biopsy in the pathological diagnosis of prostate cancer due to its anatomical location and lack of adequate imaging modality to depict cancer nodules clearly. The U.S. Preventive Services Task Force published that the harms of PSA based screening outweigh the benefits, yielding a grade D recommendation against screening. In this current situation, what we need is to optimize a biopsy template that maximizes the detection rate of clinically significant cancer and provides adequate pathological information for a treatment plan while minimizing the detection of indolent cancers and has good cost-effectiveness and safety. In this manuscript, optimal systematic biopsy templates and possible role of MRI-guided biopsy are reviewed. PMID:26793884

  5. Current status of transrectal ultrasound-guided prostate biopsy in the diagnosis of prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Raja, J. [Department of Radiology, St George' s Hospital, Tooting, London (United Kingdom)]. E-mail: jowadraja@gmail.com; Ramachandran, N. [Department of Radiology, St George' s Hospital, Tooting, London (United Kingdom); Munneke, G. [Department of Radiology, St George' s Hospital, Tooting, London (United Kingdom); Patel, U. [Department of Radiology, St George' s Hospital, Tooting, London (United Kingdom)

    2006-02-15

    In contemporary practice, most prostate cancers are either invisible on ultrasound or indistinguishable from concurrent benign prostatic hyperplasia. Diagnosis therefore rests on prostate biopsy. Biopsies are not simply directed at ultrasonically visible lesions, as these would miss many cancers; rather the whole gland is sampled. The sampling itself is systematic, using patterns based on prostate zonal anatomy and the geographical distribution and frequency of cancer. This review explains the evolution of the prostate biopsy technique, from the classical sextant biopsy method to the more recent extended biopsy protocols (8, 10, 12, >12 and saturation biopsy protocols). Extended protocols are increasingly being used to improve diagnostic accuracy, especially in those patients who require repeat biopsy. This trend has been facilitated by the ongoing improvement in safety and acceptability of the procedure, particularly with the use of antibiotic prophylaxis and local anaesthesia. The technical details of these extended protocols are discussed, as are the current data regarding procedure-related morbidity and how this may be minimized.

  6. Impact of Benign Prostatic Hyperplasia Pharmacological Treatment on Transrectal Prostate Biopsy Adverse Effects

    OpenAIRE

    Marina Zamuner; Ciro Eduardo Falcone; Arnaldo Amstalden Neto; Tomás Bernardo Costa Moretti; Luis Alberto Magna; Fernandes Denardi; Leonardo Oliveira Reis

    2014-01-01

    Background. Benign prostatic hyperplasia (BPH) pharmacological treatment may promote a decrease in prostate vascularization and bladder neck relaxation with theoretical improvement in prostate biopsy morbidity, though never explored in the literature. Methods. Among 242 consecutive unselected patients who underwent prostate biopsy, after excluding those with history of prostate biopsy/surgery or using medications not for BPH, we studied 190 patients. On the 15th day after procedure patients w...

  7. IS URINE CULTURE ROUTINELY NECESSARY BEFORE PROSTATE BIOPSY ?

    OpenAIRE

    Bruyere, Franck; Faivre D'Arcier, Benjamin; Boutin, Jean-Michel; Haillot, Olivier

    2010-01-01

    Abstract Objectives: The objective of this study was to assess the value of a urine bacterial culture performed before prostate biopsy. Methods: We performed a prospective study on 353 patients who underwent prostate biopsy. All patients had a urine bacterial culture performed before biopsy. We compared the outcomes of patients with bacteriuria (left untreated) to those of patients without bacteriuria. Results: Of the 353 men, 12 had a pre-biopsy positive bacterial culture an...

  8. Prostate biopsy after ano-rectal resection: value of CT-guided trans-gluteal biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Cantwell, Colin P.; Hahn, Peter F.; Gervais, Debra A.; Mueller, Peter R. [Massachusetts General Hospital and Harvard Medical School, Division of Abdominal Imaging and Interventional Radiology, Boston, MA (United States)

    2008-04-15

    We describe our single-institutional experience with computed tomography (CT)-guided percutaneous transgluteal biopsy of the prostate in patients in whom transrectal ultrasound-guided biopsy is precluded by prior ano-rectal resection. Between March 1995 and April 2007, 22 patients had 34 prostate biopsies (mean age 68; mean PSA 29 ng/ml; mean follow-up 6.1 years). The charts of patients who had transgluteal biopsy were reviewed for demographic, complications and pathology. Ninety-five percent (21/22) of primary biopsies were diagnostic. Of the 21 diagnostic biopsies, 11 were positive for prostate cancer and ten were definitive benign samples. Seventy-three percent (8/11) of the patients had progressive PSA elevation that mandated 11 further prostate biopsies. Six patients had a second biopsy, one patient had a third and one patient had a fourth biopsy. Among patients who had serial biopsies, 38% (3/8) had prostate cancer. No complications or death occurred. A malignant biopsy was not significantly associated with core number (P = 0.58) or a high PSA level (P = 0.15). CT-guided transgluteal biopsy of the prostate is safe and effective. (orig.)

  9. Ultrasound-guided transrectal extended prostate biopsy: a prospective study

    Institute of Scientific and Technical Information of China (English)

    Mohammed Ahmed Al-Ghazo; Ibrahim Fathi Ghalayini; Ismail Ibrahim Matalka

    2005-01-01

    Aim: To evaluate the diagnostic value of the 10 systematic transrectal ultrasound-guided (TRUS) prostate biopsy compared with the sextant biopsy technique for patients with suspected prostate cancer. Methods: One hundred and fifty-two patients with suspected prostate cancer were included in the study. Patients were entered in the study because they presented with high levels of prostate specific antigen (PSA) (over 4 ng/mL) and/or had undergone an abnormal digital rectal examination (DRE). In addition to sextant prostate biopsy cores, four more biopsies were obtained from the lateral peripheral zone with additional cores from each suspicious area revealed by transrectal ultrasound. Sextant, lateral peripheral zone and suspicious area biopsy cores were submitted separately to the pathological department. Results: Cancer detection rates were 27.6% (42/152) and 19.7% (30/152) for the 10-core and sextant core biopsy protocols, respectively. Adding the lateral peripheral zone (PZ) to the sextant prostate biopsy showed a 28.6% (12/42) increase in the cancer detection rate in patients with positive prostate cancer (P < 0.01).The cancer detection rate in patients who presented with elevated PSA was 29.3% (34/116). When serum PSA was 4-10 ng/mL TRUS-guided biopsy detected cancer in 20.6%, while the detection rate was 32.4% and 47.0% when serum PSA was 10-20 ng/mL and above 20 ng/mL, respectively. Conclusion: The 10 systematic TRUS-guided prostate biopsy improves the detection rate of prostate cancer by 28.6% when compared with the sextant biopsy technique alone, without increase in the morbidity. We therefore recommend the 10-core biopsy protocol to be the preferred method for early detection of prostate cancer.

  10. Risk Factors for Acute Prostatitis after Transrectal Biopsy of the Prostate

    OpenAIRE

    Kim, Sang Jin; Kim, Sun Il; Ahn, Hyun Soo; Choi, Jong Bo; Kim, Young Soo; Kim, Se Joong

    2010-01-01

    Purpose To investigate the incidence, clinical features, pathogenic bacteria, and risk factors associated with acute prostatitis after transrectal prostate biopsy. Materials and Methods We retrospectively reviewed the medical records of 923 transrectal ultrasound-guided needle biopsies of the prostate in 878 patients performed at our institution from June 2004 to May 2009. The indications for biopsy were generally serum prostate-specific antigen (PSA) elevation, abnormal findings on a digital...

  11. Recent advances in image-guided targeted prostate biopsy.

    Science.gov (United States)

    Brown, Anna M; Elbuluk, Osama; Mertan, Francesca; Sankineni, Sandeep; Margolis, Daniel J; Wood, Bradford J; Pinto, Peter A; Choyke, Peter L; Turkbey, Baris

    2015-08-01

    Prostate cancer is a common malignancy in the United States that results in over 30,000 deaths per year. The current state of prostate cancer diagnosis, based on PSA screening and sextant biopsy, has been criticized for both overdiagnosis of low-grade tumors and underdiagnosis of clinically significant prostate cancers (Gleason score ≥7). Recently, image guidance has been added to perform targeted biopsies of lesions detected on multi-parametric magnetic resonance imaging (mpMRI) scans. These methods have improved the ability to detect clinically significant cancer, while reducing the diagnosis of low-grade tumors. Several approaches have been explored to improve the accuracy of image-guided targeted prostate biopsy, including in-bore MRI-guided, cognitive fusion, and MRI/transrectal ultrasound fusion-guided biopsy. This review will examine recent advances in these image-guided targeted prostate biopsy techniques. PMID:25596716

  12. Elevated Prostate Health Index (phi) and Biopsy Reclassification During Active Surveillance of Prostate Cancer

    OpenAIRE

    Darian Andreas; Tosoian, Jeffrey J.; Patricia Landis; Sacha Wolf; Stephanie Glavaris; Lotan, Tamara L.; Schaeffer, Edward M.; Sokoll, Lori J.; Ross, Ashley E.

    2016-01-01

    The Prostate Health Index (phi) has been FDA approved for decision-making regarding prostate biopsy. Phi has additionally been shown to positively correlate with tumor volume, extraprostatic disease and higher Gleason grade tumors. Here we describe a case in which an elevated phi encouraged biopsy of a gentleman undergoing active surveillance leading to reclassification of his disease as high risk prostate cancer.

  13. How to perform transrectal ultrasound and prostate biopsy.

    Science.gov (United States)

    Turner, Bruce; Drudge-Coates, Lawrence

    2016-04-01

    Rationale and key points This article aims to help nurses to support patients who require a prostate biopsy to diagnose or exclude prostate cancer. Nurses will also gain an understanding of the procedure for transrectal biopsy. ▶ A transrectal biopsy is commonly used to access the prostate. ▶ Indications for a biopsy include elevated levels of prostate-specific antigen in the blood, identification of abnormal areas on digital rectal examination and active surveillance of low-risk prostate cancer. ▶ The healthcare professional uses an ultrasound probe to guide them to specific areas of the prostate to obtain biopsy specimens. Reflective activity Clinical skills articles can help update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: 1. How you would identify a patient with post-biopsy sepsis. 2. Psychological support needs of a patient undergoing prostate biopsy. Subscribers can upload their reflective accounts at rcni.com/portfolio . PMID:27050013

  14. Optimizing prostate needle biopsy through 3D simulation

    Science.gov (United States)

    Zeng, Jianchao; Kaplan, Charles; Xuan, Jian Hua; Sesterhenn, Isabell A.; Lynch, John H.; Freedman, Matthew T.; Mun, Seong K.

    1998-06-01

    Prostate needle biopsy is used for the detection of prostate cancer. The protocol of needle biopsy that is currently routinely used in the clinical environment is the systematic sextant technique, which defines six symmetric locations on the prostate surface for needle insertion. However, this protocol has been developed based on the long-term observation and experience of urologists. Little quantitative or scientific evidence supports the use of this biopsy technique. In this research, we aim at developing a statistically optimized new prostate needle biopsy protocol to improve the quality of diagnosis of prostate cancer. This new protocol will be developed by using a three-dimensional (3-D) computer- based probability map of prostate cancer. For this purpose, we have developed a computer-based 3-D visualization and simulation system with prostate models constructed from the digitized prostate specimens, in which the process of prostate needle biopsy can be simulated automatically by the computer. In this paper, we first develop an interactive biopsy simulation mode in the system, and evaluate the performance of the automatic biopsy simulation with the sextant biopsy protocol by comparing the results by the urologist using the interactive simulation mode with respect to 53 prostate models. This is required to confirm that the automatic simulation is accurate and reliable enough for the simulation with respect to a large number of prostate models. Then we compare the performance of the existing protocols using the automatic biopsy simulation system with respect to 107 prostate models, which will statistically identify if one protocol is better than another. Since the estimation of tumor volume is extremely important in determining the significance of a tumor and in deciding appropriate treatment methods, we further investigate correlation between the tumor volume and the positive core volume with 89 prostate models. This is done in order to develop a method to

  15. Optical coherence elastography (OCE) as a method for identifying benign and malignant prostate biopsies

    Science.gov (United States)

    Li, Chunhui; Guan, Guangying; Ling, Yuting; Lang, Stephen; Wang, Ruikang K.; Huang, Zhihong; Nabi, Ghulam

    2015-03-01

    Objectives. Prostate cancer is the most frequently diagnosed malignancy in men. Digital rectal examination (DRE) - a known clinical tool based on alteration in the mechanical properties of tissues due to cancer has traditionally been used for screening prostate cancer. Essentially, DRE estimates relative stiffness of cancerous and normal prostate tissue. Optical coherence elastography (OCE) are new optical imaging techniques capable of providing cross-sectional imaging of tissue microstructure as well as elastogram in vivo and in real time. In this preliminary study, OCE was used in the setting of the human prostate biopsies ex vivo, and the images acquired were compared with those obtained using standard histopathologic methods. Methods. 120 prostate biopsies were obtained by TRUS guided needle biopsy procedures from 9 patients with clinically suspected cancer of the prostate. The biopsies were approximately 0.8mm in diameter and 12mm in length, and prepared in Formalin solution. Quantitative assessment of biopsy samples using OCE was obtained in kilopascals (kPa) before histopathologic evaluation. The results obtained from OCE and standard histopathologic evaluation were compared provided the cross-validation. Sensitivity, specificity, and positive and negative predictive values were calculated for OCE (histopathology was a reference standard). Results. OCE could provide quantitative elasticity properties of prostate biopsies within benign prostate tissue, prostatic intraepithelial neoplasia, atypical hyperplasia and malignant prostate cancer. Data analysed showed that the sensitivity and specificity of OCE for PCa detection were 1 and 0.91, respectively. PCa had significantly higher stiffness values compared to benign tissues, with a trend of increasing in stiffness with increasing of malignancy. Conclusions. Using OCE, microscopic resolution elastogram is promising in diagnosis of human prostatic diseases. Further studies using this technique to improve the

  16. Head-to-head comparison of two online nomograms for prostate biopsy outcome prediction

    OpenAIRE

    M. de OLIVEIRA; Marques, V.; Carvalho, AP; Santos, A.

    2011-01-01

    LEVEL OF EVIDENCE: 2b. What's known on the subject? and What does the study add? In recent years, several nomograms were developed in an effort to decrease the number of unnecessary prostate biopsies. The European SWOP-PRI and the North American PCPT are among the most popular. However, evidence on the relative predictive accuracy is lacking. A head-to-head comparison on the diagnostic accuracy of two previously validated prostate cancer risk predictors on biopsy confirmed the superiority ...

  17. Antibiotic prophylaxis for transrectal prostate biopsy-a new strategy

    DEFF Research Database (Denmark)

    Antsupova, Valeria; Nørgaard, Nis; Bisbjerg, Rasmus;

    2014-01-01

    BACKGROUND: Fluoroquinolones are extensively used as prophylaxis for transrectal ultrasound-guided biopsy of the prostate (TRUBP). Emerging fluoroquinolone resistance and selection of multiresistant organisms warrant new prophylactic strategies. Pivmecillinam and amoxicillin/clavulanic acid have...

  18. Modified Bowel Preparation to Reduce Infection after Prostate Biopsy

    OpenAIRE

    Yun-Ching Huang; Dong-Ru Ho; Ching-Fang Wu; Jia-Jen Shee; Wei-Yu Lin; Chih-Shou Chen

    2006-01-01

    Background: Infectious complications after ultrasound guided prostate biopsy are animportant issue of concern. We found a higher infection rate with traditionalbowel preparation, the phosphate enema, for prostate biopsy and so we modifiedour technique. In addition, we tried to assess the efficacy of this modifiedmethod for aged patients in an agricultural area who have poor complianceor inaccuracy when self-administering bowel preparations.Methods: Between April 2002 and May 2005, all patient...

  19. Biopsym : a learning environment for transrectal ultrasound guided prostate biopsies

    CERN Document Server

    Thomas, Janssoone; Vadcard, Lucile; Mozer, Pierre; Troccaz, Jocelyne

    2010-01-01

    This paper describes a learning environment for image-guided prostate biopsies in cancer diagnosis; it is based on an ultrasound probe simulator virtually exploring real datasets obtained from patients. The aim is to make the training of young physicians easier and faster with a tool that combines lectures, biopsy simulations and recommended exercises to master this medical gesture. It will particularly help acquiring the three-dimensional representation of the prostate needed for practicing biopsy sequences. The simulator uses a haptic feedback to compute the position of the virtual probe from three-dimensional (3D) ultrasound recorded data. This paper presents the current version of this learning environment.

  20. Prostate Cancer Detection at Rebiopsy After an Initial Benign Diagnosis: Results Using Sextant Extended Prostate Biopsy

    OpenAIRE

    Katia Ramos Moreira Leite; Luiz Heraldo Camara-Lopes; José Cury; Marcos F. Dall'Oglio; Adriana Sañudo; Miguel Srougi

    2008-01-01

    INTRODUCTION: Sextant prostate biopsy remains the standard technique for the detection of prostate cancer. It is well known that after a diagnosis of small acinar proliferation (ASAP) or high grade prostate intraepithelial neoplasia (HGPIN), the possibility of finding cancer is approximately 40% and 30%, respectively. OBJECTIVE: We aim to analyze follow-up biopsies on patients who initially received a benign diagnosis after exclusion of HGPIN and ASAP. METHODS: From July 2000 to December 2003...

  1. Targeted prostate biopsy and MR-guided therapy for prostate cancer.

    Science.gov (United States)

    Woodrum, David A; Kawashima, Akira; Gorny, Krzysztof R; Mynderse, Lance A

    2016-05-01

    Prostate cancer is the most commonly diagnosed noncutaneous cancer and second-leading cause of death in men. Many patients with clinically organ-confined prostate cancer undergo definitive treatment of the whole gland including radical prostatectomy, radiation therapy, and cryosurgery. Active surveillance is a growing alternative option for patients with documented low-volume, low-grade prostate cancer. With recent advances in software and hardware of MRI, multiparametric MRI of the prostate has been shown to improve the accuracy in detecting and characterizing clinically significant prostate cancer. Targeted biopsy is increasingly utilized to improve the yield of MR-detected, clinically significant prostate cancer and to decrease in detection of indolent prostate cancer. MR-guided targeted biopsy techniques include cognitive MR fusion TRUS biopsy, in-bore transrectal targeted biopsy using robotic transrectal device, and in-bore direct MR-guided transperineal biopsy with a software-based transperineal grid template. In addition, advances in MR compatible thermal ablation technology allow accurate focal or regional delivery of optimal thermal energy to the biopsy-proved, MRI-detected tumor, utilizing cryoablation, laser ablation, high-intensity focused ultrasound ablation under MR guidance and real-time or near simultaneous monitoring of the ablation zone. Herein we present a contemporary review of MR-guided targeted biopsy techniques of MR-detected lesions as well as MR-guided focal or regional thermal ablative therapies for localized naïve and recurrent cancerous foci of the prostate. PMID:26907717

  2. Value of prostate multiparametric magnetic resonance imaging for predicting biopsy results in first or repeat biopsy

    International Nuclear Information System (INIS)

    Aim: To assess multiparametric magnetic resonance imaging (mp-MRI) in predicting prostate biopsy results. Materials and methods: Patients who underwent mp-MRI prior to prostate biopsy were prospectively included. The prostate was subdivided into 14 sectors and mp-MRI findings assessed using a five-level subjective suspicion score (SSS). Biopsy included targeted samples of abnormal sectors and systematic samples of normal peripheral zone sectors. Results: Two hundred and eighty-eight patients were included [153 biopsy naïve, 135 with negative (n = 51) or positive (n = 84) prior biopsy]. Biopsy was positive in 168 patients. mp-MRI area under the receiver operating characteristic (ROC) curve (AUC) was 69.1% (95% CI: 67.1–70.9%), 72.5% (95% CI: 69.5–76%), and 73.8% (95% CI: 68.3–79.3%) at per sector, per lobe, and per patient analysis, respectively. At the per sector level, the AUC was significantly larger if detection was limited to cancers with a Gleason score of ≥7 (72.6%; 95% CI: 69.8–75.8%; p < 0.01) or ≥8 (87.1%; 95% CI: 78.3–95.7%; p < 0.01). mp-MRI performance was significantly influenced by prostate volume (p = 0.02), the presence of a concordant hypoechoic area (p < 0.001), but not by prostate-specific antigen (PSA) value, status of prior biopsy, or radiologists' experience. SSS was significantly associated with the Gleason score in true-positive lobes and patients (p < 0.0001). Using a SSS threshold of ≥3, cancer was missed in 13/102 lobes and 4/72 patients with cancers of Gleason score ≥7. Conclusion: mp-MRI provides a good detection of cancers with a Gleason score of ≥7 in candidates suitable for prostate biopsy

  3. Multiparametric magnetic resonance imaging predicts the presence of prostate cancer in patients with negative prostate biopsy

    OpenAIRE

    Lista, F; Castillo, Ernesto; Gimbernat, H.; Rodríguez-Barbero, José M.; Panizo, J.; Angulo Cuesta, Javier

    2015-01-01

    The objective of this study is to assess the ability of multiparametric prostate magnetic resonance imaging (mpMRI) to detect prostate cancer in patients with prior negative transrectal prostate biopsy (TPB). mpMRI (TSE-T2-w, DWI and DCE sequences) was performed on 1.5 T (Magnetom Avanto; Siemens Healthcare Solutions) in 150 patients suspicious of prostate cancer and with negative TPB. European Society of Urogenital Radiology (ESUR) criteria were used. PSA measurement (total and free), digita...

  4. TRANSRECTAL ULTRASOUND GUIDED PROSTATIC NERVE BLOCKADE FOR PAIN CONTROL DURING TRANSRECTAL PROSTATE BIOPSY

    Institute of Scientific and Technical Information of China (English)

    YANG Liu-ping; DENG Jun-hong; ZHONG Hong; HU Jian-bo; WEI Hong-ai; WANG Liang-sheng

    2005-01-01

    Objective: To assess the effect of transrectal ultrasound guided prostatic nerve blockade on the discomfort associated with systematic biopsy of the prostate. Methods: 73 patients receiving systematic 13 cores biopsy of the prostate were randomized into two groups. Group A(37 cases) received an injection of 5 ml 1% lidocaine into the prostatic neurovascular bundles on each side at the base of the prostate under ultrasound guidance and group B(36 cases) received 5 ml saline injection (0.9% sodium chloride) at the same site. Pain during biopsy was assessed by using a 10-point linear visual analog score (VAS) immediately after the biopsy. Results: The mean pain scores during transrectal prostate biopsy were significantly lower in group A than group B(1.1±0.6 versus 5.9±3.1, t=4.81, P<0.01). During this study no patient in either group had any adverse effect from the injection. Conclusion: Transcrectal ultrasound guided prostatic nerve blockade is a safe and efficacious method for providing satisfactory anesthesia in transrectal prostate biopsy. We recommend its routine administration in all patients during this procedure.

  5. Biopsy follow-up in patients with isolated atypical small acinar proliferation (ASAP in prostate biopsy

    Directory of Open Access Journals (Sweden)

    Luca Leone

    2014-12-01

    Full Text Available The incidence of prostate cancer (PCA was evaluated in 155 patients with isolated Atypical Small Acinar Proliferation (ASAP found on initial prostate biopsy, after a medium-term follow-up (40 months with at least one re-biopsy. Clinical and histological data were analysed. Cancer was detected in 81 of 155 (52.3%. The cancer detection rate was 71.6%, 91.3%, 97.5%, 100% at the 1st re-biopsy, 2nd, 3rd, and 4th rebiopsy respectively. At the uni- and multivariate analyses, prostate volume (≤ 30 cc, transition zone volume (≤ 10 cc, small core length at the initial biopsy (≤ 10 mm and few number of cores at initial biopsy (≤ 8 are predictive of cancer. Furthermore, tumour characteristics on the whole surgical specimens was assessed in 30 men: 13 of 30 (43 % had clinically relevant cancer (volume > 0.5 ml or/and Gleason score ≥ 7, or pT3. Most of relevant cancers were detected in the distal apex, anterior gland and midline. These anatomical sites could be under-sampled at the initial biopsy using the transrectal approach. Our data suggest that follow-up biopsy is recommended in all cases of isolated ASAP detected after biopsy using endfire transrectal probe. The re-biopsy strategy should increase the number of cores (or a saturation biopsy, focusing on area of ASAP in the initial biopsy, but also including the under-sampled areas (anterior gland, distal apex and midline to detect clinically relevant cancers.

  6. MRI-Guided Prostate Biopsy of Native and Recurrent Prostate Cancer.

    Science.gov (United States)

    Woodrum, David A; Gorny, Krzysztof R; Greenwood, Bernadette; Mynderse, Lance A

    2016-09-01

    Prostate cancer is the most commonly diagnosed noncutaneous cancer and second-leading cause of death in men. Many patients with clinically organ-confined prostate cancer undergo definitive, curative treatment of the whole gland with either radical prostatectomy or radiation therapy. However, many men are reluctant to take the definitive step due to potential morbidity associated with either therapy. A growing interest in active surveillance or focal therapy has emerged as realistic alternatives for many patients. With each of these management strategies, it is critical to accurately quantify and stage the cancer with improved biopsy targeting and more precise imaging with magnetic resonance imaging (MRI). Furthermore, having dependable prostate imaging allows for targeted biopsies to improve the yield of clinically significant prostate cancer and decrease detection of indolent prostate cancer. MRI-guided targeted biopsy techniques include cognitive MRI/transrectal ultrasound fusion biopsy, in-bore transrectal targeted biopsy using a calibrated guidance device, and in-bore direct MR-guided transperineal biopsy with a software-based transperineal grid template. Herein we present a contemporary review of MRI-guided targeted biopsy techniques for new and recurrent cancerous foci of the prostate. PMID:27582607

  7. Transrectal Ultrasound-guided Systematic 13-Core Prostate Biopsy to Diagnose Prostate Carcinoma

    Institute of Scientific and Technical Information of China (English)

    Liuping Yang; Junhong Deng; Hong Zhong; Jianbo Hu; Hongai Wei; Liangsheng Wang

    2005-01-01

    OBJECTIVE To evaluate the clinical value of transrectal ultrasound guided systematic 13-core prostate biopsy.METHODS A total of 213 patients referred for abnormal digital rectal examination and/or with a prostate specific antigen of 4 ng/ml or greater underwent transrectal ultrasound guided systematic 13-core prostate biopsy. This procedure was conducted in addition to the standard sextant biopsies in which cores were taken from the far lateral and middle regions of the gland as described by Eskew. Fathological findings of the additional regions were compared with those of the sextant regions.RESULTS Of the 213 patients 31% had cancer on biopsy (66/213). Of the 66 patients with prostate cancer 14 (21%) had carcinoma only in the additional regions, which would have remained undetected had the sextant biopsy technique been used alone (P<0.05). No severe complications occurred among the patients who underwent transrectal ultrasound guided systematic 13-core prostate biopsy.CONCLUSION Our data demonstrated that transrectal ultrasound guided systematic 13-core prostate biopsy can significantly increase the cancer detection rate. It is safe and efficacious, and should be recommended for use clinically.

  8. PCA3 and PCA3-Based Nomograms Improve Diagnostic Accuracy in Patients Undergoing First Prostate Biopsy

    OpenAIRE

    Virginie Vlaeminck-Guillem; Paul Perrin; Philippe Paparel; Claire Rodriguez-Lafrasse; Myriam Decaussin-Petrucci; Alain Ruffion; Denis Champetier; Marian Devonec

    2013-01-01

    While now recognized as an aid to predict repeat prostate biopsy outcome, the urinary PCA3 (prostate cancer gene 3) test has also been recently advocated to predict initial biopsy results. The objective is to evaluate the performance of the PCA3 test in predicting results of initial prostate biopsies and to determine whether its incorporation into specific nomograms reinforces its diagnostic value. A prospective study included 601 consecutive patients addressed for initial prostate biopsy. Th...

  9. Transrectal ultrasound guided biopsy for detecting early prostate cancer: An Indian experience

    OpenAIRE

    Gupta N; Ansari M; Dass S

    2005-01-01

    BACKGROUND: With the advent of prostate specific antigen the number of patients undergoing prostate biopsy has dramatically increased. The sextant biopsy technique has been conventionally used for the diagnosis of prostate cancer. Recently, concern has arisen that the original sextant method may not include an adequate sample of the prostate, hence it may result in high false negative rates. We conducted a prospective study to determine whether the 5-region prostate biopsy technique signific...

  10. Optimizing the clinical utility of PCA3 to diagnose prostate cancer in initial prostate biopsy

    OpenAIRE

    Rubio-Briones, Jose; Borque, Angel; Esteban, Luis M.; Casanova, Juan; Fernandez-Serra, Antonio; Rubio, Luis; Casanova-Salas, Irene; Sanz, Gerardo; Domínguez-Escrig, Jose; Collado, Argimiro; Gómez-Ferrer, Alvaro; Iborra, Inmaculada; Ramírez-Backhaus, Miguel; Martínez, Francisco; Calatrava, Ana

    2015-01-01

    Background PCA3 has been included in a nomogram outperforming previous clinical models for the prediction of any prostate cancer (PCa) and high grade PCa (HGPCa) at the initial prostate biopsy (IBx). Our objective is to validate such IBx-specific PCA3-based nomogram. We also aim to optimize the use of this nomogram in clinical practice through the definition of risk groups. Methods Independent external validation. Clinical and biopsy data from a contemporary cohort of 401 men with the same in...

  11. Repeated biopsies in prostate cancer patients on active surveillance

    DEFF Research Database (Denmark)

    Thomsen, Frederik Birkebaek; Marcussen, Niels; Berg, Kasper Drimer;

    2015-01-01

    OBJECTIVE: To investigate the clinical implications of interobserver variation in the assessment of re-biopsies obtained during active surveillance (AS). MATERIAL AND METHODS: A total of 107 low-risk prostate cancer patients with a total of 93 diagnostic biopsy sets and 109 re-biopsy sets were...... included. The ISUP 2005 Gleason scoring system was applied for the histopathological assessment of all biopsies. Three different definitions of histopathological progression were applied. Unweighted and linear weighted Kappa statistics were used to compare the interobserver agreement. RESULTS: The overall...... recommendations would have changed in up to 10.1% (95% CI: 5.4%-17.7%) of the 109 re-biopsy sets. CONCLUSION: Kappa statistics demonstrated a strong agreement between the histological evaluations. Still, up to 10% of AS patients would receive different treatment recommendation depending upon which...

  12. Risk Factors Associated with Transrectal Ultrasound Guided Prostate Needle Biopsy in Patients with Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Ke-Hung Tsui

    2009-12-01

    Full Text Available Background: Transrectal ultrasound (TRUS guided prostate needle biopsy is a commonlyused diagnostic procedure. We determined associated risk factors for patientswho suffered major complications and required hospitalization after TRUSguidedprostate biopsy.Methods: A total of 1,529 patients, 27 to 92 years old (mean 67.6 years were includedin this study conducted between January 2003 and July 2006. Each patientunderwent sextant prostate biopsy under transrectal ultrasound guidance.Six-core transrectal biopsies were performed by urologists, consultant urologistsand residents in training.Results: The mean prostate-specific antigen (PSA level and prostate volume were113.2 ng/ml and 46.2 grams, respectively. One hundred forty-seven patientshad complications. Some patients may have had more than one complication,but no major sequelae were seen immediately after biopsy. Sixty-two (4.1%of these patients had gross hematuria, while 26 (1.7% had acute urinaryretention, 21 (1.4% had urinary tract infection, 17 (1.1% had hematospermia,14 (0.9% had anal bleeding and 7 (0.5% had anal pain. Urinary tractinfection and rectal preparation were found significantly associated withcomplications.Conclusions: The results of our study demonstrate that minor complications occur withoutsequelae. Thus, TRUS-guided prostate needle biopsy is a safe and effectivediagnostic tool. Urinary tract infection and rectal preparation might affect thecomplication rate.

  13. Intravenous piperacillin/tazobactam plus fluoroquinolone prophylaxis prior to prostate ultrasound biopsy reduces serious infectious complications and is cost effective

    Directory of Open Access Journals (Sweden)

    Remynse LC

    2011-08-01

    Full Text Available Louis C Remynse III, Patrick J Sweeney, Kevin A Brewton, Jay M LonswayUrology Associates of Battle Creek, PC, Battle Creek, MI, USAAbstract: Infectious complications related to prostate ultrasound and biopsy have increased in the past decade with the emergence of increasing fluoroquinolone bacterial resistance. We investigated the addition of intravenous (iv piperacillin/tazobactam immediately prior to prostate ultrasound and biopsy with standard fluoroquinolone prophylaxis to determine if it would decrease the incidence of serious infectious complications after prostate ultrasound and biopsy. Group 1 patients were a historic control of 197 patients who underwent prostate ultrasound and biopsy with standard fluoroquinolone prophylaxis. Group 2 patients, 104 patients, received standard fluoroquinolone prophylaxis and the addition of a single dose of iv piperacillin/tazobactam 30 minutes prior to prostate ultrasound and biopsy. There were ten serious bacterial infectious complications in group 1 patients. No patients in group 2 developed serious bacterial infections after prostate ultrasound and biopsy. There was approximately a 5% incidence of serious bacterial infection in group 1 patients. Subgroup analysis revealed an almost 2.5 times increased risk of infection in diabetes patients undergoing prostate ultrasound and biopsy. There was a 10% risk of serious bacterial infection in diabetics compared with a 3.8% risk group 1 nondiabetes patients. The addition of a single dose of iv piperacillin/tazobactam along with standard fluoroquinolone prophylaxis substantially reduces the risk of serious bacterial infection after prostate ultrasound and biopsy (P < 0.02.Keywords: piperacillin/tazobactam, fluoroquinolone, prostate biopsy, infectious complications

  14. The results of transperineal versus transrectal prostate biopsy: a systematic review and meta-analysis

    OpenAIRE

    Shen, Peng-Fei; Zhu, Yu-Chun; Wei, Wu-Ran; Yong-zhong LI; Yang, Jie; Li, Yu-Tao; Li, Ding-Ming; Wang, Jia; Zeng, Hao

    2011-01-01

    This systematic review was performed to compare the efficacy and complications of transperineal (TP) vs. transrectal (TR) prostate biopsy. A systematic research of PUBMED, EMBASE and the Cochrane Library was performed to identify all clinical controlled trials on prostate cancer (PCa) detection rate and complications achieved by TP and TR biopsies. Prostate biopsies included sextant, extensive and saturation biopsy procedures. All patients were assigned to a TR group and a TP group. Subgroup ...

  15. Correlation Between Prostatic Transrectal Ultrasound Findings and Biopsy Results

    Directory of Open Access Journals (Sweden)

    Mohammad Kazem Tarzamni

    2009-01-01

    Full Text Available "nIntroduction: Prostate cancer is the most commonly diagnosed cancer in men, making this disease a significant public health issue. Unfortunately, the anatomic location of the prostate does not lend itself to straightforward examination. The advent and refinement of ultrasound technology have provided a new, important method to examine the prostate. Transrectal ultrasonography (TRUS in conjunction with the development of serum assays for prostate-specific antigen (PSA has resulted in an impressive change in the manner of diagnosis and stage presentation of men with prostate cancer. This study aims at evaluating the correlation between prostatic TRUS findings and results of biopsy. "nMaterials and Methods: In an analytic-descriptive study, 130 men referred to Tabriz Sheikholraeis Sonography Center for TRUS were evaluated during a 14-month period. These patients suffered from urinary symptoms and/or had a high level of serum PSA or an abnormal digital rectal examination. After evaluation with TRUS, TRUS-guided sextant biopsy was fulfilled in all patients and this method was considered as the gold standard. Volume and echo pattern of the prostate, as well as presence of nodules were focused during TRUS. "nResults: One hundred thirty men, with the mean age of 68.67±9.56 (47-90 years were enrolled. Based on the results of histopathologic examination, there were 72 (55.38% cases with a malignant condition. The mean age of the patients with malignant disease, as well as the mean serum free and total PSA and PSA density was significantly higher than that in the group with nonmalignant disease. The mean serum free to total PSA was significantly higher in patients with nonmalignant conditions and there was no statistical difference between the two groups according to the volume of the prostate gland. The ROC curve analysis yielded the best sensitivity (88% and specificity (88% for PSA density at a cut-off point ≥ 0.26. The sensitivity and specificity

  16. Infection after transrectal ultrasound-guided prostate biopsy

    OpenAIRE

    Lee, Seung-Ju

    2015-01-01

    Infectious complications after transrectal ultrasound-guided prostate biopsy (TRUS-Bx) appear to be increasing, which reflects the high prevalence of antibiotic-resistant strains of Enterobacteriaceae. Identifying patients at high risk for antibiotic resistance with history taking is an important initial step. Targeted prophylaxis with a prebiopsy rectal swab culture or augmented antibiotic prophylaxis can be considered for patients at high risk of antibiotic resistance. If infectious complic...

  17. Safety of 12 core transrectal ultrasound guided prostate biopsy in patients on aspirin

    OpenAIRE

    Pawan Vasudeva; Niraj Kumar; Anup Kumar; Harbinder Singh; Gaurav Kumar

    2015-01-01

    ABSTRACT Objective: To prospectively assess safety outcome of TRUS guided prostate biopsy in patients taking low dose aspirin. Materials and methods: Consecutive patients, who were planned for 12 core TRUS guided prostate biopsy and satisfied eligibility criteria, were included in the study and divided into two Groups: Group A: patients on aspirin during biopsy, Group B: patients not on aspirin during biopsy, including patients in whom aspirin was stopped prior to the biopsy. Parameters inclu...

  18. Rare complication after a transrectal ultrasound guided prostate biopsy: a giant retroperitoneal hematoma.

    Science.gov (United States)

    Chiancone, Francesco; Mirone, Vincenzo; Fedelini, Maurizio; Meccariello, Clemente; Pucci, Luigi; Carrino, Maurizio; Fedelini, Paolo

    2016-05-24

    Common complications related to transrectal ultrasound (TRUS) guided prostatic needle biopsy are hematuria, hematospermia, and hematochezia. To the best of our knowledge, we report the second case of a very large hematoma extending from the pelvis into the retroperitoneal space in literature.A 66-year-old man with a serum prostate-specific antigen (PSA) of 5.4 ng/ml was admitted to our department for a TRUS-guided prostatic needle biopsy. Laboratory values on the day before biopsy, including coagulation studies, were all normal. The patients did not take any anticoagulant drugs. No immediate complications were encountered. Nevertheless, 7 hours after the biopsy, the patient reached our emergency department with severe diffuse abdominal pain, hypotension, tachycardia, and confusional state. He underwent an ultrasonography and then a computed tomography (CT) scan that showed "a blood collection in the pelvis that extending to the lower pole of left kidney associated with a focus of active contrast extravasation, indicating active ongoing prostate bleeding." Consequently, he underwent a diagnostic angiography that showed no more contrast extravasation, without the need of embolization. Management of hematoma has been conservative and hematoma was completely reabsorbed 4 months later. PMID:26616460

  19. Prostate cancer detection at rebiopsy after an initial benign diagnosis: results using sextant extended prostate biopsy

    Directory of Open Access Journals (Sweden)

    Katia Ramos Moreira Leite

    2008-01-01

    Full Text Available INTRODUCTION: Sextant prostate biopsy remains the standard technique for the detection of prostate cancer. It is well known that after a diagnosis of small acinar proliferation (ASAP or high grade prostate intraepithelial neoplasia (HGPIN, the possibility of finding cancer is approximately 40% and 30%, respectively. OBJECTIVE: We aim to analyze follow-up biopsies on patients who initially received a benign diagnosis after exclusion of HGPIN and ASAP. METHODS: From July 2000 to December 2003, 1177 patients were submitted to sextant extended prostate biopsy in our hospital. The mean patient age was 65.5 years old, and the median number of fragments collected at biopsy was 13. HGPIN and ASAP were excluded from our study. We only considered patients who had a diagnosis of benign at the first biopsy and were subjected to rebiopsies up until May 2005 because of a maintained suspicion of cancer. RESULTS: Cancer was initially detected in 524 patients (44.5%, and the diagnosis was benign in 415 (35.3%. Rebiopsy was indicated for 76 of the latter patients (18.3% because of a persistent suspicion of cancer. Eight cases of adenocarcinoma (10.5% were detected, six (75% at the first rebiopsy. Six patients were submitted to radical prostatectomy, and all tumors were considered clinically significant. CONCLUSION: Our data indicate that in extended prostate biopsy, the first biopsy detects more cancer, and the first, second, and third rebiopsies after an initial benign diagnosis succeed in finding cancer in 7.9% (6/55, 5.9% (1/15 and 20% (1/4 of patients, respectively.

  20. Anterior prostate biopsy at initial and repeat evaluation: is it useful to detect significant prostate cancer?

    Directory of Open Access Journals (Sweden)

    Pietro Pepe

    2015-10-01

    Full Text Available ABSTRACT Purpose: Detection rate for anterior prostate cancer (PCa in men who underwent initial and repeat biopsy has been prospectively evaluated. Materials and Methods: From January 2013 to March 2014, 400 patients all of Caucasian origin (median age 63.5 years underwent initial (285 cases and repeat (115 cases prostate biopsy; all the men had negative digital rectal examination and the indications to biopsy were: PSA values > 10 ng/mL, PSA between 4.1-10 or 2.6-4 ng/mL with free/total PSA≤25% and ≤20%, respectively. A median of 22 (initial biopsy and 31 cores (repeat biopsy were transperineally performed including 4 cores of the anterior zone (AZ and 4 cores of the AZ plus 2 cores of the transition zone (TZ, respectively. Results: Median PSA was 7.9 ng/mL; overall, a PCa was found in 180 (45% patients: in 135 (47.4% and 45 (36% of the men who underwent initial and repeat biopsy, respectively. An exclusive PCa of the anterior zone was found in the 8.9 (initial biopsy vs 13.3% (repeat biopsy of the men: a single microfocus of cancer was found in the 61.2% of the cases; moreover, in 7 out 18 AZ PCa the biopsy histology was predictive of significant cancer in 2 (28.5% and 5 (71.5% men who underwent initial and repeat biopsy, respectively. Conclusions: However AZ biopsies increased detection rate for PCa (10% of the cases, the majority of AZ PCa with histological findings predictive of clinically significant cancer were found at repeat biopsy (about 70% of the cases.

  1. A review of repeat prostate biopsies and the influence of technique on cancer detection: our experience.

    LENUS (Irish Health Repository)

    Quinlan, M R

    2012-02-01

    BACKGROUND: Follow-up of patients with an initial negative prostate biopsy, but surrounding whom a suspicion of prostate cancer persists, is difficult. In addition, debate exists as to the optimal technique for repeat prostate biopsy. AIMS: To assess the cancer detection rate on repeat prostate biopsy. METHODS: We reviewed patients who underwent prostate biopsy in our department in 2005 who had >or=1 previous biopsy within the preceding 5 years. Cancer detection rate on repeat biopsy and the influence of the number of biopsy cores were recorded. RESULTS: Cancer detection rate on repeat biopsy was 15.4%, with approximately 60% detected on the first repeat biopsy, but approximately 10% not confirmed until the fourth repeat biopsy. Gleason score was similar regardless of the time of diagnosis (6.1-6.5). Mean interval between first biopsy and cancer diagnosis (range 18-55 months) depended on the number of repeat procedures. There was an association between the number of biopsy cores and cancer detection. CONCLUSIONS: This study supports the practice of increasing the number of cores taken on initial and first repeat biopsy to maximise prostate cancer detection and reduce the overall number of biopsies needed.

  2. Incidental seminal vesicle amyioidosis observed in diagnostic prostate biopsies-are routine investigations for systemic amyloidosis warranted?

    Institute of Scientific and Technical Information of China (English)

    Zichu Yang; Alexander Laird; Ashley Monaghan; Morag Seywright; Imran Ahmad; Hing Y Leung

    2013-01-01

    Seminal vesicle (SV) amyloidosis is a well-documented histological entity,but it is observed infrequently.Its incidence is on the rise,which is probably related to the increasing use of prostate biopsies to investigate patients with elevated serum prostate-specific antigen levels.Here,we report seven cases of incidental SV amyloidosis over a 3-year period and consider their relationship to the previously suggested aetiological factors.Based on our series,we conclude that incidental localized SV amyloidosis observed in diagnostic prostate biopsies does not warrant formal investigations for systemic amyloidosis.

  3. Organ-confined prostate cancer: effect of prior transrectal biopsy on endorectal MRI and MR spectroscopic imaging

    International Nuclear Information System (INIS)

    Objective: Our aim was to determine the effect of prior transrectal biopsy on endorectal MRI and MR spectroscopic imaging findings in patients with organ-confined prostate cancer. Materials and Methods: Endorectal MRI and MR spectroscopic imaging were performed in 43 patients with biopsy-proven prostate cancer before radical prostatectomy confirming organ-confined disease. For each sextant, two independent reviewers scored the degree of hemorrhage on a scale from 1 to 5 and recorded the presence or absence of capsular irregularity. A spectroscopist recorded the number of spectrally degraded voxels in the peripheral zone. The outcome variables of capsular irregularity and spectral degradation were correlated with the predictor variables of time from biopsy and degree of hemorrhage after biopsy. Results: Capsular irregularity was unrelated to time from biopsy or to degree of hemorrhage. Spectral degradation was inversely related to time from biopsy (p < 0.01); the mean percentage of degraded peripheral zone voxels was 18.5% within 8 weeks of biopsy compared with 7% after 8 weeks. Spectral degradation was unrelated to the degree of hemorrhage. Conclusion: In organ-confined prostate cancer, capsular irregularity can be seen at any time after biopsy and is independent of the degree of hemorrhage, whereas spectral degradation is seen predominantly in the first 8 weeks after biopsy. MRI staging criteria and guidelines for scheduling studies after biopsy may require appropriate modification. (author)

  4. AB102. Efficacy and safety of prostate biopsy at 12 points by 16 G puncture needle

    OpenAIRE

    Liu, Zhenxiang; Chen, Wei(Department of Physics, State Key Laboratory of Nuclear Physics and Technology, Peking University, Beijing, 100871, China); Wu, Wangwen

    2015-01-01

    Objective To investigate the efficacy and safety of transrectal prostate biopsy at 12 points by 16 G puncture needle under ultrasonic guidance. Methods One hundred cases of transrectal prostate biopsy patients under ultrasonic guidance were screened from urinary surgery of our hospital. They were taken as the research objects. All patients were in accordance with “disease diagnosis and treatment guidelines of China urinary surgery [2011]” and the operation indication of prostate biopsy. All p...

  5. Does an asymmetric lobe in digital rectal examination include any risk for prostate cancer? results of 1495 biopsies

    Science.gov (United States)

    Yilmaz, Ömer; Kurul, Özgür; Ates, Ferhat; Soydan, Hasan; Aktas, Zeki

    2016-01-01

    ABSTRACT Introduction: Despite the well-known findings related to malignity in DRE such as nodule and induration, asymmetry of prostatic lobes, seen relatively, were investigated in a few studies as a predictor of prostate cancer so that there is no universally expected conclusion about asymmetry. We aimed to compare cancer detection rate of normal, asymmetric or suspicious findings in DRE by using biopsy results. Materials and Methods: Data of 1495 patients underwent prostate biopsy between 2006-2014 were searched retrospectively. Biopsy indications were abnormal DRE and or elevated PSA level(>4ng/mL). DRE findings were recorded as Group 1: Benign DRE, Group 2: Asymmetry and Group 3: Nodule/induration. Age, prostatic volume, biopsy results and PSA levels were recorded. Results: Mean age, prostate volume and PSA level were 66.72, 55.98 cc and 18.61ng/ mL respectively. Overall cancer detection rate was 38.66 % (575 of 1495). PSA levels were similar in group 1 and 2 but significantly higher in group 3. Prostatic volume was similar in group 1 and 2 and significantly lower in Group 3. Malignity detection rate of group 1,2 and 3 were 28.93%, 34.89% and 55.99% respectively. Group 1 and 2 were similar (p=0.105) but 3 had more chance for cancer detection. Conclusion: Nodule is the most important finding in DRE for cancer detection. Only an asymmetric prostate itself does not mean malignity. PMID:27564280

  6. Is Systematic Sextant Biopsy Suitable for the Detection of Clinically Significant Prostate Cancer?

    OpenAIRE

    Manseck, Andreas; Fröhner, Michael; Oehlschläger, Sven; Hakenberg, Oliver W; Friedrich, Katrin; Theissig, Franz; Wirth, Manfred P.

    2014-01-01

    Background: The optimal extent of the prostate biopsy remains controversial. There is a need to avoid detection of insignificant cancer but not to miss significant and curable tumors. In alternative treatments of prostate cancer, repeated sextant biopsies are used to estimate the response. The aim of this study was to investigate the reliability of a repeated systematic sextant biopsy as the standard biopsy technique in patients with significant tumors which are being considered for curative ...

  7. Prediction of pathological stage in prostate cancer through the percentage of involved fragments upon biopsy

    Directory of Open Access Journals (Sweden)

    Marcos F. Dall'oglio

    2005-10-01

    Full Text Available INTRODUCTION: The need for defining the extension of disease in patients undergoing radical prostatectomy due to prostate adenocarcinoma is a relevant factor cure in such individuals. In order to identify a new independent preoperative factor for predicting the extension of prostate cancer, we assessed the role of the percentage of positive fragments upon biopsy. MATERIALS AND METHODS: A retrospective study compared the percentage of positive fragments on biopsy with the extension of disease as defined by the pathological examination of the surgical specimen from 898 patients undergoing radical prostatectomy due to clinically localized prostate cancer. RESULTS: On the univariate analysis, the percentage of positive fragments on biopsy showed a statistical significance for predicting confined disease (p < 0.001, which was found in 66.7% of the cases under study. Additionally, we observed that the total number of removed fragments exerts no influence on the extension of the disease (p = 0.567. CONCLUSION: the percentage of positive fragments is an independent factor for predicting the pathological stage of prostate adenocarcinoma, and the number of removed fragments is not related to the extension of the disease.

  8. Can Western Based Online Prostate Cancer Risk Calculators Be Used to Predict Prostate Cancer after Prostate Biopsy for the Korean Population?

    OpenAIRE

    Lee, Dong Hoon; Jung, Ha Bum; Park, Jae Won; Kim, Kyu Hyun; Kim, Jongchan; Lee, Seung Hwan; Chung, Byung Ha

    2013-01-01

    Purpose To access the predictive value of the European Randomized Screening of Prostate Cancer Risk Calculator (ERSPC-RC) and the Prostate Cancer Prevention Trial Risk Calculator (PCPT-RC) in the Korean population. Materials and Methods We retrospectively analyzed the data of 517 men who underwent transrectal ultrasound guided prostate biopsy between January 2008 and November 2010. Simple and multiple logistic regression analysis were performed to compare the result of prostate biopsy. Area u...

  9. Development of a 3D ultrasound-guided prostate biopsy system

    Science.gov (United States)

    Cool, Derek; Sherebrin, Shi; Izawa, Jonathan; Fenster, Aaron

    2007-03-01

    Biopsy of the prostate using ultrasound guidance is the clinical gold standard for diagnosis of prostate adenocarinoma. However, because early stage tumors are rarely visible under US, the procedure carries high false-negative rates and often patients require multiple biopsies before cancer is detected. To improve cancer detection, it is imperative that throughout the biopsy procedure, physicians know where they are within the prostate and where they have sampled during prior biopsies. The current biopsy procedure is limited to using only 2D ultrasound images to find and record target biopsy core sample sites. This information leaves ambiguity as the physician tries to interpret the 2D information and apply it to their 3D workspace. We have developed a 3D ultrasound-guided prostate biopsy system that provides 3D intra-biopsy information to physicians for needle guidance and biopsy location recording. The system is designed to conform to the workflow of the current prostate biopsy procedure, making it easier for clinical integration. In this paper, we describe the system design and validate its accuracy by performing an in vitro biopsy procedure on US/CT multi-modal patient-specific prostate phantoms. A clinical sextant biopsy was performed by a urologist on the phantoms and the 3D models of the prostates were generated with volume errors less than 4% and mean boundary errors of less than 1 mm. Using the 3D biopsy system, needles were guided to within 1.36 +/- 0.83 mm of 3D targets and the position of the biopsy sites were accurately localized to 1.06 +/- 0.89 mm for the two prostates.

  10. PCA3 and PCA3-Based Nomograms Improve Diagnostic Accuracy in Patients Undergoing First Prostate Biopsy

    Directory of Open Access Journals (Sweden)

    Virginie Vlaeminck-Guillem

    2013-08-01

    Full Text Available While now recognized as an aid to predict repeat prostate biopsy outcome, the urinary PCA3 (prostate cancer gene 3 test has also been recently advocated to predict initial biopsy results. The objective is to evaluate the performance of the PCA3 test in predicting results of initial prostate biopsies and to determine whether its incorporation into specific nomograms reinforces its diagnostic value. A prospective study included 601 consecutive patients addressed for initial prostate biopsy. The PCA3 test was performed before ≥12-core initial prostate biopsy, along with standard risk factor assessment. Diagnostic performance of the PCA3 test was evaluated. The three available nomograms (Hansen’s and Chun’s nomograms, as well as the updated Prostate Cancer Prevention Trial risk calculator; PCPT were applied to the cohort, and their predictive accuracies were assessed in terms of biopsy outcome: the presence of any prostate cancer (PCa and high-grade prostate cancer (HGPCa. The PCA3 score provided significant predictive accuracy. While the PCPT risk calculator appeared less accurate; both Chun’s and Hansen’s nomograms provided good calibration and high net benefit on decision curve analyses. When applying nomogram-derived PCa probability thresholds ≤30%, ≤6% of HGPCa would have been missed, while avoiding up to 48% of unnecessary biopsies. The urinary PCA3 test and PCA3-incorporating nomograms can be considered as reliable tools to aid in the initial biopsy decision.

  11. Pain during Transrectal Ultrasound-Guided Prostate Biopsy and the Role of Periprostatic Nerve Block: What Radiologists Should Know

    Energy Technology Data Exchange (ETDEWEB)

    Nazir, Babar [Dept. of Oncologic Imaging, National Cancer Centre, Singapore (Singapore)

    2014-10-15

    Early prostate cancers are best detected with transrectal ultrasound (TRUS)-guided core biopsy of the prostate. Due to increased longevity and improved prostate cancer screening, more men are now subjected to TRUS-guided biopsy. To improve the detection rate of early prostate cancer, the current trend is to increase the number of cores obtained. The significant pain associated with the biopsy procedure is usually neglected in clinical practice. Although it is currently underutilized, the periprostatic nerve block is an effective technique to mitigate pain associated with prostate biopsy. This article reviews contemporary issues pertaining to pain during prostate biopsy and discusses the practical aspects of periprostatic nerve block.

  12. Pain during Transrectal Ultrasound-Guided Prostate Biopsy and the Role of Periprostatic Nerve Block: What Radiologists Should Know

    International Nuclear Information System (INIS)

    Early prostate cancers are best detected with transrectal ultrasound (TRUS)-guided core biopsy of the prostate. Due to increased longevity and improved prostate cancer screening, more men are now subjected to TRUS-guided biopsy. To improve the detection rate of early prostate cancer, the current trend is to increase the number of cores obtained. The significant pain associated with the biopsy procedure is usually neglected in clinical practice. Although it is currently underutilized, the periprostatic nerve block is an effective technique to mitigate pain associated with prostate biopsy. This article reviews contemporary issues pertaining to pain during prostate biopsy and discusses the practical aspects of periprostatic nerve block.

  13. Initial prostate biopsy: development and internal validation of a biopsy-specific nomogram based on the prostate cancer antigen 3 assay

    NARCIS (Netherlands)

    Hansen, J.; Auprich, M.; Ahyai, S.A.; Taille, A. De La; Poppel, H. van; Marberger, M.; Stenzl, A.; Mulders, P.F.A.; Huland, H.; Fisch, M.; Abbou, C.C.; Schalken, J.A.; Fradet, Y.; Marks, L.S.; Ellis, W.; Partin, A.W.; Pummer, K.; Graefen, M.; Haese, A.; Walz, J.; Briganti, A.; Shariat, S.F.; Chun, F.K.

    2013-01-01

    BACKGROUND: Urinary prostate cancer antigen 3 (PCA3) assay in combination with established clinical risk factors improves the identification of men at risk of harboring prostate cancer (PCa) at initial biopsy (IBX). OBJECTIVE: To develop and validate internally the first IBX-specific PCA3-based nomo

  14. Antibiotic prophylaxis for transrectal ultrasound biopsy of the prostate in Ireland.

    LENUS (Irish Health Repository)

    Smyth, L G

    2012-03-01

    Prostate cancer is the most common solid cancer affecting men in Ireland. Transrectal ultrasound (TRUS) biopsies of the prostate are routinely performed to diagnose prostate cancer. They are, in general, a safe procedure but are associated with a significant risk of infective complications ranging from fever, urinary tract infection to severe urosepsis. At present, there are no recommended national guidelines on the use of antibiotic prophylaxis to minimise the risk of infective complications post-TRUS biopsy.

  15. Protocol for the realization of transrectal prostatic biopsy guided by ultrasound

    International Nuclear Information System (INIS)

    A general protocol is proposed for the realization of the ultrasound-guided prostatic biopsy in patients with positive screening. The screening should be performed taking into account risk antecedents, rectal examination and prostate-specific antigen (PSA) levels in the patients. However, patients that have presented without alteration in the PSA and suspect rectal examination, should be considered for biopsy endorectal with ultrasound guidance even more with positive risk factors. The generalities of prostate cancer are described. The general prostatic anatomy and echographic are reviewed. The echographic technique is analyzed in the exploration endorectal. The echographic findings suspects of prostate cancer are characterized. The different biopsy sampling techniques are described; and based on appropriate knowledge of prostatic echographic anatomy, could increase the effectiveness in the early detection of prostate cancer in patients with positive screening. The complications derived from the process are enumerated. The final recommendations are noted on the protocol described

  16. Morbidity and Discomfort of Ten-Core Biopsy of the Prostate Evaluated by Questionnaire

    OpenAIRE

    Manseck, Andreas; Guhr, Karsten; Fröhner, Michael; Hakenberg, Oliver W; Wirth, Manfred P.

    2014-01-01

    Transition zone biopsies have been found to increase the detection rates of cancer of the prostate in patients with negative digital rectal examination. There are however no data available whether the higher biopsy rate is associated with greater morbidity. The present study was therefore designed to evaluate the complication rate of extended sextant biopsy. In this prospective study, 162 consecutive patients who presented for prostatic evaluation were included. After starting prophylactic an...

  17. Significant impact of transperineal template biopsy of the prostate at a single tertiary institution

    Directory of Open Access Journals (Sweden)

    Sean Huang

    2015-01-01

    Conclusions: Transperineal biopsy at our institution showed a high rate of disease-upgrading, with a large proportion involving anterior and transition zones. A significant amount of patients went on to receive curative treatment. TPB is a valuable diagnostic procedure with minimal risk of developing urosepsis. We believe TBP should be offered as an option for all repeat prostate biopsies and considered as an option for initial prostate biopsy.

  18. Real-time virtual sonography for navigation during targeted prostate biopsy using magnetic resonance imaging data

    International Nuclear Information System (INIS)

    The objective of this study was to evaluate the effectiveness of the medical navigation technique, namely, Real-time Virtual Sonography (RVS), for targeted prostate biopsy. Eighty-five patients with suspected prostate cancer lesions using magnetic resonance imaging (MRI) were included in this study. All selected patients had at least one negative result on the previous transrectal biopsies. The acquired MRI volume data were loaded onto a personal computer installed with RVS software, which registers the volumes between MRI and real-time ultrasound data for real-time display. The registered MRI images were displayed adjacent to the ultrasonographic sagittal image on the same computer monitor. The suspected lesions on T2-weighted images were marked with a red circle. At first suspected lesions were biopsied transperineally under real-time navigation with RVS and then followed by the conventional transrectal and transperineal biopsy under spinal anesthesia. The median age of the patients was 69 years (56-84 years), and the prostate-specific antigen level and prostate volume were 9.9 ng/mL (4.0-34.2) and 37.2 mL (18-141), respectively. Prostate cancer was detected in 52 patients (61%). The biopsy specimens obtained using RVS revealed 45/52 patients (87%) positive for prostate cancer. A total of 192 biopsy cores were obtained using RVS. Sixty-two of these (32%) were positive for prostate cancer, whereas conventional random biopsy revealed cancer only in 75/833 (9%) cores (P<0.01). Targeted prostate biopsy with RVS is very effective to diagnose lesions detected with MRI. This technique only requires additional computer and RVS software and thus is cost-effective. Therefore, RVS-guided prostate biopsy has great potential for better management of prostate cancer patients. (author)

  19. Transrectal ultrasound guided biopsy for detecting early prostate cancer: An Indian experience

    Directory of Open Access Journals (Sweden)

    Gupta N

    2005-01-01

    Full Text Available BACKGROUND: With the advent of prostate specific antigen the number of patients undergoing prostate biopsy has dramatically increased. The sextant biopsy technique has been conventionally used for the diagnosis of prostate cancer. Recently, concern has arisen that the original sextant method may not include an adequate sample of the prostate, hence it may result in high false negative rates. We conducted a prospective study to determine whether the 5-region prostate biopsy technique significantly increases the chance of prostate cancer detection as compared to the sextant biopsy technique. AIMS: To evaluate the efficacy of TRUS guided sextant and 5-region biopsy techniques in detecting carcinoma prostate in patients with PSA between 4 and 10 ng/ml and normal digital rectal examination. METHODS AND MATERIAL: Between December 2001 and August 2003 one forty-two men, aged 49-82 years, who presented with LUTS, normal digital rectal examination (DRE and PSA between 4 and 10 ng/ml underwent TRUS guided sextant prostate biopsy. Serum PSA was reassessed after 3 months in patients whose biopsies were negative for cancer. If PSA was still raised, the patients underwent extensive 5-region biopsy. RESULTS: Mean patient age was 64 years and median PSA was 6.9 ng/ml. TRUS guided sextant biopsy revealed adenocarcinoma prostate in 34 men (24%. Median Gleason score was 7. Seven men (4.9% had cellular atypia and 3(2.1% had prostatic intraepithelial neoplasia (high grade. On repeat PSA estimation after 3 months, 48 patients showed stagnant or rising trend for which they underwent TRUS guided 13-core biopsy. Five (10.4% patients were detected to have adenocarcinoma on repeat biopsy. Biopsy negative patients are on regular follow up with yearly PSA estimation. Complications included transient mild haematuria in14 patients (9.82% and haematospermia in 4 (2.8%. Urinary retention developed in one patient and required an indwelling catheter for 4 days. CONCLUSION

  20. Cost-effectiveness of culture-guided antimicrobial prophylaxis for the prevention of infections after prostate biopsy

    OpenAIRE

    Chi-kong Li; Brian C.Y. Tong; You, Joyce H S

    2016-01-01

    Background: Clinical findings suggest that the use of rectal culture-guided antibiotic prophylaxis reduces the infection rate following transrectal ultrasound-guided prostate biopsy (TRUSBx). Methods: A decision-analytic model was designed to compare the outcomes of TRUSBx performed with (rectal culture-guided group) and without (standard ciprofloxacin prophylaxis) rectal swab culture-guided antimicrobial prophylaxis in Hong Kong. The post-biopsy infection rate, infection-related costs, qu...

  1. Mapping of transrectal ultrasonographic prostate biopsies: quality control and learning curve assessment by image processing

    CERN Document Server

    Mozer, Pierre; Chevreau, Gregoire; Moreau-Gaudry, Alexandre; Bart, Stephane; Renard-Penna, Raphaele; Comperat, Eva; Conort, Pierre; Bitker, Marc-Olivier; Chartier-Kastler, Emmanuel; Richard, Francois; Troccaz, Jocelyne

    2009-01-01

    Objective: Mapping of transrectal ultrasonographic (TRUS) prostate biopsies is of fundamental importance for either diagnostic purposes or the management and treatment of prostate cancer, but the localization of the cores seems inaccurate. Our objective was to evaluate the capacities of an operator to plan transrectal prostate biopsies under 2-dimensional TRUS guidance using a registration algorithm to represent the localization of biopsies in a reference 3-dimensional ultrasonographic volume. Methods: Thirty-two patients underwent a series of 12 prostate biopsies under local anesthesia performed by 1 operator using a TRUS probe combined with specific third-party software to verify that the biopsies were indeed conducted within the planned targets. RESULTS: The operator reached 71% of the planned targets with substantial variability that depended on their localization (100% success rate for targets in the middle and right parasagittal parts versus 53% for targets in the left lateral base). Feedback from this ...

  2. Multiparametric MRI and targeted prostate biopsy: Improvements in cancer detection, localization, and risk assessment

    Science.gov (United States)

    Bjurlin, Marc A.; Mendhiratta, Neil; Wysock, James S.

    2016-01-01

    Introduction Multiparametric-MRI (mp-MRI) is an evolving noninvasive imaging modality that increases the accurate localization of prostate cancer at the time of MRI targeted biopsy, thereby enhancing clinical risk assessment, and improving the ability to appropriately counsel patients regarding therapy. Material and methods We used MEDLINE/PubMed to conduct a comprehensive search of the English medical literature. Articles were reviewed, data was extracted, analyzed, and summarized. In this review, we discuss the mp-MRI prostate exam, its role in targeted prostate biopsy, along with clinical applications and outcomes of MRI targeted biopsies. Results Mp-MRI, consisting of T2-weighted imaging, diffusion-weighted imaging, dynamic contrast-enhanced imaging, and possibly MR spectroscopy, has demonstrated improved specificity in prostate cancer detection as compared to conventional T2-weighted images alone. An MRI suspicion score has been developed and is depicted using an institutional Likert or, more recently, a standardized reporting scale (PI-RADS). Techniques of MRI-targeted biopsy include in-gantry MRI guided biopsy, TRUS-guided visual estimation biopsy, and software co-registered MRI-US guided biopsy (MRI-US fusion). Among men with no previous biopsy, MRI-US fusion biopsy demonstrates up to a 20% increase in detection of clinically significant cancers compared to systematic biopsy while avoiding a significant portion of low risk disease. These data suggest a potential role in reducing over-detection and, ultimately, over-treatment. Among men with previous negative biopsy, 72–87% of cancers detected by MRI targeted biopsy are clinically significant. Among men with known low risk cancer, repeat biopsy by MR-targeting improves risk stratification in selecting men appropriate for active surveillance secondarily reducing the need for repetitive biopsy during surveillance. Conclusions Use of mp-MRI for targeting prostate biopsies has the potential to reduce the

  3. Touch imprint cytology of prostate core needle biopsy specimens: A useful method for immediate reporting of prostate cancer

    Directory of Open Access Journals (Sweden)

    Berna Aytac

    2012-01-01

    Conclusions: TIC smears can provide an immediate and reliable cytological diagnosis of prostate carcinoma. It may clearly help the rapid detection of carcinoma, particularly in highly suspected cases that had negative routine biopsy results for malignancy with abnormal serum prostate specific antigen (PSA levels and atypical digital rectal examination.

  4. Periostin identified as a potential biomarker of prostate cancer by iTRAQ-proteomics analysis of prostate biopsy

    Directory of Open Access Journals (Sweden)

    Tong Shijun

    2011-04-01

    Full Text Available Abstract Background Proteomics may help us better understand the changes of multiple proteins involved in oncogenesis and progression of prostate cancer(PCa and identify more diagnostic and prognostic biomarkers. The aim of this study was to screen biomarkers of PCa by the proteomics analysis using isobaric tags for relative and absolute quantification(iTRAQ. Methods The patients undergoing prostate biopsies were classified into 3 groups according to pathological results: benign prostate hyperplasia (BPH, n = 20, PCa(n = 20 and BPH with local prostatic intraepithelial neoplasm(PIN, n = 10. Then, all the specimens from these patients were analyzed by iTRAQ and two-dimensional liquid chromatography-tandem mass spectrometry (2DLC-MS/MS. The Gene Ontology(GO function and the transcription regulation networks of the differentially expressed were analyzed by MetaCore software. Western blotting and Immunohistochemical staining were used to analyze the interesting proteins. Result A total of 760 proteins were identified from 13787 distinct peptides, including two common proteins that enjoy clinical application: prostate specific antigen (PSA and prostatic acid phosphatase(PAP. Proteins that expressed differentially between PCa and BPH group were further analyzed. Compared with BPH, 20 proteins were significantly differentially up-regulated (>1.5-fold while 26 were significantly down-regulated in PCa( Conclusion Our study indicates that the iTRAQ technology is a new strategy for global proteomics analysis of the tissues of PCa. A significant up-regulation of periostin in PCa compared to BPH may provide clues for not only a promising biomarker for the prognosis of PCa but also a potential target for therapeutical intervention.

  5. Medially Directed TRUS Biopsy of the Prostate: Clinical Utility and Optimal Protocol

    Energy Technology Data Exchange (ETDEWEB)

    Park, Byung Kwan; Kim, Seung Hyup [Dept. of Radiology, and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2012-06-15

    The objective of this study is to determine whether medially directed transrectal ultrasound (TRUS)-guided biopsy is necessary for detection of prostate cancer and for establishment of an optimal biopsy regimen that is equivalent to a systematic 12 core biopsy. A total of 302 patients underwent a TRUS-guided systematic 12 core biopsy consisting of both medial sextant biopsy obtained between the parasagittal line and midline and lateral sextant biopsy obtained between the parasagittal line and lateral border. We obtained cancer detection rates of various biopsy regimens that were produced from a systematic 12 core biopsy. Using a systematic 12 core biopsy, cancer was detected in 116 (38.4%) of 302 patients. No significant difference was observed between cancer detection rates of medial sextant biopsy and lateral sextant biopsy (33.8% versus 31.5%, p >.05). Biopsy regimens that were equivalent to the systematic 12 core regarding cancer detection rate included medially directed cores that were obtained from both medial portions of the apex. Both medially directed biopsy and laterally directed biopsy are necessary for detection of prostate cancer and for establishment of an optimal biopsy regimen.

  6. Medially Directed TRUS Biopsy of the Prostate: Clinical Utility and Optimal Protocol

    International Nuclear Information System (INIS)

    The objective of this study is to determine whether medially directed transrectal ultrasound (TRUS)-guided biopsy is necessary for detection of prostate cancer and for establishment of an optimal biopsy regimen that is equivalent to a systematic 12 core biopsy. A total of 302 patients underwent a TRUS-guided systematic 12 core biopsy consisting of both medial sextant biopsy obtained between the parasagittal line and midline and lateral sextant biopsy obtained between the parasagittal line and lateral border. We obtained cancer detection rates of various biopsy regimens that were produced from a systematic 12 core biopsy. Using a systematic 12 core biopsy, cancer was detected in 116 (38.4%) of 302 patients. No significant difference was observed between cancer detection rates of medial sextant biopsy and lateral sextant biopsy (33.8% versus 31.5%, p >.05). Biopsy regimens that were equivalent to the systematic 12 core regarding cancer detection rate included medially directed cores that were obtained from both medial portions of the apex. Both medially directed biopsy and laterally directed biopsy are necessary for detection of prostate cancer and for establishment of an optimal biopsy regimen.

  7. Lack of detection of human papillomavirus infection by hybridization test in prostatic biopsies

    International Nuclear Information System (INIS)

    To explore the possibility of finding human papillomavirus (HPV) infection in the prostate tissue of a cohort of Saudi men presenting with benign prostatic hyperplasia (BPH) or prostate cancer. A cohort study on prospectively collected tissue samples was conducted at King Abdulaziz University Hospital (KAUH), Jeddah, Kingdom of Saudi Arabia from March 2007 to December 2008 on a total of 56 male patients, age range 50-93 years (average 68), diagnosed as having BPH or prostate cancer. The HPV DNA hybridization by hybrid capture 2 technology was performed on prostate biopsies of these patients to detect 18 types of HPV infection, and differentiate between 2 HPV DNA groups, the low-risk types, and the high/intermediate risk types.The tissues of all the prostatic biopsies were negative for HPV DNA. Our results, using the hybridization test, indicate that it is unlikely that HPV-16 or HPV-18, or the other tested subtypes, enhance the risk of prostate cancer. (author)

  8. Our experience on developing urinary tract infections after transrectal prostate biopsy

    Directory of Open Access Journals (Sweden)

    Gülay Dede

    2014-03-01

    Full Text Available Objective: Prostate cancer is a common disease in men proportionally with age. For the diagnosis of prostate cancer, prostate biopsy be performed routinely in all centers so it has become today. Complications after prostate biopsy is a surgical procedure can be seen. The most important complications are urinary tract infection and sepsis. The use of prophylactic antibiotics before the procedure reduces the risk of infectious complications. In this study, infectious complications after transrectal prostate needle biopsy were evaluated for risk reduction practices are discussed. Methods: We evaluated infective complications after transrectal prostate needle biopsy in 276 patients admitted to our hospital in October 2009- October 2011 with high level of prostate-specific antigen, abnormal signs in transrectal ultrasound, abnormal digital rectal examination due to done transrectal prostate needle biopsy. Results: Transrectal prostate needle biopsy was performed to 276 cases and 59 (21% cases with hematuria, 21 (7% cases with hematospermia, 23 (8% cases with rectal bleeding, 6 (2.1% cases with asymptomatic bacteriuria, 12 (5.3% cases with in complicated urinary tract infection was detected. Three patients (1% had sepsis. 21 (7.3% patients had positive urine culture. Of them there were 20 positive cultures of E. coli and one Klebsiella spp. respectively. All of the bacteria cultured in twenty-one patients resistant to ciprofloxacin, while 90% to amikacin, 10% to amoxicillin-clavulanate, 35% to cefuroxime sodium and 40% were susceptible to ceftriaxone. Conclusion: Transrectal prostate needle biopsies of 276 patients, 21 (7.3% patients had positive urine culture. The most frequent complication was hematuria. The most serious complication of sepsis detected in three (1% patients.

  9. Safety of ultrasound-guided transrectal extended prostate biopsy in patients receiving low-dose aspirin

    Directory of Open Access Journals (Sweden)

    Ioannis Kariotis

    2010-06-01

    Full Text Available PURPOSE: To determine whether the peri-procedural administration of low-dose aspirin increases the risk of bleeding complications for patients undergoing extended prostate biopsies. MATERIALS AND METHODS: From February 2007 to September 2008, 530 men undergoing extended needle biopsies were divided in two groups; those receiving aspirin and those not receiving aspirin. The morbidity of the procedure, with emphasis on hemorrhagic complications, was assessed prospectively using two standardized questionnaires. RESULTS: There were no significant differences between the two groups regarding the mean number of biopsy cores (12.9 ± 1.6 vs. 13.1 ± 1.2 cores, p = 0.09. No major biopsy-related complications were noted. Statistical analysis did not demonstrate significant differences in the rate of hematuria (64.5% vs. 60.6%, p = 0.46, rectal bleeding (33.6% vs. 25.9%, p = 0.09 or hemospermia (90.1% vs. 86.9%, p = 0.45. The mean duration of hematuria and rectal bleeding was significantly greater in the aspirin group compared to the control group (4.45 ± 2.7 vs. 2.4 ± 2.6, p = < 0.001 and 3.3 ± 1.3 vs. 1.9 ± 0.7, p < 0.001. Multivariate logistic regression analysis revealed that only younger patients (mean age 60.1 ± 5.8 years with a lower body mass index (< 25 kg/m2 receiving aspirin were at a higher risk (odds ratio = 3.46, p = 0.047 for developing hematuria and rectal bleeding after the procedure. CONCLUSIONS: The continuing use of low-dose aspirin in patients undergoing extended prostatic biopsy is a relatively safe option since it does not increase the morbidity of the procedure.

  10. High efficiency for prostate biopsy qualification with full-field OCT after training

    Science.gov (United States)

    Yang, C.; Ricco, R.; Sisk, A.; Duc, A.; Sibony, M.; Beuvon, F.; Dalimier, E.; Delongchamps, N. B.

    2016-02-01

    Full-field optical coherence tomography (FFOCT) offers a fast and non-destructive method of obtaining images of biological tissues at ultrahigh resolution, approaching traditional histological sections. In the context of prostate cancer diagnosis involving multiple biopsies, FFOCT could be used to validate the cores just after they are obtained in order to guide the number of biopsies to be performed. The aim of the study was to define and test a training protocol for efficient FFOCT prostate biopsy assessment. Three readers (a pathologist with previous experience with FFOCT, a pathologist new to FFOCT, and a urologist new to FFOCT) were trained to read FFOCT images of prostate biopsies on a set of 20 commented zooms (1 mm field of view) and 25 complete images. They were later tested on a set of 115 anonymized and randomized images of prostate biopsies. The results showed that an extra 30 images were necessary for more complete training as compared to prior studies. After training, pathologists obtained 100% sensitivity on high-grade cancer detection and 96% overall specificity; the urologist obtained 88% sensitivity on high-grade cancer and 89% overall specificity. Overall, the readers obtained a mean of 93% accuracy of qualifying malignancy on prostate biopsies. Moreover, the two pathologists showed a steeper learning curve than the urologist. This study demonstrates that a training protocol for such a new imaging modality may be implemented and yield very high efficiency for the pre-histologic detection of malignancy on prostate biopsies.

  11. 3D transrectal ultrasound prostate biopsy using a mechanical imaging and needle-guidance system

    Science.gov (United States)

    Bax, Jeffrey; Cool, Derek; Gardi, Lori; Montreuil, Jacques; Gil, Elena; Bluvol, Jeremy; Knight, Kerry; Smith, David; Romagnoli, Cesare; Fenster, Aaron

    2008-03-01

    Prostate biopsy procedures are generally limited to 2D transrectal ultrasound (TRUS) imaging for biopsy needle guidance. This limitation results in needle position ambiguity and an insufficient record of biopsy core locations in cases of prostate re-biopsy. We have developed a multi-jointed mechanical device that supports a commercially available TRUS probe with an integrated needle guide for precision prostate biopsy. The device is fixed at the base, allowing the joints to be manually manipulated while fully supporting its weight throughout its full range of motion. Means are provided to track the needle trajectory and display this trajectory on a corresponding TRUS image. This allows the physician to aim the needle-guide at predefined targets within the prostate, providing true 3D navigation. The tracker has been designed for use with several end-fired transducers that can be rotated about the longitudinal axis of the probe to generate 3D images. The tracker reduces the variability associated with conventional hand-held probes, while preserving user familiarity and procedural workflow. In a prostate phantom, biopsy needles were guided to within 2 mm of their targets, and the 3D location of the biopsy core was accurate to within 3 mm. The 3D navigation system is validated in the presence of prostate motion in a preliminary patient study.

  12. Analysis of the Correlationship between Prostate Specific Antigen Related Variables and Risk Factor in Patients with Prostate Carcinoma

    OpenAIRE

    Daoyuan Wang; Tiejun Yang; Yongqiang Zou; Xinqiang Yang

    2015-01-01

    Aim: To investigate the correlation between the related variables of prostate-specific antigen (PSA) and risk factors in patients with prostate carcinoma. Methods: The clinical records of 187 cases with prostate carcinoma, diagnosed by biopsy, were retrospectively analyzed to assess the correlation of PSA density (PSAD), free PSA (FPSA), and FPSA/total PSA (TPSA) with risk factors in prostate carcinoma. Results: The results from "Spearman rank correlation analysis" and "rank sum test"...

  13. Quantification of prostate deformation due to needle insertion during TRUS-guided biopsy: comparison of hand-held and mechanically stabilized systems

    Science.gov (United States)

    De Silva, Tharindu; Bax, Jeffrey; Fenster, Aaron; Samarabandu, Jagath; Ward, Aaron D.

    2011-03-01

    Prostate biopsy is the clinical standard for the definitive diagnosis of prostate cancer. To overcome the limitations of 2D TRUS-guided biopsy systems when targeting pre-planned locations, systems have been developed with 3D guidance to improve the accuracy of cancer detection. Prostate deformation due to needle insertion and biopsy gun firing is a potential source of error that can cause target misalignments during biopsies. We use non-rigid registration of 2D TRUS images to quantify the deformation during the needle insertion and the biopsy gun firing procedure, and compare this effect in biopsies performed using a handheld TRUS probe with those performed using a mechanically assisted 3D TRUS guided biopsy system. Although the mechanically assisted biopsy system had a mean deformation approximately 0.2 mm greater than that of the handheld approach, it yielded a lower relative increase of deformation near the needle axis during the needle insertion stage and greater deformational stability of the prostate during the biopsy gun firing stage. We also analyzed the axial and lateral components of the tissue motion; our results indicated that the motion is weakly biased in the direction orthogonal to the needle, which is less than ideal from a targeting standpoint given the long, narrow cylindrical shape of the biopsy core.

  14. Endorectal coil MRI and MR-spectroscopic imaging in patients with elevated serum prostate specific antigen with negative trus transrectal ultrasound guided biopsy

    Directory of Open Access Journals (Sweden)

    Farooq Ahmad Ganie

    2013-01-01

    Conclusion: Prostatic biopsy directed with endorectal coil MRI and MR-spectroscopic imaging findings in patients with elevated serum PSA and prior negative biopsy, improves the early diagnosis of prostatic carcinoma and accurate localization of prostate cancer within the gland.

  15. Low grade urothelial carcinoma mimicking basal cell hyperplasia and transitional metaplasia in needle prostate biopsy

    OpenAIRE

    Arista-Nasr, Julian; Martinez-Benitez, Braulio; Bornstein-Quevedo, Leticia; Aguilar-Ayala, Elizmara; Aleman-Sanchez, Claudia Natalia; Ortiz-Bautista, Raul

    2016-01-01

    ABSTRACT Purpose The vast majority of urothelial carcinomas infiltrating the bladder are consistent with high-grade tumors that can be easily recognized as malignant in needle prostatic biopsies. In contrast, the histological changes of low-grade urothelial carcinomas in this kind of biopsy have not been studied. Materials and Methods We describe the clinicopathologic features of two patients with low-grade bladder carcinomas infiltrating the prostate. They reported dysuria and hematuria. Bot...

  16. Prostate Biopsy Assistance System with Gland Deformation Estimation for Enhanced Precision

    CERN Document Server

    Baumann, Michael; Daanen, Vincent; Troccaz, Jocelyne

    2009-01-01

    Computer-assisted prostate biopsies became a very active research area during the last years. Prostate tracking makes it possi- ble to overcome several drawbacks of the current standard transrectal ultrasound (TRUS) biopsy procedure, namely the insufficient targeting accuracy which may lead to a biopsy distribution of poor quality, the very approximate knowledge about the actual location of the sampled tissues which makes it difficult to implement focal therapy strategies based on biopsy results, and finally the difficulty to precisely reach non-ultrasound (US) targets stemming from different modalities, statistical atlases or previous biopsy series. The prostate tracking systems presented so far are limited to rigid transformation tracking. However, the gland can get considerably deformed during the intervention because of US probe pres- sure and patient movements. We propose to use 3D US combined with image-based elastic registration to estimate these deformations. A fast elastic registration algorithm that...

  17. Safety of 12 core transrectal ultrasound guided prostate biopsy in patients on aspirin

    Directory of Open Access Journals (Sweden)

    Pawan Vasudeva

    2015-12-01

    Full Text Available Objective: To prospectively assess safety outcome of TRUS guided prostate biopsy in patients taking low dose aspirin. Materials and methods: Consecutive patients, who were planned for 12 core TRUS guided prostate biopsy and satisfied eligibility criteria, were included in the study and divided into two Groups: Group A: patients on aspirin during biopsy, Group B: patients not on aspirin during biopsy, including patients in whom aspirin was stopped prior to the biopsy. Parameters included for statistical analysis were: age, serum prostate specific antigen (PSA, prostate volume, hemoglobin (Hb %, number of hematuria episodes, number of patient reporting hematuria, hematuria requiring intervention, number of patient reporting hematospermia and number of patient reporting rectal bleeding. Results: Of 681 eligible patients, Group A and B had 191 and 490 patients respectively. The mean age, prostate volume, serum PSA and pre-biopsy hemoglobin were similar in both Groups with no significant differences noted between them. None of the post-biopsy complications, including number of hematuria episodes (p=0.83, number of patients reporting hematuria (p=0.55, number of patients reporting hematospermia (p=0.36 and number of patients reporting rectal bleeding (p=0.65, were significantly different between Groups A and B respectively. None of the hemorrhagic complication in either group required intervention and were self limiting. Conclusion: Continuing low dose aspirin during TRUS guided prostate biopsy neither alters the minor bleeding episodes nor causes major bleeding complication. So, discontinuation of low dose aspirin prior to TRUS guided prostate biopsy is not required.

  18. Optical biopsy of the prostate: can we TRUST (trans-rectal ultrasound-coupled spectral tomography)?

    Science.gov (United States)

    Piao, Daqing; Jiang, Zhen; Bartels, Kenneth E.; Holyoak, G. Reed; Ritchey, Jerry W.; Rock, Kendra; Ownby, Charlotte L.; Bunting, Charles F.; Slobodov, Gennady

    2011-03-01

    Needle-based core-biopsy to locate prostate cancer relies heavily upon trans-rectal ultrasound (TRUS) imaging guidance. Ultrasonographic findings of classic hypoechoic peripheral zone lesions have a low specificity of ~28%, a low positive predictive value of ~29%, and an overall accuracy of ~43%, in prostate cancer diagnosis. The prevalence of isoechoic or nearly invisible prostate cancers on ultrasonography ranges from 25 to 42%. As a result, TRUS is useful and convenient to direct the needle trajectory following a systematic biopsy sampling template rather than to target only the potentially malignant lesion for focal-biopsy. To address this deficiency in the first-line of prostate cancer imaging, a trans-rectal ultrasound-coupled spectral tomography (TRUST) approach is being developed to non-invasively resolve the likely optical signatures of prostate malignancy. The approach has evolved from using one NIR wavelength to two NIR bands, and recently to three bands of NIR spectrum information. The concept has been evaluated on one normal canine prostate and three dogs with implanted prostate tumor developed as a model. The initial results implementing TRUST on the canine prostate tumor model includes: (1) quantifying substantially increased total hemoglobin concentration over the time-course of imaging in a rapidly growing prostate tumor; (2) confirming hypoxia in a prostatic cystic lesion; and (3) imaging hypoxic changes of a necrotic prostate tumor. Despite these interesting results, intensive technologic development is necessary for translating the approach to benefiting clinical practice, wherein the ultimate utility is not possibly to eliminate needle-biopsy but to perform focal-biopsy that is only necessary to confirm the cancer, as well as to monitor and predict treatment responses.

  19. Results of low threshold to biopsy following high-intensity focused ultrasound for localized prostate cancer

    OpenAIRE

    Richard L Haddad; Tania A Hossack; Woo, Henry H.

    2012-01-01

    Context: There are different treatment options for localized prostate cancer. The success of high-intensity focused ultrasound (HIFU) is based largely on biochemical prostate specific antigen (PSA) results. Aims: To evaluate the impact of using a low PSA threshold to perform prostate biopsies after HIFU in order to more accurately gauge treatment success. Settings and Design: Eleven patients underwent HIFU at Sydney Adventist Hospital in Sydney, 10 as primary and 1 as salvage therapy ...

  20. Results of low threshold to biopsy following high-intensity focused ultrasound for localized prostate cancer

    Directory of Open Access Journals (Sweden)

    Richard L Haddad

    2012-01-01

    Conclusions: A low threshold to re-biopsy post-HIFU reveals a high local failure rate of 82%. Oncological efficacy is questioned, and using high threshold to biopsy may therefore be overestimating the effectiveness of HIFU as a primary treatment for localized prostate cancer.

  1. Optimizing Performance and Interpretation of Prostate Biopsy : A Critical Analysis of the Literature

    NARCIS (Netherlands)

    Chun, Felix K. -H.; Epstein, Jonathan I.; Ficarra, Vincenzo; Freedland, Stephen J.; Montironi, Rodolfo; Montorsi, Francesco; Shariat, Shahrokh F.; Schroder, Fritz H.; Scattoni, Vincenzo

    2010-01-01

    Context: The number and location of biopsy cores and the interpretation of prostate biopsy in different clinical settings remain the subjects of continuing debate. Objective: Our aim was to review the current evidence regarding the performance and interpretation of initial, repeat, and saturation pr

  2. Adaptation of a 3D prostate cancer atlas for transrectal ultrasound guided target-specific biopsy

    International Nuclear Information System (INIS)

    Due to lack of imaging modalities to identify prostate cancer in vivo, current TRUS guided prostate biopsies are taken randomly. Consequently, many important cancers are missed during initial biopsies. The purpose of this study was to determine the potential clinical utility of a high-speed registration algorithm for a 3D prostate cancer atlas. This 3D prostate cancer atlas provides voxel-level likelihood of cancer and optimized biopsy locations on a template space (Zhan et al 2007). The atlas was constructed from 158 expert annotated, 3D reconstructed radical prostatectomy specimens outlined for cancers (Shen et al 2004). For successful clinical implementation, the prostate atlas needs to be registered to each patient's TRUS image with high registration accuracy in a time-efficient manner. This is implemented in a two-step procedure, the segmentation of the prostate gland from a patient's TRUS image followed by the registration of the prostate atlas. We have developed a fast registration algorithm suitable for clinical applications of this prostate cancer atlas. The registration algorithm was implemented on a graphical processing unit (GPU) to meet the critical processing speed requirements for atlas guided biopsy. A color overlay of the atlas superposed on the TRUS image was presented to help pick statistically likely regions known to harbor cancer. We validated our fast registration algorithm using computer simulations of two optimized 7- and 12-core biopsy protocols to maximize the overall detection rate. Using a GPU, patient's TRUS image segmentation and atlas registration took less than 12 s. The prostate cancer atlas guided 7- and 12-core biopsy protocols had cancer detection rates of 84.81% and 89.87% respectively when validated on the same set of data. Whereas the sextant biopsy approach without the utility of 3D cancer atlas detected only 70.5% of the cancers using the same histology data. We estimate 10-20% increase in prostate cancer detection rates

  3. Adaptation of a 3D prostate cancer atlas for transrectal ultrasound guided target-specific biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Narayanan, R; Suri, J S [Eigen Inc, Grass Valley, CA (United States); Werahera, P N; Barqawi, A; Crawford, E D [University of Colorado, Denver, CO (United States); Shinohara, K [University of California, San Francisco, CA (United States); Simoneau, A R [University of California, Irvine, CA (United States)], E-mail: jas.suri@eigen.com

    2008-10-21

    Due to lack of imaging modalities to identify prostate cancer in vivo, current TRUS guided prostate biopsies are taken randomly. Consequently, many important cancers are missed during initial biopsies. The purpose of this study was to determine the potential clinical utility of a high-speed registration algorithm for a 3D prostate cancer atlas. This 3D prostate cancer atlas provides voxel-level likelihood of cancer and optimized biopsy locations on a template space (Zhan et al 2007). The atlas was constructed from 158 expert annotated, 3D reconstructed radical prostatectomy specimens outlined for cancers (Shen et al 2004). For successful clinical implementation, the prostate atlas needs to be registered to each patient's TRUS image with high registration accuracy in a time-efficient manner. This is implemented in a two-step procedure, the segmentation of the prostate gland from a patient's TRUS image followed by the registration of the prostate atlas. We have developed a fast registration algorithm suitable for clinical applications of this prostate cancer atlas. The registration algorithm was implemented on a graphical processing unit (GPU) to meet the critical processing speed requirements for atlas guided biopsy. A color overlay of the atlas superposed on the TRUS image was presented to help pick statistically likely regions known to harbor cancer. We validated our fast registration algorithm using computer simulations of two optimized 7- and 12-core biopsy protocols to maximize the overall detection rate. Using a GPU, patient's TRUS image segmentation and atlas registration took less than 12 s. The prostate cancer atlas guided 7- and 12-core biopsy protocols had cancer detection rates of 84.81% and 89.87% respectively when validated on the same set of data. Whereas the sextant biopsy approach without the utility of 3D cancer atlas detected only 70.5% of the cancers using the same histology data. We estimate 10-20% increase in prostate cancer

  4. Human feasibility study of fluorescence spectroscopy guided optical biopsy needle for prostate cancer diagnosis.

    Science.gov (United States)

    Werahera, Priya N; Jasion, Edward A; Liu, Yongjun; Daily, John W; Arangua, Paul; Jones, Clifford; Nash, S Russell; Morrell, Michael; Crawford, E David

    2015-08-01

    Current prostate biopsy cores have a very low diagnostic yield. These biopsies often fail to diagnose prostate cancer since 90% of cores are histopathologically classified as benign. The concentrations of endogenous fluorophores in prostate tissue vary with disease states. Thus, fluorescence spectroscopy could be utilized to quantify these variations for identification of malignant lesions. We investigated clinical feasibility of a 14 gauge (1.98 mm) optical biopsy needle guided by fluorescence spectroscopy for real-time in vivo prostate cancer diagnosis. Built-in optical sensor has 8×100μm fibers for tissue excitation and a single 200μm fiber to collect spectral data. Custom-made fluorometer has 2 light-emitting diodes at 290 and 340 nm and a spectrometer. User interface for fluorometer operation and data collection was developed using LabView software. Each spectral data acquisition required ~2 seconds. The in vivo biopsies were performed during radical retropubic prostatectomy surgery on the exposed prostate with blood flow to the gland intact. A tissue biopsy core was obtained from each biopsy site after acquisition of spectral data. Above procedure was repeated ex vivo after surgical excision of the prostate. Biopsy cores were histopathologically classified as either benign or malignant and correlated with corresponding spectral data. Partial Least Square analysis was performed to determine diagnostically significant principal components as potential classifiers. A linear support vector machine and leave-one-out cross validation method was employed for tissue classification. Thirteen patients were consented to the study. Histopathological analysis found cancer in 29/208 in vivo and 51/224 ex vivo viable biopsy cores. Study results show 72% sensitivity, 66% specificity, and 93% negative predictive value for in vivo and 75%, 80%, and 93%, respectively, for ex vivo malignant versus benign prostatic tissue classification. Optical biopsy needle has a very high

  5. Poor glycemic control of diabetes mellitus is associated with higher risk of prostate cancer detection in a biopsy population.

    Directory of Open Access Journals (Sweden)

    Juhyun Park

    Full Text Available To evaluate the impact of glycemic control of diabetes mellitus (DM on prostate cancer detection in a biopsy population.We retrospectively reviewed the records of 1,368 men who underwent prostate biopsy at our institution. We divided our biopsy population into three groups according to their history of DM, and their Hemoglobin A1c (HbA1c level: a no-DM (DM- group; a good glycemic control (DM+GC group (HbA1c <6.5%; and a poor glycemic control (DM+PC group (HbA1c ≥6.5%. For sub-analyses, the DM+PC group was divided into a moderately poor glycemic control (DM+mPC group (6.5≤ HbA1c <7.5% and a severely poor glycemic control (DM+sPC group (HbA1c ≥7.5%.Among 1,368 men, 338 (24.7% had a history of DM, and 393 (28.7% had a positive biopsy. There was a significant difference in prostatic specific antigen density (PSAD (P = 0.037 and the frequency of abnormal DRE findings (P = 0.031 among three groups. The occurrence rate of overall prostate cancer (P<0.001 and high-grade prostate cancer (P = 0.016 also presented with a significantly difference. In the multivariate analysis, the DM+PC group was significantly associated with a higher rate of overall prostate cancer detection in biopsy subjects compared to the DM- group (OR = 2.313, P = 0.001 but the DM+PC group was not associated with a higher rate of high-grade (Gleason score ≥7 diseases detected during the biopsy (OR = 1.297, P = 0.376. However, in subgroup analysis, DM+sPC group was significantly related to a higher risk of high-grade diseases compared to the DM- group (OR = 2.446, P = 0.048.Poor glycemic control of DM was associated with a higher risk of prostate cancer detection, including high-grade disease, in the biopsy population.

  6. Percentage of Positive Biopsy Cores: A Better Risk Stratification Model for Prostate Cancer?

    International Nuclear Information System (INIS)

    Purpose: To assess the prognostic value of the percentage of positive biopsy cores (PPC) and perineural invasion in predicting the clinical outcomes after radiotherapy (RT) for prostate cancer and to explore the possibilities to improve on existing risk-stratification models. Methods and Materials: Between 1993 and 2004, 1,056 patients with clinical Stage T1c-T3N0M0 prostate cancer, who had four or more biopsy cores sampled and complete biopsy core data available, were treated with external beam RT, with or without a high-dose-rate brachytherapy boost at William Beaumont Hospital. The median follow-up was 7.6 years. Multivariate Cox regression analysis was performed with PPC, Gleason score, pretreatment prostate-specific antigen, T stage, PNI, radiation dose, androgen deprivation, age, prostate-specific antigen frequency, and follow-up duration. A new risk stratification (PPC classification) was empirically devised to incorporate PPC and replace the T stage. Results: On multivariate Cox regression analysis, the PPC was an independent predictor of distant metastasis, cause-specific survival, and overall survival (all p 50% was associated with significantly greater distant metastasis (hazard ratio, 4.01; 95% confidence interval, 1.86–8.61), and its independent predictive value remained significant with or without androgen deprivation therapy (all p 50%) with National Comprehensive Cancer Network risk stratification demonstrated added prognostic value of distant metastasis for the intermediate-risk (hazard ratio, 5.44; 95% confidence interval, 1.78–16.6) and high-risk (hazard ratio, 4.39; 95% confidence interval, 1.70–11.3) groups, regardless of the use of androgen deprivation and high-dose RT (all p < .05). The proposed PPC classification appears to provide improved stratification of the clinical outcomes relative to the National Comprehensive Cancer Network classification. Conclusions: The PPC is an independent and powerful predictor of clinical outcomes of

  7. Transrectal Ultrasound-guided 10-core Biopsy of the Prostate for Japanese Patients

    OpenAIRE

    Matsubara, Akio; Mutaguchi, Kazuaki; Yasumoto, Hiroaki; Takeshima, Yukio; Teishima, Jun; Seki, Mitsuhiro; Hasegawa, Yasuhiro; Usui, Tsuguru

    2006-01-01

    To determine the utility of transrectal ultrasound (TRUS)-guided 10-core prostate biopsy (sextant plus 4 far lateral cores) for Japanese patients, we compared it with the standard sextant for detection of prostate cancer. The study patients were 564 consecutive Japanese men (median age 71 years) who underwent 10-core biopsy because of PSA values of ≥ 2.0 ng/ml at Hiroshima University Hospital between March 2000 and December 2004. The overall cancer detection rate for the 10-core biopsy was 42...

  8. THE PROGNOSTIC AND DIAGNOSTIC VALUE OF REPEATED TRANSRECTAL PROSTATE SATURATION BIOPSY

    Directory of Open Access Journals (Sweden)

    M. A. Kurdzhiev

    2014-08-01

    Full Text Available Objective: to determine the rate of prostate cancer (PC development after repeated transrectal saturation prostate biopsy (RTRSPB, to study the characteristics of diagnosed tumors, and to estimate their clinical significance from the data of radical retropubic prostatectomy (RRP.Materials and methods. The results of RTRSPB were analyzed in 226 patients with a later evaluation of a tumor from the results of RRP. All the patients underwent at least 2 prostate biopsies (mean 2.4. The average number of biopsy cores was 26.7 (range 24—30. The average value of total prostate-specific antigen before saturation biopsy was 7.5 (range 7.5 to 28.6 ng/ml. The mean age of patients was 62 years (range 53 to 70.  Results. PC was diagnosed in 14.6% of cases (33/226. An isolated lesion of the prostatic transition zone was in 12.1% of cases. If this zone had been excluded from the biopsy scheme, the detection rate of PC during saturation biopsy should be reduced by 13.8%. Better PC detectability during repeated saturation biopsy generally occurred due to the localized forms of the disease (93.3%. The agreement of Gleason tumor grading in the biopsy and prostatectomy specimens was noted in 66.7% of cases.Conclusion. Saturation biopsy allows prediction of a pathological stage of PC, Gleason grade of a tumor and its site localization with a greater probability. Most tumors detectable by saturation biopsy were clinically significant, which makes it possible to recommend RTRSPB to some cohort of high PC-risk patients 

  9. Short-term prophylaxis with ciprofloxacin in extended 16-core prostate biopsy

    Directory of Open Access Journals (Sweden)

    Renato Caretta Chambó

    2015-02-01

    Full Text Available Objective To evaluate the safety, efficacy and possible complications of 16-core transrectal prostate biopsies using two doses of ciprofloxacin for prophylaxis of infectious complications. Materials and Methods Sixteen-core prostate biopsies were performed on a number of patients with different signs of potential prostate cancer. Complications were assessed both during the procedure and one week later. After the procedure, urine samples were collected for culture. The rate of post-biopsy complications, hospital visits and hospitalizations were also analyzed. Ciprofloxacin (500 mg was administered two hours before, and eight hours after the procedure. Results The overall rate of post-biopsy complications was 87.32%, being 5.4% of those considered major complications due to hemorrhage, or to urinary retention. Eight patients required hospital treatment post-biopsy. Fever occurred in just one patient (0.29%. There was no incidence of orchitis, epididymitis, prostatitis, septicemia, hospitalization, or death. The urine culture showed positive results in five patients (2.15%. Conclusion One-day prophylaxis with ciprofloxacin proved to be safe and effective in the prevention of infectious complications following 16-core prostate biopsies.

  10. How accurate is our prediction of biopsy outcome? PCA3-based nomograms in personalized diagnosis of prostate cancer

    OpenAIRE

    Salagierski, Maciej; Sosnowski, Marek; Schalken, Jack A.

    2012-01-01

    Purpose The sensitivity and specificity of prostate-specific antigen (PSA) alone to select men for prostate biopsy remain suboptimal. This review aims at presenting a review of current prostate cancer (PCa) nomograms that incorporate Prostate Cancer Gene 3 (PCA3), which was designed to outperform PSA at predicting biopsy outcome. Materials and methods The PubMed database and current literature search was conducted for reports on PCA3-based nomograms and tools for examining the risk of a posit...

  11. The role of extended prostate biopsy on prostate cancer detection rate: a study performed on the bench

    OpenAIRE

    Luciano Nesrallah; Adriano Nesrallah; Antunes, Alberto A.; Leite, Katia R.; Miguel Srougi

    2008-01-01

    INTRODUCTION: The aim of this prospective study was to compare the advantage of performing prostate biopsy with a greater number of cores using the classic sextant procedure, with the aim of reducing false negative results. MATERIALS AND METHODS: 100 prostates were acquired from consecutive radical prostatectomies performed by the same surgeon. Fourteen cores were obtained on the bench following surgery using an automatic pistol with an 18-gauge needle. Six of these cores were obtained accord...

  12. Biopsies

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Biopsies - Overview A biopsy is the removal of tissue ... What are the limitations of biopsies? What are biopsies? A biopsy is the removal of tissue in ...

  13. Effect on hemostasis of an absorbable hemostatic gelatin sponge after transrectal prostate needle biopsy

    Directory of Open Access Journals (Sweden)

    Kohei Kobatake

    2015-04-01

    Full Text Available Objectives To examine the usefulness of an absorbable hemostatic gelatin sponge for hemostasis after transrectal prostate needle biopsy. Subjects and Methods The subjects comprised 278 participants who underwent transrectal prostate needle biopsy. They were randomly allocated to the gelatin sponge insertion group (group A: 148 participants and to the non-insertion group (group B: 130 participants. In group A, the gelatin sponge was inserted into the rectum immediately after biopsy. A biopsy-induced hemorrhage was defined as a case in which a subject complained of bleeding from the rectum, and excretion of blood clots was confirmed. A blood test was performed before and after biopsy, and a questionnaire survey was given after the biopsy. Results Significantly fewer participants in group A required hemostasis after biopsy compared to group B (3 (2.0% vs. 11 (8.5%, P=0.029. The results of the blood tests and the responses from the questionnaire did not differ significantly between the two groups. In multivariate analysis, only “insertion of a gelatin sponge into the rectum” emerged as a significant predictor of hemostasis. Conclusion Insertion of a gelatin sponge into the rectum after transrectal prostate needle biopsy significantly increases hemostasis without increasing patient symptoms, such as pain and a sense of discomfort.

  14. Low grade urothelial carcinoma mimicking basal cell hyperplasia and transitional metaplasia in needle prostate biopsy

    Directory of Open Access Journals (Sweden)

    Julian Arista-Nasr

    2016-04-01

    Full Text Available ABSTRACT Purpose The vast majority of urothelial carcinomas infiltrating the bladder are consistent with high-grade tumors that can be easily recognized as malignant in needle prostatic biopsies. In contrast, the histological changes of low-grade urothelial carcinomas in this kind of biopsy have not been studied. Materials and Methods We describe the clinicopathologic features of two patients with low-grade bladder carcinomas infiltrating the prostate. They reported dysuria and hematuria. Both had a slight elevation of the prostate specific antigen and induration of the prostatic lobes. Needle biopsies were performed. At endoscopy bladder tumors were found in both cases. Results Both biopsies showed nests of basophilic cells and cells with perinuclear clearing and slight atypia infiltrating acini and small prostatic ducts. The stroma exhibited extensive desmoplasia and chronic inflammation. The original diagnosis was basal cell hyperplasia and transitional metaplasia. The bladder tumors also showed low-grade urothelial carcinoma. In one case, the neoplasm infiltrated the lamina propria, and in another, the muscle layer. In both, a transurethral resection was performed for obstructive urinary symptoms. The neoplasms were positive for high molecular weight keratin (34BetaE12 and thrombomodulin. No metastases were found in either of the patients, and one of them has survived for five years. Conclusions The diagnosis of low-grade urothelial carcinoma in prostate needle biopsies is difficult and may simulate benign prostate lesions including basal cell hyperplasia and urothelial metaplasia. It is crucial to recognize low-grade urothelial carcinoma in needle biopsies because only an early diagnosis and aggressive treatment can improve the prognosis for these patients.

  15. Low incidence of prostate cancer identified in the transition and anterior zones with transperineal biopsy

    Directory of Open Access Journals (Sweden)

    Danforth TL

    2012-12-01

    Full Text Available Teresa L Danforth,1 K Kent Chevli,1,2 Louis Baumann,1,2 Michael Duff1,21The State University of New York (SUNY, Buffalo, NY, 2Cancer Care of Western New York, Cheektowaga, NY, USAPurpose: Determine the incidence of anterior (AZ and transition (TZ zone prostate cancers using a transperineal mapping approach.Methods: A retrospective review of 137 patients with history of previous negative biopsy undergoing transperineal saturation biopsy for an elevated prostate-specific antigen (PSA, high-grade prostate intraepithelial neoplasia, atypical small acinar proliferation history, or abnormal digital rectal exam. The number of biopsy cores was determined by prostate volume and obtained using a predefined template. The electronic medical records were reviewed for patients' clinical and pathological characteristics.Results: Forty-one of 137 patients (31.4% had positive biopsy for prostate adenocarcinoma; 11 were from 24-core, 19 from 36-core, and 11 from 48-core sampling. Glands > 45 mL had a mean of 1.7 previous biopsies and a PSA of 9.1 ng/mL. Glands < 30 mL were 1.3 and 6.3 ng/mL and glands 30–45 mL were 1.4 and 6.5 ng/mL. Glands < 45 mL had a higher number of positive biopsies per total cores. Seven patients chose active surveillance while 34 chose treatment. Of the 36- and 48-cores biopsies, 2.2% and 1.5%, respectively, were positive in the TZ. One patient was AZ-positive, 1 was TZ-positive, and 18 were peripheral zone (PZ-positive alone. Twelve patients had cancer detected in PZ and TZ. Two patients developed urinary retention and one had a urine infection.Conclusion: Transperineal saturation biopsy is a safe and efficacious method of prostate cancer detection in patients with previous negative biopsy and high suspicion for cancer. Few cancers were found to originate in the TZ or AZ alone. We recommend that initial biopsy templates should sample PZ with less focus on the TZ.Keywords: carcinoma, prostate, biopsy, transperineal

  16. Development of a Novel Robot for Transperineal Needle Based Interventions: Focal Therapy, Brachytherapy and Prostate Biopsies

    CERN Document Server

    Long, Jean-Alexandre; Baumann, Michael; Descotes, Jean-Luc; Bolla, Michel; Giraud, Jean-Yves; Rambeaud, Jean-Jacques; Troccaz, Jocelyne; 10.1016/j.juro.2012.06.003

    2012-01-01

    Purpose: We report what is to our knowledge the initial experience with a new 3-dimensional ultrasound robotic system for prostate brachytherapy assistance, focal therapy and prostate biopsies. Its ability to track prostate motion intraoperatively allows it to manage motions and guide needles to predefined targets. Materials and Methods: A robotic system was created for transrectal ultrasound guided needle implantation combined with intraoperative prostate tracking. Experiments were done on 90 targets embedded in a total of 9 mobile, deformable, synthetic prostate phantoms. Experiments involved trying to insert glass beads as close as possible to targets in multimodal anthropomorphic imaging phantoms. Results were measured by segmenting the inserted beads in computerized tomography volumes of the phantoms. Results: The robot reached the chosen targets in phantoms with a median accuracy of 2.73 mm and a median prostate motion of 5.46 mm. Accuracy was better at the apex than at the base (2.28 vs 3.83 mm, p <...

  17. Endoclipping treatment of life-threatening rectal bleeding after prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    Panagiotis Katsinelos,; Jannis Kountouras,; Georgios Dimitriadis,; Grigoris Chatzimavroudis,; Christos Zavos,; Ioannis Pilpilidis,; George Paroutoglou,; George Germanidis,; Kostas Mimidis

    2009-01-01

    Rectal bleeding is frequently seen in patients undergoing transrectal ultrasound (TRUS)-guided multiple biopsy of the prostate, but is usually mild and stops spontaneously. We report what is believed to be the first case of life-threatening rectal bleeding following this procedure, which was successfully treated by endoscopic intervention through placement of three clips on the sites of bleeding. This case emphasizes endoscopic intervention associated with endoclipping as a safe and effective method to achieve hemostasis in massive rectal bleeding after prostate biopsy. Additionally, current data on the complications of the TRUS-guided multiple biopsy of the prostate and the options for treating fulminant rectal bleeding, a consequence of this procedure, are described.

  18. Complications of initial prostate biopsy in a European randomized screening trial

    OpenAIRE

    van den Heuvel, Suzanne; Loeb, Stacy; Zhu, Xiaoye; Verhagen, Paul CMS; Schröder, Fritz H; Bangma, Chris H; Roobol, Monique J

    2013-01-01

    Background: Transrectal prostate needle biopsy (PNB) is a standard procedure for the diagnosis of prostate cancer. We recently found an increasing frequency of hospitalization with infectious complications associated with PNB over time. Objective: To perform an updated analysis of overall complication rates in a large screening population over the past 18 years and to examine possible predictors of complications on initial PNB. Design, Setting and Participants: From 1993-2011, 7216 men underw...

  19. A tissue biopsy-based epigenetic multiplex PCR assay for prostate cancer detection

    OpenAIRE

    Van Neste Leander; Bigley Joseph; Toll Adam; Otto Gaëtan; Clark James; Delrée Paul; Van Criekinge Wim; Epstein Jonathan I

    2012-01-01

    Abstract Background PSA-directed prostate cancer screening leads to a high rate of false positive identifications and an unnecessary biopsy burden. Epigenetic biomarkers have proven useful, exhibiting frequent and abundant inactivation of tumor suppressor genes through such mechanisms. An epigenetic, multiplex PCR test for prostate cancer diagnosis could provide physicians with better tools to help their patients. Biomarkers like GSTP1, APC and RASSF1 have demonstrated involvement with prosta...

  20. BiopSym: a simulator for enhanced learning of ultrasound-guided prostate biopsy

    CERN Document Server

    Sclaverano, Stefano; Vadcard, Lucile; Mozer, Pierre; Troccaz, Jocelyne

    2008-01-01

    This paper describes a simulator of ultrasound-guided prostate biopsies for cancer diagnosis. When performing biopsy series, the clinician has to move the ultrasound probe and to mentally integrate the real-time bi-dimensional images into a three-dimensional (3D) representation of the anatomical environment. Such a 3D representation is necessary to sample regularly the prostate in order to maximize the probability of detecting a cancer if any. To make the training of young physicians easier and faster we developed a simulator that combines images computed from three-dimensional ultrasound recorded data to haptic feedback. The paper presents the first version of this simulator.

  1. How does prostate biopsy guidance error impact pathologic cancer risk assessment?

    Science.gov (United States)

    Martin, Peter R.; Gaed, Mena; Gómez, José A.; Moussa, Madeleine; Gibson, Eli; Cool, Derek W.; Chin, Joseph L.; Pautler, Stephen; Fenster, Aaron; Ward, Aaron D.

    2016-03-01

    Magnetic resonance imaging (MRI)-targeted, 3D transrectal ultrasound (TRUS)-guided "fusion" prostate biopsy aims to reduce the 21-47% false negative rate of clinical 2D TRUS-guided sextant biopsy, but still has a substantial false negative rate. This could be improved via biopsy needle target optimization, accounting for uncertainties due to guidance system errors, image registration errors, and irregular tumor shapes. As an initial step toward the broader goal of optimized prostate biopsy targeting, in this study we elucidated the impact of biopsy needle delivery error on the probability of obtaining a tumor sample, and on the core involvement. These are both important parameters to patient risk stratification and the decision for active surveillance vs. definitive therapy. We addressed these questions for cancer of all grades, and separately for high grade (>= Gleason 4+3) cancer. We used expert-contoured gold-standard prostatectomy histology to simulate targeted biopsies using an isotropic Gaussian needle delivery error from 1 to 6 mm, and investigated the amount of cancer obtained in each biopsy core as determined by histology. Needle delivery error resulted in variability in core involvement that could influence treatment decisions; the presence or absence of cancer in 1/3 or more of each needle core can be attributed to a needle delivery error of 4 mm. However, our data showed that by making multiple biopsy attempts at selected tumor foci, we may increase the probability of correctly characterizing the extent and grade of the cancer.

  2. Raising cut-off value of prostate specific antigen (PSA) for biopsy in symptomatic men in India to reduce unnecessary biopsy

    OpenAIRE

    Shalini Agnihotri; Mittal, R. D.; Kapoor, R; Anil Mandhani

    2014-01-01

    Background & objectives: The characteristics of prostate specific antigen (PSA) for trans-rectal ultrasonography guided prostate biopsy in men with lower urinary tract symptoms (LUTS) are not well defined. This study was carried out to analyse the threshold of PSA for biopsy in symptomatic men in India. Methods: From January 2000 to June 2011, consecutive patients who had digital rectal examination (DRE) and PSA testing done for LUTS were included in this study. PSA was done with ELISA te...

  3. Efficiency of 6- and 12-punctures biopsies to detect prostate cancer in patients with PSA< 10 ng/mL and normal digital rectal examination

    OpenAIRE

    Luiz E. Slongo; Mário C. Sugisawa; Sérgio O. IOSHII; Renato Tâmbara Filho; Luiz C.A. Rocha

    2003-01-01

    OBJECTIVE: Establish the efficiency of 6- and 12-punctures transrectal ultrasound-guided needle biopsies in low risk patients for prostate cancer. Six-punctures (sextant) biopsies were compared to 12-punctures biopsies, assessing which is the best strategy to detect this neoplasm. MATERIALS AND METHODS: Among 240 patients submitted to prostate biopsy, 54 with suspected small and organ-localized tumors (prostatic specific antigen < 10 ng/mL and digital exam of the prostate not suggesting cance...

  4. Using PSA, biopsy Gleason score, clinical stage, and the percentage of positive biopsies to identify optimal candidates for prostate-only radiation therapy

    International Nuclear Information System (INIS)

    Purpose: An identification of prostate cancer patients most likely to benefit from prostate-only radiation was made based upon the pretreatment prostate-specific antigen (PSA), biopsy Gleason score, clinical stage, percentage of positive biopsies, and the 5-year postoperative PSA outcome. Methods: Between 1989 and 2000, 2099 patients underwent radical prostatectomy for clinically localized prostate cancer. The primary end points were pathologic evidence of seminal vesicle invasion 2(SVI), extracapsular extension (ECE) with or without positive surgical margins, and the 5-year postoperative PSA outcome. Results: Pretreatment PSA, biopsy Gleason score, and clinical stage were used to assign patients to low-, intermediate-, and high-risk groups. These risk groups were stratified by the percentage of positive biopsies and the primary pathologic and biochemical outcomes examined. The rates of SVI, ECE with positive margin, and no biochemical evidence of disease (bNED) for low-risk patients with ≤50% positive biopsies were 2%, 7%, and 93%, respectively. Patients with >50% positive biopsies had higher rates of SVI and ECE (5% and 11%, respectively) and 52% bNED (p<0.0001). For intermediate-risk patients with ≤17% positive biopsies, the rates of SVI, ECE with positive margin, and bNED were 3%, 9%, and 90%, respectively. As the percentage of positive biopsies increased above 17% in intermediate-risk patients, there was a statistically significant increase in SVI and ECE and a significant decrease in bNED. Conclusions: Low-risk patients with ≤50% positive biopsies and intermediate-risk patients with ≤17% positive biopsies had a very low risk of SVI and ECE with positive surgical margins. Given that the presence of SVI and ECE with positive surgical margins was uncommon (<10%) with a ≥90% PSA failure-free survival after radical prostatectomy, these patients may be optimal candidates for radiation therapy directed at the prostate only (prostate gland + 1.5-cm margin)

  5. Effectiveness of stress management in patients undergoing transrectal ultrasound-guided biopsy of the prostate

    Directory of Open Access Journals (Sweden)

    Chiu LP

    2016-02-01

    Full Text Available Li-Pin Chiu,1,2 Heng-Hsin Tung,3 Kuan-Chia Lin,3 Yu-Wei Lai,1,4 Yi-Chun Chiu,1,4 Saint Shiou-Sheng Chen,1,4 Allen W Chiu1,4 1Division of Urology, Taipei City Hospital, 2University of Taipei, General Education Center, 3School of Nursing, Department of Care Management, National Taipei University of Nursing and Health Science, 4Department of Urology, National Yang-Ming University School of Medicine, Taipei, Taiwan, Republic of China Background: To assess the utilization of stress management in relieving anxiety and pain among patients who undergo transrectal ultrasound (TRUS-guided biopsy of the prostate.  Methods: Eighty-two patients admitted to a community hospital for a TRUS biopsy of the prostate participated in this case-controlled study. They were divided into an experimental group that was provided with stress management and a control group that received only routine nursing care. Stress management included music therapy and one-on-one simulation education. Before and after the TRUS biopsy, the patients’ state-anxiety inventory score, pain visual analogue scale (VAS, respiratory rate, heart rate, and blood pressure were obtained.  Results: There were no differences in baseline and disease characteristics between the two groups. The VAS in both groups increased after the TRUS biopsy, but the difference in pre- and postbiopsy VAS scores was significantly lower in the experimental group (P=0.03. Patients in both groups experienced mild anxiety before and after the biopsy, but those in the experimental group displayed a significantly greater decrease in postbiopsy state-anxiety inventory score compared to the control group (P=0.02.Conclusion: Stress management can alleviate anxiety and pain in patients who received a TRUS biopsy of the prostate under local anesthesia. Keywords: anxiety, pain, stress management, transrectal ultrasound-guided biopsy of the prostate

  6. Development and validation of risk score for predicting positive repeat prostate biopsy in patients with a previous negative biopsy in a UK population

    Directory of Open Access Journals (Sweden)

    Matthews Fiona

    2009-07-01

    Full Text Available Abstract Background Little evidence is available to determine which patients should undergo repeat biopsy after initial benign extended core biopsy (ECB. Attempts have been made to reduce the frequency of negative repeat biopsies using PSA kinetics, density, free-to-total ratios and Kattan's nomogram, to identify men more likely to harbour cancer but no single tool accurately predicts biopsy outcome. The objective of this study was to develop a predictive nomogram to identify men more likely to have a cancer diagnosed on repeat prostate biopsy. Methods Patients with previous benign ECB undergoing repeat biopsy were identified from a database. Association between age, volume, stage, previous histology, PSA kinetics and positive repeat biopsy was analysed. Variables were entered stepwise into logistic regression models. A risk score giving the probability of positive repeat biopsy was estimated. The performance of this score was assessed using receiver characteristic (ROC analysis. Results 110 repeat biopsies were performed in this period. Cancer was detected in 31% of repeat biopsies at Hospital (1 and 30% at Hospital (2. The most accurate predictive model combined age, PSA, PSA velocity, free-to-total PSA ratio, prostate volume and digital rectal examination (DRE findings. The risk model performed well in an independent sample, area under the curve (AUCROC was 0.818 (95% CI 0.707 to 0.929 for the risk model and 0.696 (95% CI 0.472 to 0.921 for the validation model. It was calculated that using a threshold risk score of > 0.2 to identify high risk individuals would reduce repeat biopsies by 39% while identifying 90% of the men with prostate cancer. Conclusion An accurate multi-variable predictive tool to determine the risk of positive repeat prostate biopsy is presented. This can be used by urologists in an outpatient setting to aid decision-making for men with prior benign histology for whom a repeat biopsy is being considered.

  7. Simultaneous Transurethral Resection of Prostate and Prostate Needle Biopsy in Patients with Acute Urinary Retention and Elevated Prostate Specific Antigen Levels

    Directory of Open Access Journals (Sweden)

    Yen-Ta Chen

    2009-08-01

    Full Text Available Background: To evaluate the safety and accuracy of simultaneous transrectal ultrasonography (TRUS-guided prostate biopsy and transurethral resection of prostate(TURP, patients with acute urinary retention (AUR who underwent simultaneous prostate biopsy and TURP were compared with those treated byTURP alone.Methods: From July 2000 to Jun 2004, 21 patients older than 70 years with AUR wereincluded in each group. Patients with elevated prostate specific antigen(PSA levels (> 4 ng/ml underwent TURP and TRUS-guided biopsy simultaneously (group I, while those with normal PSA levels (< 4 ng/ml receivedTURP alone (group II. The average ages of group I and group II patientswere 72.4 and 72.5 years.Results: In group I, 4 patients (19% were diagnosed with prostate cancer; 2 hadmetastasis and received hormone therapy; and 1 had localized cancer andwas treated with brachytherapy. An 82-year-old patient with localized canceropted for watchful waiting. Compared to group II, patients in group I did notshow aggregated morbidity, such as prolonged hospital stay, hematuria, orfever.Conclusion: Simultaneous TURP and TRUS-guided biopsy in healthy AUR patients doesnot increase the risk of morbidity. Furthermore, with this approach patientscan recover from the stress of AUR and have a definite diagnosis of theircondition.

  8. Empiric antibiotics therapy for mildly elevated prostate specific antigen: Helpful to avoid unnecessary biopsies?

    Directory of Open Access Journals (Sweden)

    Andrea Fandella

    2014-09-01

    Full Text Available Purpose: The management of mildly elevated (4.0-10.0 ng/ml prostate specific antigen (PSA is uncertain. Immediate prostate biopsy, antibiotic treatment, or monitoring PSA level for 1-3 months is still in controversy. Materials and Methods: We retrospectively analysed the effect of empiric antibiotics on an increased PSA in a mono-institutional study. We analysed the data of 100 patients with a PSA of 4-10 ng/ml and normal digital rectal examination undergoing their first prostate biopsy. Patients were divided in two different cohorts. One cohort was submitted to antibiotic therapy (Levoxacin 500 mg daily for 20 days and both cohort had a re-dosing of PSA before the prostate biopsy. Results: Average age of the whole group of patients was 66.48 ± 8.32 years and their average initial PSA level was 6.67 ± 1.57 ng/mL. In the treated group (N = 49 29 patients had a decreasing PSA value from mean baseline PSA value of 6.6 ± 1.54 ng/ml to the re-dosed mean PSA level of 5.4 ± 1,61 ng/ml (p = 0.7; 20 patients didn’t experience a decrease PSA value, with a mean PSA level of 6.9 ± 1.68 ng/ml. In the control group (N = 51, 30 patients had a decrease of PSA level from mean baseline PSA level of 6.5 ± 1,59 ng/ml to a re-dosed PSA level of 5.5 ± 1.57 ng/ml; 21 patients didn’t experience a decrease of PSA value, with a mean PSA level of 6.7 ± 1.71 ng/ml. Multivariate analysis of age, PSA changes, antibiotics therapy and biopsy results (presence or absence of cancer revealed no significant difference between the two cohorts. Sepsis after biopsy occurred in 3 patient in the antibiotics group (6% and in one of the control group (2%. Conclusions: The study, even with some limitations, does not seem to show an advantage due to the administration of antibacterial therapy to reduce PSA values before prostate biopsy and subsequently to reduce unnecessary prostate biopsies.

  9. Risk group dependence of dose-response for biopsy outcome after three-dimensional conformal radiation therapy of prostate cancer

    International Nuclear Information System (INIS)

    Background and purpose: We fit phenomenological tumor control probability (TCP) models to biopsy outcome after three-dimensional conformal radiation therapy (3D-CRT) of prostate cancer patients to quantify the local dose-response of prostate cancer. Materials and methods: We analyzed the outcome after photon beam 3D-CRT of 103 patients with stage T1c-T3 prostate cancer treated at Memorial Sloan-Kettering Cancer Center (MSKCC) (prescribed target doses between 64.8 and 81 Gy) who had a prostate biopsy performed ≥2.5 years after end of treatment. A univariate logistic regression model based on Dmean (mean dose in the planning target volume of each patient) was fit to the whole data set and separately to subgroups characterized by low and high values of tumor-related prognostic factors T-stage (6), and pre-treatment prostate-specific antigen (PSA) (≤10 ng/ml vs. >10 ng/ml). In addition, we evaluated five different classifications of the patients into three risk groups, based on all possible combinations of two or three prognostic factors, and fit bivariate logistic regression models with Dmean and the risk group category to all patients. Dose-response curves were characterized by TCD50, the dose to control 50% of the tumors, and γ50, the normalized slope of the dose-response curve at TCD50. Results: Dmean correlates significantly with biopsy outcome in all patient subgroups and larger values of TCD50 are observed for patients with unfavorable compared to favorable prognostic factors. For example, TCD50 for high T-stage patients is 7 Gy higher than for low T-stage patients. For all evaluated risk group definitions, Dmean and the risk group category are independent predictors of biopsy outcome in bivariate analysis. The fit values of TCD50 show a clear separation of 9-10.6 Gy between low and high risk patients. The corresponding dose-response curves are steeper (γ50=3.4-5.2) than those obtained when all patients are analyzed together (γ50=2.9). Conclusions: Dose

  10. The role of extended prostate biopsy on prostate cancer detection rate: a study performed on the bench

    Directory of Open Access Journals (Sweden)

    Luciano Nesrallah

    2008-10-01

    Full Text Available INTRODUCTION: The aim of this prospective study was to compare the advantage of performing prostate biopsy with a greater number of cores using the classic sextant procedure, with the aim of reducing false negative results. MATERIALS AND METHODS: 100 prostates were acquired from consecutive radical prostatectomies performed by the same surgeon. Fourteen cores were obtained on the bench following surgery using an automatic pistol with an 18-gauge needle. Six of these cores were obtained according to the sextant technique, as described by Hodge et al.; with the addition of a further three lateral cores from each lobe and one from the bilateral transition zone. The whole gland and the fragments were assessed by the same pathologist. An analysis of the frequency of the cancers identified in the cores of the sextant and the extended biopsies was undertaken and the results evaluated comparatively. The chi-square test was used for the comparative analysis of the cancer detection rate, according to the technique used. RESULTS: When 6 cores were removed, the positive cancer rate was 75%, which was increased to 88% when 14 cores were (p < 0.001. The withdrawal of 14 cores resulted in a significant 13% (95% CI [5%-21%] increase in the positive rate of cancer detection. CONCLUSION: Extended biopsy, with the removal of 14 cores, is more efficient than the sextant procedure in improving the rate of prostate cancer detection.

  11. Basal cell hyperplasia (BCH) versus high grade prostatic intraepithelial neoplasia (HGPIN) in tiny prostatic needle biopsies: Unusual diagnostic dilemma

    International Nuclear Information System (INIS)

    Histopathological differentiation between BCH and HGPIN in prostatic needle biopsies is a diagnostic challenge. The gold standard for detection of HGPIN and BCH is histopathological examination; however subjectivity in interpretation and tiny volume of obtained tissue hamper reliable diagnosis. Aims: The aim of this study was to assess usefulness of using the p63 and p504s to solve this problem. Although the use of p63 and p504s is now well established in differentiation between preneoplastic and neoplastic prostatic lesions, their usefulness in tiny tissue material is, however, not fully studied. Methods: The study included a spectrum of 30 prostatic needle biopsies (5 BCH, 10 HGPIN, 10 indefinite luminal proliferations where BCH and HGPIN could not be distinguished from each other and 5 adenocarcinomas). H and E stained sections were examined for histopathological features. Other sections were stained immunohistochemically with p63 and p504s. Results: The mean age of patients was 69 (SD = 7.6) years. PSA range was 1.3-2.7 ng/ml. Ultra- songraphic findings were unremarkable. All BCH showed p504s-/p63+ pattern, All HGPIN had p504s + /p63 + pattern while carcinomas were p504s + /p63-. After immunostaining combined with histopathological features; the 10 indefinite specimens could be diagnosed as 4 BCH and 6 HGPIN. The article explains how applying this staining pattern on the challenging specimens, combined with histopathological features, can be helpful in proper identification of prostatic proliferations.

  12. A tissue biopsy-based epigenetic multiplex PCR assay for prostate cancer detection

    Directory of Open Access Journals (Sweden)

    Van Neste Leander

    2012-06-01

    Full Text Available Abstract Background PSA-directed prostate cancer screening leads to a high rate of false positive identifications and an unnecessary biopsy burden. Epigenetic biomarkers have proven useful, exhibiting frequent and abundant inactivation of tumor suppressor genes through such mechanisms. An epigenetic, multiplex PCR test for prostate cancer diagnosis could provide physicians with better tools to help their patients. Biomarkers like GSTP1, APC and RASSF1 have demonstrated involvement with prostate cancer, with the latter two genes playing prominent roles in the field effect. The epigenetic states of these genes can be used to assess the likelihood of cancer presence or absence. Results An initial test cohort of 30 prostate cancer-positive samples and 12 cancer-negative samples was used as basis for the development and optimization of an epigenetic multiplex assay based on the GSTP1, APC and RASSF1 genes, using methylation specific PCR (MSP. The effect of prostate needle core biopsy sample volume and age of formalin-fixed paraffin-embedded (FFPE samples was evaluated on an independent follow-up cohort of 51 cancer-positive patients. Multiplexing affects copy number calculations in a consistent way per assay. Methylation ratios are therefore altered compared to the respective singleplex assays, but the correlation with patient outcome remains equivalent. In addition, tissue-biopsy samples as small as 20 μm can be used to detect methylation in a reliable manner. The age of FFPE-samples does have a negative impact on DNA quality and quantity. Conclusions The developed multiplex assay appears functionally similar to individual singleplex assays, with the benefit of lower tissue requirements, lower cost and decreased signal variation. This assay can be applied to small biopsy specimens, down to 20 microns, widening clinical applicability. Increasing the sample volume can compensate the loss of DNA quality and quantity in older samples.

  13. Early experience with multiparametric magnetic resonance imaging-targeted biopsies under visual transrectal ultrasound guidance in patients suspicious for prostate cancer undergoing repeated biopsy

    DEFF Research Database (Denmark)

    Boesen, Lars; Noergaard, Nis; Chabanova, Elizaveta;

    2015-01-01

    OBJECTIVES: The purpose of this study was to investigate the detection rate of prostate cancer (PCa) by multiparametric magnetic resonance imaging-targeted biopsies (mp-MRI-bx) in patients with prior negative transrectal ultrasound biopsy (TRUS-bx) sessions without previous experience of this....... MATERIAL AND METHODS: Eighty-three patients with prior negative TRUS-bx scheduled for repeated biopsies due to persistent suspicion of PCa were prospectively enrolled. mp-MRI was performed before biopsy and all lesions were scored according to the Prostate Imaging Reporting and Data System (PI-RADS) and...... all 39 patients. Both PI-RADS and Likert scoring showed a high correlation between suspicion of malignancy and biopsy results (p < 0.0001). Five patients (13%) had cancer detected only on mp-MRI-bx outside the TRUS-bx areas (p = 0.025) and another seven patients (21%) had an overall Gleason score...

  14. In-bore setup and software for 3T MRI-guided transperineal prostate biopsy

    Science.gov (United States)

    Tokuda, Junichi; Tuncali, Kemal; Iordachita, Iulian; Song, Sang-Eun; Fedorov, Andriy; Oguro, Sota; Lasso, Andras; Fennessy, Fiona M.; Tempany, Clare M.; Hata, Nobuhiko

    2012-09-01

    MRI-guided prostate biopsy in conventional closed-bore scanners requires transferring the patient outside the bore during needle insertion due to the constrained in-bore space, causing a safety hazard and limiting image feedback. To address this issue, we present our custom-made in-bore setup and software to support MRI-guided transperineal prostate biopsy in a wide-bore 3 T MRI scanner. The setup consists of a specially designed tabletop and a needle-guiding template with a Z-frame that gives a physician access to the perineum of the patient at the imaging position and allows the physician to perform MRI-guided transperineal biopsy without moving the patient out of the scanner. The software and Z-frame allow registration of the template, target planning and biopsy guidance. Initially, we performed phantom experiments to assess the accuracy of template registration and needle placement in a controlled environment. Subsequently, we embarked on our clinical trial (N = 10). The phantom experiments showed that the translational errors of the template registration along the right-left (RP) and anterior-posterior (AP) axes were 1.1 ± 0.8 and 1.4 ± 1.1 mm, respectively, while the rotational errors around the RL, AP and superior-inferior axes were (0.8 ± 1.0)°, (1.7 ± 1.6)° and (0.0 ± 0.0)°, respectively. The 2D root-mean-square (RMS) needle-placement error was 3 mm. The clinical biopsy procedures were safely carried out in all ten clinical cases with a needle-placement error of 5.4 mm (2D RMS). In conclusion, transperineal prostate biopsy in a wide-bore 3T scanner is feasible using our custom-made tabletop setup and software, which supports manual needle placement without moving the patient out of the magnet.

  15. In-bore setup and software for 3T MRI-guided transperineal prostate biopsy

    International Nuclear Information System (INIS)

    MRI-guided prostate biopsy in conventional closed-bore scanners requires transferring the patient outside the bore during needle insertion due to the constrained in-bore space, causing a safety hazard and limiting image feedback. To address this issue, we present our custom-made in-bore setup and software to support MRI-guided transperineal prostate biopsy in a wide-bore 3 T MRI scanner. The setup consists of a specially designed tabletop and a needle-guiding template with a Z-frame that gives a physician access to the perineum of the patient at the imaging position and allows the physician to perform MRI-guided transperineal biopsy without moving the patient out of the scanner. The software and Z-frame allow registration of the template, target planning and biopsy guidance. Initially, we performed phantom experiments to assess the accuracy of template registration and needle placement in a controlled environment. Subsequently, we embarked on our clinical trial (N = 10). The phantom experiments showed that the translational errors of the template registration along the right–left (RP) and anterior–posterior (AP) axes were 1.1 ± 0.8 and 1.4 ± 1.1 mm, respectively, while the rotational errors around the RL, AP and superior–inferior axes were (0.8 ± 1.0)°, (1.7 ± 1.6)° and (0.0 ± 0.0)°, respectively. The 2D root-mean-square (RMS) needle-placement error was 3 mm. The clinical biopsy procedures were safely carried out in all ten clinical cases with a needle-placement error of 5.4 mm (2D RMS). In conclusion, transperineal prostate biopsy in a wide-bore 3T scanner is feasible using our custom-made tabletop setup and software, which supports manual needle placement without moving the patient out of the magnet. (paper)

  16. Enrichment of prostate cancer stem cells from primary prostate cancer cultures of biopsy samples

    OpenAIRE

    Wang, Shunqi; Huang, Shengsong; Zhao, Xin; Zhang, Qimin; Wu, Min; Sun, Feng; Han, Gang; Wu, Denglong

    2013-01-01

    This study was to enrich prostate cancer stem cells (PrCSC) from primary prostate cancer cultures (PPrCC). Primary prostate cancer cells were amplified in keratinocyte serum-free medium with epidermal growth factor (EGF) and bovine pituitary extract (BPE), supplemented with leukemia inhibitory factor (LIF), stem cell factor (SCF) and cholera toxin. After amplification, cells were transferred into ultra-low attachment dishes with serum-free DMEM/F12 medium, supplemented with EGF, basic fibrobl...

  17. A Correlation of FTIR Spectra Derived from Prostate Cancer Biopsies with Gleason Grade and Tumour Stage.

    OpenAIRE

    Gazi, E

    2006-01-01

    OBJECTIVES: We introduce biochemistry as a second dimension to Gleason grading, using Fourier transform infrared (FTIR) microspectroscopy. For the first time, we correlate FTIR spectra derived from prostate cancer (pCA) tissue with Gleason score and the clinical stage of the tumour at time of biopsy. METHODS: Serial sections from paraffin-embedded pCA tissue were collected. One was stained with hematoxylin and eosin and Gleason scored; FTIR spectra were collected from malignant locations usin...

  18. Does prolonged anti-inflammatory therapy reduce number of unnecessary repeat saturation prostate biopsy?

    OpenAIRE

    Giuseppe Candiano; Pietro Pepe; Francesco Pietropaolo; Francesco Aragona

    2013-01-01

    Introduction. The effect of a prolonged oral anti-inflammatory therapy on PSA values in patients with persistent abnormal PSA values after negative prostate biopsy (PBx) was evaluated. Material and methods. From September 2011 to September 2012, 70 patients (medi- an age 62 years), with persistent abnormal PSA values after negative extended PBx, were given an herbal extract with anti-inflammatory activity for 3 months (Lenidase®; 1 tablet daily constituted of baicalina, bromelina and esci...

  19. Correlation of power Doppler with microvessel density in assessing prostate needle biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, N.M. E-mail: osamanagwa@hotmail.com; Masoud, A.M.; Barsoum, H.B.; Refaat, M.M.; Moustafa, M.I.; Kamal, T.A

    2004-10-01

    AIM: To correlate hypervascular power Doppler ultrasonography with the histological evaluation of microvasculature in the prostate using trans-rectal ultrasound (TRUS)-guided needle biopsy. MATERIALS AND METHODS: Ninety-six patients with a lower urinary tract symptoms (LUTS) and prostate specific antigen (PSA) value more than 4 ng/ml were evaluated using power Doppler ultrasonography before biopsy. The vascularity of the peripheral zone was graded on a scale of PZ0 to PZ2. Core needle biopsies were immunostained with CD31(DAKO) and counting was performed manually on separate high power fields (HPF;x400) in areas containing the highest number of vessels. RESULTS: There was a significant correlation between the grading system used for power Doppler and the microvessel density (MVD; PZ0 28.61{+-}8.97,PZ1 36.00{+-}12.11 and PZ2 64.008{+-}15.86; p<0.001). There was also a significant difference in MVD between benign, malignant and tissue cores with atypia and prostatic intra-epithelial neoplasia (PIN; p<0.001 and p<0.018, respectively). There was a significant correlation between malignant tissue having a higher Gleason score and increased MVD (p<0.001). Furthermore, cancer biopsies having a high flow PZ2 are nearly twice as likely (63.2%) to have a Gleason score of 7 or more when compared those having a Gleason score of less than 7 (36.8%). CONCLUSION: The grading system of assessing the power Doppler flow signals appears to be of value as an indicator of MVD. It also correlates with a higher Gleason score and this may reflect the clinical outcome in prostate cancer. It deserves further study and evaluation as a prognostic indicator.

  20. A fully actuated robotic assistant for MRI-guided prostate biopsy and brachytherapy

    Science.gov (United States)

    Li, Gang; Su, Hao; Shang, Weijian; Tokuda, Junichi; Hata, Nobuhiko; Tempany, Clare M.; Fischer, Gregory S.

    2013-03-01

    Intra-operative medical imaging enables incorporation of human experience and intelligence in a controlled, closed-loop fashion. Magnetic resonance imaging (MRI) is an ideal modality for surgical guidance of diagnostic and therapeutic procedures, with its ability to perform high resolution, real-time, high soft tissue contrast imaging without ionizing radiation. However, for most current image-guided approaches only static pre-operative images are accessible for guidance, which are unable to provide updated information during a surgical procedure. The high magnetic field, electrical interference, and limited access of closed-bore MRI render great challenges to developing robotic systems that can perform inside a diagnostic high-field MRI while obtaining interactively updated MR images. To overcome these limitations, we are developing a piezoelectrically actuated robotic assistant for actuated percutaneous prostate interventions under real-time MRI guidance. Utilizing a modular design, the system enables coherent and straight forward workflow for various percutaneous interventions, including prostate biopsy sampling and brachytherapy seed placement, using various needle driver configurations. The unified workflow compromises: 1) system hardware and software initialization, 2) fiducial frame registration, 3) target selection and motion planning, 4) moving to the target and performing the intervention (e.g. taking a biopsy sample) under live imaging, and 5) visualization and verification. Phantom experiments of prostate biopsy and brachytherapy were executed under MRI-guidance to evaluate the feasibility of the workflow. The robot successfully performed fully actuated biopsy sampling and delivery of simulated brachytherapy seeds under live MR imaging, as well as precise delivery of a prostate brachytherapy seed distribution with an RMS accuracy of 0.98mm.

  1. The effectivity of periprostatic nerve blockade for the pain control during transrectal ultrasound guided prostate biopsy

    Directory of Open Access Journals (Sweden)

    Alper Otunctemur

    2013-06-01

    Full Text Available Aim: Transrectal ultrasound (TRUS guided prostete biopsy is accepted as a standard procedure in the diagnosis of prostate cancer. Many different protocoles are applied to reduce the pain during the process. In this study we aimed to the comparison of two procedure with intrarectal lidocaine gel and periprostatice nerve blockade respective- ly in addition to perianal intrarectal lidocaine gel on the pain control in prostate biop- sy by TRUS. Methods: 473 patients who underwent prostate biopsy guided TRUS between 2008-2012 were included in the study. 10-point linear visual analog pain scale(VAS was used to evaluate the pain during biopsy. The patients were divided into two groups according to anesthesia procedure. In Group 1, there were 159 patients who had perianal-intrarectal lidocaine gel, in Group 2 there were 314 patients who had periprostatic nerve blockade in addition to intrarectal lidocain gel. The pain about probe manipulation was aseesed by VAS-1 and during the biopsy needle entries was evalu- ated by VAS-2. Results were compared with Mann-Whitney U and Pearson chi-square test. Results: Mean VAS-2 scores in Group 1 and Group 2 were 4.54 ± 1.02 and 2.06 ± 0.79 respectively. The pain score was determined significantly lower in the Group 2 (p = 0.001. In both groups there was no significant difference in VAS-1 scores, patient’s age, prostate volume, complication rate and PSA level. Conclusion: The combination of periprostatic nerve blockade and intrarectal lidocain gel provides a more meaningful pain relief compared to group of patients undergoing intrarectal lidocaine gel.

  2. Initial validation of a virtual-reality learning environment for prostate biopsies: realism matters!

    OpenAIRE

    Fiard, Gaelle; Selmi, Sonia-Yuki; Promayon, Emmanuel; Vadcard, Lucile; Descotes, Jean-Luc; Troccaz, Jocelyne

    2013-01-01

    International audience : Introduction-objectives: A virtual-reality learning environment dedicated to prostate biopsies was designed to overcome the limitations of current classical teaching methods. The aim of this study was to validate reliability, face, content and construct of the simulator. Materials and methods: The simulator is composed of a) a laptop computer, b) a haptic device with a stylus that mimics the ultrasound probe, c) a clinical case database including three dimensional ...

  3. Prostate cancer: 1.5 T endo-coil dynamic contrast-enhanced MRI and MR spectroscopy-correlation with prostate biopsy and prostatectomy histopathological data

    DEFF Research Database (Denmark)

    Chabanova, E.; Balslev, I.; Løgager, Vibeke Berg;

    2010-01-01

    prostatectomy, underwent prostate MR examination. Prostate cancer was identified by transrectal ultrasonographically (TRUS) guided sextant biopsy. MR examination was performed at 1.5T with an endorectal MR coil. Cancer localisation was performed on sextant-basis - for comparison between TRUS biopsy, MR...... techniques and histopathological findings on prostatectomy specimens. RESULTS: Prostate cancer was identified in all 43 patients by combination of the three MR techniques. The detection of prostate cancer on sextant-basis showed sensitivity and specificity: 50% and 91% for TRUS, 72% and 55% for T2WI, 49% and...... 69% for DCEMRI, and 46% and 78% for CSI. CONCLUSION: T2WI, DCEMRI and CSI in combination can identify prostate cancer. Further development of MR technologies for these MR methods is necessary to improve the detection of the prostate cancer...

  4. Prevalence of Antibiotic-Resistant Bacteria on Rectal Swabs and Factors Affecting Resistance to Antibiotics in Patients Undergoing Prostate Biopsy

    OpenAIRE

    Kim, Jong Beom; Jung, Seung Il; Hwang, Eu Chang; Kwon, Dong Deuk

    2014-01-01

    Purpose The prevalence of antibiotic-resistant bacteria on rectal swabs in patients undergoing transrectal ultrasound (TRUS)-guided prostate biopsy and the factors affecting resistance to antibiotics were evaluated. Materials and Methods Two hundred twenty-three men who underwent TRUS-guided prostate biopsy from November 2011 to December 2012 were retrospectively evaluated. Rectal swabs were cultured on MacConkey agar to identify antibiotic-resistant bacteria in rectal flora before TRUS-guide...

  5. Transrectal ultrasound-guided biopsy of the prostate: aspirin increases the incidence of minor bleeding complications

    Energy Technology Data Exchange (ETDEWEB)

    Halliwell, O.T. [Department of Radiology, Southampton General Hospital, Southampton (United Kingdom)], E-mail: hallo99@doctors.org.uk; Yadegafar, G. [Public Health Sciences and Medical Statistics Division, School of Medicine, Southampton General Hospital, Southampton University, Southampton (United Kingdom); Lane, C.; Dewbury, K.C. [Department of Radiology, Southampton General Hospital, Southampton (United Kingdom)

    2008-05-15

    Aim: To assess whether patients taking aspirin were more likely to experience bleeding complications after transrectal ultrasound (TRUS)-guided prostate biopsy. Materials and methods: Three hundred and eighty-seven patients taking aspirin who underwent prostate biopsy over a 3.5 year period and 731 patients not taking aspirin over a 2 year period returned a questionnaire assessing the incidence and severity of bleeding complications. Results: Patients taking aspirin had a significantly higher cumulative incidence of haematuria and rectal bleeding, but not of haemospermia. They also had a longer mean duration of bleeding, but no increase in bleeding severity. Severe bleeding was very uncommon in both groups and no patients required intervention for bleeding complications. Conclusion: Aspirin exacerbates minor bleeding complications in patients undergoing TRUS guided biopsy of the prostate, but in this large group of aspirin-taking patients no dangerous bleeding complications were encountered. It may be that the risks associated with aspirin cessation outweigh the risks of haemorrhagic complications.

  6. Evaluation of T2-weighted and dynamic contrast-enhanced MRI in localizing prostate cancer before repeat biopsy

    International Nuclear Information System (INIS)

    We assessed the accuracy of T2-weighted (T2w) and dynamic contrast-enhanced (DCE) 1.5-T magnetic resonance imaging (MRI) in localizing prostate cancer before transrectal ultrasound-guided repeat biopsy. Ninety-three patients with abnormal PSA level and negative prostate biopsy underwent T2w and DCE prostate MRI using pelvic coil before repeat biopsy. T2w and DCE images were interpreted using visual criteria only. MR results were correlated with repeat biopsy findings in ten prostate sectors. Repeat biopsy found prostate cancer in 23 patients (24.7%) and 44 sectors (6.6%). At per patient analysis, the sensitivity, specificity, positive and negative predictive values were 47.8%, 44.3%, 20.4% and 79.5% for T2w imaging and 82.6%, 20%, 24.4% and 93.3% for DCE imaging. When all suspicious areas (on T2w or DCE imaging) were taken into account, a sensitivity of 82.6% and a negative predictive value of 100% could be achieved. At per sector analysis, DCE imaging was significantly less specific (83.5% vs. 89.7%, p < 0.002) than T2w imaging; it was more sensitive (52.4% vs. 32.1%), but the difference was hardly significant (p = 0.09). T2w and DCE MRI using pelvic coil and visual diagnostic criteria can guide prostate repeat biopsy, with a good sensitivity and NPV. (orig.)

  7. Optoacoustic imaging of the prostate: development toward image-guided biopsy

    Science.gov (United States)

    Yaseen, Mohammad A.; Ermilov, Sergey A.; Brecht, Hans-Peter; Su, Richard; Conjusteau, André; Fronheiser, Matthew; Bell, Brent A.; Motamedi, Massoud; Oraevsky, Alexander A.

    2010-03-01

    Optoacoustic (OA) tomography has demonstrated utility in identifying blood-rich malignancies in breast tissue. We describe the development and characterization of a laser OA imaging system for the prostate (LOIS-P). The system consists of a fiber-coupled Q-switched laser operating at 757 nm, a commercial 128-channel ultrasonic probe, a digital signal processor, and software that uses the filtered radial back-projection algorithm for image reconstruction. The system is used to reconstruct OA images of a blood-rich lesion induced in vivo in a canine prostate. OA images obtained in vivo are compared to images acquired using ultrasound, the current gold standard for guiding biopsy of the prostate. Although key structural features such as the urethra could be identified with both imaging techniques, a bloody lesion representing a highly vascularized tumor could only be clearly identified in OA images. The advantages and limitations of both forward and backward illumination modes are also evaluated by collecting OA images of phantoms simulating blood vessels within tissue. System resolution is estimated to be 0.2 mm in the radial direction of the acoustic array. The minimum detectable pressure signal is 1.83 Pa. Our results encourage further development toward a dual-modality OA/ultrasonic system for prostate imaging and image-guided biopsy.

  8. ERG Expression in Prostate Needle Biopsy: Potential Diagnostic and Prognostic Implications.

    Science.gov (United States)

    Lee, Sandra L; Yu, Darryl; Wang, Cheng; Saba, Raya; Liu, Shuhong; Trpkov, Kiril; Donnelly, Bryan; Bismar, Tarek A

    2015-08-01

    To investigate the prognostic and diagnostic value of ERG immunohistochemistry (IHC) in prostate needle biopsy when combined with AMACR-CK5/6. ERG IHC was assessed in 119 consecutive prostate needle biopsies where the dual-stain AMACR-CK5/6 IHC was ordered and in 16 cases with a Gleason score (GS) ≥7. IHC results were evaluated in prostate carcinoma (PCA), high-grade prostatic intraepithelial neoplasia (HGPIN), HGPIN with adjacent atypical glands (PINATYP), atypical/suspicious (ASAP) foci, and benign PCA mimickers. GS, HGPIN, extraprostatic extension, perineural invasion, bilateralism of PCA, largest percent of core, and the overall percent of tissue involved by PCA were recorded. ERG was detected in 36% of PCA, 27% of HGPIN, 13% of ATYP/PINATYP, and none of benign mimickers. ERG-positive HGPIN was strongly associated with ERG-positive PCA in the same core compared with ERG-negative HGPIN (Pcore. Studies investigating the prognostic value of ERG in HGPIN should be implemented to address whether patients with ERG-positive HGPIN are at increased risk for subsequent PCA development. PMID:25517865

  9. Prostate biopsies guided by three-dimensional real-time (4-D) transrectal ultrasonography on a phantom: comparative study versus two-dimensional transrectal ultrasound-guided biopsies

    CERN Document Server

    Long, Jean-Alexandre; Moreau-Gaudry, Alexandre; Troccaz, Jocelyne; Rambeaud, Jean-Jacques; Descotes, Jean-Luc

    2007-01-01

    OBJECTIVE: This study evaluated the accuracy in localisation and distribution of real-time three-dimensional (4-D) ultrasound-guided biopsies on a prostate phantom. METHODS: A prostate phantom was created. A three-dimensional real-time ultrasound system with a 5.9MHz probe was used, making it possible to see several reconstructed orthogonal viewing planes in real time. Fourteen operators performed biopsies first under 2-D then 4-D transurethral ultrasound (TRUS) guidance (336 biopsies). The biopsy path was modelled using segmentation in a 3-D ultrasonographic volume. Special software was used to visualise the biopsy paths in a reference prostate and assess the sampled area. A comparative study was performed to examine the accuracy of the entry points and target of the needle. Distribution was assessed by measuring the volume sampled and a redundancy ratio of the sampled prostate. RESULTS: A significant increase in accuracy in hitting the target zone was identified using 4-D ultrasonography as compared to 2-D....

  10. The usefulness of the transrectal ultrasonography in the diagnosis of the prostate cancer : comparison with systemic sextant biopsy

    International Nuclear Information System (INIS)

    To retrospectively compared the usefulness of the transrectal ultrasonography LEAVE A SPACE(TRUS) and systemic sextant biopsy in the diagnosis of prostate cancer. A total of 84 patients with clinical and laboratory findings suggestive of prostate cancer underwent TRUS and systemic sextant biopsy. Nine patients with diffuse prostatic lesion had been excluded from the list. Following sonographic evaluation, additional targeted biopsy for the focal lesion was performed in 14 patients. A total of 464 biopsy specimens were obtained and retrospectively compared with the sonographic findings. For cancer, the sensitivity, specificity and false-positive rate of TRUS were 48%, 97% and 53%, respectively. The hypoechoic nodules seen in prostate cancer were more commonly located in the outer half of the peripheral zone of the prostate, while most BPH lesions were located in the inner half of this zone. Between prostate cancer and BPH there was statistically significant difference in the location of hypoechoic nodules revealed by TRUS (p=0.01). The location of the hypoechoic nodules provides useful information for differentiating between BPH nodules and malignant prostatic nodules and may reduce the false-positive rate of TRUS in the diagnosis of prostate cancer

  11. Performance of multiparametric MRI in men at risk of prostate cancer before the first biopsy: a paired validating cohort study using template prostate mapping biopsies as the reference standard

    OpenAIRE

    Abd-Alazeez, M.; Kirkham, A; Ahmed, H. U.; Arya, M; Anastasiadis, E.; Charman, S C; Freeman, A; Emberton, M

    2014-01-01

    Background:Multiparametric magnetic resonance imaging (mpMRI) has the potential to serve as a non-invasive triage test for men at risk of prostate cancer. Our objective was to determine the performance characteristics of mpMRI in men at risk before the first biopsy using 5 mm template prostate mapping (TPM) as the reference standard. Methods:One hundred and twenty-nine consecutive men with clinical suspicion of prostate cancer, who had no prior biopsy, underwent mpMRI (T1/T2-weighted, dif...

  12. Usefulness of transrectal ultrasound-guided 12 core biopsy method in patients with clinically suspected prostate cancer

    International Nuclear Information System (INIS)

    To evaluate the improvement of prostate cancer detection provided by transrectal ultrasound (TRUS)-guided 12 core biopsy method compared with sextant biopsy method. Between June 1997 and February 1999, 29 patients with pathologically proven prostate cancer in 124 patients who underwent TRUS-guided 12 core biopsy method were evaluated. They had abnormal findings in prostate specific antigen (PSA), digital rectal examination (DRE) or TRUS findings. The prostate was diffusely enlarged in all patients on DRE findings and in 15 cases (15/29, 52%), hard nodule was palpated. The average of PSA and prostate specific antigen density (PSAD) is 229.33 ng/ml (1-2280) and 9.14 ng/ml/cm3 (0.048-142.5), respectively, 12 transrectal biopsy, including 2 transition zones, was performed in both lobe, 6 biopsies were located in both base, middle and apex. Then 2 biopsies were inserted between 3 biopsies in both peripheral zone and 2 biopsies were performed in both transition zone. Each specimen was pathologically examined. The results of pathology were compared with method 1 and 2, respectively. We defined the method 1 and 2 as different sextant biopsy method. The method 1 is that cores are taken from both base, middle and apex and method 2 is that cores are taken from both base, apex and transition zone. TRUS findings were analyzed by two radiologists. Of the 29 patients with prostate cancer, 3 (10%) had carcinomas only in the additional regions as compared with method. When compared with method 2,2 (7.0%) had carcinomas only in the additional regions. 2 patients were same in both cases. TRUS findings were abnormal in 21 cases in all patients whose 12 biopsy method was not helpful. 12 biopsy method was helpful in 2/8 (25%) whose TRUS findings were non-specific and 1/21 (4.8%) whose TRUS findings were abnormal. Small low echoic lesion was seen in one patients whose 12 biopsy method was helpful, but cancer was found in other area. TRUS-guided 12 core biopsy method may be superior to

  13. Nomogram using transrectal ultrasound-derived information predicting the detection of high grade prostate cancer on initial biopsy

    OpenAIRE

    Jeong, In Gab; Lim, Ju Hyun; Hwang, Seung-Sik; Kim, Sung Cheol; You, Dalsan; Hong, Jun Hyuk; Ahn, Hanjong; Kim, Choung-Soo

    2013-01-01

    Purpose: To develop a nomogram using transrectal ultrasound (TRUS)-derived information for predicting high grade (HG) prostate cancer (PCa) on initial biopsy. Methods: Data were collected on 1,048 men with serum prostate-specific antigen (PSA) levels 4.0 to 9.9 ng/mL who underwent an initial prostate biopsy. Two logistic regression-based nomograms were constructed to predict the detection of PCa. Nomogram-1 incorporated age, digital rectal examination, PSA and percent free PSA data, whereas n...

  14. Quantification of tumor extension in prostate biopsies: importance in the identification of confined tumors

    Directory of Open Access Journals (Sweden)

    Leite Kátia R.M.

    2003-01-01

    Full Text Available OBJECTIVE: To assess the importance of quantifying the adenocarcinoma in prostate biopsies when determining the tumor's final stage in patients who undergo radical prostatectomy. To identify the best methodology for obtaining such data. PATIENTS AND METHODS: Prostate biopsies from 132 patients were examined, with determination of Gleason histological grade and tumor volume in number of involved fragments, tumor extent of the fragment mostly affected by the tumor and the total percentage of tumor in the specimen. Theses parameters were statistically correlated with the neoplasia's final stage following the evaluation of radical prostatectomy specimens. RESULTS: An average of 12 and a median of 14 biopsy fragments were evaluated per patient. In the univariate analysis the Gleason histological grade, the largest tumor extent in one fragment and the total percentage of tumor in the specimen were correlated with tumor stage of the surgical specimen. In the multivariate analysis, the Gleason histological grade and the total percentage of tumor were strongly correlated with the neoplasia's final stage. The risk of the tumor not being confined was 3 for Gleason 7 tumors and 10.6 for Gleason 8 tumors or above. In cases where the tumor involved more than 60% of the specimen, the risk of non-confined disease was 4.4 times. Among 19 patients with unfavorable histological parameters, Gleason > 7 and extension greater than 60% the tumor final stage was pT3 in 95%. CONCLUSION: When associated to the Gleason histological grade, tumor quantification in prostate biopsies is an important factor for determining organ-confined disease, and among the methods, total percentage of tumor is the most informative one. Such data should be included in the pathological report and must be incorporated in future nomograms.

  15. Prostatic biopsy in the prostate specific antigen gray zone; La biopsia prostatica multipla nalla zona grigia dei valori dell'antigene prostatico specifico

    Energy Technology Data Exchange (ETDEWEB)

    Drudi, F. M.; Ricci, P.; Iannicelli, E.; Di Nardo, R.; Novelli, L.; Laghi, A.; Passariello, R. [Rome Univ. La Sapienza, Rome (Italy). Ist. di Radiologia II Cattedra; Perugia, G. [Rome Univ. La Sapienza, Rome (Italy). Dipt. di Urologia U. Bracci

    2000-02-01

    The main purpose of this study was to identify cases of undetected prostatic cancer in patients with normal findings at digital examination and transrectal US, and prostate specific antigen (PSA) values ranging 4-10 ng/mL. 290 patients were submitted to transrectal US and random bilateral prostatic biopsy; 3 samples were collected from each side of the gland using 16-Gauge thru-cut needles. Of the 290 patients who gave full informed consent, 34 people were selected whose age range was between 56 to 76 years (mean: 64). Inclusion criteria were PSA 4-10 ng/mL, PSAD cut-off 0.15, free/total PSA ratio 15-25%, and normal findings at digital examination and transrectal US. PSA velocity was calculated collecting 3 blood samples every 30 days for 2 months. 5 of the 34 selected patients (15%) had prostatic cancer, and 2 (6%) Pin (1 Pin 1 and 1 Pin 2). As for the other 27 patients, biopsy demonstrated 4 (12%) cases of prostatitis and 23 (62%) cases of BPH. PSA values increased in all patients with positive histology, versus only 6 (22%) of those with negative histology. Our findings confirm that prostatic biopsy can detect tumors also in areas which appear normal at transrectal US and digital examination, and that PSA rate increases in patients with positive histology. Finally, the actual clinical role of prostatic biopsy relative to all other diagnostic imaging techniques remains to be defined. [Italian] Si intende qui dimostrare la percentuale di neoplasie prostatiche sfuggite all'esplorazione rettale e all'ecografia transrettale nei pazienti convalori di antigene prostatico specifico tra 4 e 10 ng/ml. 290 pazienti sono stati sottoposti a ecografia transrettale e biopsia multipla (6 prelievi, ago da 16 Gauge) dopo consenso informato. Di questi sono stati selezionati 34: eta' tra 56 e 76 anni, eta' media 64 anni. Parametri di selezione: antigene prostatico specifico con valori tra 4 e 10ng/ml; densita' dell'antigene prostatico specifico con

  16. Comparison of Two Local Anesthesia Injection Methods During a Transrectal Ultrasonography-guided Prostate Biopsy

    International Nuclear Information System (INIS)

    To compare the effectiveness of 2 injection methods of lidocaine during a transrectal ultrasound (TRUS)-guided prostate biopsy for pain control and complication rates. We retrospectively evaluated patients who underwent a TRUS-guided prostate biopsy from March 2005 to March 2006. One hundred patients were categorized into two groups based on injection method. For group 1, 10 mL of 1% lidocaine was injected bilaterally at the junction of the seminal vesicle and prostate and for group 2, into Denonvilliers' fascia. Pain scores using a visual analog scale (VAS) as well as immediate and delayed complication rates were evaluated. The mean VAS score showed no significant differences between the groups (group 1, 3.4±1.78: group 2, 2.8±1.3: p = 0.062). The difference in delayed complication rates and incidence of hematuria, hemospermia, and blood via the rectum was not significant between groups. However, two patients in group 1 complained of symptoms immediately after local anesthesia: one of tinnitus and the other of mild dizziness. There were no significant differences between pain control and complication rates between the 2 lidocaine injection methods. However, injection into Denonvilliers' fascia is thought to have less potential risk

  17. Comparison of Two Local Anesthesia Injection Methods During a Transrectal Ultrasonography-guided Prostate Biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Song Ee; Oh, Young Taik [Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Jang Hwan; Rha, Koon Ho; Hong, Sung Joon; Yang, Seung Choul [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2010-09-15

    To compare the effectiveness of 2 injection methods of lidocaine during a transrectal ultrasound (TRUS)-guided prostate biopsy for pain control and complication rates. We retrospectively evaluated patients who underwent a TRUS-guided prostate biopsy from March 2005 to March 2006. One hundred patients were categorized into two groups based on injection method. For group 1, 10 mL of 1% lidocaine was injected bilaterally at the junction of the seminal vesicle and prostate and for group 2, into Denonvilliers' fascia. Pain scores using a visual analog scale (VAS) as well as immediate and delayed complication rates were evaluated. The mean VAS score showed no significant differences between the groups (group 1, 3.4{+-}1.78: group 2, 2.8{+-}1.3: p = 0.062). The difference in delayed complication rates and incidence of hematuria, hemospermia, and blood via the rectum was not significant between groups. However, two patients in group 1 complained of symptoms immediately after local anesthesia: one of tinnitus and the other of mild dizziness. There were no significant differences between pain control and complication rates between the 2 lidocaine injection methods. However, injection into Denonvilliers' fascia is thought to have less potential risk

  18. DNA Ploidy Measured on Archived Pretreatment Biopsy Material May Correlate With Prostate-Specific Antigen Recurrence After Prostate Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Keyes, Mira, E-mail: mkeyes@bccancer.bc.ca [Radiation Oncology, Provincial Prostate Brachytherapy Program, Vancouver Cancer Centre, British Columbia Cancer Agency, Vancouver, British Columbia (Canada); MacAulay, Calum [Department of Integrative Oncology, British Columbia Cancer Research Centre, British Columbia Cancer Agency, Vancouver, British Columbia (Canada); Hayes, Malcolm [Department of Pathology, Vancouver Cancer Centre, British Columbia Cancer Agency, Vancouver, British Columbia (Canada); Korbelik, Jagoda [Department of Integrative Oncology, British Columbia Cancer Research Centre, British Columbia Cancer Agency, Vancouver, British Columbia (Canada); Morris, W. James [Radiation Oncology, Provincial Prostate Brachytherapy Program, Vancouver Cancer Centre, British Columbia Cancer Agency, Vancouver, British Columbia (Canada); Palcic, Branko [Department of Integrative Oncology, British Columbia Cancer Research Centre, British Columbia Cancer Agency, Vancouver, British Columbia (Canada)

    2013-08-01

    Purpose: To explore whether DNA ploidy of prostate cancer cells determined from archived transrectal ultrasound-guided biopsy specimens correlates with disease-free survival. Methods and Materials: Forty-seven failures and 47 controls were selected from 1006 consecutive low- and intermediate-risk patients treated with prostate {sup 125}I brachytherapy (July 1998-October 2003). Median follow-up was 7.5 years. Ten-year actuarial disease-free survival was 94.1%. Controls were matched using age, initial prostate-specific antigen level, clinical stage, Gleason score, use of hormone therapy, and follow-up (all P nonsignificant). Seventy-eight specimens were successfully processed; 27 control and 20 failure specimens contained more than 100 tumor cells were used for the final analysis. The Feulgen-Thionin stained cytology samples from archived paraffin blocks were used to determine the DNA ploidy of each tumor by measuring integrated optical densities. Results: The samples were divided into diploid and aneuploid tumors. Aneuploid tumors were found in 16 of 20 of the failures (80%) and 8 of 27 controls (30%). Diploid DNA patients had a significantly lower rate of disease recurrence (P=.0086) (hazard ratio [HR] 0.256). On multivariable analysis, patients with aneuploid tumors had a higher prostate-specific antigen failure rate (HR 5.13). Additionally, those with “excellent” dosimetry (V100 >90%; D90 >144 Gy) had a significantly lower recurrence rate (HR 0.25). All patients with aneuploid tumors and dosimetry classified as “nonexcellent” (V100 <90%; D90 <144 Gy) (5 of 5) had disease recurrence, compared with 40% of patients with aneuploid tumors and “excellent” dosimetry (8 of 15). In contrast, dosimetry did not affect the outcome for diploid patients. Conclusions: Using core biopsy material from archived paraffin blocks, DNA ploidy correctly classified the majority of failures and nonfailures in this study. The results suggest that DNA ploidy can be used as a

  19. DNA Ploidy Measured on Archived Pretreatment Biopsy Material May Correlate With Prostate-Specific Antigen Recurrence After Prostate Brachytherapy

    International Nuclear Information System (INIS)

    Purpose: To explore whether DNA ploidy of prostate cancer cells determined from archived transrectal ultrasound-guided biopsy specimens correlates with disease-free survival. Methods and Materials: Forty-seven failures and 47 controls were selected from 1006 consecutive low- and intermediate-risk patients treated with prostate 125I brachytherapy (July 1998-October 2003). Median follow-up was 7.5 years. Ten-year actuarial disease-free survival was 94.1%. Controls were matched using age, initial prostate-specific antigen level, clinical stage, Gleason score, use of hormone therapy, and follow-up (all P nonsignificant). Seventy-eight specimens were successfully processed; 27 control and 20 failure specimens contained more than 100 tumor cells were used for the final analysis. The Feulgen-Thionin stained cytology samples from archived paraffin blocks were used to determine the DNA ploidy of each tumor by measuring integrated optical densities. Results: The samples were divided into diploid and aneuploid tumors. Aneuploid tumors were found in 16 of 20 of the failures (80%) and 8 of 27 controls (30%). Diploid DNA patients had a significantly lower rate of disease recurrence (P=.0086) (hazard ratio [HR] 0.256). On multivariable analysis, patients with aneuploid tumors had a higher prostate-specific antigen failure rate (HR 5.13). Additionally, those with “excellent” dosimetry (V100 >90%; D90 >144 Gy) had a significantly lower recurrence rate (HR 0.25). All patients with aneuploid tumors and dosimetry classified as “nonexcellent” (V100 <90%; D90 <144 Gy) (5 of 5) had disease recurrence, compared with 40% of patients with aneuploid tumors and “excellent” dosimetry (8 of 15). In contrast, dosimetry did not affect the outcome for diploid patients. Conclusions: Using core biopsy material from archived paraffin blocks, DNA ploidy correctly classified the majority of failures and nonfailures in this study. The results suggest that DNA ploidy can be used as a useful

  20. Telomerase activity in needle biopsies from prostate cancer and benign prostates

    NARCIS (Netherlands)

    Wymenga, LFA; Wisman, GBA; Ruiters, MHJ; Mensink, HJA; Veenstra, R.

    2000-01-01

    Background Telomerase activation is thought to be essential for the immortality of cancer cells. It may be a prognostic factor in small volume well differentiated prostate cancers and hence a guide for the aggressiveness of the approach. The length of the chromosome tips (telomeres) are maintained b

  1. Histopathological findings in extended prostate biopsy with PSA ≤ 4 ng/mL

    Directory of Open Access Journals (Sweden)

    Katia R. Leite

    2008-06-01

    Full Text Available OBJECTIVE: Cancer detection has been reported in up to 27% of patients when lowering the PSA cutoff to 2.5 ng/mL. Although this practice could increase the number of biopsies performed, it also could lead to more frequent detection of significant prostate cancers at an organ-confined stage and/or a less aggressive state. This study describes the incidence of malignancy and tumor characteristics in extended prostate biopsies with PSA ≤ 4 ng/mL. MATERIALS AND METHODS: Prostate biopsies from 1081 patients where examined, 275 (25.4% patients had PSA level ≤ 4 ng/mL. RESULTS: Cancer was diagnosed in 32.0% and 35.7% of patients with PSA ≤ 4 ng/mL and > 4 ng/mL, respectively (p = 0.906. The median Gleason score was 7 independent of PSA > or ≤ 4 ng/mL (p = 0.078. The median number of cores positive for tumor was 4 and 3, respectively, for PSA > 4 ng/mL and PSA ≤ 4 ng/mL (p = 0.627. There was a difference in the total percent of tumors involving all cores, 11% and 7% for PSA > or ≤ 4 ng/mL (p = 0.042. Fifty-six patients underwent radical prostatectomy, 12 had PSA ≤ 4 ng/mL. In both groups, a diagnosis of cancer was accurate with no differences in Gleason score, tumor volume or staging for both groups. CONCLUSION: When PSA is below 4 ng/mL, cancer is detected in a proportion equal to the proportion diagnosed with a PSA > 4 ng/mL, and tumor characteristics are similar between the two groups. Only clinically significant tumors were diagnosed following radical prostatectomy.

  2. Prostate cancer: 1.5 T endo-coil dynamic contrast-enhanced MRI and MR spectroscopy-correlation with prostate biopsy and prostatectomy histopathological data

    Energy Technology Data Exchange (ETDEWEB)

    Chabanova, Elizaveta, E-mail: elcha@heh.regionh.dk [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark); Balslev, Ingegerd [Department of Pathology, Copenhagen University Hospital at Herlev (Denmark); Logager, Vibeke [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark); Hansen, Alastair [Department of Pathology, Copenhagen University Hospital at Herlev (Denmark); Jakobsen, Henrik; Kromann-Andersen, Bjarne; Norgaard, Nis [Department of Urology, Copenhagen University Hospital at Herlev, (Denmark); Horn, Thomas [Department of Pathology, Copenhagen University Hospital at Herlev (Denmark); Thomsen, Henrik S. [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark)

    2011-11-15

    Purpose: To investigate diagnostic accuracy of detection of prostate cancer by magnetic resonance: to evaluate the performance of T2WI, DCEMRI and CSI and to correlate the results with biopsy and radical prostatectomy histopathological data. Materials and methods: 43 patients, scheduled for radical prostatectomy, underwent prostate MR examination. Prostate cancer was identified by transrectal ultrasonographically (TRUS) guided sextant biopsy. MR examination was performed at 1.5T with an endorectal MR coil. Cancer localisation was performed on sextant-basis - for comparison between TRUS biopsy, MR techniques and histopathological findings on prostatectomy specimens. Results: Prostate cancer was identified in all 43 patients by combination of the three MR techniques. The detection of prostate cancer on sextant-basis showed sensitivity and specificity: 50% and 91% for TRUS, 72% and 55% for T2WI, 49% and 69% for DCEMRI, and 46% and 78% for CSI. Conclusion: T2WI, DCEMRI and CSI in combination can identify prostate cancer. Further development of MR technologies for these MR methods is necessary to improve the detection of the prostate cancer.

  3. Prostate cancer: 1.5 T endo-coil dynamic contrast-enhanced MRI and MR spectroscopy-correlation with prostate biopsy and prostatectomy histopathological data

    International Nuclear Information System (INIS)

    Purpose: To investigate diagnostic accuracy of detection of prostate cancer by magnetic resonance: to evaluate the performance of T2WI, DCEMRI and CSI and to correlate the results with biopsy and radical prostatectomy histopathological data. Materials and methods: 43 patients, scheduled for radical prostatectomy, underwent prostate MR examination. Prostate cancer was identified by transrectal ultrasonographically (TRUS) guided sextant biopsy. MR examination was performed at 1.5T with an endorectal MR coil. Cancer localisation was performed on sextant-basis - for comparison between TRUS biopsy, MR techniques and histopathological findings on prostatectomy specimens. Results: Prostate cancer was identified in all 43 patients by combination of the three MR techniques. The detection of prostate cancer on sextant-basis showed sensitivity and specificity: 50% and 91% for TRUS, 72% and 55% for T2WI, 49% and 69% for DCEMRI, and 46% and 78% for CSI. Conclusion: T2WI, DCEMRI and CSI in combination can identify prostate cancer. Further development of MR technologies for these MR methods is necessary to improve the detection of the prostate cancer.

  4. Gleason grading of prostate cancer in needle biopsies or radical prostatectomy specimens: contemporary approach, current clinical significance and sources of pathology discrepancies.

    Science.gov (United States)

    Montironi, Rodolfo; Mazzuccheli, Roberta; Scarpelli, Marina; Lopez-Beltran, Antonio; Fellegara, Giovanni; Algaba, Ferran

    2005-06-01

    The Gleason grading system is a powerful tool to prognosticate and aid in the treatment of men with prostate cancer. The needle biopsy Gleason score correlates with virtually all other pathological variables, including tumour volume and margin status in radical prostatectomy specimens, serum prostate-specific antigen levels and many molecular markers. The Gleason score assigned to the tumour at radical prostatectomy is the most powerful predictor of progression after radical prostatectomy. However, there are significant deficiencies in the practice of this grading system. Not only are there problems among practising pathologists but also a relative lack of interobserver reproducibility among experts. PMID:15877724

  5. Evaluation of PCR-ELISA for determination of telomerase activity in prostate needle biopsy and prostatic fluid specimens.

    Science.gov (United States)

    Wang, Zhilian; Ramin, Soroush A; Tsai, Christopher; Lui, Paul; Ruckle, Herbert C; Beltz, Richard E; Sands, John F; Slattery, Charles W

    2002-01-01

    The conventional TRAP assay will determine telomerase activity in tissue or other specimens. However, methodological disadvantages limit its clinical use. We evaluated a modified TRAP assay, the telomerase PCR-ELISA, as a practical clinical system for measuring its activity in conjunction with prostate cancer (PCa). We examined telomerase activity by both TRAP and PCR-ELISA assays in 48 sextant needle biopsy (SNB) specimens from dye-marked areas of the prostate glands of 7 PCa patients. Each specimen was histologically confirmed as cancerous or cancer-free by examining a paired specimen taken from the same marked area. In addition, prostatic fluid (PF) specimens were analyzed from 18 patients, 9 of whom were diagnosed with PCa while 9 were diagnosed as cancer-free but mostly with BPH. The results on individual SNB specimens matched well for the two methods. The sensitivity (91%) and specificity (69%) for the PCR-ELISA measurements were consistent with those for the conventional TRAP assay, 88% and 81%, respectively. Quantitatively, with the PCR-ELISA assay, the mean telomerase activity (24.5+/-28.4 units) per needle core with PCa cells was significantly higher than that in needle cores without PCa cells (7.2+/-2.2 unit), as it was with the conventional TRAP assay, namely 25.6+/-27.8 units and 7.3+/-1.8 units, respectively. In PF specimens from PCa patients, which had a lower mean telomerase than was found in needle cores containing PCa cells (7.1+/-1.5 units in the PCR-ELISA, 7.2+/-1.8 units in the conventional TRAP assay), statistical analysis showed good matching between the results from the two assays, overall. In conclusion, the PCR-ELISA can be considered a reliable method to determine telomerase activity as an adjunct in the diagnosis and treatment of prostate cancer. PMID:12644217

  6. Does prolonged anti-inflammatory therapy reduce number of unnecessary repeat saturation prostate biopsy?

    Directory of Open Access Journals (Sweden)

    Giuseppe Candiano

    2013-06-01

    Full Text Available Introduction. The effect of a prolonged oral anti-inflammatory therapy on PSA values in patients with persistent abnormal PSA values after negative prostate biopsy (PBx was evaluated. Material and methods. From September 2011 to September 2012, 70 patients (medi- an age 62 years, with persistent abnormal PSA values after negative extended PBx, were given an herbal extract with anti-inflammatory activity for 3 months (Lenidase®; 1 tablet daily constituted of baicalina, bromelina and escina. All patients were submitted to prostate biopsy for: abnormal DRE; PSA > 10 ng/mL, PSA values between 4.1-10 or 2.6-4 ng/mL with free/total PSA < 25% and < 20%, respectively. Three months after the end of anti-inflammato- ry therapy all patients were revaluated; indication for repeat saturation biopsy (SPBx and detection rate for PCa were compared with those previously recorded in our Department using the same inclusions criteria for biopsy. Results. Oral administration of Lenidase® was well tolerated and no side effects were observed; PSA values decreased in 54 (77.8% out 70 patients with a median PSA reduction of 20.5% (from 8.8 to 7 ng/mL and remained unchanged in 16 patients (22.2%; the repeat SPBx rate resulted significantly lower (22.8% vs 35.5%; p < 0.05 showing a superimposable detection rate for PCa (3 cases in comparison with our previous data (18.7% vs 22%. Conclusions. In our preliminary data a prolonged oral anti-inflammatory therapy reduced PSA levels in patients with negative PBx and persistent suspicious for PCa decreasing the indication to perform repeat SPBx (about 30% of the cases.

  7. Randomized controlled trial of antibiotic prophylaxis regimens for transrectai ultrasound-guided prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    CHAN Eddie Shu-yin; LO Ka-lun; NG Chi-fai; HOU See-ming; YIP Sidney Kam-hung

    2012-01-01

    Background A prior study showed significant antibioti resistance to quinotone in our poputation.In this study we aimed to evaluate and compare the efficacy of a single versus a combined prophylactic antibiotic regimen before transrectal ultrasound-guided prostate biopsy(TRUGPB).Methods A prospective randomized study was conducted at a university hospital.Patients undergoing TRUGPB were randomized into an amoicillin-clavulanate alone(1mg;one dose before and two doses after biopsy)or an amoxicllin-clavulanate+ciprofloxacin group(250mg;one dose before and two doses after biopsy).Patients were surveyed for infection symptoms by phine on days 3 and 30 after TRUGPB.We defined an infective complication as the iccurrence of symptoms including fever,chills or rigor within 30 days after prostate biopsy,requiring medical treatment or hospitalization,aided by a tertiory-wide etectronic medical record system.Results Between November 2007 and July 2009,367 patients were randomized to either amoxicillin-clavulanate alone or amoxicillin-caavulanate+ciprofloxacin group.The infection rates after TRUGPB were 3.9%in the former group(7 out of 179 patoents)versus 0.53%(1 out of 188 patients)in the latter.Sixty-three percent(5/8)of patients with infective complications needed hospitalization.There was no intensive care unit admission or mortality during the study period.Conclusions Combining prophylactic antibiotics with amoxicllin-clavulanate+soprofloxacin significantly reduced the in cidence of infective complications after TRUGPB.We recommended a combination regimen,especially in centre with high incidence of post-TRUGPB infection.

  8. The Practicality of Targeted Prostate Biopsy Procedures on the Dominant Side of the Tumor Determined by Magnetic Resonance Imaging in Elderly Patients with High Serum Levels of Prostate-Specific Antigen

    OpenAIRE

    Huh, Jung Sik; Kim, Bong Soo; Kim, Young Joo; Kim, Sung Dae; Park, Kyung Kgi

    2015-01-01

    Purpose To examine the possibility of reducing the number of cores per prostate biopsy in elderly patients with high levels of prostate-specific antigen (PSA) without significantly lowering the detection rate of prostate cancer. Materials and Methods Two hundreds sixteen men with PSA levels >20 ng/mL who underwent prostate biopsies from May 2009 to April 2013 were retrospectively reviewed. With the help of magnetic resonance imaging (MRI), the laterality of the dominant tumor burden in patien...

  9. The Accuracy of Prostate Cancer Localization Diagnosed on Transrectal Ultrasound-Guided Biopsy Compared to 3-Dimensional Transperineal Approach

    Directory of Open Access Journals (Sweden)

    Kevin Krughoff

    2013-01-01

    Full Text Available Background. Prostate cancer is often understaged following 12-core transrectal ultrasound- (TRUS- guided biopsies. Our goal is to understand where cancers are typically missed by this method. Methods. Transperineal 3-dimensional mapping biopsy (3DMB provides a more accurate depiction of disease status than transrectal ultrasound- (TRUS- guided biopsy. We compared 3DMB findings in men with prior TRUS-guided biopsies to determine grade and location of missed cancer. Results were evaluated for 161 men with low-risk organ confined prostate cancer. Results. The number of cancer-positive biopsy zones per patient with TRUS was 1.38 ± 1.21 compared to 3.33 ± 4.06 with 3DMB, with most newly discovered cancers originating from the middle lobe and apex. Approximately half of all newly discovered cancerous zones resulted from anterior 3DMB sampling. Gleason upgrade was recognized in 56 patients using 3DMB. When both biopsy methods found positive cores in a given zone, Gleason upgrades occurred most frequently in the middle left and right zones. TRUS cancer-positive zones not confirmed by 3DMB were most often the basal zones. Conclusion. Most cancer upgrades and cancers missed from TRUS biopsy originated in the middle left zone of the prostate, specifically in anterior regions. Anterior sampling may lead to more accurate diagnosis and appropriate followup.

  10. Comparison of Transrectal Prostate Biopsy Results with Histology of Transurethral Resection of the Prostate in Men Undergoing High-Intensity Focused Ultrasound

    OpenAIRE

    Rogenhofer, Sebastian; Walter, Bernhard; Hartmann, Arndt; Wieland, Walter Ferdinand; Mueller, S.C.; Blana, Andreas

    2014-01-01

    Introduction: The aim of our study was to evaluate the significance of transurethral resection of the prostate (TURP) to detect prostate cancer (PCa). A comparison was performed of the TURP specimens of patients undergoing high-intensity focused ultrasound (HIFU) with the core biopsies. Materials and Methods: TURP before undergoing HIFU therapy was performed in 106 patients without neoadjuvant treatment. The resected tissue was subjected to histopathological evaluation...

  11. The influence of family ties on men's prostate cancer screening, biopsy, and treatment decisions.

    Science.gov (United States)

    Shaw, Eric K; Scott, John G; Ferrante, Jeanne M

    2013-11-01

    Extensive research has focused on understanding family dynamics of men with prostate cancer. However, little qualitative work has examined the role of family ties on men's prostate cancer decisions across the spectrum of screening, diagnosis, and treatment. Using data from a larger study, we qualitatively explored the influence of family ties on men's prostate cancer decisions. Semistructured interviews were conducted with men ages ≥50 (N = 64), and data were analyzed using a grounded theory approach and a series of immersion/crystallization cycles. Three major themes of spousal/family member influence were identified: (a) spousal/family member alliance marked by open communication and shared decision making, (b) men who actively opposed spouse/family member pressure and made final decisions themselves, and (c) men who yielded to spouse/family member pressure. Our findings provide insights into men's relational dynamics that are important to consider for the shared decision-making process across the prostate cancer spectrum. PMID:23459024

  12. The Incidence of Cancer of Prostate Based on More Than 500 Pathology Reports: When is Biopsy Indicated?

    Directory of Open Access Journals (Sweden)

    Faez Faizi

    2010-05-01

    Full Text Available In my opinion, screening of prostate cancer in Iranian men should be carried out at the age of 45 years. Occult cancer shows no clinical sign, however when it does the cancer has metastasized to the bones, the patient suffers from the pain and the situation is fatal. Yet in cases with high PSA, if biopsy is indicated it is curable. With the recent advances in medical science, no human being should die of cancer of prostate.

  13. Effect of Oral Administration of Acetaminophen and Topical Application of EMLA on Pain during Transrectal Ultrasound-Guided Prostate Biopsy

    OpenAIRE

    Kim, Seol; Yoon, Byung Il; Kim, Su Jin; Cho, Hyuk Jin; Kim, Hyo Sin; Hong, Sung Hoo; Lee, Ji Youl; Hwang, Tae-Kon; Kim, Sae Woong

    2011-01-01

    Purpose Transrectal ultrasound-guided prostate biopsy is the procedure of choice for diagnosing prostate cancer. We compared with pain-relieving effect of acetaminophen, a known drug for enhancing the pain-relieving effect of tramadol, and eutectic mixture of local anesthetics (EMLA), a local anesthetic agent, with that of the conventional periprostatic nerve block method. Materials and Methods This was a prospective, randomized, single-blinded study. A total of 430 patients were randomly ass...

  14. 3D versus 2D Systematic Transrectal Ultrasound-Guided Prostate Biopsy: Higher Cancer Detection Rate in Clinical Practice

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    Alexandre Peltier

    2013-01-01

    Full Text Available Objectives. To compare prostate cancer detection rates of extended 2D versus 3D biopsies and to further assess the clinical impact of this method in day-to-day practice. Methods. We analyzed the data of a cohort of 220 consecutive patients with no prior history of prostate cancer who underwent an initial prostate biopsy in daily practice due to an abnormal PSA and/or DRE using, respectively, the classical 2D and the new 3D systems. All the biopsies were done by a single experienced operator using the same standardized protocol. Results. There was no significant difference in terms of age, total PSA, or prostate volume between the two groups. However, cancer detection rate was significantly higher using the 3D versus the 2D system, 50% versus 34% (P<0.05. There was no statistically significant difference while comparing the 2 groups in term of nonsignificant cancer detection. Conclusion. There is reasonable evidence demonstrating the superiority of the 3D-guided biopsies in detecting prostate cancers that would have been missed using the 2D extended protocol.

  15. Percentage of Cancer Volume in Biopsy Cores Is Prognostic for Prostate Cancer Death and Overall Survival in Patients Treated With Dose-Escalated External Beam Radiotherapy

    International Nuclear Information System (INIS)

    Purpose: To investigate the prognostic utility of the percentage of cancer volume (PCV) in needle biopsy specimens for prostate cancer patients treated with dose-escalated external beam radiotherapy. Methods and Materials: The outcomes were analyzed for 599 men treated for localized prostate cancer with external beam radiotherapy to a minimal planning target volume dose of 75 Gy (range, 75–79.2). We assessed the effect of PCV and the pretreatment and treatment-related factors on the freedom from biochemical failure, freedom from metastasis, cause-specific survival, and overall survival. Results: The median number of biopsy cores was 7 (interquartile range, 6–12), median PCV was 10% (interquartile range, 2.5–25%), and median follow-up was 62 months. The PCV correlated with the National Comprehensive Cancer Network risk group and individual risk features, including T stage, prostate-specific antigen level, Gleason score, and percentage of positive biopsy cores. On log–rank analysis, the PCV stratified by quartile was prognostic for all endpoints, including overall survival. In addition, the PCV was a stronger prognostic factor than the percentage of positive biopsy cores when the two metrics were analyzed together. On multivariate analysis, the PCV predicted a worse outcome for all endpoints, including freedom from biochemical failure, (hazard ratio, 1.9; p = .0035), freedom from metastasis (hazard ratio, 1.7, p = .09), cause-specific survival (hazard ratio, 3.9, p = .014), and overall survival (hazard ratio, 1.8, p = .02). Conclusions: For patients treated with dose-escalated external beam radiotherapy, the volume of cancer in the biopsy specimen adds prognostic value for clinically relevant endpoints, particularly in intermediate- and high-risk patients. Although the PCV determination is more arduous than the percentage of positive biopsy cores, it provides superior risk stratification.

  16. Health-economic evaluation of magnetic resonance imaging before biopsy for diagnosis of prostate cancer

    International Nuclear Information System (INIS)

    The aim of this study was the health-economic analysis of MR imaging in the diagnostics of suspicious prostate carcinoma (PCa) before execution of a first biopsy. The health-economic analysis included four steps: modeling, determination of probabilities, evaluation, and sensitivity analyses. We performed an effectiveness analysis from the patient perspective as well as a cost-effectiveness and a cost-utility analysis from the health insurance perspective for Austria and Germany. The effectiveness and cost-effectiveness analysis used a hypothetical cohort of 100 000 patients. The result parameters were number of biopsies, number of detected PCa, and monetary costs. For the cost-efficiency analysis, the result parameters, quality-adjusted life years (QALYs) and costs, were calculated for an individual patient. The efficiency analysis showed that MRI before a first biopsy can prevent ca. 64 000 unnecessary biopsies/ 100 000 patients. The diagnostic efficiency was higher by a factor of 1.7. Due to MRI, eight PCas were additionally detected. From a health insurance perspective, MRI was not cost-effective. Extra costs of ca. 42 m. Euro per 100 000 patients and of 650 Euro per prevented biopsy were calculated. The costs per detected PCa were increased by 1395 Euro. The attainable QALYs were a little higher for the MRI alternative, which was therefore not dominated. Our results do not permit a clear recommendation for or against the application of MRI in the diagnostics of PCa. From the patient perspective, it is to be endorsed due to the higher medical efficiency. However, it is connected with higher health insurance costs. (orig.)

  17. Sextant localization of prostate cancer in peripheral zone by MRI: correlation with systemic biopsy pathology

    International Nuclear Information System (INIS)

    Objective: To determine the efficacy of sextant localization of prostate cancer (PCa) in PZ (peripheral zone) by MR Imaging. Methods: Fifty-one cases of PCa and 29 cases of benign prostate diseases were enrolled in the study. Each peripheral zone was divided into 6 sections (left/right bottom, middle and tip ) in the same fashion for biopsy and the characteristics of each sextant was evaluated separately. Being blinded to clinical data, 2 radiologists with different subspeciahy experience analyzed MR images of the 480 sections of these 80 cases retrospectively. Each sextant region impression of likelihood for cancer was estimated by the rank of a five-point rating scale (1=definite PCa, 2=probable PCa, 3=possible PCa, 4=probably not PCa, 5=definitely not PCa). If definite PCa was considered, then it was staged furthermore. Each diagnosis of sextant region was compared with the pathological result of corresponding biopsy site. Result: (1) Four hundred and seventy sections (205 cancerous and 265 benign) were proved by biopsy. The diagnosis efficacy was best when cutoff point was 2. There was moderate consistency between the results of MRI and pathology with the kappa value of 0.549-0.560. The total accuracy was 78.1%-78.3% with the sensitivity of 69.3%-76.1% and the specificity of 84.9%-80.0%. The positive predictive value was 78.0%-74.6% and the negative predictive value was 78.1%-81.2%. (2) The ROC analysis demonstrated that Az with total impression recorded by two readers had not significant difference(0.829±0.020 vs. 0.840±0.019, U=-0.3988, P>0.05). Conclusion: MRI may be an elementary way to localize PCa in PZ, but the diagnosis efficacy need to be improved furthermore. (authors)

  18. Prediction of pathological and oncological outcomes based on extended prostate biopsy results in patients with prostate cancer receiving radical prostatectomy: a single institution study

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    Ishizaki Fumio

    2012-06-01

    Full Text Available Abstract Background The prediction of pathological outcomes prior to surgery remains a challenging problem for the appropriate surgical indication of prostate cancer. This study was performed to identify preoperative values predictive of pathological and oncological outcomes based on standardized extended prostate biopsies with core histological results diagrammed/mapped in patients receiving radical prostatectomy for prostate cancer clinically diagnosed as localized or locally advanced disease. Methods In 124 patients with clinically localized or locally advanced prostate cancer (cT1c–cT3a without prior treatment, pathological outcomes on the surgical specimen including seminal vesicle involvement (SVI, positive surgical margin (PSM, and perineural invasion (PNI were studied in comparison with clinical parameters based on the results of 14-core prostate biopsies comprising sextant, laterally-directed sextant, and bilateral transition zone (TZ sampling. Results Concerning the association of pathological outcomes with oncological outcomes, patients with PSM and PNI on surgical specimens had poorer biochemical-progression-free survival than those without PSM (logrank p = 0.002 and PNI (p = 0.003; it was also poorer concerning SVI, although the difference was not significant (p = 0.120. Concerning the impact of clinical parameters on these pathological outcomes, positive TZ and multiple positive biopsy cores in the prostatic middle were independent values predictive of SVI with multivariate analyses (p = 0.020 and p = 0.025, respectively; both positive TZ and multiple positive prostatic middle biopsies were associated with larger tumor volume (p  Conclusions %positive cores and Gleason score in extended biopsies were independent values predictive of PSM and PNI in prostate cancer clinically diagnosed as localized or locally advanced disease, respectively, which were associated with poorer oncological outcomes. When

  19. Prospective study of antibiotic prophylaxis for prostate biopsy involving >1100 men.

    LENUS (Irish Health Repository)

    Manecksha, Rustom P

    2012-01-01

    We aimed to compare infection rates for two 3-day antibiotic prophylaxis regimens for transrectal ultrasound-guided prostate biopsy (TRUSgbp) and demonstrate local microbiological trends. In 2008, 558 men and, in 2009, 625 men had TRUSgpb. Regimen 1 (2008) comprised 400 mg Ofloxacin immediately before biopsy and 200 mg 12-hourly for 3 days. Regimen 2 (2009) comprised Ofloxacin 200 mg 12-hourly for 3 days commencing 24 hours before biopsy. 20\\/558 (3.6%) men had febrile episodes with regimen 1 and 10\\/625 (1.6%) men with regimen 2 (P = 0.03). E. coli was the most frequently isolated organism. Overall, 7\\/13 (54%) of positive urine cultures were quinolone resistant and (5\\/13) 40% were multidrug resistant. Overall, 5\\/9 (56%) patients with septicaemia were quinolone resistant. All patients were sensitive to Meropenem. There was 1 (0.2%) death with regimen 1. Commencing Ofloxacin 24 hours before TRUSgpb reduced the incidence of febrile episodes significantly. We observed the emergence of quinolone and multidrug-resistant E. coli. Meropenem should be considered for unresolving sepsis.

  20. An Eight-Year Experience of HDR Brachytherapy Boost for Localized Prostate Cancer: Biopsy and PSA Outcome

    International Nuclear Information System (INIS)

    Purpose: To evaluate the biochemical recurrence-free survival (bRFS), the 2-year biopsy outcome and the prostate-specific antigen (PSA) bounce in patients with localized prostate cancer treated with an inversely planned high-dose-rate (HDR) brachytherapy boost. Materials and methods: Data were collected from 153 patients treated between 1999 and 2006 with external beam pelvic radiation followed by an HDR Ir-192 prostate boost. These patients were given a boost of 18 to 20 Gy using inverse-planning with simulated annealing (IPSA).We reviewed and analyzed all prostate-specific antigen levels and control biopsies. Results: The median follow-up was 44 months (18-95 months). When categorized by risk of progression, 74.5% of patients presented an intermediate risk and 14.4% a high one. Prostate biopsies at 2 years posttreatment were negative in 86 of 94 patients (91.5%), whereas two biopsies were inconclusive. Biochemical control at 60 months was at 96% according to the American Society for Therapeutic Radiology and Oncology and the Phoenix consensus definitions. A PSA bounce (PSA values of 2 ng/mL or more above nadir) was observed in 15 patients of 123 (9.8%). The median time to bounce was 15.2 months (interquartile range, 11.0-17.7) and the median bounce duration 18.7 months (interquartile range, 12.1-29). The estimate of overall survival at 60 months was 97.1% (95% CI, 91.6-103%). Conclusions: Considering that inverse planned HDR brachytherapy prostate boosts led to an excellent biochemical response, with a 2-year negative biopsy rate, we recommend a conservative approach in face of a PSA bounce even though it was observed in 10% of patients

  1. Optimized high-throughput microRNA expression profiling provides novel biomarker assessment of clinical prostate and breast cancer biopsies

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    Fedele Vita

    2006-06-01

    Full Text Available Abstract Background Recent studies indicate that microRNAs (miRNAs are mechanistically involved in the development of various human malignancies, suggesting that they represent a promising new class of cancer biomarkers. However, previously reported methods for measuring miRNA expression consume large amounts of tissue, prohibiting high-throughput miRNA profiling from typically small clinical samples such as excision or core needle biopsies of breast or prostate cancer. Here we describe a novel combination of linear amplification and labeling of miRNA for highly sensitive expression microarray profiling requiring only picogram quantities of purified microRNA. Results Comparison of microarray and qRT-PCR measured miRNA levels from two different prostate cancer cell lines showed concordance between the two platforms (Pearson correlation R2 = 0.81; and extension of the amplification, labeling and microarray platform was successfully demonstrated using clinical core and excision biopsy samples from breast and prostate cancer patients. Unsupervised clustering analysis of the prostate biopsy microarrays separated advanced and metastatic prostate cancers from pooled normal prostatic samples and from a non-malignant precursor lesion. Unsupervised clustering of the breast cancer microarrays significantly distinguished ErbB2-positive/ER-negative, ErbB2-positive/ER-positive, and ErbB2-negative/ER-positive breast cancer phenotypes (Fisher exact test, p = 0.03; as well, supervised analysis of these microarray profiles identified distinct miRNA subsets distinguishing ErbB2-positive from ErbB2-negative and ER-positive from ER-negative breast cancers, independent of other clinically important parameters (patient age; tumor size, node status and proliferation index. Conclusion In sum, these findings demonstrate that optimized high-throughput microRNA expression profiling offers novel biomarker identification from typically small clinical samples such as breast

  2. Comparison of diffusion weighted imaging and transrectal ultrasound-guided biopsy in predicting aggressiveness of prostate cancer

    International Nuclear Information System (INIS)

    Objective: To retrospectively evaluate the utility of apparent diffusion coefficient (ADC) values in predicting aggressiveness of prostate cancer. Comparison was made with transrectal ultrasound-guided biopsy Gleason scores (GS) and prostatectomy GS. Methods: Diffusion weighted images of 51 patients with biopsy-proven prostate cancer were obtained using 1.5 T MR with a pelvic phased-array coil. Regions of interest (ROIs) were drawn on areas of the suspicious lesion and the ADC values were calculated. The correlations between the ADC values and prostatectomy GS were assessed with Pearson correlation. The relationship between biopsy GS and prostatectomy GS were also evaluated. Meanwhile, receiver operating characteristic (ROC) curves were used to determine the ability of ADC values and biopsy GS in differentiating low-grade prostate cancer from intermediate/high grade prostate cancer. Results: The accuracy of transrectal ultrasound-guided biopsy in predicting prostatectomy GS was 41.2%(21/51). Compared with prostatectomy GS, up to 11.8% of the patients (n=6) was overestimated by biopsy, while 47.0% (n=24) were underestimated. These 51 patients had a mean ADC value of (0.974 ±0.194) × 10-3 mm2/s. The mean ADC value of intermediate/high-grade tumors (n=35) was (0.907 ±0.160) ×10-3 mm2/s while that of low-grade tumors was (1.121 ±0.185) × 10-3 mm2/s (n=16). A significant negative correlation was found between mean ADC values of suspicious lesions and their prostatectomy GS (r=-0.761, P <0.01). No significant correlation was found between biopsy GS and prostatectomy GS (r=0.187, P=0.189). The area under the ROC curves of ADC and biopsy GS was 0.827 and 0.689, respectively. Conclusion: The ADC values of cancerous areas in prostate perform better than biopsy GS in predicting aggressiveness of prostate cancer. (authors)

  3. Lidocaine spray administration in transrectal ultrasound-guided prostate biopsy: Five years of experience

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    Lucio Dell’Atti

    2014-12-01

    Full Text Available Objectives: We report in this singlecenter study our results of a five-year experience in the administration of lidocaine spray (LS during ultrasound-guided prostate biopsy (TPB. Material and Methods: Between August 2008 and July 2013 a total of 1022 consecutive male patients scheduled for TPB with elevate PSA (≥ 4 ng/ml and (or abnormal digital rectal and (or suspect TRUS were considered eligible for the study. Each patient was treated under local anaesthesia with LS (10 gr/100 ml, applied two minutes before the procedure. TPB was performed with the patient in the left lateral decubitus using multi-frequency convex probe “end-fire”. Two experienced urologists performed a 14-core biopsy, as first intention. After the procedure each patient was given a verbal numeric pain scale (VNS. The evaluation was differentiated in two scales VNS: VNS 1 for the insertion of the probe and the manoeuvres associated, while VNS 2 only for the pain during needle’s insertion. Results: Pain scores were not statistically significant different with regard to the values of PSA and prostate gland volume. Pain score levels during probe insertion and biopsy were significantly different: the mean pain score according to VNS was 3.3 (2-8 in the first questionnaire (VNS1 (p < 0.001 and 2.1 (1-7 in the second one (VNS2 (p < 0.125. The 8.2% of cases referred severe or unbearable pain (score ≥ 7, 74% of patients referred no pain at all. Only 21 patients would not ever repeat the biopsy or would request a different type of anaesthesia, while 82% of them would repeat it in the same way. In only eight patients we have not been able to insert TRUS probe. Conclusions: Our pain score data suggest that LS provides efficient patient comfort during TPB reducing pain both during insertion of the probe and the needle. This non-infiltrative anaesthesia is safe, easy to administer, psychologically well accepted by patients and of low cost.

  4. Efficiency of 6- and 12-punctures biopsies to detect prostate cancer in patients with PSA< 10 ng/mL and normal digital rectal examination

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    Luiz E. Slongo

    2003-02-01

    Full Text Available OBJECTIVE: Establish the efficiency of 6- and 12-punctures transrectal ultrasound-guided needle biopsies in low risk patients for prostate cancer. Six-punctures (sextant biopsies were compared to 12-punctures biopsies, assessing which is the best strategy to detect this neoplasm. MATERIALS AND METHODS: Among 240 patients submitted to prostate biopsy, 54 with suspected small and organ-localized tumors (prostatic specific antigen < 10 ng/mL and digital exam of the prostate not suggesting cancer in glands < 50 cm³ were selected, constituting a homogenous sample. These patients were submitted to standard 3-punctures (basal, mid, and apical sextant biopsy in parasagittal midline of each prostatic lobe, with 3 additional lateral punctures, bilaterally. Each specimen was separately submitted to histological study. RESULTS: Twenty-two (40.7% patients had prostatic cancer, and 28 presented prostatic hyperplasia, associated or not to inflammatory conditions. High-grade prostatic intraepithelial neoplasia (PIN was detected in 4 patients. From 22 tumors detected by 12-punctures biopsies, 6-punctures biopsies in the parasagittal midline (sextant diagnosed 50% of the cases, while isolated lateral punctures diagnosed 90.9% of the malignant neoplasms. Basal lateral punctures responded for 72.7% of the cancer diagnosis, while basal sextant punctures responded only for 9.1% of the cases. CONCLUSION: For low risk prostate cancer, patients’ 12-punctures biopsy was more effective, for sextant biopsy failed to diagnose half of the cases of neoplasm. Three lateral punctures (basal, mid, and apical, with 2 additional punctures in the parasagittal midline (mid and apical bilaterally are suggested as the best biopsy strategy.

  5. Fluid biopsy in patients with metastatic prostate, pancreatic and breast cancers

    International Nuclear Information System (INIS)

    Hematologic spread of carcinoma results in incurable metastasis; yet, the basic characteristics and travel mechanisms of cancer cells in the bloodstream are unknown. We have established a fluid phase biopsy approach that identifies circulating tumor cells (CTCs) without using surface protein-based enrichment and presents them in sufficiently high definition (HD) to satisfy diagnostic pathology image quality requirements. This 'HD-CTC' assay finds >5 HD-CTCs mL−1 of blood in 80% of patients with metastatic prostate cancer (n = 20), in 70% of patients with metastatic breast cancer (n = 30), in 50% of patients with metastatic pancreatic cancer (n = 18), and in 0% of normal controls (n = 15). Additionally, it finds HD-CTC clusters ranging from 2 HD-CTCs to greater than 30 HD-CTCs in the majority of these cancer patients. This initial validation of an enrichment-free assay demonstrates our ability to identify significant numbers of HD-CTCs in a majority of patients with prostate, breast and pancreatic cancers

  6. The economic effect of using magnetic resonance imaging and magnetic resonance ultrasound fusion biopsy for prostate cancer diagnosis.

    Science.gov (United States)

    Hutchinson, Ryan C; Costa, Daniel N; Lotan, Yair

    2016-07-01

    Prostate magnetic resonance imaging (MRI) is a maturing imaging modality that has been used to improve detection and staging of prostate cancer. The goal of this review is to evaluate the economic effect of the use of MRI and MRI fusion in the diagnosis of prostate cancer. A literature review was used to identify articles regarding efficacy and cost of MRI and MRI-guided biopsies. There are currently a limited number of studies evaluating cost of incorporating MRI into clinical practice. These studies are primarily models projecting cost estimates based on meta-analyses of the literature. There is considerable variance in the effectiveness of MRI-guided biopsies, both cognitive and fusion, based on user experience, type of MRI (3T vs. 1.5T), use of endorectal coil and type of scoring system for abnormalities such that there is still potential for improvement in accuracy. There is also variability in assumed costs of incorporating MRI into clinical practice. The addition of MRI to the diagnostic algorithm for prostate cancer has caused a shift in how we understand the disease and in what tumors are found on initial and repeat biopsies. Further risk stratification may allow more men to pursue noncurative therapy, which in and of itself is cost-effective in properly selected men. As prostate cancer care comes under increasing scrutiny on a national level, there is pressure on providers to be more accurate in their diagnoses. This in turn can lead to additional testing including Multiparametric MRI, which adds upfront cost. Whether the additional cost of prostate MRI is warranted in detection of prostate cancer is an area of intense research. PMID:26725249

  7. 经直肠超声引导下的前列腺活检术后感染相关并发症的研究进展%Research Progress in Postoperative Infection Related Complications after Prostate Biopsy Guided by Transrectal Ultrasound

    Institute of Scientific and Technical Information of China (English)

    王娟霞(综述); 王志平(审校)

    2016-01-01

    With the improvement of living standards,the extension of human life,and the growth of age-ing population,the incidence of prostate cancer is an uptrend .However,there is no obvious symptom of early prostate cancer, most patients miss the best treatment timinge when diagnosed at middle-late stage,so early diagnosis of prostate cancer is critical.Prostate biopsy is the gold standard in the diagnosis of prostate cancer. Here is to make a review of the epidemiology,risk factors,prevention and treatment of the infection caused by prostate biopsy guided by transrectal ultrasound.%随着生活水平的提高、人类寿命的延长,人口老龄化增长,前列腺癌的发病率呈上升趋势。但由于前列腺癌早期无明显症状,大部分患者就诊时已属于中晚期,往往失去了最佳的治疗时机,因此早期诊断前列腺癌十分关键。前列腺穿刺活检术是诊断前列腺癌的金标准,该文对经直肠超声引导下的前列腺活检术后引发的感染相关并发症的流行病学,危险因素,预防及治疗进行综述。

  8. 重复穿刺活检中高级别上皮内瘤对前列腺癌的预测价值%Prediction value of high-grade prostatic intraepithelial neoplasia for prostate cancer on repeat biopsies

    Institute of Scientific and Technical Information of China (English)

    Huilian Hou; Xuebin Zhang; Xu Li; Xingfa Chen; Chunbao Wang; Guanjun Zhang; Honghan Wang; Huilin Gong; Yuan Deng; Min Wang

    2011-01-01

    Objective: The significance of isolated high-grade prostatic intraepithelial neoplasia in initial biopsy as an predictor for prostate cancer has been extensively research, and the true relationship remnant is no clear till now. The aim of this study is to evaluate prediction value of cancer on repeat biopsy in patients with high-grade prostatic intraepithelial neoplasia,using multivariate analysis. Methods: Thirty-eight men with a diagnosis of isolated high-grade prostatic intraepithelial neoplasia in initial needle biopsy were studies, in the Fist Affiliated Hospital of Medical School of Xi'an Jiaotong University, from January 2003 to March 2009. These samples were using immunostaining of p63 and 34βE12 and P504s, with a median follow-up of 525 (range, 7 to 1650) days, and to researched the incidence of subsequent prostate cancer, and to predicted the risk of prostate cancer in clinicopathological parameters of isolated high-grade prostatic intraepithelial neoplasia on repeat biopsies by logistic regression analysis. Results: There were 10 of 38 (26.3%) men with prostate cancer on repeat biopsies after diagnosis isolated high-grade prostatic intraepithelial neoplasia in initial biopsy, of the rates of prostate cancer were 80% for micropapillary and 75% for cribriform high-grade prostatic intraepithelial neoplasia (P < 0.05), respectively. The positive cores of isolated high-grade prostatic intraepithelial neoplasia was the important for the risk of prostate cancer using Multifactor logistic regression analysis. The time range in 30 to 690 days was stronger risk for prostate cancer detection after diagnosis isolated HGPIN in initial biopsy. p63 and 34βE12 were disrupted positive expression, and P504S was weak positive expression in the 61% isolated high-grade prostatic intraepithelial neoplasia. Conclusion: Isolated high-grade prostatic intraepithelial neoplasia on repeat biopsy conferred a 26.3% risk of prostate cancer, and this risk level is lower than the

  9. Comparative Effectiveness of Single versus Combination Antibiotic Prophylaxis for Infections after Transrectal Prostate Biopsy.

    Science.gov (United States)

    Marino, Kaylee; Parlee, Anne; Orlando, Ralph; Lerner, Lori; Strymish, Judith; Gupta, Kalpana

    2015-12-01

    An increase in fluoroquinolone resistance and transrectal ultrasound-guided prostate (TRUS) biopsy infections has prompted the need for alternative effective antibiotic prophylaxis. We aimed to compare ciprofloxacin and other single-agent therapies to combination therapy for efficacy and adverse effects. Men who underwent a TRUS biopsy within the VA Boston health care system with documented receipt of prophylactic antibiotics periprocedure were eligible for inclusion. Postprocedure infections within 30 days were ascertained by chart review from electronic records, including any inpatient, outpatient, or urgent-care visits. Among 455 evaluable men over a 3-year period, there were 25 infections (5.49%), with sepsis occurring in 2.4%, urinary tract infections (UTI) in 1.54%, and bacteremia in 0.44% of patients. Escherichia coli was the most common urine (89%) and blood (92%) pathogen, with fluoroquinolone resistance rates of 88% and 91%, respectively. Ciprofloxacin alone was associated with significantly more infections than ciprofloxacin plus an additional agent (P = 0.014). Intramuscular gentamicin alone was also significantly associated with a higher infection rate obtained with all other regimens (P = 0.004). Any single-agent regimen, including ciprofloxacin, ceftriaxone, or gentamicin, was associated with significantly higher infection rates than any combination regimen (odds ratio [OR], 4; 95% confidence interval [CI], 1.47, 10.85; P = 0.004). Diabetes, immunosuppressive condition or medication, hospitalization within the previous year, and UTI within the previous 6 months were not associated with infection risk. Clostridium difficile infections were similar. These findings suggest that ciprofloxacin, ceftriaxone, and gentamicin alone are inferior to a combination regimen. Institutions with high failure rates of prophylaxis for TRUS biopsies should consider combination regimens derived from their local data. PMID:26369958

  10. Elevated levels of Dickkopf-related protein 3 in seminal plasma of prostate cancer patients

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    Zenzmaier Christoph

    2011-11-01

    Full Text Available Abstract Background Expression of Dkk-3, a secreted putative tumor suppressor, is altered in age-related proliferative disorders of the human prostate. We now investigated the suitability of Dkk-3 as a diagnostic biomarker for prostate cancer (PCa in seminal plasma (SP. Methods SP samples were obtained from 81 patients prior to TRUS-guided prostate biopsies on the basis of elevated serum prostate-specific antigen (PSA; > 4 ng/mL levels and/or abnormal digital rectal examination. A sensitive indirect immunoenzymometric assay for Dkk-3 was developed and characterized in detail. SP Dkk-3 and PSA levels were determined and normalized to total SP protein. The diagnostic accuracies of single markers including serum PSA and multivariate models to discriminate patients with positive (N = 40 and negative (N = 41 biopsy findings were investigated. Results Biopsy-confirmed PCa showed significantly higher SP Dkk-3 levels (100.9 ± 12.3 vs. 69.2 ± 9.4 fmol/mg; p = 0.026. Diagnostic accuracy (AUC of SP Dkk-3 levels (0.633 was enhanced in multivariate models by including serum PSA (model A; AUC 0.658 or both, serum and SP PSA levels (model B; AUC 0.710. In a subpopulation with clinical follow-up > 3 years post-biopsy to ensure veracity of negative biopsy status (positive biopsy N = 21; negative biopsy N = 25 AUCs for SP Dkk-3, model A and B increased to 0.667, 0.724 and 0.777, respectively. Conclusions In multivariate models to detect PCa, inclusion of SP Dkk-3 levels, which were significantly elevated in biopsy-confirmed PCa patients, improved the diagnostic performance compared with serum PSA only.

  11. Evaluation of semi-quantitative parameters of prostate MR spectroscopy: comparison with biopsy

    International Nuclear Information System (INIS)

    .0% (78/100) respectively; those of maximum positive voxel ratio >0.519 were 88.7% (47/53), 61.7% (29/47), 72.3% (47/65), 82.9% (29/35), 76.0% (76/100) respectively; those of mean positive voxel ratio >0.519 were 62.3% (33/53), 85.1% (40/47), 82.5% (33/40), 66.7% (40/60), 73.0% (73/100) respectively; the consistency between mean (Cho + Cr)/Cit ratio and mean positive voxel ratio was fairly high (Kappa =0.818). Conclusion: Single voxel criteria were suggested to diagnose clinically suspected prostate cancer. Maximum positive voxel ration criteria were suggested to guide localization in biopsy. (authors)

  12. Intérêt du guidage 3D et de la localisation des biopsies de prostate par voie endorectale

    OpenAIRE

    Mozer, Pierre; Chevreau, Grégoire; Troccaz, Jocelyne; Renard-Penna, Raphaëlle

    2011-01-01

    International audience La réalisation de biopsies de prostate, le plus souvent par voie endorectale, est primordiale pour le diagnostic et l'évaluation du pronostic du cancer. La précision de la localisation des biopsies est sujette à caution. Le développement de systèmes informatiques permet d'enregistrer avec précision leur localisation et de les guider pour améliorer leur distribution. Ces mêmes dispositifs permettent de fusionner images échographiques et images IRM et de fusionner diff...

  13. Analysis of biopsy outcome after three-dimensional conformal radiation therapy of prostate cancer using dose-distribution variables and tumor control probability models

    International Nuclear Information System (INIS)

    Purpose: To investigate tumor control following three-dimensional conformal radiation therapy (3D-CRT) of prostate cancer and to identify dose-distribution variables that correlate with local control assessed through posttreatment prostate biopsies. Methods and Material: Data from 132 patients, treated at Memorial Sloan-Kettering Cancer Center (MSKCC), who had a prostate biopsy 2.5 years or more after 3D-CRT for T1c-T3 prostate cancer with prescription doses of 64.8-81 Gy were analyzed. Variables derived from the dose distribution in the PTV included: minimum dose (Dmin), maximum dose (Dmax), mean dose (Dmean), dose to n% of the PTV (Dn), where n = 1%, ..., 99%. The concept of the equivalent uniform dose (EUD) was evaluated for different values of the surviving fraction at 2 Gy (SF2). Four tumor control probability (TCP) models (one phenomenologic model using a logistic function and three Poisson cell kill models) were investigated using two sets of input parameters, one for low and one for high T-stage tumors. Application of both sets to all patients was also investigated. In addition, several tumor-related prognostic variables were examined (including T-stage, Gleason score). Univariate and multivariate logistic regression analyses were performed. The ability of the logistic regression models (univariate and multivariate) to predict the biopsy result correctly was tested by performing cross-validation analyses and evaluating the results in terms of receiver operating characteristic (ROC) curves. Results: In univariate analysis, prescription dose (Dprescr), Dmax, Dmean, dose to n% of the PTV with n of 70% or less correlate with outcome (p 2: EUD correlates significantly with outcome for SF2 of 0.4 or more, but not for lower SF2 values. Using either of the two input parameters sets, all TCP models correlate with outcome (p 2, is limited because the low dose region may not coincide with the tumor location. Instead, for MSKCC prostate cancer patients with their

  14. The role of the maximum involvement of biopsy core in predicting outcome for patients treated with dose-escalated radiation therapy for prostate cancer

    Directory of Open Access Journals (Sweden)

    Murgic Jure

    2012-08-01

    Full Text Available Abstract Purpose To evaluate the influence of the maximum involvement of biopsy core (MIBC on outcome for prostate cancer patients treated with dose-escalated external beam radiotherapy (EBRT. Methods and materials The outcomes of 590 men with localized prostate cancer treated with EBRT (≥75 Gy at a single institution were retrospectively analyzed. The influence of MIBC on freedom from biochemical failure (FFBF, freedom from metastasis (FFM, cause-specific survival (CSS, and overall survival (OS was compared to other surrogates for biopsy tumor volume, including the percentage of positive biopsy cores (PPC and the total percentage of cancer volume (PCV. Results MIBC correlated with PSA, T-stage, Gleason score, NCCN risk group, PPC, PCV, and treatment related factors. On univariate analysis, MIBC was prognostic for all endpoints except OS; with greatest impact in those with Gleason scores of 8–10. However, on multivariate analysis, MIBC was only prognostic for FFBF (hazard ratio [HR] 1.9, p = 0.008, but not for FFM (p = 0.19, CSS (p = 0.16, and OS (p = 0.99. Conclusions In patients undergoing dose-escalated EBRT, MIBC had the greatest influence in those with Gleason scores of 8–10 but provided no additional prognostic data as compared to PPC and PCV, which remain the preferable prognostic variables in this patient population.

  15. Optimized high-throughput microRNA expression profiling provides novel biomarker assessment of clinical prostate and breast cancer biopsies

    OpenAIRE

    Fedele Vita; Scott Gary K; Wong Linda; Sensinger Kelly; Bowers Jessica; Benz Christopher C; Mattie Michael D; Ginzinger David; Getts Robert; Haqq Chris

    2006-01-01

    Abstract Background Recent studies indicate that microRNAs (miRNAs) are mechanistically involved in the development of various human malignancies, suggesting that they represent a promising new class of cancer biomarkers. However, previously reported methods for measuring miRNA expression consume large amounts of tissue, prohibiting high-throughput miRNA profiling from typically small clinical samples such as excision or core needle biopsies of breast or prostate cancer. Here we describe a no...

  16. The value of endorectal MR imaging to predict positive biopsies in clinically intermediate-risk prostate cancer patients

    International Nuclear Information System (INIS)

    The aim of this study was to assess the effectiveness of endorectal MR imaging in predicting the positive biopsy results in patients with clinically intermediate risk for prostate cancer. We performed a prospective endorectal MR imaging study with 81 patients at intermediate risk to detect prostate cancer between January 1997 and December 1998. Intermediate risk was defined as: prostatic specific antigen (PSA) levels between 4 and 10 ng/ml or PSA levels in the range of 10-20 ng/ml but negative digital rectal examination (DRE) or PSA levels progressively higher (0.75 ng/ml year-1). A transrectal sextant biopsy was performed after the endorectal MR exam, and also of the area of suspicion detected by MR imaging. The accuracies were measured, both singly for MR imaging and combined for PSA level and DRE, by calculating the area index of the receiver operating characteristics (ROC) curve. Cancer was detected in 23 patients (28 %). Overall sensitivity and specificity of endorectal MRI was 70 and 76 %, respectively. Accuracy was 71 % estimated from the area under the ROC curve for the total patient group and 84 % for the group of patients with PSA level between 10-20 ng/ml. Positive biopsy rate (PBR) was 63 % for the group with PSA 10-20 ng/ml and a positive MR imaging, and 15 % with a negative MR exam. The PBR was 43 % for the group with PSA 4-10 ng/ml and a positive MR study, and 13 % with a negative MR imaging examination. We would have avoided 63 % of negative biopsies, while missing 30 % of cancers for the total group of patients. Endorectal MR imaging was not a sufficient predictor of positive biopsies for patients clinically at intermediate risk for prostate cancer. Although we should not avoid performing systematic biopsies in patients with endorectal MR imaging negative results, as it will miss a significant number of cancers, selected patients with a PSA levels between 10-20 ng/ml or clinical-biopsy disagreement might benefit from endorectal MR imaging. (orig.)

  17. Impact of delay after biopsy and post-biopsy haemorrhage on prostate cancer tumour detection using multi-parametric MRI: A multi-reader study

    International Nuclear Information System (INIS)

    Aim: To assess impact of haemorrhage and delay after biopsy on prostate tumour detection using multi-parametric (MP) magnetic resonance imaging (MRI) assessment. Materials and methods: Forty-four patients underwent prostate MRI at 1.5 T using a pelvic phased-array coil, including T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and dynamic contrast-enhanced (DCE) imaging, before prostatectomy. Three radiologists independently reviewed images during four sessions [T2WI, DWI, DCE, and all parameters combined (MP-MRI)] to assess for tumour in each sextant. In a separate session, readers reviewed T1WI to score the extent of haemorrhage per sextant. Accuracy was assessed using logistic regression for correlated data. Results: There was no significant difference in accuracy between readers for any session (p ≥ 0.166), and results were averaged across the three readers for remaining comparisons. Accuracy was significantly greater for MP-MRI than for any parameter alone (p ≤ 0.020). For T2WI alone, there was a trend toward decreased sensitivity in sextants with extensive haemorrhage (p = 0.072). However, accuracy, sensitivity, and specificity were otherwise similar for sextants with and without extensive haemorrhage for all sessions (p = 0.192–0.934). No session showed a significant improvement in accuracy, sensitivity, or specificity in cases with delay after biopsy of over 4 weeks compared with shorter delay. Conclusion: Extensive haemorrhage and short delay after biopsy did not negatively impact accuracy for tumour detection using MP-MRI. Further studies using MP-MRI protocols and interpretation schemes from other institutions are required to confirm these observations.

  18. A prostate cancer computer-aided diagnosis system using multimodal magnetic resonance imaging and targeted biopsy labels

    Science.gov (United States)

    Liu, Peter; Wang, Shijun; Turkbey, Baris; Grant, Kinzya; Pinto, Peter; Choyke, Peter; Wood, Bradford J.; Summers, Ronald M.

    2013-02-01

    We propose a new method for prostate cancer classification based on supervised statistical learning methods by integrating T2-weighted, diffusion-weighted, and dynamic contrast-enhanced MRI images with targeted prostate biopsy results. In the first step of the method, all three imaging modalities are registered based on the image coordinates encoded in the DICOM images. In the second step, local statistical features are extracted in each imaging modality to capture intensity, shape, and texture information at every biopsy target. Finally, using support vector machines, supervised learning is conducted with the biopsy results to train a classification system that predicts the pathology of suspicious cancer lesions. The algorithm was tested with a dataset of 54 patients that underwent 164 targeted biopsies (58 positive, 106 negative). The proposed tri-modal MRI algorithm shows significant improvement over a similar approach that utilizes only T2-weighted MRI images (p= 0.048). The areas under the ROC curve for these methods were 0.82 (95% CI: [0.71, 0.93]) and 0.73 (95% CI: [0.55, 0.84]), respectively.

  19. Transrectal ultrasonically-guided core biopsies in the assessment of local cure of prostatic cancer after radical external beam radiotherapy

    International Nuclear Information System (INIS)

    Fifty-five patients were included in an extended follow-up after radical radiation therapy (RRT) for localized prostatic cancer (T1-3, Nx, M0). Local cure was assessed by a combination of digital rectal examination (DRE), transrectal ultrasound (TRUS) and systematic 'mapping' with TRUS-guided core biopsies (TGCB). After a mean follow-up of 6.8 years, 33% (18/55) of the patients were locally free of tumour, while in 67% (37/55) of cases residual cancer was demonstrated in the biopsies. Endocrine treatment did not influence the local cure rate, nor did the T stage of tumour grade at diagnosis of the cumulative radiation effect (CRE) values within the range of the present study. The sensitivity of DRE and TRUS was low; 37% and 20% respectively, while the specificity of the DRE and TRUS methods was 83% and 94% respectively. The conclusion of the study is that residual tomour was found in the high proportion of biopsied patients nearly 7 years after RRT and that multiple, TRUS-guided core biopsies are mandatory in the assessment of local cure in patients irradiated for prostatic cancer; both DRE and TRUS on their own are less reliable. (orig.)

  20. Workflow assessment of 3T MRI-guided transperineal targeted prostate biopsy using a robotic needle guidance

    Science.gov (United States)

    Song, Sang-Eun; Tuncali, Kemal; Tokuda, Junichi; Fedorov, Andriy; Penzkofer, Tobias; Fennessy, Fiona; Tempany, Clare; Yoshimitsu, Kitaro; Magill, John; Hata, Nobuhiko

    2014-03-01

    Magnetic resonance imaging (MRI) guided transperineal targeted prostate biopsy has become a valuable instrument for detection of prostate cancer in patients with continuing suspicion for aggressive cancer after transrectal ultrasound guided (TRUS) guided biopsy. The MRI-guided procedures are performed using mechanical targeting devices or templates, which suffer from limitations of spatial sampling resolution and/or manual in-bore adjustments. To overcome these limitations, we developed and clinically deployed an MRI-compatible piezoceramic-motor actuated needle guidance device, Smart Template, which allows automated needle guidance with high targeting resolution for use in a wide closed-bore 3-Tesla MRI scanner. One of the main limitations of the MRI-guided procedure is the lengthy procedure time compared to conventional TRUS-guided procedures. In order to optimize the procedure, we assessed workflow of 30 MRI-guided biopsy procedures using the Smart Template with focus on procedure time. An average of 3.4 (range: 2~6) targets were preprocedurally selected per procedure and 2.2 ± 0.8 biopsies were performed for each target with an average insertion attempt of 1.9 ± 0.7 per biopsy. The average technical preparation time was 14 ± 7 min and the in-MRI patient preparation time was 42 ± 7 min. After 21 ± 7 min of initial imaging, 64 ± 12 min of biopsy was performed yielding an average of 10 ± 2 min per tissue sample. The total procedure time occupying the MRI suite was 138 ± 16 min. No noticeable tendency in the length of any time segment was observed over the 30 clinical cases.

  1. Interobserver agreement of gleason score and modified gleason score in needle biopsy and in surgical specimen of prostate cancer

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    Sergio G. Veloso

    2007-10-01

    Full Text Available INTRODUCTION: Gleason score, which has a high interobserver variability, is used to classify prostate cancer. The most recent consensus valued the tertiary Gleason pattern and recommended its use in the final score of needle biopsies (modified Gleason score. This pattern is considered to be of high prognostic value in surgical specimens. This study emphasized the evaluation of the modified score agreement in needle biopsies and in surgical specimen, as well as the interobserver variability of this score MATERIALS AND METHODS: Three pathologists evaluated the slides of needle biopsies and surgical specimens of 110 patients, reporting primary, secondary and tertiary Gleason patterns and after that, traditional and modified Gleason scores were calculated. Kappa test (K assessed the interobserver agreement and the agreement between the traditional and modified scores of the biopsy and of the surgical specimen RESULTS: Interobserver agreement in the biopsy was K = 0.36 and K = 0.35, and in the surgical specimen it was K = 0.46 and K = 0.36, for the traditional and modified scores, respectively. The tertiary Gleason grade was found in 8%, 0% and 2% of the biopsies and in 8%, 0% and 13% of the surgical specimens, according to observers 1, 2 and 3, respectively. When evaluating the agreement of the traditional and modified Gleason scores in needle biopsy with both scores of the surgical specimen, a similar agreement was found through Kappa CONCLUSION: Contrary to what was expected, the modified Gleason score was not superior in the agreement between the biopsy score and the specimen, or in interobserver reproducibility, in this study.

  2. AB190. Could magnetic resonance imaging help identify the presence of prostate cancer before initial biopsy? The development of nomogram predicting the outcomes of prostate biopsy in the Chinese population

    Science.gov (United States)

    Fang, Dong; Ren, Da; Yu, Wei; Li, Xuesong; Yin, Wenshi; Yu, Xiaoteng; Yang, Kunlin; Liu, Pei; Shan, Gangzhi; Li, Shuqing; He, Qun; Xin, Zhongcheng; Zhou, Liqun; Zhao, Chenglin; Wang, Rui; Wang, Xiaoying; Wang, Huihui

    2016-01-01

    Objective To investigate the effectiveness of magnetic resonance imaging (MRI) in diagnosing prostate cancer (PCa) and high-grade prostate cancer (HGPCa) before transrectal ultrasound (TRUS)-guided biopsy. Methods The clinical data of 894 patients who received TRUS-guided biopsy and prior MRI test from a large Chinese center was reviewed. All MRIs were re-reviewed and assigned as Grade 0-2 (negative; suspicious; positive) based on Prostate Imaging Reporting and Data System (PI-RADS) scoring. We constructed two models both in predicting PCa and HGPCa: Model 1 with MRI and Model 2 without MRI. Other clinical factors include age, digital rectal examination, PSA, free-PSA, volume and TRUS. Results PCa and HGPCa were present in 434 (48.5%) and 218 (24.4%) patients each. An MRI Grade 0, 1 and 2 were assigned in 324 (36.2%), 193 (21.6%) and 377 (42.2%) patients, respectively, which was associated with the presence of PCa (Pnomograms could increase predictive accuracy.

  3. Stereotactic large-core needle breast biopsy: analysis of pain and discomfort related to the biopsy procedure

    Energy Technology Data Exchange (ETDEWEB)

    Hemmer, Judith M.; Heesewijk, Hans P.M. van [St. Antonius Hospital, Department of Radiology, Nieuwegein (Netherlands); Kelder, Johannes C. [St. Antonius Hospital, Department of Statistics, Nieuwegein (Netherlands)

    2008-02-15

    The purpose of this study was to determine the significance of variables such as duration of the procedure, type of breast tissue, number of passes, depth of the biopsies, underlying pathology, the operator performing the procedure, and their effect on women's perception of pain and discomfort during stereotactic large-core needle breast biopsy. One hundred and fifty consecutive patients with a non-palpable suspicious mammographic lesions were included. Between three and nine 14-gauge breast passes were taken using a prone stereotactic table. Following the biopsy procedure, patients were asked to complete a questionnaire. There was no discomfort in lying on the prone table. There is no relation between type of breast lesion and pain, underlying pathology and pain and performing operator and pain. The type of breast tissue is correlated with pain experienced from biopsy (P = 0.0001). We found out that patients with dense breast tissue complain of more pain from biopsy than patients with more involution of breast tissue. The depth of the biopsy correlates with pain from biopsy (P = 0.0028). Deep lesions are more painful than superficial ones. There is a correlation between the number of passes and pain in the neck (P = 0.0188) and shoulder (P = 0.0366). The duration of the procedure is correlated with pain experienced in the neck (P = 0.0116) but not with pain experienced from biopsy. (orig.)

  4. Stereotactic large-core needle breast biopsy: analysis of pain and discomfort related to the biopsy procedure

    International Nuclear Information System (INIS)

    The purpose of this study was to determine the significance of variables such as duration of the procedure, type of breast tissue, number of passes, depth of the biopsies, underlying pathology, the operator performing the procedure, and their effect on women's perception of pain and discomfort during stereotactic large-core needle breast biopsy. One hundred and fifty consecutive patients with a non-palpable suspicious mammographic lesions were included. Between three and nine 14-gauge breast passes were taken using a prone stereotactic table. Following the biopsy procedure, patients were asked to complete a questionnaire. There was no discomfort in lying on the prone table. There is no relation between type of breast lesion and pain, underlying pathology and pain and performing operator and pain. The type of breast tissue is correlated with pain experienced from biopsy (P = 0.0001). We found out that patients with dense breast tissue complain of more pain from biopsy than patients with more involution of breast tissue. The depth of the biopsy correlates with pain from biopsy (P = 0.0028). Deep lesions are more painful than superficial ones. There is a correlation between the number of passes and pain in the neck (P = 0.0188) and shoulder (P = 0.0366). The duration of the procedure is correlated with pain experienced in the neck (P = 0.0116) but not with pain experienced from biopsy. (orig.)

  5. Simultaneous integrated boost of biopsy proven, MRI defined dominant intra-prostatic lesions to 95 Gray with IMRT: early results of a phase I NCI study

    International Nuclear Information System (INIS)

    To assess the feasibility and early toxicity of selective, IMRT-based dose escalation (simultaneous integrated boost) to biopsy proven dominant intra-prostatic lesions visible on MRI. Patients with localized prostate cancer and an abnormality within the prostate on endorectal coil MRI were eligible. All patients underwent a MRI-guided transrectal biopsy at the location of the MRI abnormality. Gold fiducial markers were also placed. Several days later patients underwent another MRI scan for fusion with the treatment planning CT scan. This fused MRI scan was used to delineate the region of the biopsy proven intra-prostatic lesion. A 3 mm expansion was performed on the intra-prostatic lesions, defined as a separate volume within the prostate. The lesion + 3 mm and the remainder of the prostate + 7 mm received 94.5/75.6 Gray (Gy) respectively in 42 fractions. Daily seed position was verified to be within 3 mm. Three patients were treated. Follow-up was 18, 6, and 3 months respectively. Two patients had a single intra-prostatic lesion. One patient had 2 intra-prostatic lesions. All four intra-prostatic lesions, with margin, were successfully targeted and treated to 94.5 Gy. Two patients experienced acute RTOG grade 2 genitourinary (GU) toxicity. One had grade 1 gastrointestinal (GI) toxicity. All symptoms completely resolved by 3 months. One patient had no acute toxicity. These early results demonstrate the feasibility of using IMRT for simultaneous integrated boost to biopsy proven dominant intra-prostatic lesions visible on MRI. The treatment was well tolerated

  6. Prostate Cancer Detection and Dutasteride : Utility and Limitations of Prostate-Specific Antigen in Men with Previous Negative Biopsies

    NARCIS (Netherlands)

    van Leeuwen, Pim J.; Koelble, Konrad; Huland, Hartwig; Hambrock, Thomas; Barentsz, Jelle; Schroder, Fritz H.

    2011-01-01

    Context: We addressed the question whether the change of serum prostate-specific antigen (PSA) in men who use 5 alpha-reductase inhibitor (5-ARI) dutasteride is sensitive for the detection of aggressive prostate cancer (PCa). Objective: The case of a man using dutasteride diagnosed with Gleason 7 tr

  7. Importance of prostate-specific antigen (PSA as a predictive factor for concordance between the Gleason scores of prostate biopsies and RADICAL prostatectomy specimens

    Directory of Open Access Journals (Sweden)

    Nelson Gianni de Lima

    2013-06-01

    Full Text Available OBJECTIVE: To evaluate the concordance between the Gleason scores of prostate biopsies and radical prostatectomy specimens, thereby highlighting the importance of the prostate-specific antigen (PSA level as a predictive factor of concordance. METHODS: We retrospectively analyzed 253 radical prostatectomy cases performed between 2006 and 2011. The patients were divided into 4 groups for the data analysis and dichotomized according to the preoperative PSA, <10 ng/mL and ≥10 ng/mL. A p-score <0.05 was considered significant. RESULTS: The average patient age was 63.3±7.8 years. The median PSA level was 9.3±4.9 ng/mL. The overall concordance between the Gleason scores was 52%. Patients presented preoperative PSA levels <10 ng/mL in 153 of 235 cases (65% and ≥10 ng/mL in 82 of 235 cases (35%. The Gleason scores were identical in 86 of 153 cases (56% in the <10 ng/mL group and 36 of 82 (44% cases in the ≥10 ng/mL group (p = 0.017. The biopsy underestimated the Gleason score in 45 (30% patients in the <10 ng/mL group and 38 (46% patients in the ≥10 ng/mL (p = 0.243. Specifically, the patients with Gleason 3 + 3 scores according to the biopsies demonstrated global concordance in 56 of 110 cases (51%. In this group, the patients with preoperative PSA levels <10 ng/dL had higher concordance than those with preoperative PSA levels ≥10 ng/dL (61% x 23%, p = 0.023, which resulted in 77% upgrading after surgery in those patients with PSA levels ≥10 ng/dl. CONCLUSION: The Gleason scores of needle prostate biopsies and those of the surgical specimens were concordant in approximately half of the global sample. The preoperative PSA level was a strong predictor of discrepancy and might improve the identification of those patients who tended to be upgraded after surgery, particularly in patients with Gleason scores of 3 + 3 in the prostate biopsy and preoperative PSA levels ≥10 ng/mL.

  8. The value of magnetic resonance imaging and ultrasonography (MRI/US)-fusion biopsy platforms in prostate cancer detection: a systematic review.

    Science.gov (United States)

    Gayet, Maudy; van der Aa, Anouk; Beerlage, Harrie P; Schrier, Bart Ph; Mulders, Peter F A; Wijkstra, Hessel

    2016-03-01

    Despite limitations considering the presence, staging and aggressiveness of prostate cancer, ultrasonography (US)-guided systematic biopsies (SBs) are still the 'gold standard' for the diagnosis of prostate cancer. Recently, promising results have been published for targeted prostate biopsies (TBs) using magnetic resonance imaging (MRI) and ultrasonography (MRI/US)-fusion platforms. Different platforms are USA Food and Drug Administration registered and have, mostly subjective, strengths and weaknesses. To our knowledge, no systematic review exists that objectively compares prostate cancer detection rates between the different platforms available. To assess the value of the different MRI/US-fusion platforms in prostate cancer detection, we compared platform-guided TB with SB, and other ways of MRI TB (cognitive fusion or in-bore MR fusion). We performed a systematic review of well-designed prospective randomised and non-randomised trials in the English language published between 1 January 2004 and 17 February 2015, using PubMed, Embase and Cochrane Library databases. Search terms included: 'prostate cancer', 'MR/ultrasound(US) fusion' and 'targeted biopsies'. Extraction of articles was performed by two authors (M.G. and A.A.) and were evaluated by the other authors. Randomised and non-randomised prospective clinical trials comparing TB using MRI/US-fusion platforms and SB, or other ways of TB (cognitive fusion or MR in-bore fusion) were included. In all, 11 of 1865 studies met the inclusion criteria, involving seven different fusion platforms and 2626 patients: 1119 biopsy naïve, 1433 with prior negative biopsy, 50 not mentioned (either biopsy naïve or with prior negative biopsy) and 24 on active surveillance (who were disregarded). The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to assess the quality of included articles. No clear advantage of MRI/US fusion-guided TBs was seen for cancer detection rates (CDRs) of all prostate

  9. Detection of prostate cancer by real-time MR/ultrasound fusion-guided biopsy. 3T MRI and state of the art sonography

    International Nuclear Information System (INIS)

    Purpose: Multiparametric MRI of the prostate is a noninvasive diagnostic method with high sensitivity and specificity for prostate cancer. The aim of this study is to evaluate whether prostate cancer detection rates of transrectal ultrasound (TRUS)-guided biopsy may be improved by an image fusion of state-of-the-art ultrasound (CEUS, elastography) and MR (T2w, DWI) imaging. Materials and Methods: 32 consecutive patients with a history of elevated PSA levels and at least one negative TRUS-guided biopsy with clinical indication for a systematic re-biopsy underwent multiparametric 3 T MRI without endorectal coil. MR data (T2w) were uploaded to a modern sonography system and image fusion was performed in real-time mode during biopsy. B-mode, Doppler, elastography and CEUS imaging were applied to characterize suspicious lesions detected by MRI. Targeted biopsies were performed in MR/US fusion mode followed by a systematic standard TRUS-guided biopsy. Detection rates for both methods were calculated and compared using the Chi2-test. Results: Patient age was not significantly different in patients with and without histologically confirmed prostate cancer (65.2 ± 8.0 and 64.1 ± 7.3 age [p = 0.93]). The PSA value was significantly higher in patients with prostate cancer (15.5 ± 9.3 ng/ml) compared to patients without cancer (PSA 10.4 ± 9.6 ng/ml; p = 0.02). The proportion of histologically confirmed cancers in the study group (n = 32) of the MR/US fusion biopsy (11/12; 34.4 %) was significantly higher (p = 0.01) in comparison to the TRUS systematic biopsy (6/12; 18.8 %). Conclusion: Real-time MR/US image fusion may enhance cancer detection rates of TRUS-guided biopsies and should therefore be studied in further larger studies. (orig.)

  10. Targeted proteomics identifies liquid-biopsy signatures for extracapsular prostate cancer

    Science.gov (United States)

    Kim, Yunee; Jeon, Jouhyun; Mejia, Salvador; Yao, Cindy Q; Ignatchenko, Vladimir; Nyalwidhe, Julius O; Gramolini, Anthony O; Lance, Raymond S; Troyer, Dean A; Drake, Richard R; Boutros, Paul C; Semmes, O. John; Kislinger, Thomas

    2016-01-01

    Biomarkers are rapidly gaining importance in personalized medicine. Although numerous molecular signatures have been developed over the past decade, there is a lack of overlap and many biomarkers fail to validate in independent patient cohorts and hence are not useful for clinical application. For these reasons, identification of novel and robust biomarkers remains a formidable challenge. We combine targeted proteomics with computational biology to discover robust proteomic signatures for prostate cancer. Quantitative proteomics conducted in expressed prostatic secretions from men with extraprostatic and organ-confined prostate cancers identified 133 differentially expressed proteins. Using synthetic peptides, we evaluate them by targeted proteomics in a 74-patient cohort of expressed prostatic secretions in urine. We quantify a panel of 34 candidates in an independent 207-patient cohort. We apply machine-learning approaches to develop clinical predictive models for prostate cancer diagnosis and prognosis. Our results demonstrate that computationally guided proteomics can discover highly accurate non-invasive biomarkers. PMID:27350604

  11. Prevalence and Risk Factors of Prostate Cancer in Chinese Men with PSA 4–10 ng/mL Who Underwent TRUS-Guided Prostate Biopsy: The Utilization of PAMD Score

    Science.gov (United States)

    Fang, Dong; Ren, Da; Zhao, Chenglin; Li, Xuesong; Yu, Wei; Wang, Rui; Wang, Huihui; Xi, Chenguang; He, Qun; Wang, Xiaoying; Xin, Zhongcheng; Zhou, Liqun

    2015-01-01

    Purpose. To elucidate the characteristics and risk factors for positive biopsy outcomes in Chinese patients with prostate specific antigen (PSA) 4–10 ng/mL and develop a risk-stratification score model. Methods. The data of 345 patients who underwent transrectal ultrasound-guided prostate biopsy between 2011 and 2013 was retrospectively analyzed. Digital rectal examination (DRE), prostate volume (PV), magnetic resonance imaging (MRI), and smoking status were also collected. Positive biopsy outcomes were defined as prostate cancer (PCa) and high grade PCa (HGPCa, Gleason Score ≥ 7). Results. The median PSA was 7.15 (IQR 5.91–8.45) ng/mL. Overall 138 patients (40.0%) were shown to have PCa, including 100 patients (29.0%) with HGPCa. Smaller PV, elder age, MRI results, and positive DRE were proved to be predictive factors for positive biopsy outcomes in both univariate and multivariate analysis. We developed a “PAMD” score which combined the four factors to categorize patients into three risk groups, and the model performed good predictive sensitivity and specificity. Conclusion. The prevalence of prostate cancer in Chinese patients with PSA 4–10 ng/mL was 40%, including 29% patients with high grade disease. DRE, age, MRI, and PV were predictive factors for positive biopsy outcomes, and the PAMD score model could be utilized for risk-stratification and decision-making. PMID:26557679

  12. Prevalence and Risk Factors of Prostate Cancer in Chinese Men with PSA 4–10 ng/mL Who Underwent TRUS-Guided Prostate Biopsy: The Utilization of PAMD Score

    Directory of Open Access Journals (Sweden)

    Dong Fang

    2015-01-01

    Full Text Available Purpose. To elucidate the characteristics and risk factors for positive biopsy outcomes in Chinese patients with prostate specific antigen (PSA 4–10 ng/mL and develop a risk-stratification score model. Methods. The data of 345 patients who underwent transrectal ultrasound-guided prostate biopsy between 2011 and 2013 was retrospectively analyzed. Digital rectal examination (DRE, prostate volume (PV, magnetic resonance imaging (MRI, and smoking status were also collected. Positive biopsy outcomes were defined as prostate cancer (PCa and high grade PCa (HGPCa, Gleason Score≥7. Results. The median PSA was 7.15 (IQR 5.91–8.45 ng/mL. Overall 138 patients (40.0% were shown to have PCa, including 100 patients (29.0% with HGPCa. Smaller PV, elder age, MRI results, and positive DRE were proved to be predictive factors for positive biopsy outcomes in both univariate and multivariate analysis. We developed a “PAMD” score which combined the four factors to categorize patients into three risk groups, and the model performed good predictive sensitivity and specificity. Conclusion. The prevalence of prostate cancer in Chinese patients with PSA 4–10 ng/mL was 40%, including 29% patients with high grade disease. DRE, age, MRI, and PV were predictive factors for positive biopsy outcomes, and the PAMD score model could be utilized for risk-stratification and decision-making.

  13. Operator dependent choice of prostate cancer biopsy has limited impact on a gene signature analysis for the highly expressed genes IGFBP3 and F3 in prostate cancer epithelial cells.

    Directory of Open Access Journals (Sweden)

    Zhuochun Peng

    Full Text Available BACKGROUND: Predicting the prognosis of prostate cancer disease through gene expression analysis is receiving increasing interest. In many cases, such analyses are based on formalin-fixed, paraffin embedded (FFPE core needle biopsy material on which Gleason grading for diagnosis has been conducted. Since each patient typically has multiple biopsy samples, and since Gleason grading is an operator dependent procedure known to be difficult, the impact of the operator's choice of biopsy was evaluated. METHODS: Multiple biopsy samples from 43 patients were evaluated using a previously reported gene signature of IGFBP3, F3 and VGLL3 with potential prognostic value in estimating overall survival at diagnosis of prostate cancer. A four multiplex one-step qRT-PCR test kit, designed and optimized for measuring the signature in FFPE core needle biopsy samples was used. Concordance of gene expression levels between primary and secondary Gleason tumor patterns, as well as benign tissue specimens, was analyzed. RESULTS: The gene expression levels of IGFBP3 and F3 in prostate cancer epithelial cell-containing tissue representing the primary and secondary Gleason patterns were high and consistent, while the low expressed VGLL3 showed more variation in its expression levels. CONCLUSION: The assessment of IGFBP3 and F3 gene expression levels in prostate cancer tissue is independent of Gleason patterns, meaning that the impact of operator's choice of biopsy is low.

  14. Pigmentation-related phenotypes and risk of prostate cancer

    OpenAIRE

    Weinstein, S J; Virtamo, J; Albanes, D

    2013-01-01

    Background: Solar ultraviolet radiation exposure has been inversely related to prostate cancer incidence and mortality, possibly mediated through vitamin D status. Pigmentation-related traits influence endogenous vitamin D synthesis and may alter risk of prostate cancer. Methods: We examined prostate cancer in relation to hair and eye colour, and skin phototype in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study cohort. Incident cancer was diagnosed in 1982 out of 20 863 men. Multi...

  15. Nomograms for predicting Gleason upgrading in a contemporary Chinese cohort receiving radical prostatectomy after extended prostate biopsy: development and internal validation.

    Science.gov (United States)

    He, Biming; Chen, Rui; Gao, Xu; Ren, Shancheng; Yang, Bo; Hou, Jianguo; Wang, Linhui; Yang, Qing; Zhou, Tie; Zhao, Lin; Xu, Chuanliang; Sun, Yinghao

    2016-03-29

    The current strategy for the histological assessment of prostate cancer (PCa) is mainly based on the Gleason score (GS). However, 30-40% of patients who undergo radical prostatectomy (RP) are misclassified at biopsy pathologically. Thus, we developed and validated nomograms for the prediction of Gleason score upgrading (GSU) in patients who underwent radical prostatectomy after extended prostate biopsy in a Chinese population. This retrospective study included a total of 411 patients who underwent radical prostatectomy at our institute after having prostate biopsies between 2011 and 2015. The final pathologic GS was upgraded in 151 (36.74%) of the cases in all patients and 92 (60.13%) cases in men with GS=6. In multivariate analyses, the primary biopsy GS, secondary biopsy GS and obesity were predictive of GSU in the patient cohort assessed. In patients with GS=6, the significant predictors of GSU included the body mass index (BMI), prostate-specific antigen density(PSAD) and percentage of positive cores. The area under the curve (AUC) of the prediction models was 0.753 for the entire patient population and 0.727 for the patients with GS=6. Both nomograms were well calibrated, and decision curve analysis demonstrated a high net benefit across a wide range of threshold probabilities. This study may be relevant for improved risk assessment and clinical decision-making in PCa patients. PMID:26943768

  16. Droplet Digital PCR Based Androgen Receptor Variant 7 (AR-V7) Detection from Prostate Cancer Patient Blood Biopsies

    Science.gov (United States)

    Ma, Yafeng; Luk, Alison; Young, Francis P.; Lynch, David; Chua, Wei; Balakrishnar, Bavanthi; de Souza, Paul; Becker, Therese M.

    2016-01-01

    Androgen receptor splice variant V7 (AR-V7) was recently identified as a valuable predictive biomarker in metastatic castrate-resistant prostate cancer. Here, we report a new, sensitive and accurate screen for AR-V7 mRNA expression directly from circulating tumor cells (CTCs): We combined EpCAM-based immunomagnetic CTC isolation using the IsoFlux microfluidic platform with droplet digital polymerase chain reaction (ddPCR) to analyze total AR and AR-V7 expression from prostate cancer patients CTCs. We demonstrate that AR-V7 is reliably detectable in enriched CTC samples with as little as five CTCs, even considering tumor heterogeneity, and confirm detection of AR-V7 in CTC samples from advanced prostate cancer (PCa) patients with AR-V7 detection limited to castrate resistant disease status in our sample set. Sensitive molecular analyses of circulating tumor cells (CTCs) or circulating tumor nucleic acids present exciting strategies to detect biomarkers, such as AR-V7 from non-invasive blood samples, so-called blood biopsies. PMID:27527157

  17. Droplet Digital PCR Based Androgen Receptor Variant 7 (AR-V7 Detection from Prostate Cancer Patient Blood Biopsies

    Directory of Open Access Journals (Sweden)

    Yafeng Ma

    2016-08-01

    Full Text Available Androgen receptor splice variant V7 (AR-V7 was recently identified as a valuable predictive biomarker in metastatic castrate-resistant prostate cancer. Here, we report a new, sensitive and accurate screen for AR-V7 mRNA expression directly from circulating tumor cells (CTCs: We combined EpCAM-based immunomagnetic CTC isolation using the IsoFlux microfluidic platform with droplet digital polymerase chain reaction (ddPCR to analyze total AR and AR-V7 expression from prostate cancer patients CTCs. We demonstrate that AR-V7 is reliably detectable in enriched CTC samples with as little as five CTCs, even considering tumor heterogeneity, and confirm detection of AR-V7 in CTC samples from advanced prostate cancer (PCa patients with AR-V7 detection limited to castrate resistant disease status in our sample set. Sensitive molecular analyses of circulating tumor cells (CTCs or circulating tumor nucleic acids present exciting strategies to detect biomarkers, such as AR-V7 from non-invasive blood samples, so-called blood biopsies.

  18. Local Control Following Permanent Prostate Brachytherapy: Effect of High Biologically Effective Dose on Biopsy Results and Oncologic Outcomes

    International Nuclear Information System (INIS)

    Purpose: To determine factors that influence local control and systemic relapse in patients undergoing permanent prostate brachytherapy (PPB). Methods and Materials: A total of 584 patients receiving PPB alone or PPB with external beam radiation therapy (19.5%) agreed to undergo prostate biopsy (PB) at 2 years postimplantion and yearly if results were positive or if the prostate-specific antigen (PSA) level increased. Short-term hormone therapy was used with 280 (47.9%) patients. Radiation doses were converted to biologically effective doses (BED) (using α/β = 2). Comparisons were made by chi-square analysis and linear regression. Survival was determined by the Kaplan-Meier method. Results: The median PSA concentration was 7.1 ng/ml, and the median follow-up period was 7.1 years. PB results were positive for 48/584 (8.2%) patients. Positive biopsy results by BED group were as follows: 22/121 (18.2%) patients received a BED of ≤150 Gy; 15/244 (6.1%) patients received >150 to 200 Gy; and 6/193 (3.1%; p 200 Gy. Significant associations of positive PB results by risk group were low-risk group BED (p = 0.019), intermediate-risk group hormone therapy (p = 0.011) and BED (p = 0.040), and high-risk group BED (p = 0.004). Biochemical freedom from failure rate at 7 years was 82.7%. Biochemical freedom from failure rate by PB result was 84.7% for negative results vs. 59.2% for positive results (p 200 Gy with an α/β ratio of 2 yields 96.9% local control rate. Failure to establish local control impacts survival.

  19. Comparison of Pudendal Nerve Blockade, Tenoxicam Suppository and Rectal Lidocaine Gel Anesthesia for Transrectal Ultrasound-Guided Biopsy of the Prostate

    OpenAIRE

    Güzel, Cüneyt Özden; Bulut, Süleyman; Aktaş, Binhan Kağan; PALA, Yaşar; Memiş, Ali

    2009-01-01

    Aim: We assessed the safety and efficacy of three different local anesthesia methods (pudendal nerve blockade, tenoxicam suppository and rectal lidocaine gel) before transrectal ultrasound (TRUS)-guided biopsy of the prostate in this study. Materials and Methods: In our prospective and controlled study, 136 consecutive patients were randomized into four groups: men in group 1 (n=41) received no anesthesia, group 2 (n=30) received intrarectal 10 cc 2% lidocaine gel 10 mins before biopsy, g...

  20. Prolonged antibiotic therapy increases risk of infection after transrectal prostate biopsy: A case report after pancreasectomy and review of the literature

    OpenAIRE

    Guevar Maselli; Giacomo Tucci; Daniele Mazzaferro; Asim Ettamimi; Giulia Sbrollini; Marco Cordari; Gaetano Donatelli; Andrea Benedetto Galosi

    2014-01-01

    Infection due to prostate biopsy afflicted more than 5% of patients and is the most common reason for hospitalization. A large series from US SEER-Medicare reported that men undergoing biopsy were 2.26 times more likely to be hospitalized for infectious complications within 30 days compared with randomly selected controls. The factors predicting a higher susceptibility to infection remain largely unknown but some authors have higlighted in the etiopathogenesis the importance of the augmented ...

  1. A novel equation and nomogram including body weight for estimating prostate volumes in men with biopsy-proven benign prostatic hyperplasia

    Institute of Scientific and Technical Information of China (English)

    Yasukazu Nakanishi; Iwao Fukui; Kazunori Kihara; Hitoshi Masuda; Satoru Kawakami; Mizuaki Sakura; Yasuhisa Fujii; Kazutaka Saito; Fumitaka Koga; Masaya Ito; Junji Yonese

    2012-01-01

    Anthropometric measurements,e.g.,body weight (BW),body mass index (BMI),as well as serum prostate-specific antigen (PSA) and percent-free PSA (%fPSA) have been shown to have positive correlations with total prostate volume (TPV).We developed an equation and nomegram for estimating TPV,incorporating these predictors in men with benign prostatic hyperplasia (BPH).A total of 1852 men,including 1113 at Tokyo Medical and Dental University (TMDU) Hospital as a training set and 739 at Cancer Institute Hospital (CIH) as a validation set,with PSA levels of up to 20 ng ml-1,who underwent extended prostate biopsy and were proved to have BPH,were enrolled in this study.We developed an equation for continuously coded TPV and a logistic regression-based nomngram for estimating a TPV greater than 40 ml.Predictive accuracy and performance characteristics were assessed using an area under the receiver operating characteristics curve (AUC) and calibration plots.The final linear regression model indicated age,PSA,%fPSA and BW as independent predictors of continuously coded TPV.For predictions in the training set,the multiple correlation coefficient was increased from 0.38 for PSA alone to 0.60 in the final model.We developed a novel nomogram incorporating age,PSA,%fPSA and BW for estimating TPV greater than 40 ml.External validation confirmed its predictive accuracy,with AUC value of 0.764.Calibration plots showed good agreement between predicted probability and observed proportion.In conclusion,TPV can be easily estimated using these four independent predictors.

  2. Decrease in Infection Rate Following Use of Povidone-Iodine During Transrectal Ultrasound Guided Biopsy of the Prostate: A Double Blind Randomized Clinical Trial

    International Nuclear Information System (INIS)

    Infection after transrectal ultrasound (TRUS) guided biopsy of the prostate is a major and potentially life-threatening problem. Using antibiotic premedication can not completely eliminate infection after biopsy. We performed this study to determine the value of using povidone-iodine in prevention of post biopsy infection. Totally, 280 patients who were referred for TRUS guided biopsy of the prostate were divided randomly into two equal groups. The case group received an intrarectal mixture of povidone-iodine and lidocaine gel before performing biopsy, while the control group received only lidocaine gel. Patients were followed up for 30 days for possible signs of infection including fever, chills and dysuria. The mean age in the case group was 68.7 ± 7 years and 68.1 ± 7 years in the control group (P = 0.78). Overall, there were signs and symptoms of infection in 78 patients (27.9%), of which 27 (19.3%) were in the case group, while 51 (36.4%) were in the control group (P = 0.001, OR = 2.4, 95% CI = 1.4-4.1). Simple use of widely available povidone-iodine for cleaning the rectum before TRUS guided prostate biopsy can reduce the infection rate

  3. Prostate Health Index (Phi and Prostate Cancer Antigen 3 (PCA3 significantly improve prostate cancer detection at initial biopsy in a total PSA range of 2-10 ng/ml.

    Directory of Open Access Journals (Sweden)

    Matteo Ferro

    Full Text Available Many efforts to reduce prostate specific antigen (PSA overdiagnosis and overtreatment have been made. To this aim, Prostate Health Index (Phi and Prostate Cancer Antigen 3 (PCA3 have been proposed as new more specific biomarkers. We evaluated the ability of phi and PCA3 to identify prostate cancer (PCa at initial prostate biopsy in men with total PSA range of 2-10 ng/ml. The performance of phi and PCA3 were evaluated in 300 patients undergoing first prostate biopsy. ROC curve analyses tested the accuracy (AUC of phi and PCA3 in predicting PCa. Decision curve analyses (DCA were used to compare the clinical benefit of the two biomarkers. We found that the AUC value of phi (0.77 was comparable to those of %p2PSA (0.76 and PCA3 (0.73 with no significant differences in pairwise comparison (%p2PSA vs phi p = 0.673, %p2PSA vs. PCA3 p = 0.417 and phi vs. PCA3 p = 0.247. These three biomarkers significantly outperformed fPSA (AUC = 0.60, % fPSA (AUC = 0.62 and p2PSA (AUC = 0.63. At DCA, phi and PCA3 exhibited a very close net benefit profile until the threshold probability of 25%, then phi index showed higher net benefit than PCA3. Multivariable analysis showed that the addition of phi and PCA3 to the base multivariable model (age, PSA, %fPSA, DRE, prostate volume increased predictive accuracy, whereas no model improved single biomarker performance. Finally we showed that subjects with active surveillance (AS compatible cancer had significantly lower phi and PCA3 values (p<0.001 and p = 0.01, respectively. In conclusion, both phi and PCA3 comparably increase the accuracy in predicting the presence of PCa in total PSA range 2-10 ng/ml at initial biopsy, outperforming currently used %fPSA.

  4. Body mass index in relation to serum prostate-specific antigen levels and prostate cancer risk.

    Science.gov (United States)

    Bonn, Stephanie E; Sjölander, Arvid; Tillander, Annika; Wiklund, Fredrik; Grönberg, Henrik; Bälter, Katarina

    2016-07-01

    High Body mass index (BMI) has been directly associated with risk of aggressive or fatal prostate cancer. One possible explanation may be an effect of BMI on serum levels of prostate-specific antigen (PSA). To study the association between BMI and serum PSA as well as prostate cancer risk, a large cohort of men without prostate cancer at baseline was followed prospectively for prostate cancer diagnoses until 2015. Serum PSA and BMI were assessed among 15,827 men at baseline in 2010-2012. During follow-up, 735 men were diagnosed with prostate cancer with 282 (38.4%) classified as high-grade cancers. Multivariable linear regression models and natural cubic linear regression splines were fitted for analyses of BMI and log-PSA. For risk analysis, Cox proportional hazards regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) and natural cubic Cox regression splines producing standardized cancer-free probabilities were fitted. Results showed that baseline Serum PSA decreased by 1.6% (95% CI: -2.1 to -1.1) with every one unit increase in BMI. Statistically significant decreases of 3.7, 11.7 and 32.3% were seen for increasing BMI-categories of 25 prostate cancer risk although results were indicative of a positive association to incidence rates of high-grade disease and an inverse association to incidence of low-grade disease. However, findings regarding risk are limited by the short follow-up time. In conclusion, BMI was inversely associated to PSA-levels. BMI should be taken into consideration when referring men to a prostate biopsy based on serum PSA-levels. PMID:26914149

  5. Assessment of the Performance of Magnetic Resonance Imaging/Ultrasound Fusion Guided Prostate Biopsy against a Combined Targeted Plus Systematic Biopsy Approach Using 24-Core Transperineal Template Saturation Mapping Prostate Biopsy

    Science.gov (United States)

    Ting, Francis; Van Leeuwen, Pim J.; Thompson, James; Shnier, Ron; Moses, Daniel; Delprado, Warick; Stricker, Phillip D.

    2016-01-01

    Objective. To compare the performance of multiparametric resonance imaging/ultrasound fusion targeted biopsy (MRI/US-TBx) to a combined biopsy strategy (MRI/US-TBx plus 24-core transperineal template saturation mapping biopsy (TTMB)). Methods. Between May 2012 and October 2015, all patients undergoing MRI/US-TBx at our institution were included for analysis. Patients underwent MRI/US-TBx of suspicious lesions detected on multiparametric MRI +/− simultaneous TTMB. Subgroup analysis was performed on patients undergoing simultaneous MRI/US-TBx + TTMB. Primary outcome was PCa detection. Significant PCa was defined as ≥Gleason score (GS) 3 + 4 = 7 PCa. McNemar's test was used to compare detection rates between MRI/US-TBx and the combined biopsy strategy. Results. 148 patients underwent MRI/US-TBx and 80 patients underwent MRI/US-TBx + TTMB. In the MRI/US-TBx versus combined biopsy strategy subgroup analysis (n = 80), there were 55 PCa and 38 significant PCa. The detection rate for the combined biopsy strategy versus MRI/US-TBx for significant PCa was 49% versus 40% (p = 0.02) and for insignificant PCa was 20% versus 10% (p = 0.04), respectively. Eleven cases (14%) of significant PCa were detected exclusively on MRI/US-TBx and 7 cases (8.7%) of significant PCa were detected exclusively on TTMB. Conclusions. A combined biopsy approach (MRI/US-TBx + TTMB) detects more significant PCa than MRI/US-TBx alone; however, it will double the detection rate of insignificant PCa. PMID:27293898

  6. Prostate Cancer Screening: the role of biopsy, PSA, PSA dynamics and isoforms

    NARCIS (Netherlands)

    P.F.J. Raaijmakers (René)

    2009-01-01

    textabstractIn the beginning of the past century, A. Astraldi urologist from Buenos Aires, Argentina, recognized the importance of early detection of prostate cancer and was unsatisfied with the available diagnostic tools he had to his disposal. The only diagnostic means for the urologist at that ti

  7. External Validation of Urinary PCA3-Based Nomograms to Individually Predict Prostate Biopsy Outcome

    NARCIS (Netherlands)

    M. Auprich; A. Haese; J. Walz; K. Pummer; A. de la Taille; M. Graefen; T. de Reijke; M. Fisch; P. Kil; P. Gontero; J. Irani; F.K.H. Chun

    2010-01-01

    Background: Prior to safely adopting risk stratification tools, their performance must be tested in an external patient cohort. Objective: To assess accuracy and generalizability of previously reported, internally validated, prebiopsy prostate cancer antigen 3 (PCA3) gene-based nomograms when applie

  8. Seminal vesicle biopsy and laparoscopic pelvic lymph node dissection: implications for patient selection in the radiotherapeutic management of prostate cancer

    International Nuclear Information System (INIS)

    Purpose: Seminal vesicle biopsies (SVB) and laparoscopic pelvic lymph node dissection (LPLND) are safe surgical staging procedures for prostate cancer that can yield more accurate information than can be obtained by routine clinical means. This information is critical in patient and treatment selection when planning definitive prostate irradiation. An analysis of the procedural findings was undertaken to better define those patients who might benefit from these procedures. Methods and Materials: From June 1990 to February 1994, 120 patients with clinical Stage T1b to T2c prostate cancer with negative bone scan and pelvic computerized tomography (CT) scans underwent transrectal ultrasound guided SVB (three from each side). Of these patients, 99 also underwent LPLND. Twelve patients were excluded from analysis of LPLND findings because they were treated with 3 months of hormonal therapy prior to LPLND. During LPLND, 0 to 18 nodes were removed (median--five nodes) from the right side and 0 to 20 nodes (median--five nodes) were removed from the left side. Prostate specific antigen (PSA) values ranged from 1.6 to 190 ng/ml, with a median value of 11.5. Combined Gleason grades ranged from 2 to 9, with a median of 6. Results: A positive SVB was found in 18 patients (15%). A logistic regression analysis was performed to test the effect of grade, PSA, and stage on SVB results. Combined grade and PSA were significant predictors of a positive SVB (p <0.001 and p = 0.024, respectively). Patients with combined grades of 7 or greater had a higher positive SVB rate of 37.5% (12 out of 32) compared to 7% (6 out of 88) for patients with a lower grade (p <0.0001). Patients with PSA values greater than 10 had a positive SVB rate of 21% (15 out of 70) compared to 6% (3 out of 50) for patients with values up to 10. There was no morbidity associated with SVB. Laparoscopic pelvic lymph node disection detected positive pelvic nodes in nine patients (10%). The effect of a positive SVB

  9. Prolonged antibiotic therapy increases risk of infection after transrectal prostate biopsy: A case report after pancreasectomy and review of the literature

    Directory of Open Access Journals (Sweden)

    Guevar Maselli

    2014-12-01

    Full Text Available Infection due to prostate biopsy afflicted more than 5% of patients and is the most common reason for hospitalization. A large series from US SEER-Medicare reported that men undergoing biopsy were 2.26 times more likely to be hospitalized for infectious complications within 30 days compared with randomly selected controls. The factors predicting a higher susceptibility to infection remain largely unknown but some authors have higlighted in the etiopathogenesis the importance of the augmented prevalence of ciprofloxacin resistant variant of bacteria in the rectum flora. We present one case of sepsis after transrectal prostate biopsy in a patient with history of pancreatic surgery. Based on our experience patients candidated to prostate biopsy with transrectal technique with history of recent major surgery represent an high risk category for infective complication. Also major pancreatic surgery should be consider an high risk category for infection. A transperineal approach and preventive measures (such as rectal swab should be adopted to reduce biopsy driven infection.

  10. Minimization of tool tracking error using fulcrum correction in minimally invasive interventions: application to prostate biopsy procedure

    Science.gov (United States)

    Cool, Derek; Sherebrin, Shi; Izawa, Jonathan; Peters, Terrence; Fenster, Aaron

    2006-03-01

    Real-time 3D optical tracking of free-hand imaging devices or surgical tools has been studied and employed for object localization in many minimally invasive interventions. However, the surgical workspace for many interventional procedures is often sub-dermal with tool access through ports from surgical incisions or anatomical orifices. To maintain the optical line-of-sight criterion, external extensions of inserted imaging devices and rigid surgical tools must be tracked to localize the internal tool tips. Unfortunately, tracking by this form of correspondence is very susceptible to noise as orientation errors on the external tracked end compound into both rotational and translational errors on the internal, workspace position. These translational errors are proportional to the length of the probe and the sine of the angulation error, so small angulation errors can quickly compromise the accuracy of the tool tip localization. We propose a real-time tracking correction technique that uses the rotational fulcrum created by the device entry port to minimize the effect of translational and rotational noise errors for tool tip localization. Our technique could apply to many types of interventions, but we focus on the application to the prostate biopsy procedure for tracking a transrectal ultrasound (TRUS) probe commonly used for prostate biopsies. In vitro studies were performed using the Claron Technology MicronTracker 2 to track a TRUS probe in a fixed rotational device. Our experimental results showed an order of magnitude improvement in RMS localization of the internal TRUS probe tip using fulcrum correction over the raw tracking information.

  11. Magnetic resonance imaging-targeted, 3D transrectal ultrasound-guided fusion biopsy for prostate cancer: Quantifying the impact of needle delivery error on diagnosis

    International Nuclear Information System (INIS)

    Purpose: Magnetic resonance imaging (MRI)-targeted, 3D transrectal ultrasound (TRUS)-guided “fusion” prostate biopsy intends to reduce the ∼23% false negative rate of clinical two-dimensional TRUS-guided sextant biopsy. Although it has been reported to double the positive yield, MRI-targeted biopsies continue to yield false negatives. Therefore, the authors propose to investigate how biopsy system needle delivery error affects the probability of sampling each tumor, by accounting for uncertainties due to guidance system error, image registration error, and irregular tumor shapes. Methods: T2-weighted, dynamic contrast-enhanced T1-weighted, and diffusion-weighted prostate MRI and 3D TRUS images were obtained from 49 patients. A radiologist and radiology resident contoured 81 suspicious regions, yielding 3D tumor surfaces that were registered to the 3D TRUS images using an iterative closest point prostate surface-based method to yield 3D binary images of the suspicious regions in the TRUS context. The probabilityP of obtaining a sample of tumor tissue in one biopsy core was calculated by integrating a 3D Gaussian distribution over each suspicious region domain. Next, the authors performed an exhaustive search to determine the maximum root mean squared error (RMSE, in mm) of a biopsy system that gives P ≥ 95% for each tumor sample, and then repeated this procedure for equal-volume spheres corresponding to each tumor sample. Finally, the authors investigated the effect of probe-axis-direction error on measured tumor burden by studying the relationship between the error and estimated percentage of core involvement. Results: Given a 3.5 mm RMSE for contemporary fusion biopsy systems,P ≥ 95% for 21 out of 81 tumors. The authors determined that for a biopsy system with 3.5 mm RMSE, one cannot expect to sample tumors of approximately 1 cm3 or smaller with 95% probability with only one biopsy core. The predicted maximum RMSE giving P ≥ 95% for each tumor was

  12. Magnetic resonance imaging-targeted, 3D transrectal ultrasound-guided fusion biopsy for prostate cancer: Quantifying the impact of needle delivery error on diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Martin, Peter R., E-mail: pmarti46@uwo.ca [Department of Medical Biophysics, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Cool, Derek W. [Department of Medical Imaging, The University of Western Ontario, London, Ontario N6A 3K7, Canada and Robarts Research Institute, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Romagnoli, Cesare [Department of Medical Imaging, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Fenster, Aaron [Department of Medical Biophysics, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Department of Medical Imaging, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Robarts Research Institute, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Ward, Aaron D. [Department of Medical Biophysics, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Department of Oncology, The University of Western Ontario, London, Ontario N6A 3K7 (Canada)

    2014-07-15

    Purpose: Magnetic resonance imaging (MRI)-targeted, 3D transrectal ultrasound (TRUS)-guided “fusion” prostate biopsy intends to reduce the ∼23% false negative rate of clinical two-dimensional TRUS-guided sextant biopsy. Although it has been reported to double the positive yield, MRI-targeted biopsies continue to yield false negatives. Therefore, the authors propose to investigate how biopsy system needle delivery error affects the probability of sampling each tumor, by accounting for uncertainties due to guidance system error, image registration error, and irregular tumor shapes. Methods: T2-weighted, dynamic contrast-enhanced T1-weighted, and diffusion-weighted prostate MRI and 3D TRUS images were obtained from 49 patients. A radiologist and radiology resident contoured 81 suspicious regions, yielding 3D tumor surfaces that were registered to the 3D TRUS images using an iterative closest point prostate surface-based method to yield 3D binary images of the suspicious regions in the TRUS context. The probabilityP of obtaining a sample of tumor tissue in one biopsy core was calculated by integrating a 3D Gaussian distribution over each suspicious region domain. Next, the authors performed an exhaustive search to determine the maximum root mean squared error (RMSE, in mm) of a biopsy system that gives P ≥ 95% for each tumor sample, and then repeated this procedure for equal-volume spheres corresponding to each tumor sample. Finally, the authors investigated the effect of probe-axis-direction error on measured tumor burden by studying the relationship between the error and estimated percentage of core involvement. Results: Given a 3.5 mm RMSE for contemporary fusion biopsy systems,P ≥ 95% for 21 out of 81 tumors. The authors determined that for a biopsy system with 3.5 mm RMSE, one cannot expect to sample tumors of approximately 1 cm{sup 3} or smaller with 95% probability with only one biopsy core. The predicted maximum RMSE giving P ≥ 95% for each

  13. Importance of Local Control in Early-Stage Prostate Cancer: Outcomes of Patients With Positive Post-Radiation Therapy Biopsy Results Treated in RTOG 9408

    International Nuclear Information System (INIS)

    Purpose: The purpose of this study was to assess the association between positive post-radiation therapy (RT) biopsy results and subsequent clinical outcomes in males with localized prostate cancer. Methods and Materials: Radiation Therapy Oncology Group study 94-08 analyzed 1979 males with prostate cancer, stage T1b-T2b and prostate-specific antigen concentrations of ≤20 ng/dL, to investigate whether 4 months of total androgen suppression (TAS) added to RT improved survival compared to RT alone. Patients randomized to receive TAS received flutamide with luteinizing hormone releasing hormone (LHRH) agonist. According to protocol, patients without evidence of clinical recurrence or initiation of additional endocrine therapy underwent repeat prostate biopsy 2 years after RT completion. Statistical analysis was performed to evaluate the impact of positive post-RT biopsy results on clinical outcomes. Results: A total of 831 patients underwent post-RT biopsy, 398 were treated with RT alone and 433 with RT plus TAS. Patients with positive post-RT biopsy results had higher rates of biochemical failure (hazard ratio [HR] = 1.7; 95% confidence interval [CI] = 1.3-2.1) and distant metastasis (HR = 2.4; 95% CI = 1.3-4.4) and inferior disease-specific survival (HR = 3.8; 95% CI = 1.9-7.5). Positive biopsy results remained predictive of such outcomes after correction for potential confounders such as Gleason score, tumor stage, and TAS administration. Prior TAS therapy did not prevent elevated risk of adverse outcome in the setting of post-RT positive biopsy results. Patients with Gleason score ≥7 with a positive biopsy result additionally had inferior overall survival compared to those with a negative biopsy result (HR = 1.56; 95% CI = 1.04-2.35). Conclusions: Positive post-RT biopsy is associated with increased rates of distant metastases and inferior disease-specific survival in patients treated with definitive RT and was associated with inferior overall

  14. Importance of Local Control in Early-Stage Prostate Cancer: Outcomes of Patients With Positive Post-Radiation Therapy Biopsy Results Treated in RTOG 9408

    Energy Technology Data Exchange (ETDEWEB)

    Krauss, Daniel J., E-mail: dkrauss@beaumont.edu [Department of Radiation Oncology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Hu, Chen [NRG Statistics and Data Management Center, Philadelphia, Pennsylvania (United States); Bahary, Jean-Paul [Centre Hospitalier de l' Université de Montréal-Notre Dame, Montreal, Quebec (Canada); Souhami, Luis [McGill University, Montreal, Quebec (Canada); Gore, Elizabeth M. [Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Chafe, Susan Maria Jacinta [Cross Cancer Institute, Edmonton, Alberta (Canada); Leibenhaut, Mark H. [Sutter General Hospital, Sacramento, California (United States); Narayan, Samir [Michigan Cancer Research Consortium CCOP (United States); Torres-Roca, Javier [H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States); Michalski, Jeff [Washington University, St. Louis, Missouri (United States); Zeitzer, Kenneth L. [Albert Einstein Medical Center, Bronx, New York, New York (United States); Donavanik, Viroon [Christiana Care Health Services Inc CCOP, Newark, Delaware (United States); Sandler, Howard [Cedars-Sinai Medical Center, Los Angeles, California (United States); McGowan, David G. [Cross Cancer Institute, Edmonton, Alberta (Canada); Jones, Christopher U. [Sutter General Hospital, Sacramento, California (United States); Shipley, William U. [Dana-Farber Cancer Institute, Boston, Massachusetts (United States)

    2015-07-15

    Purpose: The purpose of this study was to assess the association between positive post-radiation therapy (RT) biopsy results and subsequent clinical outcomes in males with localized prostate cancer. Methods and Materials: Radiation Therapy Oncology Group study 94-08 analyzed 1979 males with prostate cancer, stage T1b-T2b and prostate-specific antigen concentrations of ≤20 ng/dL, to investigate whether 4 months of total androgen suppression (TAS) added to RT improved survival compared to RT alone. Patients randomized to receive TAS received flutamide with luteinizing hormone releasing hormone (LHRH) agonist. According to protocol, patients without evidence of clinical recurrence or initiation of additional endocrine therapy underwent repeat prostate biopsy 2 years after RT completion. Statistical analysis was performed to evaluate the impact of positive post-RT biopsy results on clinical outcomes. Results: A total of 831 patients underwent post-RT biopsy, 398 were treated with RT alone and 433 with RT plus TAS. Patients with positive post-RT biopsy results had higher rates of biochemical failure (hazard ratio [HR] = 1.7; 95% confidence interval [CI] = 1.3-2.1) and distant metastasis (HR = 2.4; 95% CI = 1.3-4.4) and inferior disease-specific survival (HR = 3.8; 95% CI = 1.9-7.5). Positive biopsy results remained predictive of such outcomes after correction for potential confounders such as Gleason score, tumor stage, and TAS administration. Prior TAS therapy did not prevent elevated risk of adverse outcome in the setting of post-RT positive biopsy results. Patients with Gleason score ≥7 with a positive biopsy result additionally had inferior overall survival compared to those with a negative biopsy result (HR = 1.56; 95% CI = 1.04-2.35). Conclusions: Positive post-RT biopsy is associated with increased rates of distant metastases and inferior disease-specific survival in patients treated with definitive RT and was associated with inferior overall

  15. Accuracy of 3 Tesla pelvic phased-array multiparametric MRI in diagnosing prostate cancer at repeat biopsy

    Directory of Open Access Journals (Sweden)

    Pietro Pepe

    2014-12-01

    Full Text Available Introduction. Multiparametric pelvic magnetic resonance imaging (mpMRI accuracy in prostate cancer (PCa diagnosis was evaluated. Materials and Methods. From June 2011 to December 2013, 168 patients (median 65 years with negative digital rectal examination underwent repeat transperineal saturation biopsy (SPBx; median 28 cores for persistently high or increasing PSA values, PSA >10 ng/ml or PSA values between 4.1-10 o r 2.6-4 ng/ml with free/total PSA < 25% and < 20%, respectively. All patients underwent mpMRI using a 3.0 Tesla scanner equipped with surface 16 channels phased-array coil and lesions suspicious for PCa were submitted to additional targeted biopsies. Results. A T1c PCa was found in 66 (39% cases; SPBx and mpMRI-suspicious targeted biopsy diagnosed 60 (91% and 52 (78.8% cancers missing 6 (all of the anterior zone and 14 cancers (12 and 2 of the lateral margins and anterior zone, respectively; in detail, mpMRI missed 12 (18.1% PCa charaterized by microfocal (1 positive core with greatest percentage of cancer and Gleason score equal to 5% and 6, respectively disease at risk for insignificant cancer. The diameter of the suspicious mpMRI lesion was directly correlated to the diagnosis of PCa with poor Gleason score (p < 0.05; detection rate of cancer for each suspicious mpMRI core was 35.3%. Diagnostic accuracy, sensitivity, specificity, positive and negative predictive value of mpMRI in diagnosing PCa was 75.7%, 82.5%, 71.8%, 78.9%, 87.9%, respectively. Conclusion. Multiparametric pMRI improved SPBx accuracy in diagnosing significant anterior PCa; the diameter of mpMRI suspicious lesion resulted significantly predictive of aggressive cancers.

  16. Diagnosis of prostate cancer in patients with persistently elevated PSA and tumor-negative biopsy in ambulatory care. Performance of MR imaging in a multi-reader environment

    International Nuclear Information System (INIS)

    Purpose: False-negative results are obtained in approx. 20 % of prostate cancer (PCa) patients (pts) at initial systematic transrectal biopsy (Bx), in particular when digital rectal examination (DRE) or transrectal ultrasound (TRUS) is negative. The aim of this study was to assess whether MR endorectal imaging of the prostate in a multi-reader ambulatory care setting may assist in patient selection for re-biopsy. Materials and Methods: 115 consecutive pts with persistent PSA elevation, negative Bx, DRE and TRUS were examined using T2w axial and coronal and T1w axial sequences for tumor diagnosis. MR images were prospectively read as tumor-suspicious or tumor-negative by the MR radiologist on duty. Additionally, a retrospective readout of a prostate MR expert and an abdominal imaging fellowship-trained radiologist was performed to evaluate the effect of the reader's experience on tumor detection. Imaging findings were compared to the results of the repeat Bx (61 pts) or the clinical course of at least two years. Results: For the prospective reading, the sensitivity of MRI was 83 %, the specificity was 69 %, the PPV was 33 % and the NPV was 96 %. ROC analysis revealed a significantly better performance of the prostate MR imaging expert compared to the abdominal imaging radiologist (area under ROC 0.88 vs. 0.66, p < 0.001). Based on the prospective reading, a pre-test probability for PCa of 17.4 % as in our study can be reduced to 5 % when obtaining a tumor-negative result in MRI. Conclusion: MR imaging in a multi-reader ambulatory care setting assists in patient selection for re-biopsy. Reducing the post-test probability for PCa to 5 % allows for further follow-up instead of re-biopsy in MR tumor-negative patients. Specific training and experience improve tumor detection in prostate MR imaging. (orig.)

  17. Can a Gleason 6 or Less Microfocus of Prostate Cancer in One Biopsy and Prostate-Specific Antigen Level <10 ng/mL Be Defined as the Archetype of Low-Risk Prostate Disease?

    Directory of Open Access Journals (Sweden)

    Gianluigi Taverna

    2012-01-01

    Full Text Available Prostate cancer (PC remains a cause of death worldwide. Here we investigate whether a single microfocus of PC at the biopsy (graded as Gleason 6 or less, ≤5% occupancy and the PSA <10 ng/mL can define the archetype of low-risk prostate disease. 4500 consecutive patients were enrolled. Among them, 134 patients with a single micro-focus of PC were followed up, and the parameters influencing the biochemical relapse (BR were analysed. Out of 134 patients, 94 had clinically significant disease, specifically in 74.26% of the patients with PSA <10 ng/mL. Positive surgical margins and the extracapsular invasion were found in 29.1% and 51.4% patients, respectively. BR was observed in 29.6% of the patients. Cox regression evidenced a correlation between the BR and Gleason grade at the retropubic radical prostatectomy (RRP, capsular invasion, and the presence of positive surgical margins. Multivariate regression analysis showed a statistically significant correlation between the presence of surgical margins at the RRP and BR. Considering a single micro-focus of PC at the biopsy and PSA serum level <10 ng/mL, clinically significant disease was found in 74.26% patients and only positive surgical margins are useful for predicting the BR.

  18. Risk of Pathologic Upgrading or Locally Advanced Disease in Early Prostate Cancer Patients Based on Biopsy Gleason Score and PSA: A Population-Based Study of Modern Patients

    Energy Technology Data Exchange (ETDEWEB)

    Caster, Joseph M.; Falchook, Aaron D. [Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Hendrix, Laura H. [Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Chen, Ronald C., E-mail: Ronald_chen@med.unc.edu [Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States)

    2015-06-01

    Purpose: Radiation oncologists rely on available clinical information (biopsy Gleason score and prostate-specific antigen [PSA]) to determine the optimal treatment regimen for each prostate cancer patient. Existing published nomograms correlating clinical to pathologic extent of disease were based on patients treated in the 1980s and 1990s at select academic institutions. We used the Surveillance, Epidemiology, and End Results (SEER) database to examine pathologic outcomes (Gleason score and cancer stage) in early prostate cancer patients based on biopsy Gleason score and PSA concentration. Methods and Materials: This analysis included 25,858 patients whose cancer was diagnosed between 2010 and 2011, with biopsy Gleason scores of 6 to 7 and clinical stage T1 to T2 disease, who underwent radical prostatectomy. In subgroups based on biopsy Gleason score and PSA level, we report the proportion of patients with pathologically advanced disease (positive surgical margin or pT3-T4 disease) or whose Gleason score was upgraded. Logistic regression was used to examine factors associated with pathologic outcomes. Results: For patients with biopsy Gleason score 6 cancers, 84% of those with PSA <10 ng/mL had surgical T2 disease with negative margins; this decreased to 61% in patients with PSA of 20 to 29.9 ng/mL. Gleason score upgrading was seen in 43% (PSA: <10 ng/mL) to 61% (PSA: 20-29.9 ng/mL) of biopsy Gleason 6 patients. Patients with biopsy Gleason 7 cancers had a one-third (Gleason 3 + 4; PSA: <10 ng/mL) to two-thirds (Gleason 4 + 3; PSA: 20-29.9 ng/mL) probability of having pathologically advanced disease. Gleason score upgrading was seen in 11% to 19% of patients with biopsy Gleason 4 + 3 cancers. Multivariable analysis showed that higher PSA and older age were associated with Gleason score upgrading and pathologically advanced disease. Conclusions: This is the first population-based study to examine pathologic extent of disease and pathologic Gleason score

  19. Risk of Pathologic Upgrading or Locally Advanced Disease in Early Prostate Cancer Patients Based on Biopsy Gleason Score and PSA: A Population-Based Study of Modern Patients

    International Nuclear Information System (INIS)

    Purpose: Radiation oncologists rely on available clinical information (biopsy Gleason score and prostate-specific antigen [PSA]) to determine the optimal treatment regimen for each prostate cancer patient. Existing published nomograms correlating clinical to pathologic extent of disease were based on patients treated in the 1980s and 1990s at select academic institutions. We used the Surveillance, Epidemiology, and End Results (SEER) database to examine pathologic outcomes (Gleason score and cancer stage) in early prostate cancer patients based on biopsy Gleason score and PSA concentration. Methods and Materials: This analysis included 25,858 patients whose cancer was diagnosed between 2010 and 2011, with biopsy Gleason scores of 6 to 7 and clinical stage T1 to T2 disease, who underwent radical prostatectomy. In subgroups based on biopsy Gleason score and PSA level, we report the proportion of patients with pathologically advanced disease (positive surgical margin or pT3-T4 disease) or whose Gleason score was upgraded. Logistic regression was used to examine factors associated with pathologic outcomes. Results: For patients with biopsy Gleason score 6 cancers, 84% of those with PSA <10 ng/mL had surgical T2 disease with negative margins; this decreased to 61% in patients with PSA of 20 to 29.9 ng/mL. Gleason score upgrading was seen in 43% (PSA: <10 ng/mL) to 61% (PSA: 20-29.9 ng/mL) of biopsy Gleason 6 patients. Patients with biopsy Gleason 7 cancers had a one-third (Gleason 3 + 4; PSA: <10 ng/mL) to two-thirds (Gleason 4 + 3; PSA: 20-29.9 ng/mL) probability of having pathologically advanced disease. Gleason score upgrading was seen in 11% to 19% of patients with biopsy Gleason 4 + 3 cancers. Multivariable analysis showed that higher PSA and older age were associated with Gleason score upgrading and pathologically advanced disease. Conclusions: This is the first population-based study to examine pathologic extent of disease and pathologic Gleason score

  20. Oral antibiotics in trans-rectal prostate biopsy and its efficacy to reduce infectious complications: Systematic review

    Directory of Open Access Journals (Sweden)

    Mohand Deeb Yaghi

    2015-01-01

    Full Text Available For the diagnosis of prostate cancer trans-rectal prostate biopsy (TRPB is used commonly, the procedure is associated with infective complications. There is evidence that antibiotics (ABx decrease infective events after TRPB, but different regimens are used. To systematically review different regimens of prophylactic oral ABx in TRPB. MEDLINE, EMBASE, clinical trials site, and Cochrane library were searched, experts were consulted for relevant studies. Randomized clinical trials conducted in the last 20 years, which investigated the different oral antibiotic regimens in TRPB, and compared their efficacy to reduce infectious complications were analyzed. Primary outcomes were bacteriuria, urinary tract infection (UTI, fever, bacteremia, and sepsis. Secondary outcomes were the hospitalization rate and the prevalence of ABx-resistant bacteria. Nine trials were eligible with 3012 patients. ABx prevented bacteriuria (3.5% vs. 9.88%, UTI (4.46% vs. 9.75%, and hospitalization (0.21% vs. 2.13% significantly in comparison with placebo or no treatment. No significant difference was found in all the outcomes of the review between the single dose regimen and the 3 days. The single dose regimen was as effective as the multiple doses except in bacteriuria (6.75% vs. 3.25%, and the prevalence of ABx-resistant bacteria (1.57% vs. 0.27%. Quinolones reduced only UTI significantly in comparison with other ABx (chloramphenicol, trimethoprim-sulfamethoxazol. It is essential to prescribe prophylactic ABx in TRPB. No conclusive evidence could be claimed about the superiority of the multiple or the 3 days regimens to the single dose regimen. Unexpectedly, ABx-resistant bacteria were identified more often in the single dose cohorts.

  1. Automated high-throughput assessment of prostate biopsy tissue using infrared spectroscopic chemical imaging

    Science.gov (United States)

    Bassan, Paul; Sachdeva, Ashwin; Shanks, Jonathan H.; Brown, Mick D.; Clarke, Noel W.; Gardner, Peter

    2014-03-01

    Fourier transform infrared (FT-IR) chemical imaging has been demonstrated as a promising technique to complement histopathological assessment of biomedical tissue samples. Current histopathology practice involves preparing thin tissue sections and staining them using hematoxylin and eosin (H&E) after which a histopathologist manually assess the tissue architecture under a visible microscope. Studies have shown that there is disagreement between operators viewing the same tissue suggesting that a complementary technique for verification could improve the robustness of the evaluation, and improve patient care. FT-IR chemical imaging allows the spatial distribution of chemistry to be rapidly imaged at a high (diffraction-limited) spatial resolution where each pixel represents an area of 5.5 × 5.5 μm2 and contains a full infrared spectrum providing a chemical fingerprint which studies have shown contains the diagnostic potential to discriminate between different cell-types, and even the benign or malignant state of prostatic epithelial cells. We report a label-free (i.e. no chemical de-waxing, or staining) method of imaging large pieces of prostate tissue (typically 1 cm × 2 cm) in tens of minutes (at a rate of 0.704 × 0.704 mm2 every 14.5 s) yielding images containing millions of spectra. Due to refractive index matching between sample and surrounding paraffin, minimal signal processing is required to recover spectra with their natural profile as opposed to harsh baseline correction methods, paving the way for future quantitative analysis of biochemical signatures. The quality of the spectral information is demonstrated by building and testing an automated cell-type classifier based upon spectral features.

  2. Nursing of Ultrasound-guided Transretal Prostatic Biopsy%超声引导下经直肠前列腺穿刺活检术的护理

    Institute of Scientific and Technical Information of China (English)

    康杰; 康庆; 雷志蕊; 李琰峰

    2015-01-01

    Objective: To summarize the nursing experience of the ultrasound guided percutaneous biopsy of the prostate in our hospital during the last 2 years. Method:To analyze 58 cases of PSA value of the prostate biopsy of the rectum were elevated in patients with suspected prostate cancer from March 2013-February2015. Results:58 cases of ultrasound guided by transrectal prostate biopsy in patients with targeted nursing, postoperative active prevention and use of Chinese Medicine auxiliary means in the treatment of bleeding, infection, pain etc., reduce complications occurred. Conclusion:Under the guidance of ultrasound, the prostate biopsy is safe and reliable, help improve the diagnosis of prostate cancer, to observe the changes of the disease and to do nursing timely, can prevent complications caused by prostate puncture, reduce the side effect and promote the complications as soon as possible to eliminate the obvious effect and positive significance.%目的:总结近两年来北京中医药大学东直门医院行超声引导下经直肠前列腺穿刺活检术的护理体会。方法:分析2013年3月-2015年2月经直肠前列腺穿刺活检的58例PSA值升高可疑前列腺癌患者。结果:58例超声引导下经直肠前列腺穿刺活检术的患者通过针对性护理,术后积极预防,运用中医辅助手段治疗出血、感染、疼痛等减少并发症的发生。结论:经超声引导下经直肠前列腺穿刺活检术是一种安全可靠,有助于提高前列腺癌的诊断率,术后及时有针对性的观察病情变化做好护理,对前列腺穿刺术引起并发症的预防,减轻副反应及促进并发症尽早消除有明显的效果和积极意义。

  3. MR-sequences for prostate cancer diagnostics: validation based on the PI-RADS scoring system and targeted MR-guided in-bore biopsy

    International Nuclear Information System (INIS)

    This study evaluated the accuracy of MR sequences [T2-, diffusion-weighted, and dynamic contrast-enhanced (T2WI, DWI, and DCE) imaging] at 3T, based on the European Society of Urogenital Radiology (ESUR) scoring system [Prostate Imaging Reporting and Data System (PI-RADS)] using MR-guided in-bore prostate biopsies as reference standard. In 235 consecutive patients [aged 65.7 ± 7.9 years; median prostate-specific antigen (PSA) 8 ng/ml] with multiparametric prostate MRI (mp-MRI), 566 lesions were scored according to PI-RADS. Histology of all lesions was obtained by targeted MR-guided in-bore biopsy. In 200 lesions, biopsy revealed prostate cancer (PCa). The area under the curve (AUC) for cancer detection was 0.70 (T2WI), 0.80 (DWI), and 0.74 (DCE). A combination of T2WI + DWI, T2WI + DCE, and DWI + DCE achieved an AUC of 0.81, 0.78, and 0.79. A summed PI-RADS score of T2WI + DWI + DCE achieved an AUC of 0.81. For higher grade PCa (primary Gleason pattern ≥ 4), the AUC was 0.85 for T2WI + DWI, 0.84 for T2WI + DCE, 0.86 for DWI + DCE, and 0.87 for T2WI + DWI + DCE. The AUC for T2WI + DWI + DCE for transitional-zone PCa was 0.73, and for the peripheral zone 0.88. Regarding higher-grade PCa, AUC for transitional-zone PCa was 0.88, and for peripheral zone 0.96. The combination of T2WI + DWI + DCE achieved the highest test accuracy, especially in patients with higher-grade PCa. The use of ≤2 MR sequences led to lower AUC in higher-grade and peripheral-zone cancers. (orig.)

  4. Prostate MRI: diffusion-weighted imaging at 1.5T correlates better with prostatectomy Gleason grades than TRUS-guided biopsies in peripheral zone tumours

    International Nuclear Information System (INIS)

    To investigate the usefulness of Apparent Diffusion Coefficients (ADC) in predicting prostatectomy Gleason Grades (pGG) and Scores (GS), compared with ultrasound-guided biopsy Gleason Grades (bGG). Twenty-four patients with biopsy-proven prostate cancer were included in the study. Diffusion-weighted images were obtained using 1.5-T MR with a pelvic phased-array coil. Median ADC values (b0,500,1000 s/mm2) were measured at the most suspicious areas in the peripheral zone. The relationship between ADC values and pGG or GS was assessed using Pearson's coefficient. The relationship between bGG and pGG or GS was also evaluated. Receiver operating characteristic (ROC) curve analysis was performed to assess the performance of each method on a qualitative level. A significant negative correlation was found between mean ADCs of suspicious lesions and their pGG (r = -0.55; p 0.05) or GS (r = 0.048; p > 0.05). ROC analysis revealed a discriminatory performance of AUC = 0.82 for ADC and AUC = 0.46 for bGG in discerning low-grade from intermediate/high-grade lesions. The ADC values of suspicious areas in the peripheral zone perform better than bGG in the correlation with prostate cancer aggressiveness, although with considerable intra-subject heterogeneity. circle Prostate cancer aggressiveness is probably underestimated and undersampled by routine ultrasound-guided biopsies. circle Diffusion-weighted MR images show good linear correlation with prostate cancer aggressiveness. circle DWI information may be used to improve risk-assessment in prostate cancer. (orig.)

  5. MR-sequences for prostate cancer diagnostics: validation based on the PI-RADS scoring system and targeted MR-guided in-bore biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Schimmoeller, Lars; Quentin, Michael; Buchbender, Christian; Antoch, Gerald; Blondin, Dirk [University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf (Germany); Arsov, Christian; Hiester, Andreas; Rabenalt, Robert; Albers, Peter [University Dusseldorf, Medical Faculty, Department of Urology, Dusseldorf (Germany)

    2014-10-15

    This study evaluated the accuracy of MR sequences [T2-, diffusion-weighted, and dynamic contrast-enhanced (T2WI, DWI, and DCE) imaging] at 3T, based on the European Society of Urogenital Radiology (ESUR) scoring system [Prostate Imaging Reporting and Data System (PI-RADS)] using MR-guided in-bore prostate biopsies as reference standard. In 235 consecutive patients [aged 65.7 ± 7.9 years; median prostate-specific antigen (PSA) 8 ng/ml] with multiparametric prostate MRI (mp-MRI), 566 lesions were scored according to PI-RADS. Histology of all lesions was obtained by targeted MR-guided in-bore biopsy. In 200 lesions, biopsy revealed prostate cancer (PCa). The area under the curve (AUC) for cancer detection was 0.70 (T2WI), 0.80 (DWI), and 0.74 (DCE). A combination of T2WI + DWI, T2WI + DCE, and DWI + DCE achieved an AUC of 0.81, 0.78, and 0.79. A summed PI-RADS score of T2WI + DWI + DCE achieved an AUC of 0.81. For higher grade PCa (primary Gleason pattern ≥ 4), the AUC was 0.85 for T2WI + DWI, 0.84 for T2WI + DCE, 0.86 for DWI + DCE, and 0.87 for T2WI + DWI + DCE. The AUC for T2WI + DWI + DCE for transitional-zone PCa was 0.73, and for the peripheral zone 0.88. Regarding higher-grade PCa, AUC for transitional-zone PCa was 0.88, and for peripheral zone 0.96. The combination of T2WI + DWI + DCE achieved the highest test accuracy, especially in patients with higher-grade PCa. The use of ≤2 MR sequences led to lower AUC in higher-grade and peripheral-zone cancers. (orig.)

  6. Erectile dysfunction in 1050 men following extended (18 cores) vs saturation (28 cores) vs saturation plus MRI-targeted prostate biopsy (32 cores).

    Science.gov (United States)

    Pepe, P; Pennisi, M

    2016-01-01

    Erectile dysfunction (ED) following transperineal prostate biopsy (TPB) was prospectively evaluated. From January 2011 to January 2014, 1050 patients were submitted to TPB: 18 core (extended TPB) in 610 cases, 28 core (saturation TPB) in 360 cases and 32 core (saturation plus magnetic resonance imaging (MRI) targeted TPB) in 210 cases. The indications for biopsy were increasing prostate-specific antigen (PSA) or PSA>10 ng ml(-1). All patients were prospectively evaluated with the 5-item version of the International Index of Erectile Function (IIEF-5) at time zero and at 1, 3 and 6 months from TPB. Prostate cancer was diagnosed in 385/1050 (36.6%) patients; 560 men (350 vs 110 vs 100) having benign histology and normal sexual activity also completed the study. Overall, IEEF-5 score at time zero and at 1, 3 and 6 months did not significantly worsen (P>0.05); in detail, at 1 month from biopsy 15 extended TPB (4.2%) vs 7 saturation TPB (6.4%) vs 7 saturation plus MRI targeted TPB (7%) men referred mild ED that disappeared after 3 months. Irrespective of method (18 vs 28 vs 32 core) TPB did not significantly worsen erectile function at 3-6 months from the procedure. PMID:26289906

  7. Radical Prostatectomy Findings in White Hispanic/Latino Men With NCCN Very Low-risk Prostate Cancer Detected by Template Biopsy

    Science.gov (United States)

    Kryvenko, Oleksandr N.; Lyapichev, Kirill; Chinea, Felix M.; Prakash, Nachiketh Soodana; Pollack, Alan; Gonzalgo, Mark L.; Punnen, Sanoj; Jorda, Merce

    2016-01-01

    Radical prostatectomy (RP) outcomes have been studied in White and Black non-Hispanic men qualifying for Epstein active surveillance criteria (EASC). Herein, we first analyzed such outcomes in White Hispanic men. We studied 70 men with nonpalpable Gleason score 3+3 = 6 (Grade Group [GG] 1) prostate cancer (PCa) with ≤2 positive cores on biopsy who underwent RP. In 18 men, prostate-specific antigen (PSA) density (PSAD) was >0.15 ng/mL/g. Three of these had insignificant and 15 had significant PCa. The remaining 52 men qualified for EASC. One patient had no PCa identified at RP. Nineteen (37%) had significant PCa defined by volume (n = 7), grade (n = 7), and volume and grade (n = 5). Nine cases were 3+4 = 7 (GG 2) (5/9 [56%] with pattern 4 0.5 cm3. Significant PCa is either a larger-volume anterior disease that may be detected by multi-parametric magnetic resonance imaging-targeted biopsy or anterior sampling of the prostate or higher-grade smaller-volume posterior disease that in most cases should not pose immediate harm and may be detected by repeat template biopsies. PMID:27158756

  8. The role of targeted prophylactic antimicrobial therapy before transrectal ultrasonography-guided prostate biopsy in reducing infection rates: a systematic review.

    Science.gov (United States)

    Cussans, Amelia; Somani, Bhaskar K; Basarab, Adriana; Dudderidge, Timothy J

    2016-05-01

    To compare the incidence of infective complications after transrectal ultrasonography (TRUS)-guided biopsy with either empirical fluoroquinolone or culture-based targeted antimicrobial prophylaxis, and the prevalence of fluoroquinolone resistance (FQ-R) in men undergoing prostate biopsy. A systematic review of the literature was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We included studies of patients undergoing TRUS-guided biopsy that compared infective outcomes of those who received targeted antimicrobial therapy based on the results of pre-procedural rectal swab cultures, with those receiving empiric fluoroquinolone antimicrobial prophylaxis. The prevalence of FQ-R was recorded as a secondary outcome measure. Studies with no control group were excluded. From 125 studies screened, nine studies (4 571 patients) met the inclusion criteria. All studies were of cohort design, and included a combination of retrospective and prospective data. Six studies included were undertaken in North America. The remaining studies were undertaken in Spain, Turkey and Columbia. Within these studies, 2 484 (54.3%) patients received empirical fluoroquinolone prophylaxis, whilst 2 087 (45.7%) patients had pre-biopsy rectal swabs and targeted antibiotics. The mean FQ-R was 22.8%. Post-biopsy infection and sepsis rates were significantly higher in groups given empirical prophylaxis (4.55% and 2.21%) compared with groups receiving targeted antibiotics (0.72% and 0.48%). Based on these results 27 men would need to receive targeted antibiotics to prevent one infective complication. Our systematic review suggests that targeted prophylactic antimicrobial therapy before TRUS-guided prostate biopsy is associated with lower rates of sepsis. We therefore recommend changing current pathways to adopt this measure. PMID:26709240

  9. IgG4-related prostatitis progressed from localized IgG4-related lymphadenopathy

    OpenAIRE

    Li, Dujuan; Kan, Yunzhen; Fu, Fangfang; Wang, Shuhuan; Shi, Ligang; Liu, Jie; Kong, Lingfei

    2015-01-01

    Immunoglobulin G4-related disease (IgG4-RD) is a recently described inflammatory disease involving multiple organs. Prostate involvement with IgG4-RD is very rare. In this report, we describe a case of IgG4-related prostatitis progressed from localized IgG4-related lymphadenopathy. This patient was present with urine retention symptoms. MRI and CT examination revealed the prostatic enlargement and the multiple lymphadenopathy. Serum IgG4 levels were elevated. Prostatic tissue samples resected...

  10. Optimizing patient selection for dose escalation techniques using the prostate-specific antigen level, biopsy gleason score, and clinical T-stage

    International Nuclear Information System (INIS)

    Purpose: Ideal candidates for 3D dose escalation conformal radiation or external beam + implant therapy are identified on the basis of the prostate-specific antigen (PSA) level, biopsy Gleason score, and the 1992 American Joint Commission Cancer (AJCC) clinical T-stage. Methods and Materials: The pathologic findings of 1742 men with clinical stage T1c,2 prostate cancer managed with a radical prostatectomy (RP) between 1990 and 1998 were subjected to a logistic regression multivariable analysis. The endpoints examined included pathologic organ-confined (OC), specimen-confined (SC), and margin (M) or seminal vesicle (SV) positive disease. SC disease was defined as extracapsular extension (ECE) with a negative surgical margin. The clinical factors tested included PSA level, biopsy Gleason score, and the 1992 AJCC clinical T-stage. PSA failure-free (bNED) survival was calculated according to the method of Kaplan and Meier. Results: Significant negative predictors of pathologic OC-disease or positive predictors of M+ or SV+ disease included a PSA > 10 ng/ml (p + or SV+ disease respectively. Conclusions: Patients most likely to derive a survival benefit from the improved local control possible using dose escalation techniques were those who had both a low risk of having occult micrometastatic disease (+ or SV+) and a reasonable likelihood of remaining disease-free after RP (>50% 5-year bNED). These patients included those having T1c, 2a, PSA > 10-15 ng/ml, and biopsy Gleason ≤6 or T1c, 2a, 2b, PSA ≤ 10 ng/ml, and biopsy Gleason ≤ 7 prostate cancer

  11. Diagnostic usefulness of endorectal magnetic resonance imaging with dynamic contrast-enhancement in patients with localized prostate cancer. Mapping studies with biopsy specimens

    International Nuclear Information System (INIS)

    New diagnostic criteria for dynamic magnetic resonance (MR) imaging in prostate cancer are presented. The diagnostic usefulness of endorectal MR imaging with dynamic contrast-enhancement in localized prostate cancer and the validity of these criteria were evaluated. Eighteen untreated patients who were suspected of localized prostate cancer were included in the study. They received endorectal dynamic MR imaging before systematic sextant needle biopsy. First, a mapping study with the findings of MR images and histopathology of biopsy specimens was performed in eight patients out of 18 to compare the difference in T2-weighted images with the endorectal coil and the body coil in the same individuals. Second, another mapping study was performed in all 18 patients by analyzing the findings of endorectal dynamic MR images. For the diagnosis of prostate cancer in MR imaging, we offered diagnostic criteria from our experience in addition to those in plain T2-weighted images from the literature. The overall diagnostic rates of endorectal dynamic MR imaging were 88.9% in accuracy, 100% in sensitivity, and 81.8% in specificity. In the comparison of the endorectal and body coils in T2-weighted images in eight patients, there was no difference in the diagnostic rates except for one more histopathologic false positive portion in endorectal MR imaging. In the second mapping study in 18 patients, the diagnostic rates were 92.6% in accuracy, 88.9% in sensitivity and 93.3% in specificity. Endorectal dynamic imaging raised the diagnostic sensitivity from 77.8 to 88.9%. The data demonstrated the validity of this diagnostic criteria and the diagnostic usefulness of endorectal dynamic MR imaging in localized prostate cancer. (author)

  12. Detecting Prostate Cancer

    Medline Plus

    Full Text Available ... such as a trans-rectal ultrasound and a biopsy. Physician: Now, just relax -- the best thing to ... prostate gland. Usually these are accompanied by a biopsy -- a sampling of the prostate tissue with a ...

  13. The PCA3 test for guiding repeat biopsy of prostate cancer and its cut-off score: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Yong Luo

    2014-06-01

    Full Text Available The specificity of prostate-specific antigen (PSA for early intervention in repeat biopsy is unsatisfactory. Prostate cancer antigen 3 (PCA3 may be more accurate in outcome prediction than other methods for the early detection of prostate cancer (PCa. However, the results were inconsistent in repeated biopsies. Therefore, we performed a systematic review and meta-analysis to evaluate the role of PCA3 in outcome prediction. A systematic bibliographic search was conducted for articles published before April 2013, using PubMed, Medline, Web of Science, Embase and other databases from health technology assessment agencies. The quality of the studies was assessed on the basis of QUADAS criteria. Eleven studies of diagnostic tests with moderate to high quality were selected. A meta-analysis was carried out to synthesize the results. The results of the meta-analyses were heterogeneous among studies. We performed a subgroup analysis (with or without inclusion of high-grade prostatic intraepithelial neoplasia (HGPIN and atypical small acinar proliferation (ASAP. Using a PCA3 cutoff of 20 or 35, in the two sub-groups, the global sensitivity values were 0.93 or 0.80 and 0.79 or 0.75, specificities were 0.65 or 0.44 and 0.78 or 0.70, positive likelihood ratios were 1.86 or 1.58 and 2.49 or 1.78, negative likelihood ratios were 0.81 or 0.43 and 0.91 or 0.82 and diagnostic odd ratios (ORs were 5.73 or 3.45 and 7.13 or 4.11, respectively. The areas under the curve (AUCs of the summary receiver operating characteristic curve were 0.85 or 0.72 and 0.81 or 0.69, respectively. PCA3 can be used for repeat biopsy of the prostate to improve accuracy of PCa detection. Unnecessary biopsies can be avoided by using a PCa cutoff score of 20.

  14. [Analgesic effect of oral tramadol on transrectal ultrasound-guided needle biopsy of the prostate in a randomized double-blind study].

    Science.gov (United States)

    Nomi, Hayahito; Azuma, Haruhito; Segawa, Naoki; Inamoto, Teruo; Takahara, Kiyoshi; Komura, Kazumasa; Koyama, Kohei; Ubai, Takanobu; Katsuoka, Yoji

    2011-08-01

    A total of 121 Japanese patients scheduled for prostate biopsy were randomly and double-blindly assigned to be given a single oral dose of 100 mg Tramadol mixed with 20 ml of sugar syrup or placebo, 30 minutes before the procedure. Pain severity was measured by verbal rating scale (VRS) and visual analog scales (VAS). We also analyzed cardio-respiratory parameters and complications. Of 121 patients, 117 replied validly to VRS and VAS ; and 91 of 117 patients replied to the cohort questionnaire for analysis of the late disorder, patient's impression, prolonged pain and past history of hemorrhoid treatment. Tramadol showed no significant effect on pain severity indicated by VRS and VAS, and no change in cardiorespiratory parameters. Furthermore, 70 patients without a history of hemorrhoid treatment, showed no significant analgesic benefits of Tramadol during the biopsy. In total, 3 patients had side effects of vomiting (CTCAE : grade 1)6), which subsided spontaneously. The oral administration of a single dose of 100 mg Tramadol 30 minutes before a transrectal needle biopsy of the prostate was safe, but was not effective to calm down the pain severity. PMID:21894078

  15. Detection of prostate cancer by real-time MR/ultrasound fusion-guided biopsy. 3T MRI and state of the art sonography; Detektion des Prostatakarzinoms durch Echtzeit-MRT/US-Fusionsbiopsie. 3T MRT und moderne Ultraschalltechnik

    Energy Technology Data Exchange (ETDEWEB)

    Durmus, T.; Grigoryev, M.; Diederichs, G.; Saleh, M.; Fischer, T. [Universitaetsmedizin Berlin, Charite Campus Mitte (Germany). Inst. fuer Radiologie; Stephan, C.; Maxeiner, A. [Universitaetsmedizin Berlin, Charite Campus Mitte (Germany). Klinik und Poliklinik fuer Urologie; Slowinski, T. [Universitaetsmedizin Berlin, Charite Campus Mitte (Germany). Klinik fuer Nephrologie; Thomas, A. [Universitaetsmedizin Berlin, Charite Campus Mitte (Germany). Ultraschall-Forschungslabor

    2013-05-15

    Purpose: Multiparametric MRI of the prostate is a noninvasive diagnostic method with high sensitivity and specificity for prostate cancer. The aim of this study is to evaluate whether prostate cancer detection rates of transrectal ultrasound (TRUS)-guided biopsy may be improved by an image fusion of state-of-the-art ultrasound (CEUS, elastography) and MR (T2w, DWI) imaging. Materials and Methods: 32 consecutive patients with a history of elevated PSA levels and at least one negative TRUS-guided biopsy with clinical indication for a systematic re-biopsy underwent multiparametric 3 T MRI without endorectal coil. MR data (T2w) were uploaded to a modern sonography system and image fusion was performed in real-time mode during biopsy. B-mode, Doppler, elastography and CEUS imaging were applied to characterize suspicious lesions detected by MRI. Targeted biopsies were performed in MR/US fusion mode followed by a systematic standard TRUS-guided biopsy. Detection rates for both methods were calculated and compared using the Chi{sup 2}-test. Results: Patient age was not significantly different in patients with and without histologically confirmed prostate cancer (65.2 {+-} 8.0 and 64.1 {+-} 7.3 age [p = 0.93]). The PSA value was significantly higher in patients with prostate cancer (15.5 {+-} 9.3 ng/ml) compared to patients without cancer (PSA 10.4 {+-} 9.6 ng/ml; p = 0.02). The proportion of histologically confirmed cancers in the study group (n = 32) of the MR/US fusion biopsy (11/12; 34.4 %) was significantly higher (p = 0.01) in comparison to the TRUS systematic biopsy (6/12; 18.8 %). Conclusion: Real-time MR/US image fusion may enhance cancer detection rates of TRUS-guided biopsies and should therefore be studied in further larger studies. (orig.)

  16. Diagnostic Accuracy of Mucosal Biopsy versus Endoscopic Mucosal Resection in Barrett's Esophagus and Related Superficial Lesions.

    Science.gov (United States)

    Elsadek, Hany M; Radwan, Mamdouh M

    2015-01-01

    Background. Endoscopic surveillance for early detection of dysplastic or neoplastic changes in patients with Barrett's esophagus (BE) depends usually on biopsy. The diagnostic and therapeutic role of endoscopic mucosal resection (EMR) in BE is rapidly growing. Objective. The aim of this study was to check the accuracy of biopsy for precise histopathologic diagnosis of dysplasia and neoplasia, compared to EMR in patients having BE and related superficial esophageal lesions. Methods. A total of 48 patients with previously diagnosed BE (36 men, 12 women, mean age 49.75 ± 13.3 years) underwent routine surveillance endoscopic examination. Biopsies were taken from superficial lesions, if present, and otherwise from BE segments. Then, EMR was performed within three weeks. Results. Biopsy based histopathologic diagnoses were nondysplastic BE (NDBE), 22 cases; low-grade dysplasia (LGD), 14 cases; high-grade dysplasia (HGD), 8 cases; intramucosal carcinoma (IMC), two cases; and invasive adenocarcinoma (IAC), two cases. EMR based diagnosis differed from biopsy based diagnosis (either upgrading or downgrading) in 20 cases (41.67%), (Kappa = 0.43, 95% CI: 0.170-0.69). Conclusions. Biopsy is not a satisfactory method for accurate diagnosis of dysplastic or neoplastic changes in BE patients with or without suspicious superficial lesions. EMR should therefore be the preferred diagnostic method in such patients. PMID:27347544

  17. Prognostic Importance of Gleason 7 Disease Among Patients Treated With External Beam Radiation Therapy for Prostate Cancer: Results of a Detailed Biopsy Core Analysis

    International Nuclear Information System (INIS)

    Purpose: To analyze the effect of primary Gleason (pG) grade among a large cohort of Gleason 7 prostate cancer patients treated with external beam radiation therapy (EBRT). Methods and Materials: From May 1989 to January 2011, 1190 Gleason 7 patients with localized prostate cancer were treated with EBRT at a single institution. Of these patients, 613 had a Gleason 7 with a minimum of a sextant biopsy with nonfragmented cores and full biopsy core details available, including number of cores of cancer involved, percentage individual core involvement, location of disease, bilaterality, and presence of perineural invasion. Median follow-up was 6 years (range, 1-16 years). The prognostic implication for the following outcomes was analyzed: biochemical recurrence-free survival (bRFS), distant metastasis-free survival (DMFS), and prostate cancer-specific mortality (PCSM). Results: The 8-year bRFS rate for pG3 versus pG4 was 77.6% versus 61.3% (P<.0001), DMFS was 96.8% versus 84.3% (P<.0001), and PCSM was 3.7% versus 8.1% (P=.002). On multivariate analysis, pG4 predicted for significantly worse outcome in all parameters. Location of disease (apex, base, mid-gland), perineural involvement, maximum individual core involvement, and the number of Gleason 3+3, 3+4, or 4+3 cores did not predict for distant metastases. Conclusions: Primary Gleason grade 4 independently predicts for worse bRFS, DMFS, and PCSM among Gleason 7 patients. Using complete core information can allow clinicians to utilize pG grade as a prognostic factor, despite not having the full pathologic details from a prostatectomy specimen. Future staging and risk grouping should investigate the incorporation of primary Gleason grade when complete biopsy core information is used

  18. Prognostic Importance of Gleason 7 Disease Among Patients Treated With External Beam Radiation Therapy for Prostate Cancer: Results of a Detailed Biopsy Core Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Spratt, Daniel E.; Zumsteg, Zach; Ghadjar, Pirus; Pangasa, Misha; Pei, Xin [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Fine, Samson W. [Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Yamada, Yoshiya; Kollmeier, Marisa [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Zelefsky, Michael J., E-mail: zelefskm@mskcc.org [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)

    2013-04-01

    Purpose: To analyze the effect of primary Gleason (pG) grade among a large cohort of Gleason 7 prostate cancer patients treated with external beam radiation therapy (EBRT). Methods and Materials: From May 1989 to January 2011, 1190 Gleason 7 patients with localized prostate cancer were treated with EBRT at a single institution. Of these patients, 613 had a Gleason 7 with a minimum of a sextant biopsy with nonfragmented cores and full biopsy core details available, including number of cores of cancer involved, percentage individual core involvement, location of disease, bilaterality, and presence of perineural invasion. Median follow-up was 6 years (range, 1-16 years). The prognostic implication for the following outcomes was analyzed: biochemical recurrence-free survival (bRFS), distant metastasis-free survival (DMFS), and prostate cancer-specific mortality (PCSM). Results: The 8-year bRFS rate for pG3 versus pG4 was 77.6% versus 61.3% (P<.0001), DMFS was 96.8% versus 84.3% (P<.0001), and PCSM was 3.7% versus 8.1% (P=.002). On multivariate analysis, pG4 predicted for significantly worse outcome in all parameters. Location of disease (apex, base, mid-gland), perineural involvement, maximum individual core involvement, and the number of Gleason 3+3, 3+4, or 4+3 cores did not predict for distant metastases. Conclusions: Primary Gleason grade 4 independently predicts for worse bRFS, DMFS, and PCSM among Gleason 7 patients. Using complete core information can allow clinicians to utilize pG grade as a prognostic factor, despite not having the full pathologic details from a prostatectomy specimen. Future staging and risk grouping should investigate the incorporation of primary Gleason grade when complete biopsy core information is used.

  19. Dose Escalation to the Dominant Intraprostatic Lesion Defined by Sextant Biopsy in a Permanent Prostate I-125 Implant: A Prospective Comparative Toxicity Analysis

    International Nuclear Information System (INIS)

    Purpose: Using real-time intraoperative inverse-planned permanent seed prostate implant (RTIOP/PSI), multiple core biopsy maps, and three-dimensional ultrasound guidance, we planned a boost volume (BV) within the prostate to which hyperdosage was delivered selectively. The aim of this study was to investigate the potential negative effects of such a procedure. Methods and Materials: Patients treated with RTIOP/PSI for localized prostate cancer with topographic biopsy results received an intraprostatic boost (boost group [BG]). They were compared with patients treated with a standard plan (reference group [RG]). Plans were generated using a simulated annealing inverse planning algorithm. Prospectively recorded urinary, rectal, and sexual toxicities and dosimetric parameters were compared between groups. Results: The study included 120 patients treated with boost technique who were compared with 70 patients treated with a standard plan. Boost technique did not significantly change the number of seeds (55.1/RG vs. 53.6/BG). The intraoperative prostate V150 was slightly higher in BG (75.2/RG vs. 77.2/BG, p = 0.039). Urethra V100, urethra D90, and rectal D50 were significantly lower in the BG. No significant differences were seen in acute or late urinary, rectal, or sexual toxicities. Conclusions: Because there were no differences between the groups in acute and late toxicities, we believe that BV can be planned and delivered to the dominant intraprostatic lesion without increasing toxicity. It is too soon to say whether a boost technique will ultimately increase local control.

  20. Impact of Fecal Carriage of Extended-Spectrum Beta-Lactamase Producing Enterobacteriaceae on the Outcomes of Transrectal Needle Biopsies of the Prostate.

    OpenAIRE

    Ergönül, Önder; Tükenmez-Tigen, Elif; Altinkanat, Gülşen; Özgen, Mahir Bülent; Ertük Şengel, Buket; Odabaşi, Zekaver; Türkerí, Levent N.; Mülazimo?lu, Lütfye; Korten, Volkan

    2013-01-01

    Objective: This study aimed to address the prevalence, the risk factors and the results of fecal carriage of extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-PE) in patients who had undergone transrectal needle biopsy of the prostate (TRNBP). Patients and Methods: A total of 143 patients who had undergone TRNBP were included. Of these, 33(23%) had fecal carriage of ESBL-PE. The mean age of the patients was 62 ± 7.5 (43-81) years. Results: A univariate analysis showed that q...

  1. Morbidade da biópsia da próstata transretal guiada por ultrassonografia Morbidity of transrectal ultrasound guided prostate biopsy

    Directory of Open Access Journals (Sweden)

    Raphael Sandes Solha

    2013-04-01

    Full Text Available OBJETIVO: Avaliar a incidência de complicações pós-procedimento nos pacientes submetidos a biópsia prostática transretal guiada por ultrassom no setor de intervenção do Departamento de Diagnóstico por Imagem da Escola Paulista de Medicina - Universidade Federal de São Paulo. MATERIAIS E MÉTODOS: Foram avaliados, via contato telefônico, 132 pacientes submetidos a biópsia de próstata transretal guiada por ultrassom no período de abril/2011 a junho/2011, seguindo o protocolo padrão do nosso setor. RESULTADOS: As complicações pós-biópsia foram categorizadas em maiores e menores de acordo com a necessidade de avaliação médica adicional. Cinquenta e nove pacientes (61,8% apresentaram complicações, e desses, grande parte (86,4% apresentou sintomas leves e autolimitados, considerados menores. Oito pacientes (8,2% apresentaram complicações maiores, sendo que apenas um deles necessitou de tratamento sob regime de internação hospitalar. A retenção urinária foi a complicação maior mais incidente no nosso estudo. CONCLUSÃO: Corroborando outros estudos da literatura, nosso trabalho demonstrou baixa prevalência de complicações maiores após a biópsia prostática transretal.OBJECTIVE: To evaluate the incidence of postprocedural complications in patients submitted to transrectal ultrasound-guided prostate biopsy at the Unit of Intervention, Department of Imaging Diagnosis of Escola Paulista de Medicina - Universidade Federal de São Paulo. MATERIALS AND METHODS: Telephone interviews were conducted with 132 patients who had undergone transrectal ultrasound-guided prostate biopsy in the period from April 2011 to June 2011, according to the institution's protocol. RESULTS: Post-biopsy complications were categorized into two groups - minor and major complications, according to their need for further clinical evaluation. Complications were reported by 59 patients (61.8%, most of them (86.4% with mild and self-limited symptoms

  2. A comparative study of transrectal contrast-enhanced ultrasound assisted prostate biopsy and system-ic prostate biopsy%经直肠超声造影辅助前列腺穿刺活检与前列腺系统穿刺活检的比较研究

    Institute of Scientific and Technical Information of China (English)

    张帆; 汪维; 张士伟; 连惠波; 黄海锋; 郭宏骞

    2014-01-01

    目的:比较经直肠超声造影辅助前列腺穿刺活检和前列腺系统穿刺活检的穿刺效率。方法2010年1月至2011年12月采用简单随机抽样方法选择213例可疑前列腺癌患者,在经直肠超声造影辅助下,针对造影异常区域行前列腺穿刺活检(造影穿刺组),年龄54~83岁,平均(71.0±8.9)岁。 PSA 4.1~150.0μg/L,平均(22.5±19.4)μg/L。直肠指检触及结节或质地不均者119例(55.9%),经直肠超声检查发现异常结节或回声不均质者80例(37.6%)。相同随机方法选择同期218例可疑前列腺癌患者行前列腺系统穿刺活检(系统穿刺组),年龄36~94岁,平均(65.0±9.1)岁。 PSA 4.6~147.0μg/L,平均(23.3±18.9)μg/L,经直肠超声检查发现异常结节或回声不均质者125例(57.3%),经直肠超声检查发现异常结节或回声不均质者83例(38.1%)。两组的PSA、前列腺体积、直肠指检阳性率及经直肠超声检查阳性率比较差异均无统计学意义( P>0.05)。比较两组的穿刺针数、单针阳性率、Gleason评分等。结果造影穿刺组与系统穿刺组比较,前列腺癌阳性率分别为38.0%(81/213)和34.9%(76/218),差异无统计学意义(P>0.05);人均穿刺针数分别为9.5针和12.0针,差异有统计学意义(P<0.05);单针阳性率分别为18.2%(369/2025)和11.5%(301/2616),差异有统计学意义( P<0.05);Gleason评分分别为7.1分和6.6分,差异有统计学意义( P<0.05)。%Objective To evaluate the advantages of transrectal contrast-enhanced ultrasound assis-ted prostate biopsy by comparing with systemic prostate biopsy . Methods From Jan.2010 to Dec.2011, 213 cases were selected randomly.Patient's mean age was 71.0±8.9 (54-83) years.Their PSA level was 22.5±19.4 (4.1-150.0) μg/L.The positive rates of DRE and

  3. Cribriform morphology predicts upstaging after radical prostatectomy in patients with Gleason score 3 + 4 = 7 prostate cancer at transrectal ultrasound (TRUS)-guided needle biopsy.

    Science.gov (United States)

    Keefe, Daniel T; Schieda, Nicola; El Hallani, Soufiane; Breau, Rodney H; Morash, Chris; Robertson, Susan J; Mai, Kien T; Belanger, Eric C; Flood, Trevor A

    2015-10-01

    Selected patients with transrectal ultrasound (TRUS)-guided biopsies containing Gleason score 3 + 4 = 7 prostate cancer (PCa) may be considered candidates for active surveillance (AS). The purpose of this study was to determine if there are features that predict PCa upstaging and/or upgrading after radical prostatectomy (RP) in patients with Gleason score 3 + 4 = 7 PCa diagnosed on TRUS-guided biopsies. We searched our institution's database for patients with Gleason score 3 + 4 = 7 PCa diagnosed on TRUS-guided biopsy who underwent subsequent RP between January 2010 and January 2015. Two blinded genitourinary pathologists independently reviewed and assessed the following on biopsies: (a) nuclear size, nucleolar size and distribution of macronucleoli of PCa, which were subjectively graded using a semi-quantitative scale from 1 to 3, and (b) PCa with cribriform morphology and the size of cribriform disease. Patient age, serum prostate-specific antigen (PSA) and PSA density (PSAD) were also recorded. The Gleason score and stage (presence or absence of organ-confined disease (OCD)) were retrieved from RP reports. Comparisons were performed between groups using the chi-square test and Spearman correlation. One hundred and four patients were identified to have met inclusion criteria. The mean age was 63 (±6.1) years. Mean PSA and PSAD at diagnosis were 7.5 (±4.2) and 0.25 (±0.15) ng/mL, respectively. Gleason scores were upgraded to greater than 3 + 4 = 7 in 26.9 % (28/104) of patients, and 44.2 % (46/104) of patients had no OCD after RP. There was no correlation between age, PSA, PSAD or percent of biopsies with Gleason pattern 4 for either Gleason score upgrading or absence of OCD at the time of RP (p > 0.05). Thirty patients had cribriform morphology on TRUS-guided biopsy of which 60 % (18/30) had no OCD at RP (p = 0.04) while 36.7 % (11/30) were upgraded to Gleason score ≥3 + 4 = 7 after RP (p = 0.15). There

  4. A hypothesis to relate salivary tumors with mammary and prostate neoplasias

    OpenAIRE

    Actis, Adriana B

    2005-01-01

    Salivary, mammary and prostate glands are sex hormone-dependent organs sharing common aspects in structure, hormonal responsiveness and tumor histopathology. Salivary tumors (especially the malignant types) are not as frequent as mammary and prostate neoplasias. Hence, prognosis of some salivary tumors is not always efficient. Here, we review the oncology of salivary gland and its putative relation to breast/prostate tumors.

  5. [Erectile disfunction and benign prostatic hyperplasia - causal relation or coincidence?].

    Science.gov (United States)

    Gasser, Thomas

    2010-03-01

    There is increasing evidence of causal relation between benign prostatic hyperplasia (BPH) and erectile dysfunction (ED). BPH appears to have a negative impact on sexual function. Drugs commonly used for the treatment of BPH (i.e. alphablockers, 5-alpha reductase inhibitors) may cause retrograde ejaculation, ED and reduced libido. Physicians should be aware of these adverse events and inform their patients accordingly. Conversely, phosphodiestease-5-inhibitors may have a beneficial effect on BPH symptoms. PMID:20235043

  6. Comparisons of the incidence and pathological characteristics of prostate cancer between Chinese and Portuguese in Macau

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Background Aging of population in Macau has become a serious problem and we are diagnosing more and more Patients with prostate cancer.To investigate the effect of ethnicity and environment on incidence of prostate carcinoma,We compared the difference of biopsy and postoperative pathology of prostate between indigenous Chinese(Chinese)and Chinese of Portuguese descent(Portuguese)with elevated serologic prostate specific antigen(PSA)and incidence of prostate carcinoma in Macau.Methods Between 1999 and 2006,prostate biopsy was performed in a random sample of 462 patients with elevated serologic PSA who,on followup,were diagnosed in this hospital with benign prostate hyperplasia.Of these,416 were indigenous Chinese,46 Portuguese.Based on demographic statistics by Macau government for 2005,we compared differences in incidences of prostate carcinoma,positive rate of random prostate biopsy in patients with elevated serologic PSA,factors related to serological PSA and pathological grade and stage between both ethnic groups.Results Prostate carcinoma was diagnosed on biopsy in 178 cases.Positive biopsies of prostate carcinoma were Present in 160 Chinese with positive rate of 38.5% and in 18 Portuguese with 39.1%.For patients diagnosed with prostate carcinoma,there was no significant difference in age,incidence,grade of cancerous cells,stage of the disease,incidence of inflammation of prostatic tissues or prostatic intraepithelial neoplasia(PIN)related to elevated PSA between the groups(All P>0.05).Conclusions There was no significant difference in incidence or characteristics of prostate carcinoma between people of Portuguese and Chinese descent in Macau based on our limited data.Long term residence in the same environment may be associated with the incidence and progression of prostate carcinoma in Portuguese living in Macau,but further rigorous epidemiological investigation and analysis of risk factors about prostate carcinoma are needed to corroborate this conclusion.

  7. Salvage HIFU for biopsy confirmed local prostate cancer recurrence after radical prostatectomy and radiation therapy: Case report and literature review.

    Science.gov (United States)

    Rittberg, Rebekah; Kroczak, Tadeusz; Fleshner, Neil; Drachenberg, Darrel

    2015-01-01

    High-intensity focused ultrasound (HIFU) is a treatment option for low- and intermediate-risk prostate cancer and more recently has been used as salvage therapy after failed radiation therapy. We present a case of local recurrence with biochemical failure after radical prostatectomy and salvage external beam radiation therapy with salvage HIFU without biochemical recurrence at 20 months. PMID:26425239

  8. Salvage HIFU for biopsy confirmed local prostate cancer recurrence after radical prostatectomy and radiation therapy: Case report and literature review

    OpenAIRE

    Rittberg, Rebekah; Kroczak, Tadeusz; Fleshner, Neil; Drachenberg, Darrel

    2015-01-01

    High-intensity focused ultrasound (HIFU) is a treatment option for low- and intermediate-risk prostate cancer and more recently has been used as salvage therapy after failed radiation therapy. We present a case of local recurrence with biochemical failure after radical prostatectomy and salvage external beam radiation therapy with salvage HIFU without biochemical recurrence at 20 months.

  9. Prospective validation of a risk calculator which calculates the probability of a positive prostate biopsy in a contemporary clinical cohort

    NARCIS (Netherlands)

    van Vugt, Heidi A.; Kranse, Ries; Steyerberg, Ewout W.; van der Poel, Henk G.; Busstra, Martijn; Kil, Paul; Oomens, Eric H.; de Jong, Igle J.; Bangma, Chris H.; Roobol, Monique J.

    2012-01-01

    Background: Prediction models need validation to assess their value outside the development setting. Objective: To assess the external validity of the European Randomised study of Screening for Prostate Cancer (ERSPC) Risk Calculator (RC) in a contemporary clinical cohort. Methods: The RC calculates

  10. Predictive power of the ESUR scoring system for prostate cancer diagnosis verified with targeted MR-guided in-bore biopsy

    International Nuclear Information System (INIS)

    Highlights: • The PI-RADS summed score (PSsum) demonstrated very good diagnostic values, especially for higher grade PCa. • Lesions with PSsum ≥13 represented prostate cancer in 88% and higher grade prostate cancer in 42%. • Sensitivity and NPV was nearly 100% for higher grade PCa detection using a cut-off limit of PSsum 10. • Peripheral zone lesions demonstrated better diagnostic value with the PSsum compared to transitional zone lesions. • Further improvement of the PI-RADS score is required to prevent unnecessary overdiagnosis. - Abstract: Purpose: This study evaluates the diagnostic value of the ESUR scoring system (PI-RADS) regarding prostate cancer detection using MR-guided in-bore biopsies (IB-GB) as the reference standard. Methods: 566 lesions in 235 consecutive patients (65.7 ± 7.9 years, PSA 9.9 ± 8.5 ng/ml) with a multiparametric (mp)-MRI (T2WI, DWI, DCE) of the prostate at 3 T were scored using the PI-RADS scoring system. PI-RADS single (PSsingle), summed (PSsum), and overall (PSoverall) scores were determined. All lesions were histologically verified by IB-GB. Results: Lesions with a PSsum below 9 contained no prostate cancer (PCa) with Gleason score (GS) ≥ 4 + 3 = 7. A PSsum of 13–15 (PSoverall V) resulted in 87.8% (n = 108) in PCa and in 42.3% (n = 52) in GS ≥ 4 + 3 = 7. Transition zone (TZ) lesions with a PSsum of 13–15 (PSoverall V) resulted in 76.3% (n = 36) in PCa and in 26.3% (n = 10) in GS ≥ 4 + 3 = 7, whereas for peripheral zone (PZ) lesions cancer detection rate at this score was 92.9% (n = 79) and 49.4% (n = 42) for GS ≥ 4 + 3 = 7. Using a threshold of PSsum ≥ 10, sensitivity was 86.0%, and negative predictive value (NPV) was 86.2%. For higher grade PCa sensitivity was 98.6%, and NPV was 99.5%. Conclusion: A PSsum below 9 excluded a higher grade PCa, whereas lesions with a PSsum ≥ 13 (PSoverall V) represented in 88% PCa, and in 42% higher grade PCa. The PSsum or PSoverall demonstrated a better diagnostic value

  11. 初步建立中国人前列腺癌预测的数学模型%Development of a Nomogram for Predicting Positive Initial Prostate Biopsy Among Chinese Patients

    Institute of Scientific and Technical Information of China (English)

    李秋洋; 唐杰; 李岩密; 费翔; 张艳; 何恩辉

    2011-01-01

    目的 建立中国人前列腺癌预测模型.方法 对556例疑似前列腺癌患者行前列腺穿刺活检,收集建立模型的变量:患者年龄、前列腺体积、前列腺特异性抗原(PSA)、游离PSA(f-PSA)/总PSA(t-PSA).将变量通过逐步回归建立回归方程,在此基础上建立穿刺活检阳性的危险评分数学模型,并通过受试者工作曲线下面积来评估该模型的预测价值.结果 556例患者中,205例(36.87%)经前列腺穿刺活检证实为前列腺癌.单因素分析结果显示,患者的年龄、前列腺体积、血清PSA、f-PSA/t-PSA均为建立数学模型的影响因素.对受试者工作曲线的分析结果显示,所建模型的曲线下面积为0.8767,大于患者年龄、前列腺体积、PSA、f-PSA/t-PSA等单因素的0.6397、0.7255、0.7111、0.6973.结论 初步建立具有较高预测价值的前列腺癌预测模型.%Objective To develop a predictive nomogram for predicting the prostate carcinoma among Chinese population. Methods Totally 356 Chinese male patients who had undergone an initial prostate biopsy in our hospital from July 2004 to February 2009 were enrolled in this study. Variables including age, volume, prostate specific antigen (PSA) level, and free PSA ( f-PSA) /total PSA (t-PSA) were collected. Logistic regression analysis was performed to estimate the relative risk. Regression equation was established for variables via stepwise regression, via which a nomogram for assessing the positive biopsy results was established, and then the predictive value of this nomogram was evaluated using receiver area under curve ( ROC) analysis. Results Of these 556 patients, cancer was detected in 205 patients (36. 87% ) via biopsies. Univariate analysis showed that age, prostate volume, PSA levels, and f-PSA/t-PSA were the influencing factors of the nomogram. The risk model performed well in an independent sample, with an AUCROC of 0. 8767, which was significantly larger than that of the prediction

  12. Transrectal prostate biopsy:a review of 16 years experience in single center%经直肠前列腺活检的单中心16年回顾

    Institute of Scientific and Technical Information of China (English)

    潘永昇; 王增军; 华立新; 成功; 汪骏; 李潇; 张成; 吴杰; 郑雨潇; 黄源; 秦超

    2016-01-01

    Objective To assess the improvement of prostate cancer detection rate ( PCDR) with the advance of prostate biopsy technologies and analyse the changing epidemiology of patients with positive prostate biopsy, especially the PCDR and classficaton of risk.Methods From March 1999 to March 2015, a total of 3 762 patients were recruited to the department of urology, the first affiliated hospital of Nanjing medical university.All patients underwent a systematic 6-, 8-or 13-core biopsy, guided by finger or TRUS. The PCDR of different prostate specific antigen ( PSA) interval was analyzed.The PCDR of 6-or 8-core biopsy guided by finger and 13-core biopsy guided by TRUS were compared.The trends of PSA level, age and Gleason score in the patients with positive biopsy were summarized.Results A total of 3 762 patients underwent prostate biopsies and PCa were detected in 1479 patients (39.3%).Finger-guided 6-core biopsy was performed on 1 106 patients, and PCa were detected in 343 cases ( 31.0%) .Finger-guided 8-core biopsy was performed on 398 patients, and PCa were diagnosed in 144 cases (36.2%).Since 2009, 2 258 patients underwent TRUS-guided 13-core biopsy, and 992 ( 43.9%) were diagnosed as PCa, higher than that of finger-guided biopsies ( 43.9% vs.32.4%, P4 ng/ml) were lower than that of positive in digital rectal examination.The PCDR of 6 needles biopsy was higher in prostate peripheral zone than that of prostate medial zone (37.5% vs.31.4%, P<0.001) and further analysis indicated that the PCDR of extra 13th biopsy of the area with abnormal TRUS or MRI findings was higher than the mean positive rate of the other 12 biopsies.Regarding adverse effects, 34.9%(1312/3762) reported slight gross hematuria or microscopic haematuria, 56 ( 1.5%) developed gross hematuria, 72 (1.9%) occurred rectal bleeding, 63(1.7%) needed short-term hospitalization due to fever, one patient suffered hepatorenal function failure and one patient died after biopsy.Since 1999, the PSDR rise gradually

  13. MRI-TRUS融合导航成像引导前列腺癌穿刺活检的临床应用%A fusion system of transrectal ultrasound with magnetic resonance imaging in guidance of prostate cancer biopsy

    Institute of Scientific and Technical Information of China (English)

    孙彦(综述); 崔立刚(审校)

    2016-01-01

    Transrectal ultrasound (TRUS) in the guidance of prostate cancer biopsy is the deifnite method, however, some limitations still exist, such as high number of biopsy cores, low sensitivity and so on. Many researchers continue to ifnd new technical methods to improve the sensitivity and efifciency of prostate cancer diagnosis. This paper reviews and comments the fusion system of transrectal ultrasound with magnetic resonance imaging (MRI) in the guidance of prostate cancer biopsy, including the situation and development of transrectal ultrasound in the guidance of prostate cancer biopsy, the application of the fusion system of transrectal ultrasound with MRI in the guidance of prostate cancer biopsy, the progress on the fusion system and existing problems, so as to objectively and comprehensively evaluate the fusion system.%超声引导下系统性穿刺活检前列腺一直是前列腺癌的确诊方法,由于存在穿刺针数多、灵敏度较低等局限性,人们一直在不断探索新的成像方法来提高超声引导的灵敏度,从而提高诊断效率。本文综述了融合导航成像应用于前列腺癌诊断,包括经直肠超声(transrectal ultrasound,TRUS)引导前列腺穿刺的现状、MRI-TRUS融合导航成像引导前列腺穿刺的应用、目前融合导航成像研究新进展和成果及存在问题,旨在客观全面地评价融合导航成像在前列腺癌穿刺活检中的价值。

  14. Needle Biopsy of the Lung

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Needle Biopsy of the Lung Needle biopsy of the lung ... Needle Biopsy of Lung Nodules? What is Needle Biopsy of the Lung? A lung nodule is relatively ...

  15. Bone Biopsy

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Bone Biopsy Bone biopsy uses a needle and imaging guidance ... limitations of Bone Biopsy? What is a Bone Biopsy? A bone biopsy is an image-guided procedure ...

  16. Multi-transcript profiling in archival diagnostic prostate cancer needle biopsies to evaluate biomarkers in non-surgically treated men

    OpenAIRE

    Kachroo, Naveen; Warren, Anne Y; Gnanapragasam, Vincent J.

    2014-01-01

    Background Most biomarkers in prostate cancer have only been evaluated in surgical cohorts. The value of these biomarkers in a different therapy context remains unclear. Our objective was to test a panel of surgical biomarkers for prognostic value in men treated by external beam radiotherapy (EBRT) and primary androgen deprivation therapy (PADT). Methods The Fluidigm® PCR array was used for multi-transcript profiling of laser microdissected tumours from archival formalin-fixed diagnostic biop...

  17. Prostate cancer

    DEFF Research Database (Denmark)

    Chabanova, Elizaveta; Balslev, Ingegerd; Logager, Vibeke;

    2011-01-01

    To investigate diagnostic accuracy of detection of prostate cancer by magnetic resonance: to evaluate the performance of T2WI, DCEMRI and CSI and to correlate the results with biopsy and radical prostatectomy histopathological data....

  18. Multiparametric 3T MRI for the prediction of pathological downgrading after radical prostatectomy in patients with biopsy-proven Gleason score 3 + 4 prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gondo, Tatsuo [Memorial Sloan-Kettering Cancer Center, Urology Service, Department of Surgery, New York, NY (United States); Tokyo Medical University, Department of Urology, Tokyo (Japan); Hricak, Hedvig; Sala, Evis; Vargas, Hebert Alberto [Memorial Sloan-Kettering Cancer Center, Department of Radiology, New York, NY (United States); Zheng, Junting; Moskowitz, Chaya S. [Memorial Sloan-Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY (United States); Bernstein, Melanie; Eastham, James A. [Memorial Sloan-Kettering Cancer Center, Urology Service, Department of Surgery, New York, NY (United States)

    2014-12-15

    The aim of this study was to assess the diagnostic performance of pre-treatment 3-Tesla (3T) multiparametric magnetic resonance imaging (mpMRI) for predicting Gleason score (GS) downgrading after radical prostatectomy (RP) in patients with GS 3 + 4 prostate cancer (PCa) on biopsy. We retrospectively reviewed 304 patients with biopsy-proven GS 3 + 4 PCa who underwent mpMRI before RP. On T2-weighted imaging and three mpMRI combinations (T2-weighted imaging + diffusion-weighted imaging [DWI], T2-weighted imaging + dynamic contrast-enhanced-MRI [DCE-MRI], and T2-weighted imaging + DWI + DCE-MRI), two radiologists (R1/R2) scored the presence of a dominant tumour using a 5-point Likert scale (1 = definitely absent to 5 = definitely present). Diagnostic performance in identifying downgrading was evaluated via areas under the curves (AUCs). Predictive accuracies of multivariate models were calculated. In predicting downgrading, T2-weighted imaging + DWI (AUC = 0.89/0.85 for R1/R2) performed significantly better than T2-weighted imaging alone (AUC = 0.72/0.73; p < 0.001/p = 0.02 for R1/R2), while T2-weighted imaging + DWI + DCE-MRI (AUC = 0.89/0.84 for R1/R2) performed no better than T2-weighted imaging + DWI (p = 0.48/p > 0.99 for R1/R2). On multivariate analysis, the clinical + mpMRI model incorporating T2-weighted imaging + DWI (AUC = 0.92/0.88 for R1/R2) predicted downgrading significantly better than the clinical model (AUC = 0.73; p < 0.001 for R1/R2). mpMRI improves the ability to identify a subgroup of patients with Gleason 3 + 4 PCa on biopsy who are candidates for active surveillance. DCE-MRI (compared to T2 + DWI) offered no additional benefit to the prediction of downgrading. (orig.)

  19. Multiparametric 3T MRI for the prediction of pathological downgrading after radical prostatectomy in patients with biopsy-proven Gleason score 3 + 4 prostate cancer

    International Nuclear Information System (INIS)

    The aim of this study was to assess the diagnostic performance of pre-treatment 3-Tesla (3T) multiparametric magnetic resonance imaging (mpMRI) for predicting Gleason score (GS) downgrading after radical prostatectomy (RP) in patients with GS 3 + 4 prostate cancer (PCa) on biopsy. We retrospectively reviewed 304 patients with biopsy-proven GS 3 + 4 PCa who underwent mpMRI before RP. On T2-weighted imaging and three mpMRI combinations (T2-weighted imaging + diffusion-weighted imaging [DWI], T2-weighted imaging + dynamic contrast-enhanced-MRI [DCE-MRI], and T2-weighted imaging + DWI + DCE-MRI), two radiologists (R1/R2) scored the presence of a dominant tumour using a 5-point Likert scale (1 = definitely absent to 5 = definitely present). Diagnostic performance in identifying downgrading was evaluated via areas under the curves (AUCs). Predictive accuracies of multivariate models were calculated. In predicting downgrading, T2-weighted imaging + DWI (AUC = 0.89/0.85 for R1/R2) performed significantly better than T2-weighted imaging alone (AUC = 0.72/0.73; p 0.99 for R1/R2). On multivariate analysis, the clinical + mpMRI model incorporating T2-weighted imaging + DWI (AUC = 0.92/0.88 for R1/R2) predicted downgrading significantly better than the clinical model (AUC = 0.73; p < 0.001 for R1/R2). mpMRI improves the ability to identify a subgroup of patients with Gleason 3 + 4 PCa on biopsy who are candidates for active surveillance. DCE-MRI (compared to T2 + DWI) offered no additional benefit to the prediction of downgrading. (orig.)

  20. Biomarkers for the diagnosis of prostatic inflammation in benign prostatic hyperplasia

    NARCIS (Netherlands)

    Robert, G.Y.M.; Smit, F.; Hessels, D.; Jannink, S.A.; Karthaus, H.F.M.; Aalders, T.; Jansen, K.; Taille, A. De La; Mulders, P.F.A.; Schalken, J.A.

    2011-01-01

    BACKGROUND: Chronic prostatic inflammation could be a central mechanism in benign prostatic hyperplasia (BPH) progression. Currently, the histological examination of prostate biopsies remains the only way to diagnose prostatic inflammation. Our objective was to find new noninvasive biomarkers for th

  1. Prostate cancer

    DEFF Research Database (Denmark)

    Chabanova, Elizaveta; Balslev, Ingegerd; Logager, Vibeke;

    2011-01-01

    To investigate diagnostic accuracy of detection of prostate cancer by magnetic resonance: to evaluate the performance of T2WI, DCEMRI and CSI and to correlate the results with biopsy and radical prostatectomy histopathological data.......To investigate diagnostic accuracy of detection of prostate cancer by magnetic resonance: to evaluate the performance of T2WI, DCEMRI and CSI and to correlate the results with biopsy and radical prostatectomy histopathological data....

  2. Exophytic benign prostatic hyperplasia.

    Science.gov (United States)

    Blaschko, Sarah D; Eisenberg, Michael L

    2011-08-01

    A 60-year-old man had incidental finding of a multilobular 8 × 7 × 7-cm mass identified posterior to the urinary bladder in continuity with the prostate. The man's prostate-specific antigen was 1.87, and he denied any lower urinary tract symptoms. A transrectal ultrasound-guided biopsy demonstrated benign prostatic tissue. A computed tomography-guided needle aspiration demonstrated a benign epithelium-lined cyst, likely prostatic in origin. Benign prostatic hyperplasia is a proliferation of prostatic epithelial and stromal cells. Although prostatic hyperplasia is usually restricted to the prostate gland, hyperplastic nodules occasionally protrude outside the prostate and rarely form exophytic pelvic masses. PMID:20869104

  3. Clinical background and its relation to results of percutaneous needle biopsy of suspected bone metastasis under guidance with CT fluoroscopy

    International Nuclear Information System (INIS)

    The purpose of this study was to investigate the clinical background of needle biopsy of suspected bone metastasis under guidance with CT fluoroscopy. During a 3-year period (from April 2000 to March 2003), 103 needle biopsies on 101 lesions of 90 patients were performed for pathological evaluation of suspected bone metastasis. The clinical course of these patients prior to biopsy and its relation to the biopsy results were retrospectively reviewed. Sixty-two patients (69% of total cases) were referred for biopsy from orthopedic surgeons, and 51 of these patients consulted orthopedic surgeons on the initial presentation. Malignancy was pathologically proved in 47 (76%) of the 62 orthopedic patients, and in 19 (68%) of the 28 patients referred from other clinicians. Thirteen (21%) of the orthopedic patients had a history of malignancy, while 22 (78%) of the non-orthopedic patients were cancer patients. Metastasis was pathologically proved in 23 (66%) of the 35 patients with a history of malignancy, while malignancy was pathologically proved in 43 (78%) of the 55 patients without known malignancy. Diagnostic accuracy of the needle bone biopsy was 96%, and its complication rate was 0.7%. In the era of CT fluoroscopy, needle biopsy for suspected bone metastasis was most frequently requested for the patients who consulted orthopedic surgeons for the occurrence of local bone pain as the initial symptom of unknown malignancy. Frequency of malignancy proved by the biopsy in those patients was as high as that in the cancer patients referred from other clinicians. (author)

  4. The short-term impact of protocol biopsies in a live-related renal transplant program using tacrolimus based immunosuppression.

    Science.gov (United States)

    Guleria, S; Jain, S; Dinda, A K; Mahajan, S; Gupta, S; Mehra, N K

    2013-07-01

    The aim of the study was to assess the impact of protocol biopsies in a live-related renal transplant program using tacrolimus-based immunosuppression in the short term. Eighty-three live-related transplant recipients were randomly allocated to protocol biopsy group (Group I, n = 40) and a control group (Group II, n = 43). Other immunosuppressants in these groups consisted of either mycophenolate mofetil or azathioprine and steroids. Protocol biopsies were conducted in biopsy group at 1, 6, and 12 months post-transplant. The non-biopsy group was followed by serial serum creatinine and biopsies in them were conducted as and when clinically indicated. Both groups were analyzed at 12 months with respect to graft function and survival. The two groups were similar with respect to age, number of dialysis pre-operatively, tacrolimus levels, induction therapy, donor age, and donor glomerular filtration rate. Forty protocol biopsies were conducted at 1 month, 31 at 6 months, and 26 at 12 months. The prevalence of sub-clinical rejection at 1, 6, and 12 months in these biopsies was 17.5%, 11.2%, and 10.3%, respectively. The prevalence of calcineurin inhibitor toxicity during same period was 15%, 15.5%, and 14.4%, respectively. The cumulative rejection rate in Group I and Group II at 12-month follow-up was 10.3% and 11.3% (P = 0.78), respectively, and cumulative calcineurin inhibitor toxicity at 12 months was 14.4% and 9.3% (P = 0.59), respectively, were not statistically significant. There was no difference in graft survival and function at 1 year. Protocol biopsies have a limited role in a well-matched renal transplant program with tacrolimus-based immunosuppression in the short term. However, the long-term impact of protocol biopsies needs further evaluation. PMID:23960339

  5. Risk of prostate, ovarian, and endometrial cancer among relatives of women with breast cancer.

    OpenAIRE

    Tulinius, H.; Egilsson, V.; Olafsdóttir, G. H.; Sigvaldason, H

    1992-01-01

    OBJECTIVE--To investigate the risk of prostate, ovarian, and endometrial cancer among relatives of patients with breast cancer. DESIGN--Cohort study of 947 pedigrees in which the proband had breast cancer, linked with the Icelandic cancer registry. SETTING--Iceland. SUBJECTS--The 947 pedigrees included 29,725 people, of whom 1539 had breast cancer, 467 had prostate cancer, 135 ovarian cancer, and 105 endometrial cancer. MAIN OUTCOME MEASURES--Risk of prostate, ovarian, and endometrial cancer ...

  6. Testicular biopsy

    Science.gov (United States)

    Biopsy - testicle ... The biopsy can be done in many ways. The type of biopsy you have depends on the reason for the ... will talk to you about your options. Open biopsy may be done in the health care provider's ...

  7. Gum biopsy

    Science.gov (United States)

    Biopsy - gingiva (gums) ... used to close the opening created for the biopsy. ... to eat for a few hours before the biopsy. ... Risks for this procedure include: Bleeding from the biopsy site Infection of the gums Soreness

  8. Liver biopsy

    Science.gov (United States)

    Biopsy - liver; Percutaneous biopsy ... prevent pain or to calm you (sedative). The biopsy may be done through the abdominal wall: You ... provider will find the correct spot for the biopsy needle to be inserted into the liver. This ...

  9. Establishment of a nomogram for predicting positive repeat prostate biopsy in Chinese men%建立预测中国人前列腺重复穿刺活检阳性的数学模型

    Institute of Scientific and Technical Information of China (English)

    李秋洋; 唐杰; 李岩密; 费翔; 张艳; 何恩辉; 周昀

    2012-01-01

    目的:建立可以预测国人经直肠超声引导下重复穿刺活检阳性的数学模型.方法:170例在首次穿刺活检诊断为前列腺良性病变的患者行重复穿刺.记录并分析患者的年龄、前列腺体积、血清PSA、游离PSA(f-PSA)/总PSA (t-PSA)、PSA上升速度、PSA密度(PSAD)、直肠指检(DRE)、首次穿刺病理结果等相关因素.将变量通过逐步回归建立回归方程,在此基础上建立重复穿刺活检阳性的危险评分数学模型.该模型的预测价值通过受试者工作曲线下面积来评估.结果:170例前列腺重复穿刺活检的患者中,前列腺癌的穿刺检出率为31.8% (54/170).建立的数学模型影响因素包括:患者的年龄、前列腺体积、PSA、f-PSA/t-PSA、PSA上升速度、PSAD、DRE、首次穿刺结果是否为上皮内瘤变.该模型预测价值较高,曲线下面积为82.4%,大于患者PSAD、前列腺体积、PSA上升速度、f-PSA/t-PSA、DRE等单因素的66.9%、72.6%、69.6%、69.3%、58.5%.结论:该数学模型是临床多因素综合分析基础上建立的,可以很好地预测前列腺重复穿刺活检阳性的概率.%Objective: To develop a nomogram for predicting the probability of prostate cancer at transrectal ultrasound-guided repeat prostate biopsy in Chinese men. Methods; We performed repeat biopsy for 170 patients with benign prostate diseases diagnosed on the first biopsy, and analyzed the correlation of positive repeat biopsy with age, prostate volume, PSA, tree-lo-total PSA (f-PSA/t-PSA), PSA velocity, PSA density, results of digital rectal examination (DRE) and previous histology. We entered the variables stepwise into logistic regression models, and established a nomogram for the risk score on the probability of positive repeat biopsy, whose predictive value was assessed by receiver operating characteristic ( ROC) analysis. Results; Prostate cancer was detected in 31.8% of the repeat biopsies (54/170). The most accurate

  10. Predictive power of the ESUR scoring system for prostate cancer diagnosis verified with targeted MR-guided in-bore biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Schimmöller, L., E-mail: Lars.Schimmoeller@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Quentin, M., E-mail: Michael.Quentin@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Arsov, C., E-mail: Cristian.Arsov@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Urology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Hiester, A., E-mail: Andreas.Hiester@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Urology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Kröpil, P., E-mail: Patric.Kroepil@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Rabenalt, R., E-mail: Robert.Rabenalt@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Urology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Albers, P., E-mail: urologie@uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Urology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Antoch, G., E-mail: Antoch@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Blondin, D., E-mail: Dirk.Blondin@sk-mg.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany)

    2014-12-15

    Highlights: • The PI-RADS summed score (PS{sub sum}) demonstrated very good diagnostic values, especially for higher grade PCa. • Lesions with PS{sub sum} ≥13 represented prostate cancer in 88% and higher grade prostate cancer in 42%. • Sensitivity and NPV was nearly 100% for higher grade PCa detection using a cut-off limit of PS{sub sum} 10. • Peripheral zone lesions demonstrated better diagnostic value with the PS{sub sum} compared to transitional zone lesions. • Further improvement of the PI-RADS score is required to prevent unnecessary overdiagnosis. - Abstract: Purpose: This study evaluates the diagnostic value of the ESUR scoring system (PI-RADS) regarding prostate cancer detection using MR-guided in-bore biopsies (IB-GB) as the reference standard. Methods: 566 lesions in 235 consecutive patients (65.7 ± 7.9 years, PSA 9.9 ± 8.5 ng/ml) with a multiparametric (mp)-MRI (T2WI, DWI, DCE) of the prostate at 3 T were scored using the PI-RADS scoring system. PI-RADS single (PS{sub single}), summed (PS{sub sum}), and overall (PS{sub overall}) scores were determined. All lesions were histologically verified by IB-GB. Results: Lesions with a PS{sub sum} below 9 contained no prostate cancer (PCa) with Gleason score (GS) ≥ 4 + 3 = 7. A PS{sub sum} of 13–15 (PS{sub overall} V) resulted in 87.8% (n = 108) in PCa and in 42.3% (n = 52) in GS ≥ 4 + 3 = 7. Transition zone (TZ) lesions with a PS{sub sum} of 13–15 (PS{sub overall} V) resulted in 76.3% (n = 36) in PCa and in 26.3% (n = 10) in GS ≥ 4 + 3 = 7, whereas for peripheral zone (PZ) lesions cancer detection rate at this score was 92.9% (n = 79) and 49.4% (n = 42) for GS ≥ 4 + 3 = 7. Using a threshold of PS{sub sum} ≥ 10, sensitivity was 86.0%, and negative predictive value (NPV) was 86.2%. For higher grade PCa sensitivity was 98.6%, and NPV was 99.5%. Conclusion: A PS{sub sum} below 9 excluded a higher grade PCa, whereas lesions with a PS{sub sum} ≥ 13 (PS{sub overall} V) represented in 88

  11. The incidence and risk factors of resistant E. coli infections after prostate biopsy under fluoroquinolone prophylaxis: a single-centre experience with 2215 patients.

    Science.gov (United States)

    Kandemir, Özlem; Bozlu, Murat; Efesoy, Ozan; Güntekin, Onur; Tek, Mesut; Akbay, Erdem

    2016-08-01

    We evaluated the incidence and risk factors of resistant Escherichia coli infections after the prostate biopsy under flouroquinolone prophylaxis. From January 2003 to December 2012, we retrospectively evaluated the records of 2215 patients. The risk factors were described for infective complications and resistant E. coli in positive cultures was calculated. Of 2215 patients, 153 had positive urine cultures, such as 129 (84·3%) E. coli, 8 (5·2%) Enterococcus spp., 6 (3·9%) Enterobacter spp., 5 (3·2%) Pseudomonas spp., 3 (1·9%) MRCNS, and 2 (1·3%) Klebsiella spp. Of the positive urine cultures which yielded E. coli, 99 (76·7%) were evaluated for fluoroquinolone resistance. Of those, 83 (83·8%) were fluoroquinolone-resistant and composed of 51 (61·4%) extended-spectrum beta-lactamase (ESBL)-positive. Fluoroquinolone-resistant E. coli ratios were 73·4 and 95·9% before 2008 and after 2008, respectively (P = 0·002). The most sensitive antibiotics for fluoroquinolone-resistant E. coli strains were imipenem (100%), amikacin (84%) and cefoperazone (83%). The use of quinolones in the last 6 months and a history of hospitalization in the last 30 days were found to be significant risk factors. We found that resistant E. coli strains might be a common microorganism in patients with this kind of complication. The risk factors for development of infection with these resistant strains were history of the use of fluoroquinolones and hospitalization. PMID:25630553

  12. Treatment of a biliary-venous fistula following percutaneous biopsy in a pediatric living related liver transplant patient

    Energy Technology Data Exchange (ETDEWEB)

    Weintraub, Joshua L.; Mobley, David [Mount Sinai Medical Center, Department of Radiology, Division of Vascular and Interventional Radiology, One Gustave L. Levy Place, Box 1234, New York, NY (United States); Hawari, Ashraf; English, Benjamin [New York Medical College, Department of Radiology, Valhalla, NY (United States)

    2006-06-15

    Liver biopsy is a common study performed after hepatic transplantation. Most centers routinely perform a biopsy 1 week after surgery to evaluate for the possibility of acute rejection. Subsequent biopsies are based on clinical symptoms and routine hepatic function laboratory testing. We report the clinical presentation and treatment of a biliary-venous fistula resulting in sepsis and bilhemia (elevated serum bilirubin levels caused by a biliary-venous fistula) in a 21/2-year-old patient 4 months after partial left lateral segment living related liver transplantation. This case is unusual in that the fistula is the reversal of the more common venous-biliary fistula. The fistula developed after a percutaneous liver biopsy was performed. (orig.)

  13. A magnetic resonance imaging study of prostate deformation relative to implanted gold fiducial markers

    International Nuclear Information System (INIS)

    Purpose: To describe prostate deformation during radiotherapy and determine the margins required to account for prostate deformation after setup to intraprostatic fiducial markers (FM). Methods and Materials: Twenty-five patients with T1c-T2c prostate cancer had three gold FMs implanted. The patients presented with a full bladder and empty rectum for two axial magnetic resonance imaging (MRI) scans using a gradient recalled echo (GRE) sequence capable of imaging the FMs. The MRIs were done at the time of radiotherapy (RT) planning and a randomly assigned fraction. A single observer contoured the prostate surfaces. They were entered into a finite element model and aligned using the centroid of the three FMs. Results: During RT, the prostate volume decreased by 0.5%/fraction (p = 0.03) and the FMs in-migrated by 0.05 mm/fraction (p < 0.05). Prostate deformation was unrelated to differential bladder and bowel filling, but was related to a transurethral resection of the prostate (TURP) (p = 0.003). The standard deviation for systematic uncertainty of prostate surface contouring was 0.8 mm and for FM centroid localization was 0.4 mm. The standard deviation of random interfraction prostate deformation was 1.5 mm and for FM centroid variability was 1.1 mm. These uncertainties from prostate deformation can be incorporated into a margin recipe to determine the total margins required for RT. Conclusions: During RT, the prostate exhibited: volume decrease, deformation, and in-migration of FMs. Patients with TURPs were prone to prostate deformation

  14. Prostate Cancer-Associated Kallikrein-Related Peptidase 4 Activates Matrix Metalloproteinase-1 and Thrombospondin-1.

    Science.gov (United States)

    Fuhrman-Luck, Ruth A; Stansfield, Scott H; Stephens, Carson R; Loessner, Daniela; Clements, Judith A

    2016-08-01

    Prostate cancer metastasis to bone is terminal; thus, novel therapies are required to prevent end-stage disease. Kallikrein-related peptidase 4 (KLK4) is a serine protease that is overproduced in localized prostate cancer and is abundant in prostate cancer bone metastases. In vitro, KLK4 induces tumor-promoting phenotypes; however, the underlying proteolytic mechanism is undefined. The protein topography and migration analysis platform (PROTOMAP) was used for high-depth identification of KLK4 substrates secreted by prostate cancer bone metastasis-derived PC-3 cells to delineate the mechanism of KLK4 action in advanced prostate cancer. Thirty-six putative novel substrates were determined from the PROTOMAP analysis. In addition, KLK4 cleaved the established substrate, urokinase-type plasminogen activator, thus validating the approach. KLK4 activated matrix metalloproteinase-1 (MMP1), a protease that promotes prostate tumor growth and metastasis. MMP1 was produced in the tumor compartment of prostate cancer bone metastases, highlighting its accessibility to KLK4 at this site. KLK4 further liberated an N-terminal product, with purported angiogenic activity, from thrombospondin-1 (TSP1) and cleaved TSP1 in an osteoblast-derived matrix. This is the most comprehensive analysis of the proteolytic action of KLK4 in an advanced prostate cancer model to date, highlighting KLK4 as a potential multifunctional regulator of prostate cancer progression. PMID:27378148

  15. Insulin-like growth factor 1 in relation to prostate cancer and benign prostatic hyperplasia.

    OpenAIRE

    Mantzoros, C S; Tzonou, A.; Signorello, L B; Stampfer, M.; Trichopoulos, D; Adami, H. O.

    1997-01-01

    Blood samples were collected from 52 incident cases of histologically confirmed prostate cancer, an equal number of cases of benign prostatic hyperplasia (BPH) and an equal number of apparently healthy control subjects. The three groups were matched for age and town of residence in the greater Athens area. Steroid hormones, sex hormone-binding globulin, and insulin-like growth factor 1 (IGF-1) were measured in duplicate by radioimmunoassay in a specialized US centre. Statistical analyses were...

  16. ERG–TMPRSS2 rearrangement is shared by concurrent prostatic adenocarcinoma and prostatic small cell carcinoma and absent in small cell carcinoma of the urinary bladder: evidence supporting monoclonal origin

    OpenAIRE

    Williamson, Sean R; Zhang, Shaobo; Yao, Jorge L.; Huang, Jiaoti; Lopez-Beltran, Antonio; Shen, Steven; Osunkoya, Adeboye O.; MacLennan, Gregory T.; Montironi, Rodolfo; Cheng, Liang

    2011-01-01

    Prostatic carcinoma is a heterogeneous disease with frequent multifocality and variability in morphology. Particularly, prostatic small cell carcinoma is a rare variant with aggressive behavior. Distinction between small cell carcinoma of the prostate and urinary bladder may be challenging, especially in small biopsy specimens without associated prostatic adenocarcinoma or urothelial carcinoma. Recently, gene fusions between ETS genes, particularly ETS-related gene (ERG), and transmembrane pr...

  17. Age-related changes in the testes and prostate of the Beagle dog

    International Nuclear Information System (INIS)

    Age-related changes in the histologic morphology of the Beagle dog prostate and testes must be separated from those changes that may result from the testing of experimental compounds. The prostate and testes of healthy age-matched Beagle dogs 3 to 14 yr of age were obtained. Serum to evaluate testosterone levels was also obtained from each dog at the time of euthanasia. Tissue sections from the prostate and testes were examined by light microscopy for both qualitative and quantitative morphologic assessment. A statistically significant increase in prostatic weight with increased age was noted. Significant morphometric findings in the prostate included a decrease in the relative percent of epithelial cells and an increase in the relative lumen size of glandular acini with increased age. The absolute volume of prostate interstitial tissue and inflammation showed a statistically significant increase with age. Stereological analysis of the testes showed a decrease in the relative percent epithelium with increasing age. No distinct age-related trend could be detected in serum testosterone levels. Serum testosterone levels did not correlate with the morphologic age-related changes observed in the testes or prostate. (author)

  18. 体质指数、血脂水平与前列腺穿刺活检阳性间的关系%Relationship of body mass index and blood lipid level with cancer detection on prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    张浩宇; 吕广霖; 袁和兴; 魏雪栋; 胡林昆; 张学锋; 侯建全

    2015-01-01

    Objective To investigate the relationship between body mass index (BMI), blood lipid level and cancer de⁃tection in prostate biopsy. Methods A total of 214 patients undergoing a prostate biopsy during 2013.2—2014.8 were re⁃viewed retrospectively. They were divided into prostate cancer and non-cancer groups by biopsy results. The differences of age, prostate-specific antigen (PSA) level, prostate volume (PV), blood lipid level and BMI were analyzed between two groups. Risk factors for cancer detection of biopsy were also analyzed. Results Compared with non-cancer patients, pros⁃tate cancer patients were older, had higher level of PSA and BMI, but smaller PV and lower level of HDL-C ( P<0.05). Lo⁃gistic regression analysis showed that older, higher level of PSA and BMI were risk factors for prostate biopsy positive, but larger PV and higher level of HDL-C were protective factors (P<0.05). Conclusion Comprehensive assessment of BMI and blood lipid levels can provide important reference for prostate cancer screening at early time and establishment of pros⁃tate biopsy scheme, which also provide significant evidence for the prevention, diagnosis and treatment of prostate cancer at early stage for high risk population.%目的:探讨体质指数(BMI)、血脂水平与前列腺穿刺活检阳性之间的关系。方法回顾性分析2013年2月—2014年8月间在我院行前列腺穿刺活检患者214例,根据穿刺病理结果分为前列腺癌组和非癌组,比较2组间年龄、前列腺特异性抗原(PSA)、前列腺体积(PV)、血脂水平、体质指数(BMI)等指标,并分析前列腺穿刺阳性的危险因素。结果前列腺癌组年龄、PSA、BMI高于非癌组,而PV、高密度脂蛋白胆固醇(HDL-C)则低于非癌组(均P<0.05)。Logistic回归分析提示年龄大,PSA、BMI升高是前列腺穿刺活检阳性的危险因素,而PV、HDL-C升高则为保护因素(均P<0.05)。结论综合评估患者BMI

  19. IgG4-related sialadenitis: IgG4 is helpful, but biopsies are still crucial

    OpenAIRE

    Witte, Torsten; Schulze-Koops, Hendrik

    2015-01-01

    IgG4-related disease is rare, but a frequent differential diagnosis for malignant and for autoimmune diseases. Li and colleagues report the largest cohort of patients with IgG4-related sialadenitis. The observations reveal that the most important diagnostic step is obtaining biopsies. In addition, the IgG4 serum concentration may be a biomarker for the disease progression.

  20. Cold spot mapping inferred from MRI at time of failure predicts biopsy-proven local failure after permanent seed brachytherapy in prostate cancer patients: Implications for focal salvage brachytherapy

    International Nuclear Information System (INIS)

    Background and purpose: (1) To establish a method to evaluate dosimetry at the time of primary prostate permanent implant (pPPI) using MRI of the shrunken prostate at the time of failure (tf). (2) To compare cold spot mapping with sextant-biopsy mapping at tf. Material and methods: Twenty-four patients were referred for biopsy-proven local failure (LF) after pPPI. Multiparametric MRI and combined-sextant biopsy with a central review of the pathology at tf were systematically performed. A model of the shrinking pattern was defined as a Volumetric Change Factor (VCF) as a function of time from time of pPPI (t0). An isotropic expansion to both prostate volume (PV) and seed position (SP) coordinates determined at tf was performed using a validated algorithm using the VCF. Results: pPPI CT-based evaluation (at 4 weeks) vs. MR-based evaluation: Mean D90% was 145.23 ± 19.16 Gy [100.0–167.5] vs. 85.28 ± 27.36 Gy [39–139] (p = 0.001), respectively. Mean V100% was 91.6 ± 7.9% [70–100%] vs. 73.1 ± 13.8% [55–98%] (p = 0.0006), respectively. Seventy-seven per cent of the pathologically positive sextants were classified as cold. Conclusions: Patients with biopsy-proven LF had poorer implantation quality when evaluated by MRI several years after implantation. There is a strong relationship between microscopic involvement at tf and cold spots

  1. Biopsy - polyps

    Science.gov (United States)

    Polyp biopsy ... are treated is the colon. How a polyp biopsy is done depends on the location: Colonoscopy or flexible sigmoidoscopy explores the large bowel Colposcopy-directed biopsy examines the vagina and cervix Esophagogastroduodenoscopy (EGD) or ...

  2. Synovial biopsy

    Science.gov (United States)

    Biopsy - synovial membrane ... fluid in and out of the area. A biopsy grasper is inserted through the trocar and turned ... Synovial biopsy helps diagnose gout and bacterial infections, or rule out other infections. It can be used to diagnose ...

  3. Nerve biopsy

    Science.gov (United States)

    Biopsy - nerve ... A nerve biopsy is most often done on a nerve in the ankle, forearm, or along a rib. The health care ... feel a prick and a mild sting. The biopsy site may be sore for a few days ...

  4. Endometrial biopsy

    Science.gov (United States)

    Biopsy - endometrium ... The biopsy is normal if the cells in the sample are not abnormal. ... Risks of endometrial biopsy include: Infection Causing a hole in (perforating) the uterus or tearing the cervix (rarely occurs) Prolonged bleeding Slight spotting ...

  5. Liver biopsy

    Science.gov (United States)

    Biopsy - liver; Percutaneous biopsy ... the biopsy needle to be inserted into the liver. This is often done by using ultrasound. The ... the chance of damage to the lung or liver. The needle is removed quickly. Pressure will be ...

  6. Skin Biopsy

    Science.gov (United States)

    ... skin condition cannot be diagnosed by the patient's history and what the physician finds on examination alone. Confirming a clinical diagnosis may also be necessary prior to starting therapy. Skin biopsy types are as follows: Shave biopsies Punch biopsies ...

  7. Relation between serum PAP (prostate acid phosphatase) and bone scintigraphy in prostatic cancer

    International Nuclear Information System (INIS)

    Seventy-seven patients with prostatic cancer were treated at our department in the last 5 years. Of these patients 30 cases were followed by bone scintigraphy and serum PAP. In 27 follow-up scintigraphy procedures changes of bone scintigraphy corresponded to changes in serum PAP levels. Changes of PAP levels did not always correspond to changes of scintigraphy, but almost all cases in which the level of PAP increased in a short period showed progression of bone metastasis. A 3-month interval between bone scintigraphy procedure in stage D2 prostatic cancer patients is generally recommended. However, we think that in prostatic cancer patients follow-up bone scintigraphy at regular short intervals is unnecessary if there is no change in serum PAP levels, symptoms or physical condition. Bone scintigraphy should be performed when the tumor marker changes rapidly or when any physical symptom appears. (author)

  8. Expression of leukemia/lymphoma related factor (LRF/Pokemon) in human benign prostate hyperplasia and prostate cancer.

    Science.gov (United States)

    Aggarwal, Himanshu; Aggarwal, Anshu; Hunter, William J; Yohannes, Paulos; Khan, Ansar U; Agrawal, Devendra K

    2011-04-01

    Leukemia/lymphoma related factor (LRF), also known as Pokemon, is a protein that belongs to the POK family of transcriptional repressors. It has an oncogenic role in many different solid tumors. In this study, the expression of LRF was evaluated in benign prostate hyperplastic (BPH) and prostate cancer (PC) tissues. The functional expression of LRF was studied using multiple cellular and molecular methods including RT-PCR, western blotting, immunohistochemistry, and immunofluorescence. Paraffin-embedded human tissues of BPH and PC were used to examine LRF expression. Histological staining of the BPH and PC tissue sections revealed nuclear expression of LRF with minimal expression in the surrounding stroma. The semi-quantitative RT-PCR and western immunoblot analyses demonstrated significantly higher mRNA transcripts and protein expression in PC than BPH. High expression of LRF suggests that it may have a potential role in the pathogenesis of both BPH and prostate cancer. Further studies will help elucidate the mechanisms and signaling pathways that LRF may follow in the pathogenesis of prostate carcinoma. PMID:21251909

  9. Avaliação da extensão da neoplasia em câncer da próstata: valor do PSA, da percentagem de fragmentos positivos e da escala de Gleason Extraprostatic disease prediction in patients with carcinoma of the prostate: role of PSA, prostatic biopsy fragments percentage and Gleason score

    Directory of Open Access Journals (Sweden)

    Antonio Carlos Calvete

    2003-09-01

    ática, verificamos que o PSA pré-operatório foi o mais discriminante (p = 0,000000, seguido pela escala de Gleason da biópsia prostática (p = 0,000003 e pela percentagem de biópsias positivas (p = 0,000574.OBJECTIVE: To valuate the behavior of the prostatic biopsy fragments percentage, guided by transrectal ultrasonography in extraprostatic disease prediction in patients with localized adenocarcinoma of the prostate gland and, also, to compare the efficiency of this pattern with them got by the valuation of PSA and preoperative Gleason score. METHODS: This retrospective non-controlled study consisted of 522 patients with adenocarcinoma located in the prostate. They were submitted to surgical treatment through retropubic radical prostatectomy. The ages of the patients ranged from 42 to 76 years with a mean of 62.44 years. All of them were submitted to transrectal ultrasonography with prostatic biopsy (direct of the lesion and/or suspected area and sextant previous to the radical surgical treatment. The 522 patients were divided in groups according to the positive fragments found by the biopsy, what was correlated with the anatomicpathologic findings of intraprostatic disease (limited to the gland and extraprostatic (invasion periprostatic adiposity and/or the bladder neck and/or the seminal vesicles and/or positive pelvic lymph nodes of the surgical specimen. RESULTS: Regarding the analysis of the positive fragments percentage, the groups G1 (0-25%, G2 (20-50% and G3 (51-75% showed an incidence of the intraprostatic disease two and three times greater than the extraprostatic one. However, when more than 75% of the biopsy fragments were positive (G4, 76-100%, the relation inverted occurring a predominance of the extraprostatic disease over the intraprostatic. In this group 56.98% of the patients showed extraprostatic disease. There was a statistically significant difference of the extraprostatic disease between the groups G3 and G4 (p 0.0068. CONCLUSION: When we compared the

  10. 穿刺活检前列腺癌ERG基因重排分析%ERG rearrangement prevalence in Chinese prostatic carcinoma biopsy cohort

    Institute of Scientific and Technical Information of China (English)

    肖立; 殷于磊; 陈燕; 卢晨; 余波

    2015-01-01

    Purpose To study the prevalence and feature of EGR gene rearrangement in prostatic carcinoma. Methods 242 consecu-tive core biopsies of prostatic carcinoma were evaluated. All biopsy specimens contained 6-14 cores from left and right sides separately delivered. The patient age ranged 58 to 91 years, and PSA value 5 ng/ml to more than 5 000 ng/ml. Immunohistochemistry ( IHC) for ERG protein overexpression and fluorescent in situ hybridization ( FISH) for ERG gene rearrangement were performed. Results 42 cases were detected positive for ERG by IHC ( positive rate 17. 4%) , and positive for ERG rearrangement by FISH either, with 19 ca-ses showing fusion through deletion and 23 through insertion, while no negative cases by IHC demonstrated positive by FISH. 5 cases revealed positive and negative staining in different carcinoma foci of ERG. No ERG positive staining and rearrangement were found in adjacent benign glands. Of positive cases, 12 cases were graded as Gleason score 6, 23 Gleason score 7, and 7 Gleason score 8 or more. Positive rate was 19. 6% in the group of PSA value less than 100 ng/ml, and 10% of more than 100 ng/ml, whereas 17. 2% in the group of clinical T3 stage or less, and 19% of clinical T4 and lymph node or remote metastasis. ERG rearrangement was associated with lower Gleason score, but not with PSA value, clinical stage and progression using theχ2 test analysis. Conclusions IHC is relia-ble for detection ERG rearrangement and helpful for interpretation of prostatic carcinoma. Multiple foci are common in prostatic carcino-ma. There is no significance between ERG rearrangement and disease prognosis.%目的:探讨ERG基因重排在前列腺癌中的发生率及特征。方法收集前列腺癌连续穿刺标本242例,均为6~14针,左、右侧不同部位分瓶送检,年龄58~91岁,PSA水平5~5000 ng/ml,免疫组化法检测ERG蛋白表达,荧光原位杂交( fluores-cent in situ hybridization, FISH)技术检测ERG基因重排

  11. PCA3 IS A TRUE ONCOMARKER OF PROSTATE CANCER: A REVIEW OF LITERATURE

    Directory of Open Access Journals (Sweden)

    A. V. Sidorenkov

    2014-07-01

    Full Text Available Routine measurement of prostate-specific antigen (PSA levels has resulted in the increased number of prostate biopsies. The lower age-related reference values of PSA have in its turn led to the larger number of unnecessary prostate biopsies (to the hyperdiagnosis of clinically insignificant PC. Biopsy can presently identify prostate cancer (PC in only 35 % of the patients with total PSA level of 4–10 ng/ml and PSA-negative PC in 20–25 %. The diagnostic potentialities of PSA as an independent marker have been obviously exhausted. The new PC oncomarkers described in the latest literature are certain to deserve meticulous attention and investigation. From a variety of oncomarkers, PCA3 is most promising biomarker. PCA3 versus total PSA or its other derivatives is the best predictor of PC during primary or repeated prostate biopsy. Some publications show that PCA3 may be used to schedule primary or repeated prostate biopsy, by constructing risk nomograms, in conjunction with other individu-al indicators of a patient’s examination, including those with other newest biomarkers for PC. The use of PCA3 in everyday practice may assist in increasing the specificity of PC diagnosis and in reducing the number of unnecessary prostate biopsies

  12. PCA3 IS A TRUE ONCOMARKER OF PROSTATE CANCER: A REVIEW OF LITERATURE

    Directory of Open Access Journals (Sweden)

    A. V. Sidorenkov

    2014-01-01

    Full Text Available Routine measurement of prostate-specific antigen (PSA levels has resulted in the increased number of prostate biopsies. The lower age-related reference values of PSA have in its turn led to the larger number of unnecessary prostate biopsies (to the hyperdiagnosis of clinically insignificant PC. Biopsy can presently identify prostate cancer (PC in only 35 % of the patients with total PSA level of 4–10 ng/ml and PSA-negative PC in 20–25 %. The diagnostic potentialities of PSA as an independent marker have been obviously exhausted. The new PC oncomarkers described in the latest literature are certain to deserve meticulous attention and investigation. From a variety of oncomarkers, PCA3 is most promising biomarker. PCA3 versus total PSA or its other derivatives is the best predictor of PC during primary or repeated prostate biopsy. Some publications show that PCA3 may be used to schedule primary or repeated prostate biopsy, by constructing risk nomograms, in conjunction with other individu-al indicators of a patient’s examination, including those with other newest biomarkers for PC. The use of PCA3 in everyday practice may assist in increasing the specificity of PC diagnosis and in reducing the number of unnecessary prostate biopsies

  13. Multiparametric magnetic resonance imaging of prostate cancer

    Directory of Open Access Journals (Sweden)

    Sandeep S Hedgire

    2012-01-01

    Full Text Available In India, prostate cancer has an incidence rate of 3.9 per 100,000 men and is responsible for 9% of cancer-related mortality. It is the only malignancy that is diagnosed with an apparently blind technique, i.e., transrectal sextant biopsy. With increasing numbers of high-Tesla magnetic resonance imaging (MRI equipment being installed in India, the radiologist needs to be cognizant about endorectal MRI and multiparametric imaging for prostate cancer. In this review article, we aim to highlight the utility of multiparamteric MRI in prostate cancer. It plays a crucial role, mainly in initial staging, restaging, and post-treatment follow-up.

  14. Pediatric case report on magnetic resonance imaging/transrectal ultrasound-fusion biopsy of rhabdomyosarcoma of the bladder/prostate: a new tool to reduce therapy-associated morbidity?

    Science.gov (United States)

    Kuru, Timur H; Roethke, Matthias C; Nyarangi-Dix, Joanne; Okouoyo, Stella; Stockklausner, Clemens; Schenk, Jens-Peter; Debus, Jürgen; Roth, Wilfried; Teber, Dogu; Pahernik, Sascha; Schlemmer, Heinz-Peter; Hohenfellner, Markus; Hadaschik, Boris A

    2013-02-01

    Rhabdomyosarcomas are the most common soft tissue sarcomas in children. Here we present management of an 18-month-old boy with metastatic rhabdomyosarcoma of the bladder/prostate. After radiochemotherapy, high-spatial-resolution 3-Tesla multiparametric magnetic resonance imaging (MRI) showed regressive systemic disease but a residual mass at the right seminal vesicle. For histologic re-evaluation, 3-dimensional-controlled stereotactic MRI/transrectal ultrasound (TRUS)-fusion biopsy specimens were taken. Because histologic analysis showed nonvital tissue, a decision could be made against adjuvant radical cystoprostatectomy. Advanced 3-Tesla imaging and MRI/TRUS-fusion biopsies in children are feasible and represent an effective tool to examine suspicious pelvic lesions. Depending on histology, this can lead to a significant reduction of therapy-associated morbidity. PMID:23374821

  15. Functional evaluation of DNA repair in human biopsies and their relation to other cellular biomarkers

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    Jana eSlyskova

    2014-05-01

    Full Text Available Thousands of DNA lesions are estimated to occur in each cell every day and almost all are recognized and repaired. DNA repair is an essential system that prevents accumulation of mutations which can lead to serious cellular malfunctions. Phenotypic evaluation of DNA repair activity of individuals is a relatively new approach. Methods to assess base and nucleotide excision repair pathways (BER and NER in peripheral blood cells based on modified comet assay protocols have been widely applied in human epidemiological studies. These provided some interesting observations of individual DNA repair activity being suppressed among cancer patients. However, extension of these results to cancer target tissues requires a different approach. Here we describe the evaluation of BER and NER activities in extracts from deep-frozen colon biopsies using an upgraded version of the in vitro comet-based DNA repair assay in which twelve reactions on one microscope slide can be performed. The aim of this report is to provide a detailed, easy-to-follow protocol together with results of optimization experiments. Additionally, results obtained by functional assays were analysed in the context of other cellular biomarkers, namely single nucleotide polymorphisms and gene expressions. We have shown that measuring DNA repair activity is not easily replaceable by genomic or transcriptomic approaches, but should be applied with the latter techniques in a complementary manner. The ability to measure DNA repair directly in cancer target tissues might finally answer questions about the tissue-specificity of DNA repair processes and their real involvement in the process of carcinogenesis.

  16. Advanced prostate cancer risk in relation to toenail selenium levels

    NARCIS (Netherlands)

    Geybels, M.S.; Verhage, B.A.J.; Schooten, F.J. van; Goldbohm, A.; Brandt, P.A. van den

    2013-01-01

    BACKGROUND: Selenium may prevent advanced prostate cancer (PCa), but most studies on this topic were conducted in populations with moderate to high selenium status. We investigated the association of toenail selenium, reflecting long-term selenium exposure, and advanced PCa risk in a population from

  17. Evaluation of the ESUR PI-RADS scoring system for multiparametric MRI of the prostate with targeted MR/TRUS fusion-guided biopsy at 3.0 Tesla

    International Nuclear Information System (INIS)

    To evaluate the Prostate Imaging Reporting and Data System (PI-RADS) proposed by the European Society of Urogenital Radiology (ESUR) for detection of prostate cancer (PCa) by multiparametric magnetic resonance imaging (mpMRI) in a consecutive cohort of patients with magnetic resonance/transrectal ultrasound (MR/TRUS) fusion-guided biopsy. Suspicious lesions on mpMRI at 3.0 T were scored according to the PI-RADS system before MR/TRUS fusion-guided biopsy and correlated to histopathology results. Statistical correlation was obtained by a Mann-Whitney U test. Receiver operating characteristics (ROC) and optimal thresholds were calculated. In 64 patients, 128/445 positive biopsy cores were obtained out of 95 suspicious regions of interest (ROIs). PCa was present in 27/64 (42 %) of the patients. ROC results for the aggregated PI-RADS scores exhibited higher areas under the curve compared to those of the Likert score. Sensitivity/specificity for the following thresholds were calculated: 73 %/92 % and 85 %/67 % for PI-RADS scores of 9 and 10, respectively; 85 %/56 % and 60 %/97 % for Likert scores of 3 and 4, respectively. The standardised ESUR PI-RADS system is beneficial to indicate the likelihood of PCa of suspicious lesions on mpMRI. It is also valuable to identify locations to be targeted with biopsy. The aggregated PI-RADS score achieved better results compared to the single five-point Likert score. circle The ESUR PI-RADS scoring system was evaluated using multiparametric 3.0-T MRI. (orig.)

  18. Parathyroid biopsy

    Science.gov (United States)

    ... Feel The test feels like a quick needle jab or stick. You may feel a sting as ... activities the same day. Alternative Names Biopsy - parathyroid Images Endocrine glands Parathyroid biopsy References Pellitteri PK, Sofferman ...

  19. Scoring of treatment-related late effects in prostate cancer

    International Nuclear Information System (INIS)

    Background and purpose: To assess the correlation between different general and organ specific quality of life and morbidity scoring methods in a cohort of men treated with radical radiotherapy for prostate cancer. Materials and methods: Men who had been treated with radical radiotherapy (50 Gy in 16 fractions over 21 days) for localized prostate cancer more than 3 years previously and who had no evidence of recurrent disease were invited to take part in the study. A total of 101 of 135 invited patients agreed and completed LENT/SOMA, UCLA Prostate Cancer Index, and 36 item RAND Health survey questionnaires. Results: The patients had comparable results with other published series with respect to the UCLA and SF-36 indices. There was significant correlation between the corresponding parts of the UCLA and LENT/SOMA scales (P<0.0005). However, for the same symptoms, a patient tended to score lower (worse) on the UCLA scale in comparison to LENT/SOMA. The relationship between the average LENT/SOMA score and maximum score was also not straightforward with each set of data revealing different information. Conclusions: The LENT/SOMA questions were, in the main, more wide-ranging and informative than the UCLA index. It is helpful to give both the overall and maximum LENT/SOMA scores to most efficiently use all of the data. There may need to be a further LENT/SOMA question to allow both symptoms of tenesmus and faecal urgency to be fully addressed

  20. Impact of Comorbidity, Race, and Marital Status in Men Referred for Prostate Biopsy with PSA >20 ng/mL: A Pilot Study in High-Risk Patients.

    Science.gov (United States)

    Klaassen, Zachary; Muller, Roberto; Li, Qiang; Tatem, Alexander J; King, Sherita A; Freedland, Stephen J; Madi, Rabii; Terris, Martha K; Moses, Kelvin A

    2014-01-01

    Objective. To assess the impact of comorbidity, race, and marital status on overall survival (OS) among men presenting for prostate biopsy with PSA >20 ng/mL. Methods. Data were reviewed from 2000 to 2012 and 78 patients were included in the cohort. We analyzed predictors of OS using a Cox proportional hazards model and the association between Charlson Comorbidity Index (CCI) score and PCa diagnosis or high-grade cancer using logistic regression and multinomial regression models, respectively. Results. The median age of patients was 62.5 (IQR 57-73) years. Median CCI was 3 (IQR 2-4), 69% of patients were African American men, 56% of patients were married, and 85% of patients had a positive biopsy. CCI (HR 1.52, 95% CI 1.19, 1.94), PSA (HR 1.62, 95% CI 1.09, 2.42), and Gleason sum (HR 2.04, 95% CI 1.17, 3.56) were associated with OS. CCI was associated with Gleason sum 7 (OR 4.06, 95% CI 1.04, 15.89) and Gleason sum 8-10 (OR 4.52, 95% CI 1.16, 17.54) PCa. Conclusions. CCI is an independent predictor of high-grade disease and worse OS among men with PCa. Race and marital status were not significantly associated with survival in this cohort. Patient comorbidity is an important component of determining the optimal approach to management of prostate cancer. PMID:27355056

  1. Expression of kallikrein-related peptidase 7 is decreased in prostate cancer

    Directory of Open Access Journals (Sweden)

    Chong-Yu Zhang

    2015-02-01

    Full Text Available Recent evidence suggests that the human kallikrein 7 (KLK7 is differentially regulated in a variety of tumors. The aim of this study was to determine the expression of kallikrein-related peptidase 7 and KLK7 in our large collection of prostate samples. Between August 2000 and December 2012, 116 patients with histologically confirmed prostate cancer (PCa and 92 with benign prostate hyperplasia (BPH were recruited into the study. Using immunohistochemistry, quantitative reverse transcription polymerase chain reaction (RT-PCR and western blot, kallikrein-related peptidase 7 expression in BPH and PCa tissues was determined at the mRNA and protein levels. The relationships between kallikrein-related peptidase 7 mRNA expression and clinicopathological features were analyzed. A total of 64 of 92 (69.57% benign cases showed positive staining for KLK7 and 23 of 116 (19.83% malignant cases showed positive, the difference of KLK7 expression between PCa and BPH was statistically significant (P < 0.001. The expression level of kallikrein-related peptidase 7 mRNA was significantly decreased in PCa tissues compared with that in BPH tissues and normal prostate tissue. Kallikrein-related peptidase 7 mRNA exhibited different expression patterns in terms of localization depending on pathological category of PCa. Similarly, our western immunoblot analyses demonstrated that the protein expression levels of KLK7 was lower in PCa than in BPH tissues and normal prostate tissue. Kallikrein-related peptidase 7 and KLK7 expression are down-regulated in PCa and lower expression of kallikrein-related peptidase 7 closely correlates with higher Gleason score and higher prostate-specific antigen level.

  2. Usefulness of automated biopsy guns in image-guided biopsy

    International Nuclear Information System (INIS)

    To evaluate the usefulness of automated biopsy guns in image-guided biopsy of lung, liver, pancreas and other organs. Using automated biopsy devices, 160 biopsies of variable anatomic sites were performed: Biopsies were performed under ultrasonographic(US) guidance in 95 and computed tomographic (CT) guidance in 65. We retrospectively analyzed histologic results and complications. Specimens were adequate for histopathologic diagnosis in 143 of the 160 patients(89.4%)-Diagnostic tissue was obtained in 130 (81.3%), suggestive tissue obtained in 13(8.1%), and non-diagnostic tissue was obtained in 14(8.7%). Inadequate tissue was obtained in only 3(1.9%). There was no statistically significant difference between US-guided and CT-guided percutaneous biopsy. There was no occurrence of significant complication. We have experienced mild complications in only 5 patients-2 hematuria and 2 hematochezia in transrectal prostatic biopsy, and 1 minimal pneumothorax in CT-guided percutaneous lung biopsy. All of them were resolved spontaneously. The image-guided biopsy using the automated biopsy gun was a simple, safe and accurate method of obtaining adequate specimen for the histopathologic diagnosis

  3. Expression analysis of spermatogenesis-related genes in biopsies from non-obstructive azoospermia (NOA) patients

    Czech Academy of Sciences Publication Activity Database

    Dorosh, Andriy; Teplá, O.; Žatecká, Eva; Děd, Lukáš; Kočí, K.; Pěknicová, Jana

    Praha : Biotechnologický ústav, 2013 - (Pěknicová, J.). s. 28-28 [XIX. Symposium imunologie a biologie reprodukce s mezinárodní účastí. 23.05.2013-25.05.2013, Třešť] R&D Projects: GA ČR(CZ) GAP503/12/1834 Institutional research plan: CEZ:AV0Z50520701 Keywords : Non-obstructive azoospermia * Testicular biopsies * RT-PCR * Fertilization rate * Spermatogenesis Subject RIV: EB - Genetics ; Molecular Biology

  4. Analysis on Causes and Prevention of Septic Shock Caused by Puncture Biopsy in Patients with Prostate Cancer%前列腺癌穿刺活检导致感染性休克的原因及预防

    Institute of Scientific and Technical Information of China (English)

    李娟; 郭广亚; 周莉

    2015-01-01

    Objective To explore the causes and preventive measures of septic shock caused by puncture biopsy in pa-tients with prostate cancer.Methods 84 cases of patients with prostate cancer who received puncture biopsy were divided into shock group and non-shock group,the pathogenic biological characteristics of patients with septic shock was observed,the single factor and multivariate logistic regression were used to analyse the factors affecting septic shock.Results The incidence of septic shock was 8.33%,and its occurrence time was 12-37 h after operation.11 strains of pathogenic bacteria were detected in 7 pa-tients with septic shock including gram negative bacteria accounting for 72.73% and gram positive bacteria accounting for 27.27%.There were significant difference in age,diabetes plus,prostate infection plus,urinary tract infection plus,APACHEⅡscore and repeated puncture between the 2 groups (P<0.05).Combined prostate infection or urinary tract infection,lower score of APACHEⅡand age≥55 were risk factors leading to septic shock of patients with prostate cancer using biopsy raised.Conclu-sion Septic shock is mainly caused by gram negative bacteria and occurs 12~37 h after operation.Patients with elder age,lower score of APACHE II,prostate infections or urinary tract infection should be given prevention and treatment to reduce the incidence of septic shock.%目的:探讨前列腺癌患者穿刺活检引发感染性休克的原因及预防措施。方法选择行穿刺活检术的前列腺癌患者84例,按照是否发生感染性休克分为休克组和非休克组,观察感染性休克患者病原菌生物学特征,采用单因素和多因素logistic回归分析影响感染性休克的因素。结果感染性休克发生率为8.33%,发生时间为术后12~37 h。7例感染性休克患者共检出病原菌11株,其中革兰氏阴性菌占72.73%,革兰氏阳性菌占27.27%。两组患者在年龄、合并糖尿病、合并前列腺

  5. Prostate position relative to pelvic bony anatomy based on intraprostatic gold markers and electronic portal imaging

    International Nuclear Information System (INIS)

    Purpose: To describe the relative positions and motions of the prostate, pelvic bony anatomy, and intraprostatic gold fiducial markers during daily electronic portal localization of the prostate. Methods and Materials: Twenty prostate cancer patients were treated supine with definitive external radiotherapy according to an on-line target localization protocol using three or four intraprostatic gold fiducial markers and an electronic portal imaging device. Daily pretherapy and through-treatment electronic portal images (EPIs) were obtained for each of four treatment fields. The patients' pelvic bony anatomy, intraprostatic gold markers, and a best visual match to the target (i.e., prostate) were identified on simulation digitally reconstructed radiographs and during daily treatment setup and delivery. These data provided quantitative inter- and intrafractional analysis of prostate motion, its position relative to the bony anatomy, and the individual intraprostatic fiducial markers. Treatment planning margins, with and without on-line localization, were subsequently compared. Results: A total of 22,266 data points were obtained from daily pretherapy and through-treatment EPIs. The pretherapy three-dimensional (3D) average displacement of the fiducial markers, as a surrogate for the prostate, was 5.6 mm, which improved to 2.8 mm after use of the localization protocol. The bony anatomy 3D average displacement was 4.4 mm both before and after localization to the prostate (p = 0.46). Along the superior-inferior (SI), anterior-posterior (AP), and right-left (RL) axes, the average prostate displacement improved from 2.5, 3.7, and 1.9 mm, respectively, before localization to 1.4, 1.6, and 1.1 mm after (all p < 0.001). The pretherapy to through-treatment position of the bony landmarks worsened from 1.7 to 2.5 mm (p < 0.001) in the SI axis, remained statistically unchanged at 2.8 mm (p = 0.39) in the AP axis, and improved from 2.0 to 1.2 mm in the RL axis (p < 0.001). There

  6. Detecting Prostate Cancer

    Medline Plus

    Full Text Available ... have other tests, such as a trans-rectal ultrasound and a biopsy. Physician: Now, just relax -- the ... exam or PSA test indicates an abnormality, an ultrasound image is made of the prostate gland. Usually ...

  7. The experience of using sonoelastography of prostate in prostatic diseases

    Directory of Open Access Journals (Sweden)

    P. S. Zubeev

    2014-11-01

    Full Text Available Objective. To assess sonoelastography opportunities in differential diagnosis of prostatic diseases; to place sonoelastography in general algorithm of prostatic diseases diagnostics.Materials and methods. 91 patients under examination were divided into three groups. The first group included 21 patients (23.1 % with suspected prostate carcinoma, later they underwent puncture multifocal biopsy of prostate with morphological verification of prostate carcinoma. The second group consisted of 51 patients (56.0 % with benign prostatic hyperplasia, and in the third group there were 19 patients (20.9 % with acute and chronic prostatitis.Results. 91 patients with different prostatic diseases were examined. There were defined PSA (prostate specific antigen level, and performed TRUS (transrectal ultrasound, biopsy and sonoelastography of prostate. In 72 patients SEG (sonoelastography-picture of prostate was compared to morphological diagnosis. According to SEG findings, 43 (81.1 % patients were revealed to have the areas of reduced compliance due to what malignancy in prostate gland (PG was excluded. Morphological diagnosis of prostate carcinoma was confirmed in 21 patients. In 51 patients SEG-picture corresponded to benign process confirmed by histology.Conclusion. Sonoelastography is a modern diagnostic technique of prostatic diseases, seminal vesicles, paraprostatic space. The distinguished mapping types enable to make differential diagnosis of different prostatic pathological processes. Sonoelastography improves prostate carcinoma diagnostics and staging, and also has economic significance value when compared to MRP (magnetic resonance tomography with bolus contrast.

  8. Ultrasonographic Findings of the Prostatic Disease : Comparative Analysis of the Benign and Malignant Nodules

    Energy Technology Data Exchange (ETDEWEB)

    Song, Yun Gyu; Kim, Ji Yang; Lee, Su Han; Kong, Su Jin; Sung, Young Soon; Kwon, Jae Soo [Masan Samsung General Hospital, Masan (Korea, Republic of)

    1996-06-15

    We evaluated the characteristics of the benign and malignant nodules on transrectal ultrasound in diagnosis of prostatic disease. Histologic examination of the trans perineal prostatic biopsy of the total 47 cases resulted in 19 cases of BPH, 8 cases of prostatic cancer, and 20 cases of normal prostatic tissue group. The hypoechoic mass in peripheral zone on TRUS had high possibility of prostatic carcinoma and the isoechoic or mixed echogenic mass in central gland had high possibility of benign lesion. Hypoechoic haloes around nodules and cysts were noted in BPH and normal prostatic tissue group, that were compatible with benign lesion. The mean value of PSA was 12.0 ng/ ml in BPH, 8.5 ng / ml in normal prostatic tissue group, and 65.6 ng / ml in prostatic cancer, which was very high in prostatic cancer. Between BPH and normal prostatic tissue group, there was no demonstrable difference in location of nodule, pattern of calcification, and echogenicity of the nodules on TRUS. The size of prostatic gland was relatively smaller and mean value of PSA was lower in normal prostatic tissue group, compared with in BPH. In conclusion, the location of the nodules and PSA value are considered to be important in differentiation of the benign and malignant prostatic nodules

  9. CYP19A1 genetic variation in relation to prostate cancer risk and circulating sex hormone concentrations in men from the Breast and Prostate Cancer Cohort Consortium.

    Science.gov (United States)

    Travis, Ruth C; Schumacher, Fredrick; Hirschhorn, Joel N; Kraft, Peter; Allen, Naomi E; Albanes, Demetrius; Berglund, Goran; Berndt, Sonja I; Boeing, Heiner; Bueno-de-Mesquita, H Bas; Calle, Eugenia E; Chanock, Stephen; Dunning, Alison M; Hayes, Richard; Feigelson, Heather Spencer; Gaziano, J Michael; Giovannucci, Edward; Haiman, Christopher A; Henderson, Brian E; Kaaks, Rudolf; Kolonel, Laurence N; Ma, Jing; Rodriguez, Laudina; Riboli, Elio; Stampfer, Meir; Stram, Daniel O; Thun, Michael J; Tjønneland, Anne; Trichopoulos, Dimitrios; Vineis, Paolo; Virtamo, Jarmo; Le Marchand, Loïc; Hunter, David J

    2009-10-01

    Sex hormones, particularly the androgens, are important for the growth of the prostate gland and have been implicated in prostate cancer carcinogenesis, yet the determinants of endogenous steroid hormone levels remain poorly understood. Twin studies suggest a heritable component for circulating concentrations of sex hormones, although epidemiologic evidence linking steroid hormone gene variants to prostate cancer is limited. Here we report on findings from a comprehensive study of genetic variation at the CYP19A1 locus in relation to prostate cancer risk and to circulating steroid hormone concentrations in men by the Breast and Prostate Cancer Cohort Consortium (BPC3), a large collaborative prospective study. The BPC3 systematically characterized variation in CYP19A1 by targeted resequencing and dense genotyping; selected haplotype-tagging single nucleotide polymorphisms (htSNP) that efficiently predict common variants in U.S. and European whites, Latinos, Japanese Americans, and Native Hawaiians; and genotyped these htSNPs in 8,166 prostate cancer cases and 9,079 study-, age-, and ethnicity-matched controls. CYP19A1 htSNPs, two common missense variants and common haplotypes were not significantly associated with risk of prostate cancer. However, several htSNPs in linkage disequilibrium blocks 3 and 4 were significantly associated with a 5% to 10% difference in estradiol concentrations in men [association per copy of the two-SNP haplotype rs749292-rs727479 (A-A) versus noncarriers; P = 1 x 10(-5)], and with inverse, although less marked changes, in free testosterone concentrations. These results suggest that although germline variation in CYP19A1 characterized by the htSNPs produces measurable differences in sex hormone concentrations in men, they do not substantially influence risk of prostate cancer. PMID:19789370

  10. Prostatic Stromal Hyperplasia with Atypia

    OpenAIRE

    Hutchinson, Ryan C.; Wu, Kevin J.; Cheville, John C.; Thiel, David D

    2013-01-01

    Prostatic stromal hyperplasia with atypia (PSHA) is a rare histologic finding diagnosed incidentally on prostate biopsies, transurethral resection specimens, and radical prostatectomy specimens. PSHA has a bizarre histologic appearance and these lesions often raise concern for sarcoma; however, their clinical course is indolent and does not include extraprostatic progression. We discuss a case of PHSA discovered on prostate biopsy performed for an abnormal digital rectal examination and revie...

  11. Prostatic Stromal Hyperplasia with Atypia

    Directory of Open Access Journals (Sweden)

    Ryan C. Hutchinson

    2013-01-01

    Full Text Available Prostatic stromal hyperplasia with atypia (PSHA is a rare histologic finding diagnosed incidentally on prostate biopsies, transurethral resection specimens, and radical prostatectomy specimens. PSHA has a bizarre histologic appearance and these lesions often raise concern for sarcoma; however, their clinical course is indolent and does not include extraprostatic progression. We discuss a case of PHSA discovered on prostate biopsy performed for an abnormal digital rectal examination and review the literature on this rare pathologic finding.

  12. Health-related quality of life and treatment outcomes for men with prostate cancer treated by combined external-beam radiotherapy and hormone therapy

    International Nuclear Information System (INIS)

    Health-related quality of life (HR-QOL) is important when considering the treatment options for prostate cancer. From 1992 to 1998, 57 patients were treated by radiotherapy plus hormone therapy (median age, 79 years; median prostate-specific antigen concentration, 15.0 ng/ml; median radiotherapy dosage, 60 Gy). General HR-QOL was measured by the European Organization for Research and Treatment of Cancer Prostate Cancer QOL Questionnaire, and a newly developed disease-specific QOL survey was used to assess urinary and bowel functions. QOL was also measured in a control group of patients admitted for prostate biopsy. The general HR-QOL scores in the radiation group ranged from 70.0 to 91.3, with sexual problems showing the lowest (i.e., worst) score (38.5). Compared with the control group, the scores in the radiation group were worse for physical function and sexual problems. For disease-specific QOL, the radiation group had worse urinary function than controls, but were more satisfied with their urinary function. There was no difference between the radiation group and controls in satisfaction with bowel function. When the control group was subdivided at into two groups: age 75 years or less, and age over 75 years, the QOL score in the radiation group was the same as that in the subgroup aged over 75 years. In subgroups of the radiation patients, according to survey period, there was no difference between the first and last surveys in longitudinal HR-QOL evaluations. The 5- and 10-year overall survival rates were 67.6% and 41.6%, respectively, and the 5- and 10-year cause-specific survival rates were 97.9% and 94.7%. The combination of radiotherapy and hormone therapy has a good outcome and patients do not experience poor HR-QOL, except for sexual problems. Moreover, the disease-specific QOL is good, especially for urinary bother. (author)

  13. Bone Marrow Aspiration and Biopsy

    Science.gov (United States)

    ... Global Sites Search Help? Bone Marrow Aspiration and Biopsy Share this page: Was this page helpful? Also ... Examination Formal name: Bone Marrow Aspiration; Bone Marrow Biopsy Related tests: Complete Blood Count ; WBC Differential ; Reticulocyte ...

  14. Detecting Prostate Cancer

    Medline Plus

    Full Text Available ... rectal examination does not mean that they have prostate cancer. It means that we're concerned about it and they should go on to have other tests, such as a trans-rectal ultrasound ... made of the prostate gland. Usually these are accompanied by a biopsy -- ...

  15. Detecting Prostate Cancer

    Science.gov (United States)

    ... rectal examination does not mean that they have prostate cancer. It means that we're concerned about it and they should go on to have other tests, such as a trans-rectal ultrasound ... made of the prostate gland. Usually these are accompanied by a biopsy -- ...

  16. Human papillomavirus infection is not related with prostatitis-related symptoms: results from a case-control study

    Directory of Open Access Journals (Sweden)

    Riccardo Bartoletti

    2014-04-01

    Full Text Available PurposeTo investigate the relationship between human papillomavirus (HPV infection and prostatitis-related symptoms.Materials and MethodsAll young heterosexual patients with prostatitis-related symptoms attending the same Center from January 2005 to December 2010 were eligible for this case-control study. Sexually active asymptomatic men were considered as the control group. All subjects underwent clinical examination, Meares-Stamey test and DNA-HPV test. Patients with prostatitis-related symptoms and asymptomatic men were compared in terms of HPV prevalence. Moreover, multivariable Cox proportional hazards regression analysis was performed to determine the association between HPV infection and prostatitis-related symptoms.ResultsOverall, 814 out of 2,938 patients (27.7% and 292 out of 1,081 controls (27.0% proved positive to HPV. The HPV genotype distribution was as follows: HR-HPV 478 (43.3%, PHR-HPV 77 (6.9%, LR-HPV 187 (16.9% and PNG-HPV 364 (32.9%. The most common HPV genotypes were: 6, 11, 16, 26, 51, 53 and 81. No difference was found between the two groups in terms of HPV infection (OR 1.03; 95% CI 0.88-1.22; p = 0.66. We noted a statistically significant increase in HPV infection over the period 2005 to 2010 (p < 0.001 in both groups. Moreover, we found a statistically significant increase in HPV 16 frequency from 2005 to 2010 (p = 0.002.ConclusionsThis study highlights that prostatitis-like symptoms are unrelated to HPV infection. Secondary, we highlight the high prevalence of asymptomatic HPV infection among young heterosexual men.

  17. A nomogram based on age, prostate-specific antigen level, prostate volume and digital rectal examination for predicting risk of prostate cancer

    OpenAIRE

    Tang, Ping; CHEN, HUI; Uhlman, Matthew; Lin, Yu-Rong; Deng, Xiang-Rong; Wang, Bin; Yang, Wen-Jun; Xie, Ke-Ji

    2012-01-01

    Nomograms for predicting the risk of prostate cancer developed using other populations may introduce sizable bias when applied to a Chinese cohort. In the present study, we sought to develop a nomogram for predicting the probability of a positive initial prostate biopsy in a Chinese population. A total of 535 Chinese men who underwent a prostatic biopsy for the detection of prostate cancer in the past decade with complete biopsy data were included. Stepwise logistic regression was used to det...

  18. Analysis of results related to the percent free prostate specific antigen among men without prostate diseases in Xi'an area

    Institute of Scientific and Technical Information of China (English)

    Peng Zhang; Ziming Wang; Tie Chong; Lihua Zhao

    2007-01-01

    Objective: To measure the percent of free prostate specific antigen (fPSA) among men without prostate diseases in Xi'an area, and to study the relationship of percent fPSA with age and pathological grade, clinical stage of prostate cancer (PCa) with percent fPSA, and to analyze the difference between the data in China and theoverseas data to determine appropriate reference range for Chinese male. Methods: A total of 713 participants were enrolled into the study, with PSA, fPSA in serum measured and the percent fPSA calculated. Out of 713 cases, 679 without prostate diseases were divided into 5 groups by age, and then the relationships of PSA, fPSA and percent fPSA with age were studied, respectively. The relationship of pathological grade and clinical stage with percent fPSA of the 34 participants with PCa was also studied. With the help of the related data of men without prostate disease, the appropriate reference range for Chinese male was established. Results: The increases in PSA or fPSA were correlated with age, while there was no significant correlation between age and percent fPSA. The percent fPSA was also correlated with pathological grade and clinical stage of PCa. The percent fPSA of men without prostate disease in Xi'an area was significantly lower than that in the related overseas data. The reference range of percent fPSA for Chinese male was≥15%. Conclusion: Percent fPSA might be more useful than PSA in the detection of prostate cancer. As the percent fPSA is decreased, the pathological grade is decreased, and the clinical stage is increased, the malignant degree is increased. The reference range of≥15% is more appropriate for Chinese male.

  19. The role of secreted frizzled-related protein 2 expression in prostate cancer.

    LENUS (Irish Health Repository)

    O'Hurley, Gillian

    2012-02-01

    AIMS: Improved prostate cancer (PCa)-specific biomarkers are urgently required to distinguish between indolent and aggressive disease, in order to avoid overtreatment. In this study, we investigated the prostatic tissue expression of secreted frizzled-related protein (SFRP)-2. METHODS AND RESULTS: Following immunohistochemical analysis on PCa tissue microarrays with samples from 216 patients, strong\\/moderate SFRP-2 expression was observed in epithelial cells of benign prostatic hyperplasia, and negative\\/weak SFRP-2 expression was observed in the majority of tumour epithelia. However, among Gleason grade 5 carcinomas, 40% showed strong\\/moderate SFRP-2 expression and 60% showed negative SFRP-2 expression in epithelial cells. Further microscopic evaluation of Gleason grade 5 tumours revealed different morphological patterns, corresponding with differential SFRP-2 expression. The first subgroup (referred to as Type A) appeared to have a morphologically solid growth pattern, whereas the second subgroup (referred to as Type B) appeared to have a more diffuse pattern. Furthermore, 100% (4\\/4) of Type A patients experienced biochemical recurrence, as compared with 0% (0\\/6) of Type B patients. CONCLUSIONS: These results imply: (i) that there is a loss of SFRP-2 expression from benign to malignant prostate glands; and (ii) differential SFRP-2 expression among two possible subgroups of Gleason grade 5 tumours.

  20. Diffusion-weighted imaging with relative signal intensity statistical thresholding for delineating prostate cancer tumors

    International Nuclear Information System (INIS)

    We assessed the utility of diffusion-weighted imaging (DWI) with relative signal intensity (rSI) statistical thresholding for delineating prostate cancer tumors. Seventeen patients with prostate cancer underwent DWI before total prostatectomy. We measured standard deviation (SD) of the signal intensity (SI) of the lesser pelvic space at DWI, created rSI maps, displaying signal intensities with SDs of only > +3, > +3.5, > +4, or > +5, and assessed correlation between the proportion of cancerous area on the 4 different rSI maps and that on pathological slices. We could detect prostate cancer on rSI maps for all cases with SD > +3, but not 2 cases with SD > +3.5, five with SD > +4, and eight with SD > +5. The correlation coefficients (R) between the proportion of cancerous area on pathological examination and rSI maps were 0.7464 for SD > +3 (P=0.0006); 0.6469 for SD > +3.5 (P=0.0050); 0.6459 for SD > +4 (P=0.0051), and 0.4540 for SD > +5 (P=0.0671). DWI-based rSI mapping may be used to delineate the extent of prostate cancer. We achieved best correlation between ratio of cancerous area of the lesser pelvic space on pathological examination and on rSI map using a threshold with SD > +3 of the SI. (author)

  1. Role of transurethral resection of the prostate in the management of prostate cancer

    OpenAIRE

    Szollosi Attila; Martha Orsolya; Denes Lorand; Vida Arpad Oliver; Maier Adrian; Pavai Zoltan

    2016-01-01

    Introduction: Prostate cancer is the second most diagnosed cancer in men, after lung cancer. The gold standard procedure in prostate cancer (PCa) diagnosis is the ultrasound guided prostate biopsy. Transurethral resection of the prostate (TURP) used in solving the bladder outlet obstruction, can have a role in detection of PCa. The aim of this retrospective study is to examine the role of transurethral resection of the prostate in the diagnosis and therapy of prostate cancer.

  2. Role of transurethral resection of the prostate in the management of prostate cancer

    Directory of Open Access Journals (Sweden)

    Szollosi Attila

    2016-06-01

    Full Text Available Introduction: Prostate cancer is the second most diagnosed cancer in men, after lung cancer. The gold standard procedure in prostate cancer (PCa diagnosis is the ultrasound guided prostate biopsy. Transurethral resection of the prostate (TURP used in solving the bladder outlet obstruction, can have a role in detection of PCa. The aim of this retrospective study is to examine the role of transurethral resection of the prostate in the diagnosis and therapy of prostate cancer.

  3. Concurrent AURKA and MYCN Gene Amplifications Are Harbingers of Lethal TreatmentRelated Neuroendocrine Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Juan Miguel Mosquera

    2013-01-01

    Full Text Available Neuroendocrine prostate cancer (NEPC, also referred to as anaplastic prostate cancer, is a lethal tumor that most commonly arises in late stages of prostate adenocarcinoma (PCA with predilection to metastasize to visceral organs. In the current study, we explore for evidence that Aurora kinase A (AURKA and N-myc (MYCN gene abnormalities are harbingers of treatment-related NEPC (t-NEPC. We studied primary prostate tissue from 15 hormone naïve PCAs, 51 castration-resistant prostate cancers, and 15 metastatic tumors from 72 patients at different stages of disease progression to t-NEPC, some with multiple specimens. Histologic evaluation, immunohistochemistry, and fluorescence in situ hybridization were performed and correlated with clinical variables. AURKA amplification was identified in overall 65% of PCAs (hormone naïve and treated from patients that developed t-NEPC and in 86% of metastases. Concurrent amplification of MYCN was present in 70% of primary PCAs, 69% of treated PCAs, and 83% of metastases. In contrast, in an unselected PCA cohort, AURKA and MYCN amplifications were identified in only 5% of 169 cases. When metastatic t-NEPC was compared to primary PCA from the same patients, there was 100% concordance of ERG rearrangement, 100% concordance of AURKA amplification, and 60% concordance of MYCN amplification. In tumors with mixed features, there was also 100% concordance of ERG rearrangement and 94% concordance of AURKA and MYCN co-amplification between areas of NEPC and adenocarcinoma. AURKA and MYCN amplifications may be prognostic and predictive biomarkers, as they are harbingers of tumors at risk of progressing to t-NEPC after hormonal therapy.

  4. Deformation of Prostate and Seminal Vesicles Relative to Intraprostatic Fiducial Markers

    International Nuclear Information System (INIS)

    Purpose: To quantify the residual geometric uncertainties after on-line corrections with intraprostatic fiducial markers, this study analyzed the deformation of the prostate and, in particular, the seminal vesicles relative to such markers. Patients and Methods: A planning computed tomography (CT) scan and three repeat CT scans were obtained for 21 prostate cancer patients who had had three to four cylindrical gold markers placed. The prostate and whole seminal vesicles (clinical target volume [CTV]) were delineated on each scan at a slice thickness of 1.5 mm. Rigid body transformations (translation and rotation) mapping the markers onto the planning scan positions were obtained. The translation only (Tonly) or both translation and rotation were applied to the delineated CTVs. Next, the residue CTV surface displacements were determined using nonrigid registration of the delineated contours. For translation and rotation of the CTV, the residues represented deformation; for Tonly, the residues stemmed from deformation and rotation. Tonly represented the residues for most currently applied on-line protocols. The patient and population statistics of the CTV surface displacements were calculated. The intraobserver delineation variation was similarly quantified using repeat delineations for all patients and corrected for. Results: The largest CTV deformations were observed at the anterior and posterior side of the seminal vesicles (population average standard deviation ≤3 mm). Prostate deformation was small (standard deviation ≤1 mm). The increase in these deviations when neglecting rotation (Tonly) was small. Conclusion: Although prostate deformation with respect to implanted fiducial markers was small, the corresponding deformation of the seminal vesicles was considerable. Adding marker-based rotational corrections to on-line translation corrections provided a limited reduction in the estimated planning margins

  5. MRI & MR SPECTROSCOPIC EVALUATION OF PROSTATIC CARCINOMA

    Directory of Open Access Journals (Sweden)

    Rupak

    2015-09-01

    Full Text Available BACKGROUND : Prostate cancer is the most common malignancy among men more than fifty years of age (Cancer foundation of India. Imaging may help in clarifying several important issues in localized prostate cancer. MRI provides the best depiction of the contours of the prostate as well as its internal zonal anatomy. Recent evidence suggests that multi - parametric MRI could improve the accuracy of diagnostic assessment in prostate cancer. In addition, MRI also allows functional assessment with techniques such as diffusion - weighted MRI (DWI, MR spectroscopy (MRS, and dynamic contrast enhanced MRI (DCE - MRI. Strong opinions are held about the need for endorectal coil imaging. Endorectal coils provide large gains in signal with reductions in noise, most noticeably at 1.5 T; however, endorectal coils are uncomfortable and expensive. At 3 T, the need for endorectal coils has been debated. Clearly, the highest - quality MRI results from the combined use of endorectal coils and phased array body coils at 3 T. Prostate cancer is associated with proportionately lower levels of citrate and higher levels of choline and creatine than are seen in benign prostatic hyperplasia (BPH or in normal prostate tissu e. This difference can be detected by magnetic resonance spectroscopic imaging (MRSI. MRSI uses a strong magnetic field to obtain metabolic information (spectra that identifies the relative concentrations of various metabolites in the cell cytoplasm and the extracellular space. This technique can identify metabolic differences in prostate tissue (BPH, prostate cance r, and normal prostate tissue. AIM: To evaluate the role of MRI and MR Spectroscopy in the diagnosis of prostatic carcinoma by pelvic phased array coil in the detection of prostatic carcinoma in men with Prostatomegaly & elevated PSA levels and establishing statistical analysis of the same. METHOD: A prospective study of minimum 50 consecutive cases with Prostatomegaly & raised PSA levels

  6. Finasteride concentrations and prostate cancer risk: results from the Prostate Cancer Prevention Trial.

    Directory of Open Access Journals (Sweden)

    Cindy H Chau

    Full Text Available In the Prostate Cancer Prevention Trial (PCPT, finasteride reduced the risk of prostate cancer by 25%, even though high-grade prostate cancer was more common in the finasteride group. However, it remains to be determined whether finasteride concentrations may affect prostate cancer risk. In this study, we examined the association between serum finasteride concentrations and the risk of prostate cancer in the treatment arm of the PCPT and determined factors involved in modifying drug concentrations.Data for this nested case-control study are from the PCPT. Cases were drawn from men with biopsy-proven prostate cancer and matched controls. Finasteride concentrations were measured using a liquid chromatography-mass spectrometry validated assay. The association of serum finasteride concentrations with prostate cancer risk was determined by logistic regression. We also examine whether polymorphisms in the enzyme target and metabolism genes of finasteride are related to drug concentrations using linear regression.Among men with detectable finasteride concentrations, there was no association between finasteride concentrations and prostate cancer risk, low-grade or high-grade, when finasteride concentration was analyzed as a continuous variable or categorized by cutoff points. Since there was no concentration-dependent effect on prostate cancer, any exposure to finasteride intake may reduce prostate cancer risk. Of the twenty-seven SNPs assessed in the enzyme target and metabolism pathway, five SNPs in two genes, CYP3A4 (rs2242480; rs4646437; rs4986910, and CYP3A5 (rs15524; rs776746 were significantly associated with modifying finasteride concentrations. These results suggest that finasteride exposure may reduce prostate cancer risk and finasteride concentrations are affected by genetic variations in genes responsible for altering its metabolism pathway.ClinicalTrials.gov NCT00288106.

  7. Endomyocardial biopsy

    International Nuclear Information System (INIS)

    As the result of recent improvements in catheter design and pathologic interpretation, transvascular endomyocardial biopsy has become an important component in the invasive evaluation of patients with known or suspected primary myocardial dysfunction. Because significant controversy remains about the definition, frequency, natural history, and optimal treatment, of many of these myocardial disorders, however, use of the endomyocardial biopsy in the routine evaluation of patients with myocardial disease varies from center to center. This chapter focuses on the currently available techniques for endomyocardial histology appears most valuable, rather than on a precise listing of current indications for this procedure

  8. Gene expression in skeletal muscle biopsies from people with type 2 diabetes and relatives

    DEFF Research Database (Denmark)

    Palsgaard, Jane; Brøns, Charlotte; Friedrichsen, Martin;

    2009-01-01

    BACKGROUND: Gene expression alterations have previously been associated with type 2 diabetes, however whether these changes are primary causes or secondary effects of type 2 diabetes is not known. As healthy first degree relatives of people with type 2 diabetes have an increased risk of developing...

  9. Health-related quality of life in men receiving prostate brachytherapy on RTOG 98-05

    International Nuclear Information System (INIS)

    Purpose: To prospectively assess health-related quality of life (HRQOL) during the first year after treatment with prostate brachytherapy (PB) alone for T1c-2a prostate cancer. Materials and Methods: Ninety-eight patients from 24 institutions were eligible and properly entered on this study. All patients were treated with PB alone using I-125 (Oncura Model 6711). The prescription dose was 145 Gy. Three separate health-related quality of life questionnaires (HRQOL) (Functional Assessment of Cancer Therapy-Prostate [FACT-P], Sexual Adjustment Questionnaire [SAQ], and International Prostate Symptom Score [IPSS]) were self-administered before and after PB (baseline; 3, 6, 9, and 12 months after PB). The standard error of the mean (SEM) was used to analyze changes in HRQOL scores over time. Patients who improved greater than the SEM were categorized as improved; patients that declined greater than the SEM were categorized as declined; patients were otherwise categorized as stable. All changes are measured using the pretreatment HRQOL score as baseline. Results: The percentage of men who reported the ability to have an erection decreased from 73% at baseline (65% unassisted, 8% assisted) to 57% at 1 year (36% unassisted, 21% assisted). The rate of urinary incontinence increased to 14% at 6 months but had decreased to 1% at the 12-month follow-up. At 1 year after PB, 80% of men reported decreased sexual functioning according to SAQ scores. More than 60% of men reported decreased urinary function at 12 months compared with baseline. Conclusions: This article represents the first prospective, multi-institutional study of HRQOL in men treated with PB and demonstrates that patients undergoing PB have a very high overall HRQOL. The rate of incontinence by 1 year after PB is low, but many patients continue to have obstructive symptoms at 1 year. Although 78% of 1-year respondents state that they can achieve an erection with or without assistance, almost 50% report a decrease in

  10. Parathyroid hormone related-protein promotes epithelial-to-mesenchymal transition in prostate cancer.

    Directory of Open Access Journals (Sweden)

    Weg M Ongkeko

    Full Text Available Parathyroid hormone-related protein (PTHrP possesses a variety of physiological and developmental functions and is also known to facilitate the progression of many common cancers, notably their skeletal invasion, primarily by increasing bone resorption. The purpose of this study was to determine whether PTHrP could promote epithelial-to-mesenchymal transition (EMT, a process implicated in cancer stem cells that is critically involved in cancer invasion and metastasis. EMT was observed in DU 145 prostate cancer cells stably overexpressing either the 1-141 or 1-173 isoform of PTHrP, where there was upregulation of Snail and vimentin and downregulation of E-cadherin relative to parental DU 145. By contrast, the opposite effect was observed in PC-3 prostate cancer cells where high levels of PTHrP were knocked-down via lentiviral siRNA transduction. Increased tumor progression was observed in PTHrP-overexpressing DU 145 cells while decreased progression was observed in PTHrP-knockdown PC-3 cells. PTHrP-overexpressing DU 145 formed larger tumors when implanted orthoptopically into nude mice and in one case resulted in spinal metastasis, an effect not observed among mice injected with parental DU 145 cells. PTHrP-overexpressing DU 145 cells also caused significant bone destruction when injected into the tibiae of nude mice, while parental DU 145 cells caused little to no destruction of bone. Together, these results suggest that PTHrP may work through EMT to promote an aggressive and metastatic phenotype in prostate cancer, a pathway of importance in cancer stem cells. Thus, continued efforts to elucidate the pathways involved in PTHrP-induced EMT as well as to develop ways to specifically target PTHrP signaling may lead to more effective therapies for prostate cancer.

  11. Functional evaluation of DNA repair in human biopsies and their relation to other cellular biomarkers

    OpenAIRE

    Slyskova, Jana; Langie, Sabine A. S.; Collins, Andrew R.; Vodicka, Pavel

    2014-01-01

    Thousands of DNA lesions are estimated to occur in each cell every day and almost all are recognized and repaired. DNA repair is an essential system that prevents accumulation of mutations which can lead to serious cellular malfunctions. Phenotypic evaluation of DNA repair activity of individuals is a relatively new approach. Methods to assess base and nucleotide excision repair pathways (BER and NER) in peripheral blood cells based on modified comet assay protocols have been widely applied i...

  12. Lymph node biopsy

    Science.gov (United States)

    Biopsy - lymph nodes; Open lymph node biopsy; Fine needle aspiration biopsy; Sentinel lymph node biopsy ... A lymph node biopsy is done in an operating room in a hospital. Or, it is done at an outpatient surgical center. The ...

  13. Ureteral retrograde brush biopsy

    Science.gov (United States)

    Biopsy - brush - urinary tract; Retrograde ureteral brush biopsy cytology; Cytology - ureteral retrograde brush biopsy ... to be biopsied is rubbed with the brush. Biopsy forceps may be used instead to collect a ...

  14. Clinical Perspective of Prostate Cancer.

    Science.gov (United States)

    Patil, Nilesh; Gaitonde, Krishnanath

    2016-06-01

    Prostate cancer is the most common noncutaneous cancer affecting men today. It largely affects men in the fifth and sixth decade of life. Screening for prostate cancer, though controversial, is still the only way to detect early prostate cancer. Multiple newer options such as blood tests and genetic markers are being used in the clinical domain today to improve cancer detection and avoid unnecessary biopsies. To date, biopsy of the prostate remains the only modality to stratify the grade of cancer. Significant improvements in the imaging technology have improved localizing and detecting the disease. Treatment of prostate cancer is stratified on the basis of the grade and volume of the disease. There are multiple treatment options involved in the management of prostate cancer. Treatment of localized prostate cancer still continues to have very high cure rates and long-term cancer-specific survival rates. PMID:27187167

  15. Health-Related Quality of Life up to Six Years After 125I Brachytherapy for Early-Stage Prostate Cancer

    International Nuclear Information System (INIS)

    Purpose: Health-related quality of life (HRQOL) after prostate brachytherapy has been extensively described in published reports but hardly any long-term data are available. The aim of the present study was to prospectively assess long-term HRQOL 6 years after 125I prostate brachytherapy. Methods and Materials: A total of 127 patients treated with 125I brachytherapy for early-stage prostate cancer between December 2000 and June 2003 completed a HRQOL questionnaire at five time-points: before treatment and 1 month, 6 months, 1 year, and 6 years after treatment. The questionnaire included the RAND-36 generic health survey, the cancer-specific European Organization for Research and Treatment of Cancer core questionnaire (EORTCQLQ-C30), and the tumor-specific EORTC prostate cancer module (EORTC-PR25). A change in a score of ≥10 points was considered clinically relevant. Results: Overall, the HRQOL at 6 years after 125I prostate brachytherapy did not significantly differ from baseline. Although a statistically significant deterioration in HRQOL at 6 years was seen for urinary symptoms, bowel symptoms, pain, physical functioning, and sexual activity (p 125I prostate brachytherapy. HRQOL scores returned to approximately baseline values at 1 year and remained stable up to 6 years after treatment. 125I prostate brachytherapy did not adversely affect patients' long-term HRQOL.

  16. Renal Tumor Biopsy Technique

    Institute of Scientific and Technical Information of China (English)

    Lei Zhang; Xue-Song Li; Li-Qun Zhou

    2016-01-01

    Objective:To review hot issues and future direction of renal tumor biopsy (RTB) technique.Data Sources:The literature concerning or including RTB technique in English was collected from PubMed published from 1990 to 2015.Study Selection:We included all the relevant articles on RTB technique in English,with no limitation of study design.Results:Computed tomography and ultrasound were usually used for guiding RTB with respective advantages.Core biopsy is more preferred over fine needle aspiration because of superior accuracy.A minimum of two good-quality cores for a single renal tumor is generally accepted.The use of coaxial guide is recommended.For biopsy location,sampling different regions including central and peripheral biopsies are recommended.Conclusion:In spite of some limitations,RTB technique is relatively mature to help optimize the treatment of renal tumors.

  17. [Intravesical active prostate bleeding diagnosed in B-mode ultrasound].

    Science.gov (United States)

    Kirchgesner, T; Danse, E; Tombal, B

    2013-09-01

    Hematuria is one of the most frequent minor complications after prostatic biopsy. We would like to report the case of a 68-year-old patient with massive hematuria after prostatic biopsy and intravesical active prostate bleeding diagnosed in B-mode ultrasonography. PMID:24034804

  18. A nomogram based on age,prostate-specific antigen level,prostate volume and digital rectal examination for predicting risk of prostate cancer

    Institute of Scientific and Technical Information of China (English)

    Ping Tang; Hui Chen; Matthew Uhlman; Yu-Rong Lin; Xiang-Rong Deng; Bin Wang; Wen-Jun Yang; Ke-Ji Xie

    2013-01-01

    Nomograms for predicting the risk of prostate cancer developed using other populations may introduce sizable bias when applied to a Chinese cohort.In the present study,we sought to develop a nomogram for predicting the probability of a positive initial prostate biopsy in a Chinese population.A total of 535 Chinese men who underwent a prostatic biopsy for the detection of prostate cancer in the past decade with complete biopsy data were included.Stepwise logistic regression was used to determine the independent predictors of a positive initial biopsy.Age,prostate-specific antigen (PSA),prostate volume (PV),digital rectal examination (DRE) status,% free PSA and transrectal ultrasound (TRUS) findings were included in the analysis.A nomogram model was developed that was based on these independent predictors to calculate the probability of a positive initial prostate biopsy.A receiver-operating characteristic curve was used to assess the accuracy of using the nomogram and PSA levels alone for predicting positive prostate biopsy.The rate for positive initial prostate biopsy was 41.7% (223/535).The independent variables used to predict a positive initial prostate biopsy were age,PSA,PV and DRE status.The areas under the receiver-operating characteristic curve for a positive initial prostate biopsy for PSA alone and the nomogram were 79.7% and 84.8%,respectively.Our results indicate that the risk of a positive initial prostate biopsy can be predicted to a satisfactory level in a Chinese population using our nomogram.The nomogram can be used to identify and Counsel patients who should consider a prostate biopsy,ultimately enhancing accuracy in diagnosing prostate cancer.

  19. Comparison of per rectum two-dimensional and three-dimensional ultrasound guidance in prostatic systematicness puncture biopsy%经直肠二维及三维超声引导下前列腺系统性穿刺的比较

    Institute of Scientific and Technical Information of China (English)

    常莹; 杨敬春; 王萍

    2014-01-01

    Objective To compare the positive rate of per rectum two-dimensional and three-dimensional ultrasound guidance in prostatic systematicness puncture biopsy, to evaluate the value of clinical application of the two methods. Methods 60 patients with digital rectal examination or abnormal of prostatic specific antigen(PSA) (> 4.0ng/mL)without past medical history of prostate cancer were divided into two groups who were respectively actualized on prostatic systematicness puncture biopsy of two-dimensional and three-dimensional ultrasound guidance. Results The positive rate of prostatic cancer of 3D-TRUS(50.0%)in prostatic systematicness puncture biopsy was higher than which of 2D-TRUS(36.7%)(P=0.001), the number of positive needles of 3D-TRUS was obviously higher than which of 2D-TRUS(P=0.000). Conclusion The positive rate of 3D-TRUS in prostatic systematicness puncture biopsy was higher than which of 2D-TRUS.%目的:比较经直肠二维及三维超声引导下前列腺穿刺活检的阳性率,评价这两种方法在临床应用中的价值。方法选取既往无前列腺癌病史的60例直肠指检或者前列腺特异抗原(PSA)异常(>4.0ng/mL)的患者,随机分为两组,分别行2D-TRUS及3D-TRUS超声引导下的穿刺活检。结果3D-TRUS引导下的前列腺穿刺活检,其前列腺癌的阳性检出率高于2D-TRUS(50.0%∶36.7%),P=0.001,3D-TRUS阳性针数的比例明显高于2D-TRUS,P=0.000。结论3D-TRUS超声引导下的前列腺穿刺活检阳性检出率明显高于2D-TRUS。

  20. Gene expression in skeletal muscle biopsies from people with type 2 diabetes and relatives: differential regulation of insulin signaling pathways.

    Directory of Open Access Journals (Sweden)

    Jane Palsgaard

    Full Text Available BACKGROUND: Gene expression alterations have previously been associated with type 2 diabetes, however whether these changes are primary causes or secondary effects of type 2 diabetes is not known. As healthy first degree relatives of people with type 2 diabetes have an increased risk of developing type 2 diabetes, they provide a good model in the search for primary causes of the disease. METHODS/PRINCIPAL FINDINGS: We determined gene expression profiles in skeletal muscle biopsies from Caucasian males with type 2 diabetes, healthy first degree relatives, and healthy controls. Gene expression was measured using Affymetrix Human Genome U133 Plus 2.0 Arrays covering the entire human genome. These arrays have not previously been used for this type of study. We show for the first time that genes involved in insulin signaling are significantly upregulated in first degree relatives and significantly downregulated in people with type 2 diabetes. On the individual gene level, 11 genes showed altered expression levels in first degree relatives compared to controls, among others KIF1B and GDF8 (myostatin. LDHB was found to have a decreased expression in both groups compared to controls. CONCLUSIONS/SIGNIFICANCE: We hypothesize that increased expression of insulin signaling molecules in first degree relatives of people with type 2 diabetes, work in concert with increased levels of insulin as a compensatory mechanism, counter-acting otherwise reduced insulin signaling activity, protecting these individuals from severe insulin resistance. This compensation is lost in people with type 2 diabetes where expression of insulin signaling molecules is reduced.

  1. IL-8 secretion in primary cultures of prostate cells is associated with prostate cancer aggressiveness

    Directory of Open Access Journals (Sweden)

    Neveu B

    2014-05-01

    Full Text Available Bertrand Neveu*, Xavier Moreel*, Marie-Pier Deschênes-Rompré, Alain Bergeron, Hélène LaRue, Cherifa Ayari, Yves Fradet, Vincent FradetDepartment of Surgery, Laval University Cancer Research Centre, CHU de Quebec Research Centre, Quebec, QC, Canada *These authors contributed equally to this workBackground: Chronic inflammation is believed to be a major factor in prostate cancer initiation and promotion and has been studied using prostate cancer cells and immortalized cell lines. However, little is known about the contribution of normal cells to the prostatic microenvironment and inflammation. We aim to study the contribution of normal prostate epithelial cells to prostate inflammation and to link the inflammatory status of normal cells to prostate cancer aggressiveness.Materials and methods: Short-term primary cell cultures of normal epithelial prostate cells were derived from prostate biopsies from 25 men undergoing radical prostatectomy, cystoprostatectomy, or organ donation. Cells were treated with polyinosinic:polycytidylic acid, a mimic of double-stranded viral RNA and a potent inducer of the inflammatory response. Secretion of interleukin (IL-8 in the cell culture medium by untreated and treated cells was measured and we determined the association between IL-8 levels in these primary cell cultures and prostate cancer characteristics. The Fligner–Policello test was used to compare the groups.Results: Baseline and induced IL-8 secretion were highly variable between cultured cells from different patients. This variation was not related to drug use, past medical history, age, or preoperative prostate-specific antigen value. Nonetheless, an elevated secretion of IL-8 from normal cultured epithelial cells was associated with prostate cancer aggressiveness (P=0.0005.Conclusion: The baseline secretion of IL-8 from normal prostate epithelial cells in culture is strongly correlated with cancer aggressiveness and may drive prostate cancer

  2. Impact of pre-treatment prostate tissue androgen content on the prediction of castration-resistant prostate cancer development in patients treated with primary androgen deprivation therapy.

    Science.gov (United States)

    Shibata, Y; Suzuki, K; Arai, S; Miyoshi, Y; Umemoto, S; Masumori, N; Kamiya, N; Ichikawa, T; Kitagawa, Y; Mizokami, A; Sugimura, Y; Nonomura, N; Sakai, H; Honma, S; Kubota, Y

    2013-05-01

    Great advances in tissue androgen analysis using liquid chromatography-tandem mass spectrometry (LC-MS/MS) have made it possible to evaluate the tissue androgen content from a single needle prostate biopsy specimen. In this study, we investigated if pre-treatment androgen content in prostate biopsy specimens could predict their response to primary androgen deprivation therapy (ADT) and future castration-resistant prostate cancer (CRPC). One-hundred and sixty-five prostate cancer patients who received primary ADT were enrolled. They had received multiple core prostate needle biopsy at diagnosis, and an additional one needle biopsy specimen was obtained for tissue androgen determination using LC-MS/MS. The patients' prostate specific antigen (PSA) values were periodically followed during the treatment and patients were determined to have CRPC when their PSA value increased continuously to 25% above the nadir and a 2.0 ng/mL increase. A significant correlation was found between PSA value decline velocity (PSA half-time) after ADT and pre-ADT tissue androgen content. Twenty-three patients were determined to have CRPC. These CRPC patients had a significantly high concentration of tissue T (p development. By using the two statistically significant variables, the relative risk of CRPC development could be calculated. The results of this study suggest that the evaluation of prostate androgen content in a single needle biopsy specimen may be useful to predict future CRPC development after primary ADT. Further studies are required for the clinical application of T/DHT ratio evaluation. PMID:23444052

  3. Serum Oxidized Protein and Prostate Cancer Risk within the Prostate Cancer Prevention Trial

    OpenAIRE

    Hoque, Ashraful; Ambrosone, Christine B; Till, Cathee; Goodman, Phyllis J.; Tangen, Cathy; Kristal, Alan; Lucia, Scott; Wang, Qiao; Kappil, Maya; Thompson, Ian; Hsing, Ann W.; Parnes, Howard; Lippman, Scott M.; Santella, Regina M.

    2010-01-01

    To evaluate the role of oxidative stress in prostate cancer risk, we analyzed serum levels of protein carbonyl groups in 1808 prostate cancer cases and 1805 controls, nested in the Prostate Cancer Prevention Trial, a randomized, placebo-control trial that found finasteride decreased prostate cancer risk. There were no significant differences in protein carbonyl levels in baseline samples between those later diagnosed with prostate cancer and those without at the end of study biopsy. Adjusted ...

  4. Genetic Determinants of Metabolism and Benign Prostate Enlargement: Associations with Prostate Volume

    OpenAIRE

    Giri, Ayush; Edwards, Todd L.; Motley, Saundra S.; Byerly, Susan H.; Fowke, Jay H.

    2015-01-01

    Prostate enlargement leading to clinical benign prostatic hyperplasia (BPH) is associated with metabolic dysregulation and obesity. The genetic basis of this association is unclear. Our objective was to evaluate whether single nucleotide polymorphisms (SNPs) previously associated with metabolic disorders are also associated with prostate volume (PV). Participants included 876 men referred for prostate biopsy and found to be prostate cancer free. PV was measured by transrectal ultrasound. Samp...

  5. [Prostate cancer].

    Science.gov (United States)

    Morote, Joan; Maldonado, Xavier; Morales-Bárrera, Rafael

    2016-02-01

    The Vall d'Hebron multidisciplinary prostate cancer (PC) team reviews recent advances in the management of this neoplasm. Screening studies with long follow-up show a reduction in mortality, whereas active surveillance is emerging as a therapeutic approach of non-aggressive cancers. New markers increase the specificity of PSA and also allow targeting suspected aggressive cancers. Multiparametric magnetic resonance (mMRI) has emerged as the most effective method in the selection of patients for biopsy and also for local tumor staging. The paradigm of random prostatic biopsy is changing through the fusion techniques that allow guiding ultrasonography-driven biopsy of suspicious areas detected in mMRI. Radical prostatectomy (RP) and radiotherapy (RT) are curative treatments of localized PC and both have experienced significant technological improvements. RP is highly effective and the incorporation of robotic surgery is reducing morbidity. Modern RT allows the possibility of high tumor dose with minimal adjacent dose reducing its toxicity. Androgen deprivation therapy with LHRH analogues remains the treatment of choice for advanced PC, but should be limited to this indication. The loss of bone mass and adverse metabolic effects increases the frequency of fractures and cardiovascular morbimortality. After castration resistance in metastatic disease, new hormone-based drugs have demonstrated efficacy even after chemotherapy resistance. PMID:25727526

  6. Prospective investigation of change in the prostate-specific antigens after various urologic procedures

    Directory of Open Access Journals (Sweden)

    Park SC

    2015-07-01

    serum after DRE and TRUS. The mean differences were greater for free PSA level in the serum for TURP, TRUS-guided prostate biopsy, prostate massage, and rigid cystoscopy.Conclusion: Total and free PSA levels in the serum are altered by prostate massage, rigid cystoscopy, TRUS-guided prostate biopsy, and TURP. The PSA rises were related to the stimulation strength of the procedures. The total and free PSA levels were increased significantly from 10 minutes after procedures, except DRE and TRUS, and were increased to maximal level at 60 minutes after procedures.Keywords: prostate specific antigen (PSA, marker, diagnosis, prostate cancer, urologic procedures

  7. Biopsy in Musculoskeletal Tumors

    Directory of Open Access Journals (Sweden)

    Mohammad Gharehdaghi

    2014-09-01

    proximity to the skin incision, because this tract is also contaminated and must be excised with the surgical specimen. Imaging-guided core needle biopsy is a well-established technique for the diagnosis of bone and soft tissue tumors and tumor-like lesions in specialized orthopedic oncology centers. Although large lesions of the limbs can easily be biopsied without image guidance, lesions in the spine, para spinal area, and pelvis are difficult to target, therefore taking the advantage of C.T. guidance will improve the accuracy of targeting the lesion for biopsy purposes. We can benefit from image intensifiers for targeting limb lesions rather than C.T. guidance. Also sonographic guide can be applied for soft tissue lesions (Figure D, E, F. In soft tissue tumors, the results of percutaneous CNB are relatively inferior compared to open biopsy whereas almost equal results are expected for bony tumors except for low-grade chondrosarcoma. CNB is a safe, minimally invasive, and cost effective technique for the diagnosis of bone lesions if done by an experienced orthopedic oncologic surgeon and be evaluated by an experienced anatomical bone pathologist (1, 3. For soft tissue tumors, CNB results depend on the size of the lesion, its location and amount of tumor necrosis. Guided needle biopsy have become the standard technique in most orthopedic oncologic centers. The accuracy of this method in our center is more than 90% for bone tumors. Cores should be taken in different directions including areas of central necrotic tissues but from a single well planned entrance. The procedure is quick, especially for bone CNB or soft tissue FNA and CNB, and the diagnosis can be achieved within 24 – 48 hours. The material should be sufficient for immunohistochemistry evaluations as well (1-3. Because I have seen 3 cases of tumor implantation at the towel clips puncture site including 2 chondrosarcomas and a case of malignant schowanoma, so I highly suggest that never crush the skin by towel

  8. Androgen-independent proliferation of LNCaP prostate cancer cells infected by xenotropic murine leukemia virus-related virus

    Energy Technology Data Exchange (ETDEWEB)

    Kakoki, Katsura [Division of Cytokine Signaling, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523 (Japan); Department of AIDS Research, Institute of Tropical Medicine, G-COE, Nagasaki University, Nagasaki 852-8523 (Japan); Department of Urology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523 (Japan); Kamiyama, Haruka [Division of Cytokine Signaling, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523 (Japan); Department of AIDS Research, Institute of Tropical Medicine, G-COE, Nagasaki University, Nagasaki 852-8523 (Japan); Izumida, Mai; Yashima, Yuka; Hayashi, Hideki [Division of Cytokine Signaling, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523 (Japan); Yamamoto, Naoki [Department of AIDS Research, Institute of Tropical Medicine, G-COE, Nagasaki University, Nagasaki 852-8523 (Japan); Department of Microbiology, National University of Singapore (Singapore); Matsuyama, Toshifumi [Division of Cytokine Signaling, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523 (Japan); Igawa, Tsukasa; Sakai, Hideki [Department of Urology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523 (Japan); Kubo, Yoshinao, E-mail: yoshinao@nagasaki-u.ac.jp [Division of Cytokine Signaling, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523 (Japan); Department of AIDS Research, Institute of Tropical Medicine, G-COE, Nagasaki University, Nagasaki 852-8523 (Japan)

    2014-04-25

    Highlights: • XMRV infection induces androgen-independent growth in LNCaP cells. • XMRV infection reduces expression of androgen receptor. • XMRV promotes appearance of androgen blocker-resistant prostate cancer cells. - Abstract: Xenotropic murine leukemia virus-related virus (XMRV) is a novel gammaretrovirus that was originally isolated from human prostate cancer. It is now believed that XMRV is not the etiologic agent of prostate cancer. An analysis of murine leukemia virus (MLV) infection in various human cell lines revealed that prostate cancer cell lines are preferentially infected by XMRV, and this suggested that XMRV infection may confer some sort of growth advantage to prostate cancer cell lines. To examine this hypothesis, androgen-dependent LNCaP cells were infected with XMRV and tested for changes in certain cell growth properties. We found that XMRV-infected LNCaP cells can proliferate in the absence of the androgen dihydrotestosterone. Moreover, androgen receptor expression is significantly reduced in XMRV-infected LNCaP cells. Such alterations were not observed in uninfected and amphotropic MLV-infected LNCaP cells. This finding explains why prostate cancer cell lines are preferentially infected with XMRV.

  9. Androgen-independent proliferation of LNCaP prostate cancer cells infected by xenotropic murine leukemia virus-related virus

    International Nuclear Information System (INIS)

    Highlights: • XMRV infection induces androgen-independent growth in LNCaP cells. • XMRV infection reduces expression of androgen receptor. • XMRV promotes appearance of androgen blocker-resistant prostate cancer cells. - Abstract: Xenotropic murine leukemia virus-related virus (XMRV) is a novel gammaretrovirus that was originally isolated from human prostate cancer. It is now believed that XMRV is not the etiologic agent of prostate cancer. An analysis of murine leukemia virus (MLV) infection in various human cell lines revealed that prostate cancer cell lines are preferentially infected by XMRV, and this suggested that XMRV infection may confer some sort of growth advantage to prostate cancer cell lines. To examine this hypothesis, androgen-dependent LNCaP cells were infected with XMRV and tested for changes in certain cell growth properties. We found that XMRV-infected LNCaP cells can proliferate in the absence of the androgen dihydrotestosterone. Moreover, androgen receptor expression is significantly reduced in XMRV-infected LNCaP cells. Such alterations were not observed in uninfected and amphotropic MLV-infected LNCaP cells. This finding explains why prostate cancer cell lines are preferentially infected with XMRV

  10. Prostatitis - acute

    Science.gov (United States)

    ... bladder, such as alcohol, caffeinated foods and drinks, citrus juices, and hot or spicy foods. Drink more ... A.D.A.M. Editorial team. Related MedlinePlus Health Topics Prostate Diseases Browse the Encyclopedia A.D. ...

  11. Depression related to (neo)adjuvant hormonal therapy for prostate cancer

    International Nuclear Information System (INIS)

    Background: We studied whether hormonal therapy, (neo)adjuvant to radiotherapy for localized prostate cancer, is related to an increase in depression and whether this is caused by the hormonal therapy itself or by the relatively poor prognosis of patients who get (neo)adjuvant hormonal therapy. Methods: Between 2002 and 2005, 288 patients, irradiated for prostate cancer (T1-3N0M0), were studied prospectively in two clinics. In one clinic almost all patients received (neo)adjuvant androgen deprivation (Bicalutamide + Gosereline). In a second clinic hormonal therapy was prescribed mainly for high risk patients. This allowed us to separate the effects of hormonal therapy and the patient's prognosis. Results: During the course of hormonal therapy, depression was significantly heightened by both hormone use (p < 0.001) and poor prognosis (p < 0.01). After completion of hormonal therapy, poor prognosis continued to affect the depression score (p < 0.01). The increase was, however, small. Conclusions: Depression was mildly increased in patients receiving hormonal therapy. The increase appeared to be related to both the hormone therapy itself and the high risk status of patients. High risk status, with the associated poor prognosis, had a more sustained effect on depression. The rise was statistically significant, but was too small, however, to bear clinical significance.

  12. The value and limitations of contrast-enhanced transrectal ultrasonography for the detection of prostate cancer

    International Nuclear Information System (INIS)

    Objectives: To evaluate the role of contrast-enhanced transrectal ultrasonography (CE-TRUS) for detecting prostate carcinoma. Methods: Sixty-five patients with elevated serum prostate-specific antigen (PSA) and/or abnormal digital rectal examination (DRE) were assessed using transrectal ultrasound (TRUS) and CE-TRUS. In all the patients, CE-TRUS was performed with intravenous injection of contrast agent (SonoVue, 2.4 ml) before biopsy. The cancer detection rates of the two techniques were compared. False-positive and false-negative findings related to CE-TRUS were analyzed in comparison to the pathological results of biopsy or radical prostatectomy. The targeted biopsy to abnormal CE-TRUS areas was also compared to systematic biopsy. Results: Prostate cancer was detected in 29 of the 65 patients. CE-TRUS showed rapid focal enhancement or asymmetric vessels of peripheral zones in 28 patients; 23 of them had prostate cancer. CE-TRUS had 79.3% sensitivity, compared to 65.5% of TRUS (P < 0.05). There were five false-positive and six false-negative findings from CE-TRUS. Benign prostate hyperplasia, and acute and chronic prostatitis were important causes related to the false-positive results of CE-TRUS. Prostate cancer originating from the transition zone or peripheral zone with lower PSA levels, small-size foci, and moderately or well-differentiated tumor was missed by CE-TRUS. The cancer detection rate of targeted biopsy (75%, 33/44 cores) was significantly higher than one of systematic biopsy (48.2%, 162/336) in those 28 cases (P < 0.05). In addition, no significant correlation was found between the cancer detection rate with CE-TRUS and serum PSA levels. Conclusion: CE-TRUS may improve the detection rate of prostate cancer through targeted biopsy of contrast-enhanced abnormalities. Our findings indicate that systematic biopsies should not be eliminated on the basis of false-positive and false-negative findings related to CE-TRUS

  13. Nasal mucosal biopsy

    Science.gov (United States)

    Biopsy - nasal mucosa; Nose biopsy ... to fast for a few hours before the biopsy. ... Nasal mucosal biopsy is usually done when abnormal tissue is seen during examination of the nose. It may also be done ...

  14. Bone lesion biopsy

    Science.gov (United States)

    Bone biopsy; Biopsy - bone ... is sent to a lab for examination. Bone biopsy may also be done under general anesthesia to ... remove the bone can be done if the biopsy exam shows that there is an abnormal growth ...

  15. Biopsy - biliary tract

    Science.gov (United States)

    Cytology analysis - biliary tract; Biliary tract biopsy ... A sample for a biliary tract biopsy can be obtained in different ways. A needle biopsy can be done if you have a well-defined tumor. The biopsy site ...

  16. Algorithms, nomograms and the detection of indolent prostate cancer

    NARCIS (Netherlands)

    M.J. Roobol-Bouts (Monique)

    2008-01-01

    textabstractPurpose: Prostate cancer is the most commonly diagnosed cancer in men. However, only about 12% of the men diagnosed with prostate cancer will die of their disease. Result: The serum PSA test can detect prostate cancers early, but using a PSA based cut-off indication for prostate biopsy r

  17. PSA Velocity Does Not Improve Prostate Cancer Detection

    Science.gov (United States)

    A rapid increase in prostate-specific antigen (PSA) levels is not grounds for automatically recommending a prostate biopsy, according to a study published online February 24, 2011, in the Journal of the National Cancer Institute.

  18. Prospective Randomized Phase 2 Trial of Intensity Modulated Radiation Therapy With or Without Oncolytic Adenovirus-Mediated Cytotoxic Gene Therapy in Intermediate-Risk Prostate Cancer

    International Nuclear Information System (INIS)

    Purpose: To assess the safety and efficacy of combining oncolytic adenovirus-mediated cytotoxic gene therapy (OAMCGT) with intensity modulated radiation therapy (IMRT) in intermediate-risk prostate cancer. Methods and Materials: Forty-four men with intermediate-risk prostate cancer were randomly assigned to receive either OAMCGT plus IMRT (arm 1; n=21) or IMRT only (arm 2; n=23). The primary phase 2 endpoint was acute (≤90 days) toxicity. Secondary endpoints included quality of life (QOL), prostate biopsy (12-core) positivity at 2 years, freedom from biochemical/clinical failure (FFF), freedom from metastases, and survival. Results: Men in arm 1 exhibited a greater incidence of low-grade influenza-like symptoms, transaminitis, neutropenia, and thrombocytopenia than men in arm 2. There were no significant differences in gastrointestinal or genitourinary events or QOL between the 2 arms. Two-year prostate biopsies were obtained from 37 men (84%). Thirty-three percent of men in arm 1 were biopsy-positive versus 58% in arm 2, representing a 42% relative reduction in biopsy positivity in the investigational arm (P=.13). There was a 60% relative reduction in biopsy positivity in the investigational arm in men with <50% positive biopsy cores at baseline (P=.07). To date, 1 patient in each arm exhibited biochemical failure (arm 1, 4.8%; arm 2, 4.3%). No patient developed hormone-refractory or metastatic disease, and none has died from prostate cancer. Conclusions: Combining OAMCGT with IMRT does not exacerbate the most common side effects of prostate radiation therapy and suggests a clinically meaningful reduction in positive biopsy results at 2 years in men with intermediate-risk prostate cancer

  19. Prospective Randomized Phase 2 Trial of Intensity Modulated Radiation Therapy With or Without Oncolytic Adenovirus-Mediated Cytotoxic Gene Therapy in Intermediate-Risk Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Freytag, Svend O., E-mail: sfreyta1@hfhs.org [Department of Radiation Oncology, Henry Ford Health System, Detroit, Michigan (United States); Stricker, Hans [Vattikuti Urology Institute, Henry Ford Health System, Detroit, Michigan (United States); Lu, Mei [Public Health Sciences, Henry Ford Health System, Detroit, Michigan (United States); Elshaikh, Mohamed; Aref, Ibrahim; Pradhan, Deepak; Levin, Kenneth; Kim, Jae Ho [Department of Radiation Oncology, Henry Ford Health System, Detroit, Michigan (United States); Peabody, James [Vattikuti Urology Institute, Henry Ford Health System, Detroit, Michigan (United States); Siddiqui, Farzan; Barton, Kenneth; Pegg, Jan; Zhang, Yingshu; Cheng, Jingfang [Department of Radiation Oncology, Henry Ford Health System, Detroit, Michigan (United States); Oja-Tebbe, Nancy; Bourgeois, Renee [Public Health Sciences, Henry Ford Health System, Detroit, Michigan (United States); Gupta, Nilesh; Lane, Zhaoli [Pathology, Henry Ford Health System, Detroit, Michigan (United States); Rodriguez, Ron [Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); DeWeese, Theodore [Department of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); and others

    2014-06-01

    Purpose: To assess the safety and efficacy of combining oncolytic adenovirus-mediated cytotoxic gene therapy (OAMCGT) with intensity modulated radiation therapy (IMRT) in intermediate-risk prostate cancer. Methods and Materials: Forty-four men with intermediate-risk prostate cancer were randomly assigned to receive either OAMCGT plus IMRT (arm 1; n=21) or IMRT only (arm 2; n=23). The primary phase 2 endpoint was acute (≤90 days) toxicity. Secondary endpoints included quality of life (QOL), prostate biopsy (12-core) positivity at 2 years, freedom from biochemical/clinical failure (FFF), freedom from metastases, and survival. Results: Men in arm 1 exhibited a greater incidence of low-grade influenza-like symptoms, transaminitis, neutropenia, and thrombocytopenia than men in arm 2. There were no significant differences in gastrointestinal or genitourinary events or QOL between the 2 arms. Two-year prostate biopsies were obtained from 37 men (84%). Thirty-three percent of men in arm 1 were biopsy-positive versus 58% in arm 2, representing a 42% relative reduction in biopsy positivity in the investigational arm (P=.13). There was a 60% relative reduction in biopsy positivity in the investigational arm in men with <50% positive biopsy cores at baseline (P=.07). To date, 1 patient in each arm exhibited biochemical failure (arm 1, 4.8%; arm 2, 4.3%). No patient developed hormone-refractory or metastatic disease, and none has died from prostate cancer. Conclusions: Combining OAMCGT with IMRT does not exacerbate the most common side effects of prostate radiation therapy and suggests a clinically meaningful reduction in positive biopsy results at 2 years in men with intermediate-risk prostate cancer.

  20. Managing cancer-related fatigue in men with prostate cancer: a systematic review of non-pharmacological interventions.

    Science.gov (United States)

    Larkin, David; Lopez, Violeta; Aromataris, Edoardo

    2014-10-01

    The aim of this systematic review was to synthesize the best available evidence informing the effectiveness of non-pharmacological interventions for managing cancer-related fatigue in men treated for prostate cancer. This review considered experimental studies that included men with prostate cancer (regardless of staging, previous treatment or comorbidities), aged 18 years and over who were undergoing any treatment, or had completed any treatment for prostate cancer within the previous 12 months. Three interventions were identified for the management of cancer-related fatigue in men with prostate cancer. Evidence from five studies including 447 participants demonstrates the effectiveness of physical activity, both aerobic and resistance exercise, and from three studies including 153 participants suggesting the benefits of psychosocial interventions including education and cognitive behavioural therapy. Health professionals require knowledge of a range of effective interventions aimed at reducing cancer-related fatigue in men with prostate cancer and should incorporate those interventions into their patient management. Although physical activity appears to show the greatest benefit, other non-pharmacological interventions such as education and cognitive behavioural therapy have demonstrated benefit and should also be considered as a strategy in treating this debilitating side effect of cancer and its treatment. PMID:24237792

  1. Thin needle aspiration biopsy of endocrine organs.

    Science.gov (United States)

    Koss, L G

    1979-01-01

    The purpose of this paper is to summarize the advantages and disadvantages of the fine needle aspiration technique in reference to the endocrine organs. The principles of technique and interpretation are presented. The application of aspiration biopsies to the breast, the prostate, the pancreas and the thyroid are briefly discussed. PMID:485094

  2. Prostate carcinoma

    International Nuclear Information System (INIS)

    Prostate cancer is the most common malignancy in men in Europe, North America, and in some African states. Early diagnosis in an asymptomatic stage is possible through the combination of digitorectal examination, PSA serum testing, and systematic biopsy. However, general screening is so far not recommended by the Urologic Societies, because the efficiency is not yet proved. Imaging is also not recommended for first-line screening. Novel functional methods of transrectal ultrasound (TRUS) and endorectal MRI can improve accuracy of tumor detection to more than 90% and can be used for TRUS- and now also MRI-guided biopsy leading to two- to threefold higher tumor detection rates. There is general agreement that all men over 50 years of age should be informed about the possibilities, benefits, and risks of the available methods for early tumor detection. (orig.)

  3. Magnetic resonance imaging and morphometric histologic analysis of prostate tissue composition in predicting the clinical outcome of terazosin therapy in benign prostatic hyperplasia

    Energy Technology Data Exchange (ETDEWEB)

    Isen, K. [Karaelmas Univ., Zonguldak (Turkey). School of Medicine; Sinik, Z.; Alkibay, T.; Sezer, C.; Soezen, S.; Atilla, S.; Ataoglu, O.; Isik, S.

    2001-02-01

    The purpose of this study was to determine whether magnetic resonance imaging (MRI) or quantitative color-imaged morphometric analysis (MA) of the prostate gland are related to the clinical response to terazosin. Thirty-six male patients with symptomatic benign prostatic hyperplasia (BPH) with a serum prostate-specific antigen level of 4-10 ng/mL underwent MRI with body coil, transrectal prostate unltrasonography and biopsy prior to terazosin therapy. For MRI-determined stromal and non-stromal BPH, the ratio of the signal intensity of the inner gland to the obturator internus muscle was evaluated. Histologic sections were stained with hematoxylin and eosin. The MA of the specimens was performed by Samba 2000. Results of the two techniques were interpreted according to the terazosin therapy results. The mean stromal percentage was 60.5{+-}18.0%. No statistically significant relationship was found between the clinical outcome of terazosin and the MRI findings. The MA results showed a significant relationship between the percentage of stroma and the percent change of the peak urinary flow rate, but not with the percent change of the international prostate symptom score after terazosin therapy (P<0.05). Magnetic resonance imaging alone is not sufficient in predicting the response to terazosin therapy. Morphometric analysis of BPH tissue composition can be used in predicting the clinical outcome of terazosin therapy but it is suitable only in patients for whom prostatic biopsy is necessary in order to rule out prostate cancer. (author)

  4. Health-Related Quality of Life 2 Years After Treatment With Radical Prostatectomy, Prostate Brachytherapy, or External Beam Radiotherapy in Patients With Clinically Localized Prostate Cancer

    International Nuclear Information System (INIS)

    Purpose: To compare treatment impact on health-related quality of life (HRQL) in patients with localized prostate cancer, from before treatment to 2 years after the intervention. Methods and Materials: This was a longitudinal, prospective study of 614 patients with localized prostate cancer treated with radical prostatectomy (134), three-dimensional external conformal radiotherapy (205), and brachytherapy (275). The HRQL questionnaires administered before and after treatment (months 1, 3, 6, 12, and 24) were the Medical Outcomes Study 36-Item Short Form, the Functional Assessment of Cancer Therapy (General and Prostate Specific), the Expanded Prostate Cancer Index Composite (EPIC), and the American Urological Association Symptom Index. Differences between groups were tested by analysis of variance and within-group changes by univariate repeated-measures analysis of variance. Generalized estimating equations (GEE) models were constructed to assess between-group differences in HRQL at 2 years of follow-up after adjusting for clinical variables. Results: In each treatment group, HRQL initially deteriorated after treatment with subsequent partial recovery. However, some dimension scores were still significantly lower after 2 years of treatment. The GEE models showed that, compared with the brachytherapy group, radical prostatectomy patients had worse EPIC sexual summary and urinary incontinence scores (-20.4 and -14.1; p < 0.001), and external radiotherapy patients had worse EPIC bowel, sexual, and hormonal summary scores (-3.55, -5.24, and -1.94; p < 0.05). Prostatectomy patients had significantly better EPIC urinary irritation scores than brachytherapy patients (+4.16; p < 0.001). Conclusions: Relevant differences between treatment groups persisted after 2 years of follow-up. Radical prostatectomy had a considerable negative effect on sexual functioning and urinary continence. Three-dimensional conformal radiotherapy had a moderate negative impact on bowel

  5. Factors related to late GI and GU complications in conformal and conventional radiation treatment of cancer of the prostate

    International Nuclear Information System (INIS)

    Purpose: To assess the factors that predict for late GI and GU morbidity in radiation treatment of the prostate. Materials and Methods: Six hundred sixteen consecutive prostate cancer patients treated between 1985 and 1994 with conformal or conventional techniques were included in the analysis. All patients had at least 3 months followup (median 26 months) and received at least 65 Gy. Late GI morbidity was rectal bleeding (requiring more than 2 procedures) or proctitis. Late GU morbidity was cystitis or stricture. Univariate analysis compared the differences in the incidence of RTOG-EORTC grade 3 and 4 late morbidity by age (<60 versus ≥ 60 years), peracute side effects ≥ grade 1 (during treatment), subacute side effects ≥ grade 1 (0 to 90 days after treatment), irradiated volume parameters, and dose. Multivariate proportional hazards analysis includes these same variables in a model of time to complication. Multivariate logistic regression was used to analyze incidence of peracute and subacute GI and GU side effects by GI and GU comorbidities, performance status, pretreatment procedures (biopsy, TURP, etc.), age, treatment volume parameters, and peracute responses. Results: Peracute GI and GU side effects were noted in 441 and 442 patients, respectively. Subacute GI and GU side effects were noted in 34 and 54 patients, respectively. Subacute GI side effects were highly correlated with subacute GU side effects (p<0.00001). Late morbidities were not correlated with peracute side effects but were correlated with subacute side effects (both GI and GU). Thirteen of the 616 patients expressed grade 3 or 4 GI injuries 3 to 32 months after the end of treatment, with a mean of 13 months. The 6 GU morbidities occurred significantly later (9 - 52 months) with a mean of 33 months. Central axis dose and age less than 60 years were the only independent variables significantly related to the incidence of late GI morbidity on multivariate analysis. Subacute and peracute

  6. In-Bore MR-Guided Biopsy Systems and Utility of PI-RADS.

    Science.gov (United States)

    Fütterer, Jurgen J; Moche, Michael; Busse, Harald; Yakar, Derya

    2016-06-01

    A diagnostic dilemma exists in cases wherein a patient with clinical suspicion for prostate cancer has a negative transrectal ultrasound-guided biopsy session. Although transrectal ultrasound-guided biopsy is the standard of care, a paradigm shift is being observed. In biopsy-naive patients and patients with at least 1 negative biopsy session, multiparametric magnetic resonance imaging (MRI) is being utilized for tumor detection and subsequent targeting. Several commercial devices are now available for targeted prostate biopsy ranging from transrectal ultrasound-MR fusion biopsy to in bore MR-guided biopsy. In this review, we will give an update on the current status of in-bore MRI-guided biopsy systems and discuss value of prostate imaging-reporting and data system (PIRADS). PMID:27187168

  7. 超声引导下经直肠前列腺穿刺活检术护理研究%Study of Nursing to Patients with Transretal Prostatic Biopsy

    Institute of Scientific and Technical Information of China (English)

    朱国宁; 黄立锋; 韩利坤

    2009-01-01

    目的:探讨接受超声引导下经直肠前列腺穿刺活检术(transreral prostatic biopsy,TPB)检查的临床护理相关问题,为前列腺穿刺活检临床护理提供参考.方法:通过心理疏导接解除者术前对TPB的恐惧心理.明确TPB足比较安全、可靠的、不可替代的检查方法,了解手术过程、护理方法和一般并发症,提高TPB的检查效果及护理质量.结果:71例患者进行TPB枪查.全部患者均能主动配合检查操作,检查术中并发迷走神经心血管反射1例,术后并发血尿4例,短期内疼确5例,均早期发现,给与相应的护理与治疗后治愈.结论:TPB是前列腺占位性病变患者有效的定性有创性检查方法,对行TPB检察患者患者应采取针对性的护理措施,提高护理质量及检查安全性.

  8. 超声引导下经直肠前列腺穿刺活检术护理研究%Nursing of Patients Accepting Transretal Prostatic Biopsy Guided by Ultrasound

    Institute of Scientific and Technical Information of China (English)

    朱国宁; 黄立锋; 韩利坤

    2009-01-01

    目的:探讨接受超声引导下经直肠前列腺穿刺活检术(transretal prostatic biopsy,TPB)检查的临床护理相关问题,为前列腺穿刺活检临床护理提供参考.方法:通过心理疏导接解除者术前对TPB的恐惧心理,明确TPB是比较安全、可靠的、不可替代的检查方法,了解手术过程、护理方法和一般并发症,提高TPB的检查效果及护理质量.结果:71例患者进行TPB检查,全部患者均能主动配合检查操作,检查术中并发迷走神经心血管反射1例,术后并发血尿4例,短期内疼痛5例,均早期发现,给与相应的护理与治疗后治愈.结论:TPB是前列腺占位性病变患者有效的定性有创性检查方法,对行TPB检察患者患者应采取针对性的护理措施,提高护理质量及检查安全性.

  9. The role of transrectal ultrasound in the diagnosis of prostate cancer: new contributions

    OpenAIRE

    Pedro Marinho Lopes; Luís Sepúlveda; Rui Ramos; Pedro Sousa

    2015-01-01

    Objective: The present study was aimed at evaluating the contribution of transrectal prostate ultrasound in the screening for prostate neoplasias and in the guidance of prostate biopsies. Materials and Methods: Prospective study developed over a one-year period. All the patients with indication for prostate biopsy were evaluated. Regardless of PSA values, the patients underwent ultrasound in order to identify suspicious nodules (confirmed by two observers). Sextant biopsy was subsequently per...

  10. Diagnosis and treatment for prostate cancer

    Institute of Scientific and Technical Information of China (English)

    Zuoxing Niu; Guohua Ren; Shuping Song

    2008-01-01

    The morbility of prostate cancer has risen in China in recent years, it is important to diagnose and treat prostate cancer standardly and systemically.This review analyzed the status and advances of PSA examination, digital rectal examination, prostate biopsy in prostate cancer, and it gave a detailed description of radical prostatectomy, radiotherapy, chemotherapy, hormonal therapy, etc.The advances of targeted therapy and tumor vaccine is also discussed.

  11. Health-related quality of life in Japanese men with localized prostate cancer. Assessment with the SF-8

    International Nuclear Information System (INIS)

    The objective of this study was to evaluate health related quality of life (HRQOL) using the Medical Outcomes Study 8-items Short Form Health Survey (SF-8) questionnaire in Japanese patients with early prostate cancer. A cross-sectional analysis was done in 457 patients with prostate cancer treated with radical prostatectomy, external beam radiotherapy, brachytherapy, androgen deprivation therapy, and watchful waiting or a combination these therapies. General HRQOL was measured using the Japanese version of the SF-8 questionnaire and disease-specific HRQOL was assessed using the Japanese version of the Extended Prostate Cancer Index Composite. The external beam radiotherapy group reported significantly lower values for the physical health component summary score (PCS) in comparison to the radical prostatectomy and brachytherapy groups (P<0.05). In the analysis of both the PCS and the mental health component summary score (MCS) over time after treatment, higher scores with time were found in the radical prostatectomy group. No significant change over time after androgen deprivation therapy in the PCS was found. In contrast, the MCS was found to deteriorate in the early period, showing a significant increase over time. SF-8 in combination with the Extended Prostate Cancer Index Composite has shown to be a helpful tool in the HRQOL assessment of Japanese patients treated for localized prostate cancer. (author)

  12. Casodex treatment induces hypoxia-related gene expression in the LNCaP prostate cancer progression model

    Directory of Open Access Journals (Sweden)

    Gopalakrishnan Velliyur K

    2005-03-01

    Full Text Available Abstract Background The changes in gene expression profile as prostate cancer progresses from an androgen-dependent disease to an androgen-independent disease are still largely unknown. Methods We examined the gene expression profile in the LNCaP prostate cancer progression model during chronic treatment with Casodex using cDNA microarrays consisting of 2305 randomly chosen genes. Results Our studies revealed a representative collection of genes whose expression was differentially regulated in LNCaP cells upon treatment with Casodex. A set of 15 genes were shown to be highly expressed in Casodex-treated LNCaP cells compared to the reference sample. This set of highly expressed genes represents a signature collection unique to prostate cancer since their expression was significantly greater than that of the collective pool of ten cancer cell lines of the reference sample. The highly expressed signature collection included the hypoxia-related genes membrane metallo-endopeptidase (MME, cyclin G2, and Bcl2/adenovirus E1B 19 kDa (BNIP3. Given the roles of these genes in angiogenesis, cell cycle regulation, and apoptosis, we further analyzed their expression and concluded that these genes may be involved in the molecular changes that lead to androgen-independence in prostate cancer. Conclusion Our data indicate that one of the mechanisms of Casodex action in prostate cancer cells is induction of hypoxic gene expression.

  13. Clinical Analysis of 29 Cases with Primary Malignant Lymphoma of the Prostate

    Institute of Scientific and Technical Information of China (English)

    Tong Fang

    2007-01-01

    OBJECTIVE To summarize the clinical characteristics, pathology, treatment and prognosis of malignant lymphoma of the prostate. METHODS Clinical data from 29 patients with primary malignant lymphoma of the prostate were reviewed retrospectively. The median age was 66 years. Clinical signs and symptoms were due to lower urinary tract obstruction resulting from a diffusely enlarged prostate. Prostate biopsies revealed diffuse large B-cell non-Hodgkin's lymphoma. The therapeutic modalities included prostatectomy, radiotherapy and chemotherapy. RESULTS Extraprostatic involvement at various sites became evident in 19 of the 29 patients after diagnosis. Ten patients died from lymphoma with a median survival of 23 months (range, 2-30 months). Seven patients were alive up to 60 months.CONCLUSION Malignant lymphoma involving the prostate was rare and has a rather poor prognosis. Prognosis related to the patient age, histologic type, and treatment or clinical stage of the disease at presentation.

  14. Parotid gland biopsy compared with labial biopsy in the diagnosis of patients with primary Sjogren's syndrome

    NARCIS (Netherlands)

    Pijpe, J.; Kalk, W. W. I.; van der Wal, J. E.; Vissink, A.; Kluin, Ph. M.; Roodenburg, J. L. N.; Bootsma, H.; Kallenberg, C. G. M.; Spijkervet, F. K. L.

    2007-01-01

    Objective. To assess the value of the parotid biopsy as a diagnostic tool for primary Sjogren's syndrome ( pSS), and to compare the parotid biopsy and the labial biopsy with regard to diagnostic value and biopsy-related morbidity. Methods. In 15 consecutive patients with pSS and 20 controls, the par

  15. Assessment of the contents related to screening on Portuguese language websites providing information on breast and prostate cancer

    Directory of Open Access Journals (Sweden)

    Daniel Ferreira

    2013-11-01

    Full Text Available The objective of this study was to assess the quality of the contents related to screening in a sample of websites providing information on breast and prostate cancer in the Portuguese language. The first 200 results of each cancer-specific Google search were considered. The accuracy of the screening contents was defined in accordance with the state of the art, and its readability was assessed. Most websites mentioned mammography as a method for breast cancer screening (80%, although only 28% referred to it as the only recommended method. Almost all websites mentioned PSA evaluation as a possible screening test, but correct information regarding its effectiveness was given in less than 10%. For both breast and prostate cancer screening contents, the potential for overdiagnosis and false positive results was seldom addressed, and the median readability index was approximately 70. There is ample margin for improving the quality of websites providing information on breast and prostate cancer in Portuguese.

  16. Health-related quality of life after adjuvant and salvage postoperative radiotherapy for prostate cancer - A prospective analysis

    International Nuclear Information System (INIS)

    Background and purpose: The aim of the study was to analyze health-related quality of life changes after postoperative radiotherapy (RT) for prostate cancer. Materials and methods: A group of 101 patients has been surveyed prospectively before (time A), at the last day (B), two months after (C) and >1 year after (D) RT using a validated questionnaire (Expanded Prostate Cancer Index Composite) with urinary, bowel, sexual and hormonal domains. The prostatic fossa was treated with a four-field box technique up to a total dose of 66.6 Gy. Results: While median urinary scores reached baseline levels already two months after radiotherapy (function/bother scores at time A-B-C-D: 94/89-89/75-94/89-94/89; A vs. B: p 1 year, only minor HRQOL changes occurred in comparison to baseline scores

  17. Focal therapy for prostate cancer: current status and future perspectives.

    Science.gov (United States)

    Miano, R; Asimakopoulos, A; Da Silva, R; Bove, P; Jones, S; De La Rosette, J; Kim, F

    2015-09-01

    Focal therapy is a relatively new and extremely attractive option of treatment for prostate cancer. It has been described as the "middle approach" between active surveillance and radical treatment, aiming to destroy the tumor itself or the region containing the tumor in order to preserve surrounding non-cancerous tissue. The goal is to maintain disease control at acceptable levels, while preserving erectile, urinary, and rectal function. While a lot of technologies have been described for delivering targeted therapy to the prostate, such as cryoablation, high intensity focused ultrasound, photodynamic therapy, irreversible electroporation and laser, the key point is the patient selection. Recent advances in mpMRI and the introduction of new biopsy techniques that use MR images as a guidance, have significantly improved localization of the tumor lesions and the detection rate, evolving prostate biopsy toward targeted rather than systematic biopsies. The future challenge to clinicians is to precisely risk-stratify patients to differentiate between those who would profit from focal treatment and who would not. Forthcoming research efforts should pursue to identify molecular, genetic, and imaging characteristics that distinguish aggressive prostate tumors from indolent lesions. PMID:26013953

  18. Meta分析抗生素对经直肠前列腺活检术后感染性并发症的预防效果%Meta-analysis of antibiotic prophylaxis use in transrectal prostatic biopsy

    Institute of Scientific and Technical Information of China (English)

    杨明根; 赵晓昆; 吴志平; 肖宁; 吕晨

    2009-01-01

    ObjectiveTo determine whether antibiotic prophylaxis can reduce the risk of postoperative infective complications in men undergoing transrectal prostatic biopsy (TPB) who had sterile preoperative urine.MethodsMEDLINE, EMBASE, Cochrane Collaboration Reviews, Chinese Medical Current Contents (CMCC), and National Knowledge Infrastructure (CNKI) were searched for rando-mized controlled trials that compared the effect of antibiotic prophylaxis with placebo or active controls for men undergoing TPB with preoperative sterile urine. Two reviewers independently extracted the data of patient characteristics and outcomes based on a prospectively developed protocol.ResultsA total of 12 trials (3 placebo controlled, 3 non-treatment controlled, and 6 activly controlled) involving 1 987 patients, met the inclusion criteria. Prophylactic antibiotic use in patients at low risk undergoing TPB significantly decreased bacteriuria and middle degree fever incidence, but could not decrease the incidence of bacteremia. The relative risk for post-TPB bacteriuria, middle degree fever, and bacteremia were 0.32 (95% CI 0.23 to 0.46), 0.37 (95% CI 0.17 to 0.77), and 0.96 (95% CI 0.61 to 1.50), respectively. Effective antibiotic classes included quinolone, co-quinolone and nitroimidazole, and co-trimethoprim and sulfamethoxazole. Treatment protocols of any duration were effective.ConclusionAntibiotic prophylaxis obviously decreases the incidence of bacteriuria and middle degree fever but not bacteremia in men with preoperative sterile urine undergoing TPB. A significant decrease in bacteriuria incidence can be achieved with a range of antibiotic agents, including quinolones and co-quinolone and nitroimidazole. Treatment protocols of any duration are effective with no heterogeneity.%目的:分析预防性抗生素能否减少术前为清洁尿、行经直肠前列腺活检术(TPB)患者的术后感染性并发症.方法:制定原始文献的纳入标准、排除标准及检索策略,

  19. Implementation of Multi-parametric Prostate MRI in Clinical Practice.

    Science.gov (United States)

    Kierans, Andrea S; Taneja, Samir S; Rosenkrantz, Andrew B

    2015-08-01

    While initial implementations of prostate MRI suffered from suboptimal performance in tumor detection, technological advances over the past decade have allowed modern multi-parametric prostate MRI (mpMRI) to achieve high diagnostic accuracy for detection, localization, and staging and thereby impact patient management. A particular emerging application of mpMRI is in the pre-biopsy setting to allow for MRI-targeted biopsy, for instance, through real-time MRI/ultrasound fusion, which may help reduce the over-detection of low-risk disease and selectively detect clinically significant cancers, in comparison with use of standard systematic biopsy alone. mpMRI and MRI-targeted biopsy are spreading beyond the large academic centers to increasingly be adopted within small and community practices. Aims of this review article are to summarize the hardware and sequences used for performing mpMRI, explore patient specific technical considerations, delineate approaches for study interpretation and reporting [including the recent American College of Radiology Prostate Imaging Reporting and Data System (PI-RADS) version 2], and describe challenges and implications relating to the widespread clinical implementation of mpMRI. PMID:26077358

  20. Correlation of transrectal ultrasonographic findings with histo pathology in prostatic cancer

    OpenAIRE

    Ganie, Farooq Ahmad; Wanie, Mohd Saleem; Ganie, Shabir Ahmad; Lone, Hafezulla; Gani, Masaratul; Mir, Mohd Farooq; Khan, Naseer Ahmad

    2014-01-01

    Objective: To estimate the incidence of hyperechoic, hypoechoic, isoechoic, prostatic cancer in TRUS (transrectal ultrasound guided) guided prostatic specimens. Materials and Methods: Four hundred and ninety three patients with raised serum prostatic specific antigen (PSA) and abnormal DRE findings were subjected to TRUS-Guided prostate biopsy. Lateralized sextant biopsy plus prostatic cores from suspicious areas were obtained. Results: Out of 493 patients who were enrolled in the study, 65 (...

  1. A nomogram to predict Gleason sum upgrading of clinically diagnosed localized prostate cancer among Chinese patients

    OpenAIRE

    Jin-You Wang; Yao Zhu; Chao-Fu Wang; Shi-Lin Zhang; Bo Dai; Ding-Wei Ye

    2014-01-01

    Although several models have been developed to predict the probability of Gleason sum upgrading between biopsy and radical prostatectomy specimens, most of these models are restricted to prostate-specific antigen screening-detected prostate cancer. This study aimed to build a nomogram for the prediction of Gleason sum upgrading in clinically diagnosed prostate cancer. The study cohort comprised 269 Chinese prostate cancer patients who underwent prostate biopsy with a minimum of 10 cores and w...

  2. Antibiotic and anti-inflammatory use and the risk of prostate cancer

    Directory of Open Access Journals (Sweden)

    Bent Stephen

    2009-04-01

    Full Text Available Abstract Background Prostate inflammation or infection may increase the risk of prostate cancer. Antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs are used to treat prostatitis and urinary tract infections (UTIs. The objective of our study was to assess whether their use decreases the risk of prostate cancer. Methods We conducted a case-control study among men with incident prostate cancer (N = 65 cases and without prostate cancer (N = 195 controls at the San Francisco Veteran Affairs medical center (VAMC between June 1996 and June 2006. Cases were all patients who had prostate biopsies positive for cancer. We matched controls to cases on age group and race at a 3:1 ratio, and each matched pair was given an identical index date. Total antibiotic, aspirin, and NSAID use (number of prescriptions was computed for each participant by drug type and was restricted to a fill date at least 1 year before the index date. Logistic regression was used for analysis. We adjusted for the matching variables (age group and race and potential confounders (years of VAMC enrollment and number of clinic visits. Results Neither total antibiotic use nor total anti-inflammatory use reduces the risk of prostate cancer (P > 0.05. Conclusion Our analysis did not reveal a relation between use of antibiotics, aspirin, or NSAIDs and the risk of prostate cancer.

  3. Childhood Height and Birth Weight in Relation to Future Prostate Cancer Risk

    DEFF Research Database (Denmark)

    Cook, Michael B; Gamborg, Michael; Aarestrup, Julie;

    2013-01-01

    Adult height has been positively associated with prostate cancer risk. However, the exposure window of importance is currently unknown and assessments of height during earlier growth periods are scarce. In addition, the association between birth weight and prostate cancer remains undetermined. We...

  4. Genetic Determinants of Metabolism and Benign Prostate Enlargement: Associations with Prostate Volume.

    Directory of Open Access Journals (Sweden)

    Ayush Giri

    Full Text Available Prostate enlargement leading to clinical benign prostatic hyperplasia (BPH is associated with metabolic dysregulation and obesity. The genetic basis of this association is unclear. Our objective was to evaluate whether single nucleotide polymorphisms (SNPs previously associated with metabolic disorders are also associated with prostate volume (PV. Participants included 876 men referred for prostate biopsy and found to be prostate cancer free. PV was measured by transrectal ultrasound. Samples were genotyped using the Illumina Cardio-MetaboChip platform. Multivariable adjusted linear regression models were used to evaluate SNPs (additive coding in relation to natural-log transformed (log PV. We compared SNP-PV results from biopsy-negative men to 442 men with low-grade prostate cancer with similar levels of obesity and PV. Beta-coefficients from the discovery and replication samples were then aggregated with fixed effects inverse variance weighted meta-analysis. SNP rs11736129 (near the pseudo-gene LOC100131429 was significantly associated with log-PV (beta: 0.16, p-value 1.16x10(-8 after adjusting for multiple testing. Other noteworthy SNPs that were nominally associated (p-value < 1x10(-4 with log-PV included rs9583484 (intronic SNP in COL4A2, rs10146527 (intronic SNP in NRXN3, rs9909466 (SNP near RPL32P31, and rs2241606 (synonymous SNP in SLC12A7. We found several SNPs in metabolic loci associated with PV. Further studies are needed to confirm our results and elucidate the mechanism between these genetic loci, PV, and clinical BPH.

  5. Bone lesion biopsy

    Science.gov (United States)

    Bone biopsy; Biopsy - bone ... needle is gently pushed and twisted into the bone. Once the sample is obtained, the needle is ... sample is sent to a lab for examination. Bone biopsy may also be done under general anesthesia ...

  6. Muscle biopsy (image)

    Science.gov (United States)

    A muscle biopsy involves removal of a plug of tissue usually by a needle to be later used for examination. Sometimes ... there is a patchy condition expected an open biopsy may be used. Open biopsy involves a small ...

  7. Bone biopsy (image)

    Science.gov (United States)

    A bone biopsy is performed by making a small incision into the skin. A biopsy needle retrieves a sample of bone and it ... examination. The most common reasons for bone lesion biopsy are to distinguish between benign and malignant bone ...

  8. Renal biopsy: methods and interpretation.

    Science.gov (United States)

    Vaden, Shelly L

    2004-07-01

    Renal biopsy most often is indicated in the management of dogs and cats with glomerular disease or acute renal failure. Renal biopsy can readily be performed in dogs and cats via either percutaneous or surgical methods. Care should be taken to ensure that proper technique is used. When proper technique is employed and patient factors are properly addressed, renal biopsy is a relatively safe procedure that minimally affects renal function. Patients should be monitored during the post biopsy period for severe hemorrhage, the most common complication. Accurate diagnosis of glomerular disease, and therefore, accurate treatment planning,requires that the biopsy specimens not only be evaluated by light microscopy using special stains but by electron and immunofluorescent microscopy. PMID:15223207

  9. Focal therapy for prostate cancer: The current status

    OpenAIRE

    Marshall, Susan; Taneja, Samir

    2015-01-01

    Purpose In an era of increasing prostate cancer incidence and earlier detection, the assessment of clinical significance of prostate cancer is critical. Minimally invasive therapies are increasingly being investigated in localized prostate cancer. Methods and results In this review, we discuss the current status of magnetic resonance imaging targeted fusion prostate biopsy and focal therapy for prostate cancer, its rationale, and techniques. Conclusion Focal therapy offers a promising outlook...

  10. Cell kinetic measurements in prostate cancer

    International Nuclear Information System (INIS)

    Purpose: Two approaches have been suggested for escalating the total dose in radiotherapy treatment of prostate cancer. One is conformal radiotherapy; the other is hyperfractionation using many small fractions. Both imply some possible prolongation in overall treatment time. To judge whether prolonged treatment schedules would be detrimental, it is necessary to know the proliferation rates in human prostate tumors, specifically, the potential doubling time (Tpot). There is a lack of data on this parameter in the literature. Methods and Materials: Seven patients with adenocarcinoma of the prostate were studied. A tracer dose of 100 mg/m2 of IUdR was infused intravenously 4-12 h before biopsies were taken. Biopsies were fixed in 70% ethanol, stored at 4 deg. C, and later prepared and stained by standard methods for flow cytometry, using the red fluorescence signal for DNA and the green fluorescence signal (fluorescein isothiocyanate) for 5-iodo-2'-deoxyuridine. The duration of DNA synthesis (Ts) was determined by the relative movement (RM) method, knowing the interval between tracer administration and biopsy. Tpot was calculated as the quotient of Ts by labeling index (LI). Results: In two of the seven tumors the LI was too low (<0.6%) for a reliable estimate of RM to be made, so no determination of Tpot was possible for these tumors. The mean LI values in the other five tumors were 2.4%, 1.4%, 1.0%, 3.0%, and 0.9%. The durations of Ts were 13.2, 9.5, 10.0, 11.7, and 12.7 h, respectively. The resulting values of Tpot were 23, 28, 42, 16, and 61 days, respectively. Conclusion: The low labeling indices in prostate tumors, also reported by others, made estimation of Ts by RM impossible in about a third of these tumors. However, five tumors yielded long estimates for Tpot, implying that prolongation from 6 to about 8 weeks should not be detrimental

  11. [New challenges and earlier approved methods in the laboratory diagnosis of prostate cancer].

    Science.gov (United States)

    Kovács, Gábor L

    2014-12-01

    Prostate cancer is usually a disease of elderly men, however, over 40 years of age the tumor can appear at any times. PSA is a protein molecule synthesized by prostate cells. Measurement of serum PSA has revolutionized the diagnosis and treatment of prostate cancer. However, PSA is not sufficiently specific for the detection of prostate cancer, since serum PSA might also be elevated in benign prostate diseases, as well as following physical stimulation of the gland (digital rectal examination, biopsy, catheterization, or even ejaculation). To increase the specificity of PSA, different derivative parameters have been developed i.e. PSA density (ratio of PSA to prostate volume), PSA velocity (change of PSA over a time period) or age-specific reference ranges. 65-95% of circulating PSA is bound to different proteins, while the rest of PSA circulates in a non-bound form (free PSA, fPSA). In addition to fPSA, the prostate health index [phi; (-2)proPSA/fPSA×√PSA] is increasingly used to differentiate between carcinoma-induced and non-carcinoma-induced increase in PSA. PCA3 is a non-coding messenger RNA, which is 60-70-fold overexpressed by cancer cells in the prostate. Measurement of urine PCA3 appears to be more sensitive than %tPSA, and is independent of prostate volume, age or tPSA. The author reviews laboratory biomarkers related to prostate cancer, used either in the routine clinical practice, or in research. Laboratory biomarkers seem to be useful tools to reduce the incidence of advanced stage, or metastatic prostate cancer, and the cancer-related death rate. A promising perspective for the future is the detection of circulating prostate cancer cells and the profiling of microRNAs, especially on the field of tumor prognosis. PMID:25517448

  12. Histopathologic characteristics of the prostatic intraepithelial neoplasia

    International Nuclear Information System (INIS)

    The prostate disease is a health problem nowadays due to its high morbidity and mortality in adults older than 50 years. Based on this, a descriptive and cross sectional study was carried out on the histopathologic findings of the prostatic intraepithelial neoplasia in the useful prostate biopsies examined in the Pathology Department of 'Dr. Ambrosio Grillo Portuondo' Clinical Surgical Teaching Hospital in Santiago de Cuba during the biennium 2008-2009. Among the main results there were: the confirmation of prostate fibroadenomatous hyperplasia, prostatic lesions, carcinomas and other alterations in that male gland, all through biopsy. The obtained data confirmed that the diagnosis through samples from the prostatic intraepithelial neoplasia tissue, constitutes one of the ways by which pathologists can contribute to the opportune detection of the prostatic carcinoma. (author)

  13. Association of Symptomatic Benign Prostatic Hyperplasia and Prostate Cancer: Results from the Prostate Cancer Prevention Trial

    OpenAIRE

    Schenk, Jeannette M.; Kristal, Alan R.; Arnold, Kathryn B.; Tangen, Catherine M.; Neuhouser, Marian L; Lin, Daniel W; White, Emily; Thompson, Ian M

    2011-01-01

    This study examined the association between symptomatic benign prostatic hyperplasia (BPH) and prostate cancer risk in 5,068 placebo-arm participants enrolled in the Prostate Cancer Prevention Trial (1993–2003). These data include 1,225 men whose cancer was detected during the 7-year trial—556 detected for cause (following abnormal prostate-specific antigen or digital rectal examination) and 669 detected not for cause (without indication), as well as 3,843 men who had biopsy-proven absence of...

  14. Diet, Supplement Use, and Prostate Cancer Risk: Results From the Prostate Cancer Prevention Trial

    OpenAIRE

    Kristal, Alan R.; Arnold, Kathryn B.; Neuhouser, Marian L; Goodman, Phyllis; Platz, Elizabeth A.; Albanes, Demetrius; Thompson, Ian M

    2010-01-01

    The authors examined nutritional risk factors for prostate cancer among 9,559 participants in the Prostate Cancer Prevention Trial (United States and Canada, 1994–2003). The presence or absence of cancer was determined by prostate biopsy, which was recommended during the trial because of an elevated prostate-specific antigen level or an abnormal digital rectal examination and was offered to all men at the trial's end. Nutrient intake was assessed using a food frequency questionnaire and a str...

  15. Correlação entre a graduação histológica de biópsias e do espécimen cirúrgico em câncer da prostata Correlation between histologic biopsy grading and radical prostatectomy specimen in prostate cancer

    Directory of Open Access Journals (Sweden)

    José Cury

    1999-02-01

    Full Text Available Foram estudados, retrospectivamente, os prontuários de 120 pacientes com câncer localizado da próstata nos estádios clínicos T1, T2 e T3a e que foram submetidos a 1infadenectomia ilíaca e a cirurgia radical da próstata. Todos haviam sido graduados pela escala de Gleason através de biópsias da próstata guiadas pela ultra-sonografia transretal. Correlacionamos a graduação histo1ógica destas biópsias da próstata com a graduação final obtida no exame da peça cirúrgica correspondente e obtivemos exata concordância em 39 pacientes (32,50%. Ao considerarmos a concordância de ± 1unidade, observamos concordância de resultado em 81 pacientes (67,50%. A subgraduação histológica das biópsias prostáticas foi encontrada em 75 pacientes (62,50% dos casos.The treatment of patients with adenocarcinoma of the prostate is based on the tumor stage and grade. For this reason the interpretation of the biopsy especimen is crucial and demands a great expertize from its examiner. ln order to define the accuracy of biopsy interpretation we settled the present study, trying to correlate the relationship between the histological grade of the biopsy especimens and the definitive pathological report read by the same pathologist. One hundred and twenty patients with localized prostate cancer stages TI - T3a submitted to radical prostatectomy were evaluated. The histological grade of the tumor was defined using the Gleason score sistem and a correlation was made between the score of biopsy and the surgical especimens. Complete agreement of the Gleason score was seen in 39 patients (32,5% and if 1 digit discordance (± 1 Gleason score was not considered, agreement was seen in 81 patients (67,5%. Seventy five tumors (62,5% were undergraded and the rate of discordance was more common in patients with grade 2 to 4 tumors. According to our date, we conclude that the histological evaluation of the biopsy especimen in prostate cancer tends to underevaluate

  16. MR imaging of prostate cancer

    International Nuclear Information System (INIS)

    Accurate diagnosis and staging of prostate cancer (PC) is developing into an important health care issue in light of the high incidence of PC and the improvements in stage-adapted therapy. The purpose of this paper is to provide an overview on the current role of MR imaging and MR spectroscopy in the diagnosis and staging of PC.Material and methods Pertinent literature was searched and evaluated to collect information on current clinical indications, study techniques, diagnostic value, and limitations of magnetic resonance imaging and spectroscopy. Major indications for MR imaging of patients with supected PC are to define tumor location before biopsy when clinical or TRUS findings are inconclusive, and to provide accurate staging of histologically proven PC to ascertain effective therapy. Current MR imaging techniques for the evaluation of PC include multiplanar high-resolution T2-weighted FSE and T1-weighted SE sequences using combined endorectal and phased-array coils. Using these techniques, the reported accuracy of MR imaging for the diagnosis of extracapsular tumor extension ranges between 82 and 88% with sensitivities between 80 and 95%, and specificities between 82 and 93%. Typical MR findings of PC in different stages of disease, as well as diagnostic problems, such as chronic prostatitis, biopsy-related hemorrhage and therapy-related changes of prostatic tissue are discussed. In addition, the current perspectives and limitations of MR spectroscopy in PC are summarized. Current MR imaging techniques provide important diagnostic information in the pretherapeutic workup of PC including a high staging accuracy, and is superior to TRUS. (orig.)

  17. Cosuppression of Sprouty and Sprouty-Related Negative Regulators of FGF Signalling in Prostate Cancer: A Working Hypothesis

    Directory of Open Access Journals (Sweden)

    Stephen J. Assinder

    2015-01-01

    Full Text Available Deregulation of FGF receptor tyrosine kinase (RTK signalling is common in prostate cancer. Normally, to moderate RTK signalling, induction of Sprouty (SPRY and Sprouty-related (SPRED antagonists occurs. Whilst decreased SPRY and SPRED has been described in some cancers, their role in prostate cancer is poorly understood. Therefore, we hypothesise that due to the need for tight regulation of RTK signalling, SPRY and SPRED negative regulators provide a degree of redundancy which ensures that a suppression of one or more family member does not lead to disease. Contrary to this, our analyses of prostates from 24-week-old Spry1- or Spry2-deficientmice, either hemizygous (+/− or homozygous (−/− for the null allele, revealed a significantly greater incidence of PIN compared to wild-type littermates. We further investigated redundancy of negative regulators in the clinical setting in a preliminary analysis of Gene Expression Omnibus and Oncomine human prostate cancer datasets. Consistent with our hypothesis, in two datasets analysed a significant cosuppression of SPRYs and SPREDs is evident. These findings demonstrate the importance of negative regulators of receptor tyrosine signalling, such as Spry, in the clinical setting, and highlight their importance for future pharmacopeia.

  18. Collagen I and III and metalloproteinase gene and protein expression in prostate cancer in relation to Gleason score

    Directory of Open Access Journals (Sweden)

    Antonio H. Duarte

    2012-06-01

    Full Text Available PURPOSE: To evaluate if the expression of metalloproteinase, collagen I and III are related to Gleason score, preoperative PSA and pathological stage in prostate cancer. MATERIALS AND METHODS: Our study group included radical prostatectomy specimens of 33 patients with prostatic adenocarcinoma who underwent surgery from 2001 to 2009. Patients were divided into 3 groups: Gleason score=6 (13 patients, Gleason score=7 (10 patients, Gleason score>8 (10 patients. The control group included prostates of patients submitted to cystoprostatectomy and benign prostatic tissues adjacent to the cancer area. Specific areas of tissues were selected under microscope and further processed for collagen I and III analysis by real time PCR. In addition, 10 deparaffined sections of each group were used to evaluate collagen I, III and metalloproteinase immune expression. The results were correlated with Gleason score, preoperative PSA and pathological stage. RESULTS: We found significant difference in both collagen I and III gene expression between benign and tumoral areas in the prostate samples from Gleason score=6 (collagen I=0.4±0.2 vs 5±2.4, p8 (collagen I=8±3.4 vs 1.4±0.8, p<0.07; collagen III=1.8±0.5 vs 0.6±0.1, p<0.05. There was no correlation of collagen expression with Gleason score, preoperative PSA or pathological stage. There was a positive correlation between metalloproteinase expression and Gleason score (r²=0.47. CONCLUSIONS: The positive correlation between metalloproteinase expression and Gleason score suggests that metalloproteinase could be a promising factor to improve Gleason score evaluation. Its expression and regulation do not seem to be related with collagen degradation.

  19. MR imaging of the prostate; MRT der Prostata

    Energy Technology Data Exchange (ETDEWEB)

    Asbach, P.; Haas, M.; Hamm, B. [Charite Campus Benjamin Franklin, Klinik fuer Radiologie, Berlin (Germany)

    2015-12-15

    Prostate cancer is the most common form of cancer in men in Germany; however, there is a distinct difference between incidence and mortality. The detection of prostate cancer is based on clinical and laboratory testing using serum prostate-specific antigen (PSA) levels and transrectal ultrasound with randomized biopsy. Multiparametric MR imaging of the prostate can provide valuable diagnostic information for detection of prostate cancer, especially after negative results of a biopsy prior to repeat biopsy. In addition the use of MR ultrasound fusion-guided biopsy has gained in diagnostic importance and has increased the prostate cancer detection rate. The prostate imaging reporting and data system (PI-RADS) classification has standardized the reporting of prostate MRI which has positively influenced the acceptance by urologists. (orig.) [German] Das Prostatakarzinom ist in Deutschland die haeufigste Krebserkrankung des Mannes, wobei ein deutlicher Unterschied zwischen Inzidenz und Mortalitaet besteht. Die Detektion des Prostatakarzinoms basiert auf klinischer und laborchemischer Untersuchung (prostataspezifisches-Antigen[PSA]-Wert) sowie der transrektalen Ultraschalluntersuchung mit randomisierter Biopsie. Die multiparametrische MR-Tomographie kann zur Detektion des Prostatakarzinoms, insbesondere bei negativer Biopsie vor einer erneuten Biopsie wertvolle diagnostische Informationen liefern. Zudem wird zunehmend die MRT-Ultraschall-Fusionsbiopsie in der Diagnostik eingesetzt, wodurch die Detektionsrate des Prostatakarzinoms deutlich gesteigert werden kann. Mit Einfuehrung der PI-RADS-Klassifikation (Prostate Imaging-Reporting and Data System) konnte zudem eine Standardisierung der Befundung erreicht werden, was die Akzeptanz der MRT der Prostata in der Urologie erhoeht hat. (orig.)

  20. Prostate brachytherapy in patients with prior evidence of prostatitis

    International Nuclear Information System (INIS)

    Purpose: To refute a misconception that a prior history of prostatitis is a contraindication to prostate brachytherapy. Methods and Materials: Five patients with clinical or pathologic evidence of prior prostatitis were treated with transperineal brachytherapy. Four of the patients received a single i.v. dose of ciprofloxacin (500 mg) intraoperatively. Postimplant antibiotics were not given. The pretreatment biopsy slides were reviewed. Results: Two of the five patients developed postimplant urinary retention requiring short-term catheterization, and both resolved spontaneously. One patient developed what appeared to be an exacerbation of his chronic prostatitis. Conclusion: We continue to recommend prostate brachytherapy for the treatment of clinically organ-confined cancer, with no concern about prior clinical or pathologic evidence of prostatitis

  1. Human epidermal growth factor receptor type 2 protein expression in Chinese metastatic prostate cancer patients correlates with cancer specific survival and increases after exposure to hormonal therapy

    Institute of Scientific and Technical Information of China (English)

    Bo Dai; Yun-Yi Kong; Ding-Wei Ye; Chun-Guang Ma; Xiao-Yan Zhou; Xu-Dong Yao

    2008-01-01

    Aim: To investigate human epidermal growth factor receptor type 2 (HER2) protein expression and gene amplification in Chinese metastatic prostate cancer patients and their potential value as prognostic factors. Methods: Immuno-histochemistry (IHC) was performed to investigate HER2 protein expression in prostate biopsy specimens from 104 Chinese metastatic prostate cancer patients. After 3-11 months of hormonal therapy, 12 patients underwent transure- thral resection of the prostate (TURP). HER2 protein expression of TURP specimens was compared with that of the original biopsy specimens. Of these, 10 biopsy and 4 TURP specimens with HER2 IHC staining scores ≥ 2+ were investigated for HER2 gene amplification status by fluorescent in situ hybridization (FISH). Results: Of the 104 prostate biopsy specimens, HER2 protein expression was 0, 1+, 2+ and 3+ in 49 (47.1%), 45 (43.3%), 8 (7.7%) and 2 (1.9%) cases, respectively. There was a significant association between HER2 expression and Gleason score (P = 0.026). HER2 protein expression of prostate cancer tissues increased in 33.3% of patients after hormonal therapy. None of the 14 specimens with HER2 IHC scores > 2+ showed HER2 gene amplification. Patients with HER2 scores ≥ 2+ had a significantly higher chance of dying from prostate cancer than those with HER2 scores of 0 (P = 0.004) and 1+ (P = 0.034). Multivariate Cox regression analysis showed that HER2 protein expression intensity was an independent predictor of cancer-related death (P = 0.039). Conclusion: An HER2 IHC score ≥ 2+ should be defined as HER2 protein overexpression in prostate cancer. Overexpression of HER2 protein in cancer tissue might suggest an increased risk of dying from prostate cancer. HER2 protein expression increases in some individual patients after hormonal therapy.

  2. An analysis of clinical and treatment related prognostic factors on outcome using biochemical control as an end-point in patients with prostate cancer treated with external beam irradiation

    International Nuclear Information System (INIS)

    Purpose: We reviewed our institution's experience in treating patients with clinically localized prostate cancer with external beam irradiation (RT) to determine if previously analyzed clinical and treatment related prognostic factors affected outcome when biochemical control was used as an end-point to evaluate results. Materials and methods: Between 1 January 1987 and 31 December 1991, 470 patients with clinically localized prostate cancer were treated with external beam RT using localized prostate fields at William Beaumont Hospital. Biochemical control was defined as PSA nadir ≤1.5 ng/ml within 1 year of treatment. After achieving nadir, if two consecutive increases of PSA were noted, the patient was scored a failure at the time of the first increase. Prognostic factors, including the total number of days in treatment, the method of diagnosis, a history of any pretreatment transurethral resection of the prostate (TURP) and the type of boost were analyzed. Results: Median follow-up was 48 months. No statistically significant difference in rates of biochemical control were noted for treatment time, overall time (date of biopsy to completion of RT), history of any pretreatment TURP, history of diagnosis by TURP, or boost techniques. Patients diagnosed by TURP had a significant improvement in the overall rate of biochemical control (P < 0.03) compared to transrectal/transperineal biopsy. The 5-year actuarial rates were 58 versus 39%, respectively. This improvement was not evident when pretreatment PSA, T stage, or Gleason score were controlled for. On multivariate analysis, no variable was associated with outcome. When analysis was limited to a more favorable group of patients (T1/T2 tumors, pretreatment PSA ≤20 ng/ml and Gleason score <7), none of these variables were significantly predictive of biochemical control when controlling for pretreatment PSA, T stage and Gleason score. Conclusions: No significant effect of treatment time, overall time, pretreatment

  3. The Impact of Acute Urinary Retention After Iodine-125 Prostate Brachytherapy on Health-Related Quality of Life

    International Nuclear Information System (INIS)

    Purpose: To evaluate the impact of acute urinary retention (AUR) in patients treated with 125I prostate brachytherapy on short- and long-term health-related quality of life (HRQOL); and to assess whether pretreatment HRQOL has additional value in the prediction of AUR. Methods and Materials: For 127 patients treated with 125I brachytherapy for localized prostate cancer between December 2000 and June 2003, toxicity and HRQOL data were prospectively collected. Patients received a HRQOL questionnaire at five time points: before and 1 month, 6 months, 1 year, and 6 years after treatment. The questionnaire included the RAND-36 generic health survey, the cancer-specific European Organization for Research and Treatment of Cancer core questionnaire (EORTC QLQ-C30), the tumor-specific EORTC prostate cancer module (EORTC QLQ-PR25), and the American Urological Association (AUA) symptom index. Results: Of 127 patients, 13 (10.2%) developed AUR. Patients with AUR had a significantly worse urinary QOL at all time points compared with patients without AUR. The mean difference over time (6 years) between both groups for the EORTC QLQ-PR25 urinary symptom score was 13.0 points (p < 0.001) and for the AUA urinary symptom score was 15.7 points (p = 0.001). Global QOL scores (EORTC QLQ-C30) over time for patients who developed AUR were significantly worse compared with patients without AUR (mean difference 6.7 points; p = 0.043). In multivariate logistic regression analysis, pretreatment International Prostate Symptom Score (p = 0.004) and neoadjuvant hormonal treatment (p = 0.034) were predictors of AUR. Quality of life did not have added predictive value. Conclusion: Acute urinary retention after prostate brachytherapy has a significant negative impact on patient's HRQOL up to 6 years after treatment, in terms of both global QOL measures and urinary symptom scores. Furthermore, our results suggest limited value of pretreatment HRQOL measures for the prediction of AUR.

  4. Ultrasonographic and cytopathologic aspects of prostate disease in 52 dogs

    Directory of Open Access Journals (Sweden)

    Antonio Carlos Cunha Lacreta Junior

    2012-03-01

    Full Text Available This study evaluated 52 dogs, which were male, intact, varied in age, of pure or mixed breed, with clinical signs suggestive of prostatic disease. Each individual underwent an ultrasound examination and fine-needle aspiration biopsy of the prostate gland for cytological evaluation. Benign prostatic hyperplasia (BPH was the most frequent prostatic disease, followed by cystic benign prostatic hyperplasia, bacterial prostatitis, abscesses, cysts, adenocarcinoma, nonbacterial prostatitis and paraprostatic cysts. The highest frequencies of prostate disorder were found in mixed breeds, followed by poodles and German shepherds. Ultrasound examination allowed the determination of prostate size, as well as the visualization of the diseases affecting the gland, and was effective in guiding aspiration biopsy. The cytological evaluation of the gland, especially when associated with changes in ultrasound images, revealed the presumptive diagnosis of the condition.

  5. The novel prostate cancer antigen 3 (PCA3 biomarker

    Directory of Open Access Journals (Sweden)

    Andreas Bourdoumis

    2010-12-01

    Full Text Available PCA3 is a prostate specific, nonprotein coding RNA that is significantly over expressed in prostate cancer, without any correlation to prostatic volume and/or other prostatic diseases (e.g. prostatitis. It can now easily be measured in urine with a novel transcription-mediated amplification based test. Quantification of PCA3 mRNA levels can predict the outcome of prostatic biopsies with a higher specificity rate in comparison to PSA. Several studies have demonstrated that PCA3 can be used as a prognostic marker of prostate cancer, especially in conjunction with other predictive markers. Novel PCA3-based nomograms have already been introduced into clinical practice. PCA3 test may be of valuable help in several PSA quandary situations such as negative prostatic biopsies, concomitant prostatic diseases, and active surveillance. Results from relevant clinical studies, comparative with PSA, are warranted in order to confirm the perspective of PCA3 to substitute PSA.

  6. Biopsy with the New Essen Biopsy Forceps

    Directory of Open Access Journals (Sweden)

    Peter G. Traine

    2013-01-01

    Full Text Available Purpose. To present initial experience with a novel biopsy method, the Essen biopsy forceps. Therefore, two patients with diagnostic suspicion of uveal melanoma underwent biopsy for histopathological confirmation. Case Presentation. Two patients presented with painless unilateral vision reduction. Ultrasound revealed the diagnostic suspicion of uveal melanoma. Therefore, biopsy with the Essen biopsy forceps using a sutureless 23-gauge three-port vitrectomy system was performed. The specimens were then submitted to a pathologist and processed. Histopathology of the obtained specimen confirmed the diagnostic suspicion of choroid melanoma in both patients. Conclusion. Essen biopsy forceps is a very practicable alternative method to the FNAB, allowing a combined histopathological and immunohistochemical examination for achieving high diagnostic accuracy at minimal risk.

  7. Determinación de la utilidad de la relación APE l/t (Antígeno Prostático Específico libre sobre el total en pacientes con sospecha de cáncer de próstata estudiados por biopsia ecográfica endorrectal Utility of Free/Total Serum Prostate-Specific Antigen Ratio in prostatic cancer studied with endorectal ultrasound biopsy

    Directory of Open Access Journals (Sweden)

    Alberto Marangoni

    2008-09-01

    Full Text Available Introducción: Los marcadores tumorales son importantes al momento de decidir la realización de biopsias para el diagnóstico de cáncer de próstata. El objetivo de este trabajo es evaluar la exactitud diagnóstica del APE libre como marcador tumoral en casos de pacientes con sospecha de cáncer prostático en su relación con el APE total (APEL/T y determinar un valor de corte ajustado. Material y Método: En total, fueron evaluados 248 pacientes de entre 38 y 88 años de edad, en un período comprendido entre noviembre de 2001 y junio de 2007, con un análisis del APE libre, identificación de la presencia de un área hipoecogénica como ayuda diagnóstica y un análisis anatomopatológico para confirmación pospunción prostática endorrectal, realizado en forma prospectiva. Resultados: La identificación de pacientes con cáncer de próstata a través de la sospecha por el APE libre es relativa pero puede ser potenciada con otros hallazgos. Un 23,3% de pacientes con APEL/T por debajo de 0,20 presentaron biopsias positivas, pero, con un valor de 0,14, el porcentaje fue del 60%. Discusión: La identificación de pacientes para ser estudiados mediante Biopsia Prostática Endorrectal (BPE es un problema de la práctica diaria en los consultorios de Urología. Debido a que la BPE es un procedimiento diagnóstico medianamente invasivo y no exento de morbilidad, es que se debería ajustar su indicación. La relación APEL/T debe ser considerada en este contexto con mayor importancia. Conclusión: La identificación de valores alterados de la relación APE L/T con un valor de corte ajustado a 0,14 puede ayudar en el diagnóstico presuntivo de cáncer de próstata y a la elección de pacientes para biopsia a fin de ahorrar biopsias innecesarias.Introduction: The tumor markers are important to decide to perform biopsies in the prostate cancer diagnosis. The goal of this article is to evaluate the diagnosis precision of FPSA (Free Prostatic Specific

  8. Quality of life of patients after permanent prostate brachytherapy in relation to dosimetry

    International Nuclear Information System (INIS)

    Purpose: To investigate changes in quality of life (QoL) after permanent prostate brachytherapy and to correlate these changes with postimplant dosimetry based on magnetic resonance (MR) images. Methods and Materials: For this study, 127 patients with low-stage prostate cancer and treated with brachytherapy received a QoL questionnaire at five time points: before treatment and at 4 weeks, 6 months, 1 year, and 2 years after treatment. The questionnaire included the RAND-36 generic health survey, the cancer-specific European Organization for Research and Treatment of Cancer (EORTC) core questionnaire, the tumor-specific EORTC prostate cancer module, and the American Urological Association symptom index. Postimplant dosimetry was based on registered T1 spin echo transversal, T2 turbo spin echo transversal, and T2 turbo spin echo sagittal MR images and CT images taken 4 weeks after implantation of the iodine-125 seeds. Calculated parameters were prostate volume, prostate volume receiving 100% (V100) and 150% (V150) dose, dose to 90% of the prostate volume (D90), maximum dose in 1-, 2-, and 5-cm3 rectum volume, distance between prostate and anterior rectum wall, and the maximum dose in 1%, 2%, and 5% urethra volume. Analysis of variance for repeated measures was used for comparison of the means of all variables in the different questionnaires. Linear regression analysis (stepwise) was used to investigate the correlations between QoL parameters and dosimetry parameters. Results: On average, only the QoL at 4 weeks after implant was significantly different from (worse than) the QoL at the other time points. Regression analysis showed a significant correlation between changes in bowel problems and the maximum dose in 2-cm3 rectum volume, between changes in urinary symptoms and prostate volume, and between changes in urinary problems and the D90 value of the prostate. Conclusions: The QoL for patients with permanent prostate implants was worse in the first months after

  9. Overexpression and purification of folded domain of prostate cancer related proteins MSMB and PSA.

    Science.gov (United States)

    Tiwary, Mohini; Agarwal, Nipanshu; Dinda, Amit; Yadav, Subhash C

    2016-05-01

    Overexpression of domains of a human protein using recombinant DNA technology has been challenging because individual domains intend to accumulate as non-soluble aggregate when expressed separately. Studies on identifying right sequences for a domain to be able to fold independently may help understand the folding pattern and underlying protein-engineering events to isolate the functional domains of a protein. In this report, individual domains of prostate cancer related biomarkers; MSMB and PSA were overexpressed in bacterial system and purified in their folded forms using affinity chromatography. The western blotting experiment using domain specific antibodies further confirmed these proteins. The designed nucleotide sequences domains were truncated using fold index software and folding were predicted by phyre2 and I-TASSER software. Other parameters were optimized for their overexpression and purification using Co-NTA affinity chromatography. Purified domains of each protein showed secondary structures such as α + β type for PSA, α/β and β type for the each domains of PSA and MSMB respectively. This is the first report on producing PSA and MSMB individual domains in functional folded forms. This study may help produce the folded domain of many such proteins to be used for better diagnostic purpose. PMID:27038170

  10. Oncology Section EDGE Task Force on Prostate Cancer: A Systematic Review of Outcome Measures for Health-Related Quality of Life

    Science.gov (United States)

    Harrington, Shana; Lee, Jeannette; Colon, Genevieve; Alappattu, Meryl

    2016-01-01

    Background Health-related quality of life (HRQOL) is multidimensional and subjective, encompassing occupational and physical function, psychological state, social interaction, and somatic sensation. Because of the wide scope of HRQOL and its implications for the medical management of prostate cancer survivors, clinicians and researchers need to know the most reliable and valid measures currently available for addressing this clinical construct in men diagnosed with prostate cancer. Purpose To identify and evaluate patient-reported outcome measures used to assess HRQOL in men diagnosed with prostate cancer and make recommendations for the use of these patient-reported outcome measures in both the research and clinic settings. Methods The literature was systematically reviewed for patient-reported outcome measures used in peer-reviewed, published research to assess HRQOL in men diagnosed with prostate cancer. The goals were to examine the psychometric properties of commonly used HRQOL measures in order to determine their clinical utility. Results The following patient-reported outcome measures are highly recommended by the Task Force to assess HRQOL in men diagnosed with prostate cancer: EORTC QLQ-P25 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire–Prostate 25), EPIC (Expanded Prostate Cancer Index Composite), FACT-P (Functional Assessment of Cancer Therapy–Prostate), UCLA-PCI (UCLA–Prostate Cancer Index), EORTC QLQ-C30 (EORTC Quality of Life Questionnaire–Cancer 30), FACT-G (Functional Assessment of Cancer Therapy–General), and SF (Short-Form) 36, 12, and 8. Conclusions A variety of patient-reported outcome measures have been reported in the literature to assess HRQOL in men diagnosed with prostate cancer. Seven measures were found to have satisfactory psychometric properties, as well as good clinical utility, and are recommended for use by the researchers on this Task Force.

  11. Malakoplakia associated with prostatic adenocarcinoma: Report of 4 cases and literature review.

    Science.gov (United States)

    Medlicott, Shaun; Magi-Galluzzi, Cristina; Jimenez, Rafael E; Trpkov, Kiril

    2016-06-01

    Malakoplakia is an inflammatory process that has been rarely reported in the prostate. Malakoplakia in association with prostatic carcinoma is exceedingly rare with only 4 previously reported cases. We describe the clinical features and the associated pathology in 4 patients who demonstrated malakoplakia of the prostate in association with prostatic adenocarcinoma. Prostatic malakoplakia presenting in association with prostatic adenocarcinoma was identified in 4 patients through a search from the records of 3 institutional databases with large in-house and consult uropathology practices. In 2 of the patients the diagnostic needle biopsy contained only prostatic carcinoma; malakoplakia in association with prostatic carcinoma was documented on prostatectomy, performed 15 and 8weeks after the biopsy, respectively. Both patients experienced urinary infections during the interval between the biopsy and the prostatectomy. The third and fourth patient had a long-standing history of "prostatitis", and acute urinary tract infection with urinary retention, respectively. The needle biopsy in both patients showed concomitant malakoplakia and prostatic carcinoma. One of them also had malakoplakia on the initial biopsy containing only atypical glands and on the subsequent one demonstrating carcinoma. One patient was treated conservatively and one with prostatectomy. Although coexistent prostatic carcinoma and malakoplakia are exceedingly rare, malakoplakia can likely occur as an exceptionally rare complication of a prostate needle biopsy, particularly in individuals with long-term or acute urinary tract infections at the time of the biopsy. PMID:27180057

  12. Organoid cultures derived from patients with advanced prostate cancer

    NARCIS (Netherlands)

    Gao, Dong; Vela, Ian; Sboner, Andrea; Iaquinta, Phillip J; Karthaus, Wouter R; Gopalan, Anuradha; Dowling, Catherine; Wanjala, Jackline N; Undvall, Eva A; Arora, Vivek K; Wongvipat, John; Kossai, Myriam; Ramazanoglu, Sinan; Barboza, Luendreo P; Di, Wei; Cao, Zhen; Zhang, Qi Fan; Sirota, Inna; Ran, Leili; MacDonald, Theresa Y; Beltran, Himisha; Mosquera, Juan-Miguel; Touijer, Karim A; Scardino, Peter T; Laudone, Vincent P; Curtis, Kristen R; Rathkopf, Dana E; Morris, Michael J; Danila, Daniel C; Slovin, Susan F; Solomon, Stephen B; Eastham, James A; Chi, Ping; Carver, Brett; Rubin, Mark A; Scher, Howard I; Clevers, Hans; Sawyers, Charles L; Chen, Yu

    2014-01-01

    The lack of in vitro prostate cancer models that recapitulate the diversity of human prostate cancer has hampered progress in understanding disease pathogenesis and therapy response. Using a 3D organoid system, we report success in long-term culture of prostate cancer from biopsy specimens and circu

  13. Thioredoxin 1 in Prostate Tissue Is Associated with Gleason Score, Erythrocyte Antioxidant Enzyme Activity, and Dietary Antioxidants

    Directory of Open Access Journals (Sweden)

    Terrence M. Vance

    2015-01-01

    Full Text Available Background. Prostate cancer is the most common noncutaneous cancer and second leading cause of cancer-related mortality in men in the US. Growing evidence suggests that oxidative stress is involved in prostate cancer. Methods. In this study, thioredoxin 1 (Trx 1, an enzyme and subcellular indicator of redox status, was measured in prostate biopsy tissue from 55 men from the North Carolina-Louisiana Prostate Cancer Project. A pathologist blindly scored levels of Trx 1. The association between Trx 1 and the Gleason score, erythrocyte antioxidant enzyme activity, and dietary antioxidant intake was determined using Fisher’s exact test. Results. Trx 1 levels in benign prostate tissue in men with incident prostate cancer were positively associated with the Gleason score (P=0.01 and inversely associated with dietary antioxidant intake (P=0.03. In prostate cancer tissue, Trx 1 levels were associated with erythrocyte glutathione peroxidase activity (P=0.01. No association was found for other erythrocyte enzymes. Greater Gleason score of malignant tissue corresponds to a greater difference in Trx 1 levels between malignant and benign tissue (P=0.04. Conclusion. These results suggest that the redox status of prostate tissue is associated with prostate cancer grade and both endogenous and exogenous antioxidants.

  14. Polymorphisms in genes related to inflammation, NSAID use, and the risk of prostate cancer among Danish men

    DEFF Research Database (Denmark)

    Kopp, Tine Iskov; Friis, Søren; Christensen, Jane; Tjønneland, Anne; Vogel, Ulla

    The etiology of prostate cancer (PC) remains mostly unknown, but increasing evidence suggests that chronic inflammation in the prostate is associated with an increased risk of PC. Epidemiological studies have suggested that use of nonsteroidal anti-inflammatory drugs (NSAIDs) may protect against PC....... Inborn variations in genes involved in the inflammatory response may modulate the risk of PC and interact with NSAIDs. The aims of this study were 1) to evaluate whether polymorphisms and haplotypes of the inflammation-related genes COX-2, Il1B, NFKB1, and PPARG are associated with risk of PC; 2) to...... investigate gene–environment interactions between polymorphisms and NSAID use; and 3) to examine whether the studied polymorphisms were associated with the aggressiveness of PC. The study population consisted of 370 cases of PC and 370 risk-set matched (age) controls nested within the prospective Danish “Diet...

  15. Pain-related behavior was not observed in dairy cattle in the days after liver biopsy, regardless of whether NSAIDs were administered.

    Science.gov (United States)

    Barrett, Lorelle A; Beausoleil, Ngaio J; Benschop, Jackie; Stafford, Kevin J

    2016-02-01

    For liver biopsy in cattle, it is routine practice to only provide local anesthesia (LA) to the skin and muscle layers, with visceral tissues remaining unanesthetized. Cattle being biopsied may therefore benefit from additional analgesia. This study aimed to determine if non-steroidal anti-inflammatory drugs would decrease post-biopsy pain in cattle. Twenty-four dairy cows were allocated into four treatment groups: biopsy under LA only; biopsy under LA with ketoprofen; biopsy under LA with meloxicam; and a sham-biopsied control group. Behavior was observed for 4h immediately following biopsy, and for 2h each day for the first three days after biopsy. No significant differences in behavior were found between any treatment groups on any day. This suggests that any post-biopsy pain present was not of enough significance to alter the cows' normal behavior patterns. Without identifying post-biopsy pain, it is not possible to determine what effect NSAID analgesia may have had on alleviating it. PMID:26850560

  16. Prostate-specific antigen (PSA) blood test

    Science.gov (United States)

    ... for prostate cancer, such as ethnicity and family history Men at high risk may need to have more tests. These may include: Repeating your PSA test, most often sometime within 3 months A prostate biopsy A follow-up test called a free PSA ( ...

  17. Molecular Profiling of Prostate Cancer Patients

    OpenAIRE

    Nna, Emmanuel Okechukwu

    2009-01-01

    In the UK, more than 30 000 men are diagnosed annually with prostate cancer (PCa) and about 10 000 men die from it each year. Although several molecular markers have been associated with prostate cancer development and/ or progression, only few of them are used in diagnostic pathology. The current standard tests include serum PSA test, digital rectal examination and histology of prostate biopsy. Recently the PCA-3 molecular test was approved in the European Union, and it is now...

  18. Multidisciplinary Functional MR Imaging for Prostate Cancer

    OpenAIRE

    Kim, Jeong Kon; Jang, Yun-Jin; Cho, Gyunggoo

    2009-01-01

    Various functional magnetic resonance (MR) imaging techniques are used for evaluating prostate cancer including diffusion-weighted imaging, dynamic contrast-enhanced MR imaging, and MR spectroscopy. These techniques provide unique information that is helpful to differentiate prostate cancer from non-cancerous tissue and have been proven to improve the diagnostic performance of MRI not only for cancer detection, but also for staging, post-treatment monitoring, and guiding prostate biopsies. Ho...

  19. The link between benign prostatic hyperplasia and prostate cancer.

    Science.gov (United States)

    Ørsted, David D; Bojesen, Stig E

    2013-01-01

    Benign prostatic hyperplasia (BPH) and prostate cancer are among the most common diseases of the prostate gland and represent significant burdens for patients and health-care systems in many countries. The two diseases share traits such as hormone-dependent growth and response to antiandrogen therapy. Furthermore, risk factors such as prostate inflammation and metabolic disruption have key roles in the development of both diseases. Despite these commonalities, BPH and prostate cancer exhibit important differences in terms of histology and localization. Although large-scale epidemiological studies have shown that men with BPH have an increased risk of prostate cancer and prostate-cancer-related mortality, it remains unclear whether this association reflects a causal link, shared risk factors or pathophysiological mechanisms, or detection bias upon statistical analysis. Establishing BPH as a causal factor for prostate cancer development could improve the accuracy of prognostication and expedite intervention, potentially reducing the number of men who die from prostate cancer. PMID:23165396

  20. Bone marrow biopsy

    Science.gov (United States)

    Biopsy - bone marrow ... A bone marrow biopsy may be done in the health care provider's office or in a hospital. The sample may be taken from the pelvic or breast bone. Sometimes, other areas are used. Marrow is removed ...

  1. Mediastinoscopy with biopsy

    Science.gov (United States)

    ... medlineplus.gov/ency/article/003864.htm Mediastinoscopy with biopsy To use the sharing features on this page, please enable JavaScript. Mediastinoscopy with biopsy is a procedure in which a lighted instrument ( ...

  2. Sentinel Lymph Node Biopsy

    Science.gov (United States)

    ... Ask about Your Diagnosis Research Sentinel Lymph Node Biopsy On This Page What are lymph nodes? What ... lymph node? What is a sentinel lymph node biopsy? What happens during an SLNB? What are the ...

  3. Nerve biopsy (image)

    Science.gov (United States)

    Nerve biopsy is the removal of a small piece of nerve for examination. Through a small incision, a sample ... is removed and examined under a microscope. Nerve biopsy may be performed to identify nerve degeneration, identify ...

  4. Sentinel node biopsy (image)

    Science.gov (United States)

    Sentinel node biopsy is a technique which helps determine if a cancer has spread (metastasized), or is contained locally. When a ... is closest to the cancer site. Sentinel node biopsy is used to stage many kinds of cancer, ...

  5. Cold knife cone biopsy

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003910.htm Cold knife cone biopsy To use the sharing features on this page, please enable JavaScript. A cold knife cone biopsy (conization) is surgery to remove ...

  6. Predicting Gleason score using the initial serum total prostate-specific antigen in Black men with symptomatic prostate adenocarcinoma in Nigeria

    Directory of Open Access Journals (Sweden)

    Nnabugwu II

    2016-07-01

    Full Text Available Ikenna I Nnabugwu, Emeka I Udeh, Fredrick O Ugwumba, Francis O Ozoemena Urology Unit, Department of Surgery, College of Medicine, Enugu Campus, University of Nigeria, Enugu, Nigeria Background: Men of Black African descent are known to have the highest incidence of prostate cancer. The disease is also more aggressive in this group possibly due to biologically more aggressive tumor or late presentation. Currently, serum prostate-specific antigen (PSA assay plays a significant role in making the diagnosis of prostate cancer. However, the obtained value of serum PSA may not directly relate with the Gleason score (GS, a measure of tumor aggression in prostate cancer. This study explores the relationship between serum total PSA at presentation (iPSA and GS.Patients and methods: The iPSA of patients with histologically confirmed prostate cancer was compared with the obtained GS of the prostate biopsy specimens. The age of the patients at presentation and the prostate volumes were also analyzed with respect to the iPSA and GS. The data were analyzed retrospectively using IBM SPSS Version 20. Pearson correlation was used for numeric variables, whereas Fisher’s exact test was used for categorical variables. Significance was set at P≤0.05.Results: There were 205 patients from January 2010 to November 2013 who satisfied the inclusion criteria. iPSA as well as age at presentation and prostate volume were not found to significantly correlate with the primary Gleason grade, the secondary Gleason grade, or the GS. However, the presence of distant metastasis was identified to significantly correlate positively with GS.Conclusion: GS may not be confidently predicted by the iPSA. Higher iPSA does not correlate with higher GS and vice versa. Keywords: PSA, patient age, prostate volume, prostate adenocarcinoma, Gleason score

  7. 两种肠道准备方法预防前列腺穿刺活检术后并发症效果比较%Comparation the effects of two bowel preparation methods in preventing the complications of prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    迟易欣; 唐喆; 关升

    2011-01-01

    [ Objective] To investigate the effects of two different bowel preparation methods in the prevention of the complications following prostate biopsy. [ Methods] All of 98 patients with suspected prostate cancer were divided into A and B groups. All patients received routine bowel preparation for 2 ~ 3 days, took oral antibiotics, began fasting after 8 the night before. The patients in group A received oral cathartic agent but not enema, while those in group B received oral cathartic agent and routine cleansing enema in the morning before biopsy. [ Results] In group A,63.6% patients (35 of 55 ) had complications,including 2 patients with fever(T >38 ℃ ) and chill (3.6%) ;in group B,67.4% patients (29 of 43) had complications, including 2 patients with fever (4.7 % ), one of them expressing chill (2.3%). [ Conclusion ] The prebiopsy enemas might not decrease overall rates of complication in patients with prostate biopsy.%[目的]探讨两种肠道准备方法对前列腺穿刺活检术后并发症发生率的影响.[方法]将2008年12月~2010年10月疑前列腺癌并行穿刺活检患者98例分为A、B两组.A组(n=55)术前不行灌肠,术前夜口服导泻剂;B组(n=43)术前夜口服导泻剂,术晨灌肠.两组患者术前2~3 d均行常规肠道准备、口服抗感染药物,术前晚禁食.[结果]A组患者中35例出现并发症(63.6%),发热(T>38℃)伴寒战2例(3.6%);B组43例患者中29例出现并发症(67.4%),发热2例(4.7%),出现寒战者1例(2.3%).[结论]术前灌肠可能不会减少前列腺活检患者术后并发症发生率.

  8. Nuclear receptors in early hormone refractory prostate cancer and their relationship to apoptosis-related proteins

    Czech Academy of Sciences Publication Activity Database

    Kolář, Z.; Murray, P. G.; Maďarová, J.; Lukešová, M.; Hlobilková, A.; Řiháková, P.; Flavell, J. R.; Strnad, Miroslav; Student, V.; Vojtěšek, B.

    2002-01-01

    Roč. 49, - (2002), s. 172-177. ISSN 0028-2685 R&D Projects: GA ČR GA301/02/0475 Institutional research plan: CEZ:AV0Z5038910 Keywords : Nuclear receptors * prostate cancer * apoptosis Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 0.679, year: 2002

  9. Detailed urethral dosimetry in the evaluation of prostate brachytherapy-related urinary morbidity

    International Nuclear Information System (INIS)

    Purpose: To evaluate the relationship between urinary morbidity after prostate brachytherapy and urethral doses calculated at the base, midprostate, apex, and urogenital diaphragm. Methods and Materials: From February 1998 through July 2002, 186 consecutive patients without a prior history of a transurethral resection underwent monotherapeutic brachytherapy (no supplemental external beam radiation therapy or androgen deprivation therapy) with urethral-sparing techniques (average urethral dose 100%-140% minimum peripheral dose) for clinical T1c-T2b (2002 AJCC) prostate cancer. The median follow-up was 45.5 months. Urinary morbidity was defined by time to International Prostate Symptom Score (IPSS) resolution, maximum increase in IPSS, catheter dependency, and the need for postimplant surgical intervention. An alpha blocker was initiated approximately 2 weeks before implantation and continued at least until the IPSS returned to baseline. Evaluated parameters included overall urethral dose (average and maximum), doses to the base, midprostate, apex, and urogenital diaphragm, patient age, clinical T stage, preimplant IPSS, ultrasound volume, isotope, and D90 and V100/150/200. Results: Of the 186 patients, 176 (94.6%) had the urinary catheter permanently removed on the day of implantation with only 1 patient requiring a urinary catheter >5 days. No patient had a urethral stricture and only 2 patients (1.1%) required a postbrachytherapy transurethral resection of the prostate (TURP). For the entire cohort, IPSS on average peaked 2 weeks after implantation with a mean and median time to IPSS resolution of 14 and 3 weeks, respectively. For the entire cohort, only isotope predicted for IPSS resolution, while neither overall average prostatic urethra nor segmental urethral dose predicted for IPSS resolution. The maximum postimplant IPSS increase was best predicted by preimplant IPSS and the maximum apical urethral dose. Conclusions: With the routine use of prophylactic alpha

  10. Analysis of the codon 72 polymorphism of TP53 and human papillomavirus infection in Iranian patients with prostate cancer.

    Science.gov (United States)

    Salehi, Zivar; Hadavi, Mahvash

    2012-09-01

    The TP53 gene is one of the most important tumor suppressor genes controlling DNA transcription and cell regulation. Common polymorphisms in p53 gene may play a role in some cancers. Some studies have reported an association between human papillomavirus (HPV) infections and prostate cancer. The aim of this study was to investigate whether the TP53 codon 72 polymorphism and HPV infection are responsible for susceptibility to prostate cancer in Iranian men. The prostate biopsies were taken during surgery from 68 Iranian prostatic cancer patients, and 85 patients with benign prostate hyperplasia. For genotyping of the p53 polymorphism at codon 72, PCRRFLP methods were used and the PCR products were digested with BstU1. An attempt was also made to detect HPV DNA in benign prostate hyperplasia and prostate cancer specimens. Among cancer cases, the distribution of Arg/Arg, Arg/Pro and Pro/Pro genotypes were 26.5%, 45.4%, and 19.1%, respectively. Among patients with benign prostate hyperplasia, the distribution of Arg/Arg, Arg/Pro, and Pro/Pro genotypes were 27%, 53%, and 20%, respectively. The allele frequencies did not differ significantly between prostate cancer and benign prostate hyperplasia samples. Human papillomavirus was detected only in three patients (4.4%; P = 0.71). The results from this study suggest that the TP53 codon 72 polymorphism and HPV infection do not confer susceptibility to prostate cancer in the Iranian population. Larger population-based studies are needed to clarify the relation between prostate carcinoma and p53 polymorphism and HPV infection. PMID:22825821

  11. Determination of the Normal Prostate Specific Antigen (PSA) Value in Iraqi Society and its Relation to Bacterial Urinary Tract Infection (UTI)

    International Nuclear Information System (INIS)

    The study was carried out by radioimmunoassay and immuno radiographic analysis in the Iraqi Ministry of Health, within the research plan of Kurdistan institution for strategic study and scientific research. A total of 793 serum samples were collected in which 50 patient samples have biopsy with positive bacterial UTI. The other 743 samples were obtained from normal healthy volunteers all were over 45 years old. The samples were gathered randomly from three regions in Iraq namely, from north (Sulaymaniyah, Erbil and Dohuk), from the middle (Baghdad and Diyala) and from south (Basra, Missan and Najaf). The total PSA was measured and the results were subjected to statistical analysis based on statistical package social science (SPSS) method. The obtained data showed that the normal PSA values are function of the age of the donors. The results were grouped and clarified that PSA was less than 3.8 ng/ml for the age 45-55 years, while it was less than 4.8 ng/ml for the volunteers from 56-65 years old and the values lower than 5.9 ng/ml for group aged 66-75 years old. On the other hand, the obtained data illustrated that there were non-significant variations in PSA values as a function of the geographic regions. The PSA values for the 50 male positive bacterial UTI samples were within the same grouping previously stated for the normal healthy volunteers. Seven cases of the 743 samples showed abnormal high PSA values (i.e. greater than 9 ng/ml) which represent 0.93% of the healthy collected samples. It could be concluded that the PSA has non-significance relation to the bacterial UTI. In addition, the radioimmunoassay has a sensitivity of about 99.04% for the normal cases and specificity of 0.96% for prostate cancer.

  12. The effect of walnut intake on factors related to prostate and vascular health in older men

    Directory of Open Access Journals (Sweden)

    West Sheila G

    2008-05-01

    Full Text Available Abstract Background Tocopherols may protect against prostate cancer and cardiovascular disease (CVD. Methods We assessed the effect of walnuts, which are rich in tocopherols, on markers of prostate and vascular health in men at risk for prostate cancer. We conducted an 8-week walnut supplement study to examine effects of walnuts on serum tocopherols and prostate specific antigen (PSA. Subjects (n = 21 consumed (in random order their usual diet +/- a walnut supplement (75 g/d that was isocalorically incorporated in their habitual diets. Prior to the supplement study, 5 fasted subjects participated in an acute timecourse experiment and had blood taken at baseline and 1, 2, 4, and 8 h after consuming walnuts (75 g. Results During the timecourse experiment, triglycerides peaked at 4 h, and gamma-tocopherol (γ-T increased from 4 to 8 h. Triglyceride – normalized γ-T was two-fold higher (P = 0.01 after 8 versus 4 h. In the supplement study, change from baseline was +0.83 ± 0.52 μmol/L for γ-T, -2.65 ± 1.30 μmol/L for alpha-tocopherol (α-T and -3.49 ± 1.99 for the tocopherol ratio (α-T: γ-T. A linear mixed model showed that, although PSA did not change, the ratio of free PSA:total PSA increased and approached significance (P = 0.07. The α-T: γ-T ratio decreased significantly (P = 0.01, partly reflecting an increase in serum γ-T, which approached significance (P = 0.08. Conclusion The significant decrease in the α-T: γ-T ratio with an increase in serum γ-T and a trend towards an increase in the ratio of free PSA:total PSA following the 8-week supplement study suggest that walnuts may improve biomarkers of prostate and vascular status.

  13. Developing a nanoparticle test for prostate cancer scoring

    OpenAIRE

    Huo Qun; Litherland Sally A; Sullivan Shannon; Hallquist Hillari; Decker David A; Rivera-Ramirez Inoel

    2012-01-01

    Abstract Background Over-diagnosis and treatment of prostate cancer has been a major problem in prostate cancer care and management. Currently the most relevant prognostic factor to predict a patient's risk of death due to prostate cancer is the Gleason score of the biopsied tissue samples. However, pathological analysis is subjective, and the Gleason score is only a qualitative estimate of the cancer malignancy. Molecular biomarkers and diagnostic tests that can accurately predict prostate t...

  14. Prostate carcinoma with neuroendocrine differentiation: case report and literature review

    Directory of Open Access Journals (Sweden)

    Fernandes Raquel Civolani Marques

    2001-01-01

    Full Text Available Neuroendocrine differentiation in prostatic carcinomas generally confers a more aggressive clinical behavior and less favorable prognosis than usual prostatic carcinomas. In this manuscript, we report a case of a 58-year-old man with prostatic carcinoma who died 1 year after initial diagnosis. Autopsy showed a disseminated prostatic carcinoma with neuroendocrine differentiation. There were metastasis to the spleen, an organ infrequently involved by disseminated epithelial neoplasms. Neuroendocrine differentiation was demonstrated by immunohistochemical studies in the biopsy and autopsy material.

  15. Multiple urinary bladder masses from metastatic prostate adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Richard Choo

    2010-12-01

    Full Text Available We present an unusual case of metastatic prostate adenocarcinoma that manifested with multiple exophytic intravesical masses, mimicking a multifocal primary bladder tumor. Biopsy with immunohistochemical analysis confirmed metastatic prostate adenocarcinoma. The patient was treated palliatively with external beam radiotherapy to prevent possible symptoms from local tumor progression. This case illustrates that when a patient with known prostate cancer presents with multifocal bladder tumors, the possibility of metastatic prostate cancer should be considered.

  16. The Value of Prostate MRI with Endorectal Coil in Detecting Seminal Vesicle Involvement in Patients with Prostate Cancer

    OpenAIRE

    Ghafoori, Mahyar; Alavi, Manijeh; Shakiba, Madjid; Hoseini, Kamal

    2015-01-01

    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 en...

  17. Serum estrogen levels and prostate cancer risk in the prostate cancer prevention trial: a nested case–control study

    OpenAIRE

    Yao, Song; Till, Cathee; Kristal, Alan R.; Goodman, Phyllis J.; Hsing, Ann W.; Tangen, Catherine M.; Platz, Elizabeth A.; Stanczyk, Frank Z.; Reichardt, Juergen K. V.; Tang, Li; Neuhouser, Marian L; Santella, Regina M.; William D Figg; Price, Douglas K.; Parnes, Howard L.

    2011-01-01

    Objective Finasteride reduces prostate cancer risk by blocking the conversion of testosterone to dihydrotestosterone. However, whether finasteride affects estrogens levels or change in estrogens affects prostate cancer risk is unknown. Methods These questions were investigated in a case–control study nested within the prostate cancer prevention trial (PCPT) with 1,798 biopsy-proven prostate cancer cases and 1,798 matched controls. Results Among men on placebo, no relationship of serum estroge...

  18. Sonoelastographic evaluation with the determination of compressibility ratio for symmetrical prostatic regions in the diagnosis of clinically significant prostate cancer

    OpenAIRE

    Przewor, Artur; Słapa, Rafał Z.; Jakubowski, Wiesław S.; Migda, Bartosz; Dmowski, Tadeusz

    2014-01-01

    Aim Sonoelastography is a technique that assesses tissue hardness/compressibility. Utility and sensitivity of the method in prostate cancer diagnostics were assessed compared to the current gold standard in prostate cancer diagnostics i.e. systematic biopsy. Material and methods The study involved 84 patients suspected of prostate cancer based on elevated PSA levels or abnormal per rectal examination findings. Sonoelastography was used to evaluate the prostate gland. In the case of regions wi...

  19. Active surveillance for localized prostate cancer

    DEFF Research Database (Denmark)

    Thomsen, Frederik B; Berg, Kasper D; Røder, M Andreas;

    2015-01-01

    OBJECTIVE: Evidence supports active surveillance (AS) as a means to reduce overtreatment of low-risk prostate cancer (PCa). The consequences of close and long-standing follow-up with regard to outpatient visits, tests and repeated biopsies are widely unknown. This study investigated the trajectory...... and costs of AS in patients with localized PCa. MATERIALS AND METHODS: In total, 317 PCa patients were followed in a prospective, single-arm AS cohort. The primary outcomes were number of patient contacts, prostate-specific antigen (PSA) tests, biopsies, hospital admissions due to biopsy complications...

  20. Is extended biopsy protocol justified in all patients with PSA ≥ 20 ng/mL?

    Institute of Scientific and Technical Information of China (English)

    Xiaojun Deng; Jian Chu; Bo Yang; Feng Liu; Weifeng Wang; Jidong Hao; Jiansheng Wan; Hui Liu

    2014-01-01

    Objective: The aim of this study was to investigate whether it was necessary to increase the number of cores at initial prostate biopsy with patients of prostate-specific antigen (PSA) ≥ 20 ng/mL and to explore an appropriate individual-ized transrectal ultrasonograhpy (TRUS)-guided prostate biopsy for the detection of prostate cancer in men suspicious of prostate cancer.Methods:A total of 115 patients with PSA ≥ 20 ng/mL and suspicious of prostate cancer were prospectively randomized to perform TRUS-guided biopsy. Patients were randomized to a “6 + X” cores or a “10 + X” cores protocol. The primary end point was cancer detection rate. Secondary end points were cancer characteristics, rate of complications and the level of pain experienced by patients during TRUS-guided prostate biopsy.Results:Preoperative variables were similar in both groups. The overal prostate cancer detection rate was 73.9%. The “10 + X” cores strategy increased cancer detection rate only 9.7% in patients with PSA ≥ 20 ng/mL but < 50 ng/mL, while there was no diference between the two strategies for cancer detection in patients with PSA ≥ 50.1 ng/mL. The number of extended biopsy cores and pain score of extended biopsy in prostate cancer patients increased significantly (P < 0.001).Conclusion:Our findings suggest that there is no significant advantage in using extended biopsy protocol in al patients with PSA ≥ 20 ng/mL.

  1. Acute Bacterial Prostatitis: Diagnosis and Management.

    Science.gov (United States)

    Coker, Timothy J; Dierfeldt, Daniel M

    2016-01-15

    Acute bacterial prostatitis is an acute infection of the prostate gland that causes pelvic pain and urinary tract symptoms, such as dysuria, urinary frequency, and urinary retention, and may lead to systemic symptoms, such as fevers, chills, nausea, emesis, and malaise. Although the true incidence is unknown, acute bacterial prostatitis is estimated to comprise approximately 10% of all cases of prostatitis. Most acute bacterial prostatitis infections are community acquired, but some occur after transurethral manipulation procedures, such as urethral catheterization and cystoscopy, or after transrectal prostate biopsy. The physical examination should include abdominal, genital, and digital rectal examination to assess for a tender, enlarged, or boggy prostate. Diagnosis is predominantly made based on history and physical examination, but may be aided by urinalysis. Urine cultures should be obtained in all patients who are suspected of having acute bacterial prostatitis to determine the responsible bacteria and its antibiotic sensitivity pattern. Additional laboratory studies can be obtained based on risk factors and severity of illness. Radiography is typically unnecessary. Most patients can be treated as outpatients with oral antibiotics and supportive measures. Hospitalization and broad-spectrum intravenous antibiotics should be considered in patients who are systemically ill, unable to voluntarily urinate, unable to tolerate oral intake, or have risk factors for antibiotic resistance. Typical antibiotic regimens include ceftriaxone and doxycycline, ciprofloxacin, and piperacillin/tazobactam. The risk of nosocomial bacterial prostatitis can be reduced by using antibiotics, such as ciprofloxacin, before transrectal prostate biopsy. PMID:26926407

  2. Inflammatory Genetic Markers of Prostate Cancer Risk

    International Nuclear Information System (INIS)

    Prostate cancer is the most common cancer in Western society males, with incidence rates predicted to rise with global aging. Etiology of prostate cancer is however poorly understood, while current diagnostic tools can be invasive (digital rectal exam or biopsy) and/or lack specificity for the disease (prostate-specific antigen (PSA) testing). Substantial histological, epidemiological and molecular genetic evidence indicates that inflammation is important in prostate cancer pathogenesis. In this review, we summarize the current status of inflammatory genetic markers influencing susceptibility to prostate cancer. The focus will be on inflammatory cytokines regulating T-helper cell and chemokine homeostasis, together with the Toll-like receptors as key players in the host innate immune system. Although association studies indicating a genetic basis for prostate cancer are presently limited mainly due to lack of replication, larger and more ethnically and clinically defined study populations may help elucidate the true contribution of inflammatory gene variants to prostate cancer risk

  3. Ultrasound-Guided Breast Biopsy

    Science.gov (United States)

    ... Professions Site Index A-Z Ultrasound-Guided Breast Biopsy An ultrasound-guided breast biopsy uses sound waves ... Guided Breast Biopsy? What is Ultrasound-Guided Breast Biopsy? Lumps or abnormalities in the breast are often ...

  4. Stereotactic (Mammographically Guided) Breast Biopsy

    Science.gov (United States)

    ... Resources Professions Site Index A-Z Stereotactic Breast Biopsy Stereotactic breast biopsy uses mammography – a specific type ... Breast Biopsy? What is Stereotactic (Mammographically Guided) Breast Biopsy? Lumps or abnormalities in the breast are often ...

  5. The prediction of mandibular invasion by squamous cell carcinomas with the expression of osteoclast-related cytokines in biopsy specimens.

    NARCIS (Netherlands)

    Cann, E.M. van; Slootweg, P.J.; Wilde, P.C.M. de; Otte-Holler, I.; Koole, R.; Stoelinga, P.J.W.; Merkx, M.A.W.

    2009-01-01

    Destruction of bone by tumour is caused by osteoclasts rather than by tumour cells directly. Tumour cells of invasive oral squamous cell carcinomas (SCC) release osteoclast-related cytokines and cytokines activate osteoclasts. The purpose of this study was to investigate the possibility of predictin

  6. Dosimetric uncertainties related to the elasticity of bladder and rectal walls: Adenocarcinoma of the prostate

    CERN Document Server

    Voyant, Cyril; Delphine, Leschi; Briancon, Jerome; Marcovici, Celine Lantieri; 10.1016/j.canrad.2010.12.006

    2011-01-01

    Purpose. - Radiotherapy is an important treatment for prostate cancer.During treatment sessions, bladder and rectal repletion is difficult to quantify and cannot be measured with a single and initial CT scan acquisition. Some methods, such as image-guided radiation therapy and dose-guided radiation therapy, aimto compensate thismissing information through periodic CT acquisitions. The aimis to adapt patient's position, beam configuration or prescribed dose for a dosimetric compliance. Methods. -We evaluated organmotion (and repletion) for 54 patients after having computed the original ballistic on a new CT scan acquisition. A new delineation was done on the prostate, bladder and rectum to determine the newdisplacements and define organ dosesmistakes (equivalent uniformdose, average dose and dose-volume histograms). Results. - The new CT acquisitions confirmed that bladder and rectal volumes were not constant during sessions. Some cases showed that previously validated treatment plan became unsuitable. A propo...

  7. Dose-related estrogen effects on gene expression in fetal mouse prostate mesenchymal cells.

    Directory of Open Access Journals (Sweden)

    Julia A Taylor

    Full Text Available Developmental exposure of mouse fetuses to estrogens results in dose-dependent permanent effects on prostate morphology and function. Fetal prostatic mesenchyme cells express estrogen receptor alpha (ERα and androgen receptors and convert stimuli from circulating estrogens and androgens into paracrine signaling to regulate epithelial cell proliferation and differentiation. To obtain mechanistic insight into the role of different doses of estradiol (E2 in regulating mesenchymal cells, we examined E2-induced transcriptomal changes in primary cultures of fetal mouse prostate mesenchymal cells. Urogenital sinus mesenchyme cells were obtained from male mouse fetuses at gestation day 17 and exposed to 10 pM, 100 pM or 100 nM E2 in the presence of a physiological concentration of dihydrotestosterone (0.69 nM for four days. Gene ontology studies suggested that low doses of E2 (10 pM and 100 pM induce genes involved in morphological tissue development and sterol biosynthesis but suppress genes involved in growth factor signaling. Genes involved in cell adhesion were enriched among both up-regulated and down-regulated genes. Genes showing inverted-U-shape dose responses (enhanced by E2 at 10 pM E2 but suppressed at 100 pM were enriched in the glycolytic pathway. At the highest dose (100 nM, E2 induced genes enriched for cell adhesion, steroid hormone signaling and metabolism, cytokines and their receptors, cell-to-cell communication, Wnt signaling, and TGF- β signaling. These results suggest that prostate mesenchymal cells may regulate epithelial cells through direct cell contacts when estrogen level is low whereas secreted growth factors and cytokines might play significant roles when estrogen level is high.

  8. Circulating Prostate Cells Found in Men with Benign Prostate Disease Are P504S Negative: Clinical Implications

    Directory of Open Access Journals (Sweden)

    Nigel P. Murray

    2013-01-01

    Full Text Available Introduction. Developments in immunological and quantitative real-time PCR-based analysis have enabled the detection, enumeration, and characterization of circulating tumor cells (CTCs. It is assumed that the detection of CTCs is associated with cancer, based on the finding that CTCs can be detected in all major cancer and not in healthy subjects or those with benign disease. Methods and Patients. Consecutive men, with suspicion of prostate cancer, had blood samples taken before prostate biopsy; mononuclear cells were obtained using differential gel centrifugation and CPCs detecting using anti-PSA immunocytochemistry. Positive samples underwent further classification with anti-P504S. Results. 329 men underwent prostate biopsy; of these men 83 underwent a second biopsy and 44 a third one. Of those with a biopsy negative for cancer, 19/226 (8.4% had CPCs PSA (+ P504S (− detected at first biopsy, 6/74 (8.1% at second biopsy, and 5/33 (15.2% at third biopsy. Men with cancer-positive biopsies did not have PSA (+ P504S (− CPCs detected. These benign cells were associated with chronic prostatitis. Conclusions. Patients with chronic prostatitis may have circulating prostate cells detected in blood, which do not express the enzyme P504S and should be thought of as benign in nature.

  9. Proton MR spectroscopy of the prostate

    Energy Technology Data Exchange (ETDEWEB)

    Mueller-Lisse, Ullrich G. [Dept. of Clinical Radiology, Klinikum der Universitaet Muenchen, Standorte Grosshadern und Innenstadt, Ziemssenstrasse 1, D-80336 Munich (Germany)], E-mail: ullrich.mueller-lisse@med.uni-muenchen.de; Scherr, Michael K. [Dept. of Clinical Radiology, Klinikum der Universitaet Muenchen, Standorte Grosshadern und Innenstadt, Ziemssenstrasse 1, D-80336 Munich (Germany)

    2007-09-15

    Purpose: To summarize current technical and biochemical aspects and clinical applications of proton magnetic resonance spectroscopy (MRS) of the human prostate in vivo. Material and methods: Pertinent radiological and biochemical literature was searched and retrieved via electronic media (medline, pubmed). Basic concepts of MRS of the prostate and its clinical applications were extracted. Results: Clinical MRS is usually based on point resolved spectroscopy (PRESS) or spin echo (SE) sequences, along with outer volume suppression of signals from outside of the prostate. MRS of the prostate detects indicator lines of citrate, choline, and creatine. While healthy prostate tissue demonstrates high levels of citrate and low levels of choline that marks cell wall turnover, prostate cancer utilizes citrate for energy metabolism and shows high levels of choline. The ratio of (choline + creatine)/citrate distinguishes between healthy tissue and prostate cancer. Particularly when combined with magnetic resonance (MR) imaging, three-dimensional MRS imaging (3D-CSI, or 3D-MRSI) detects and localizes prostate cancer in the entire prostate with high sensitivity and specificity. Combined MR imaging and 3D-MRSI exceed the sensitivity and specificity of sextant biopsy of the prostate. When MRS and MR imaging agree on prostate cancer presence, the positive predictive value is about 80-90%. Distinction between healthy tissue and prostate cancer principally is maintained after various therapeutic treatments, including hormone ablation therapy, radiation therapy, and cryotherapy of the prostate. Conclusions: Since it is non-invasive, reliable, radiation-free, and essentially repeatable, combined MR imaging and 3D-MRSI of the prostate lends itself to the planning of biopsy and therapy, and to post-therapeutic follow-up. For broad clinical acceptance, it will be necessary to facilitate MRS examinations and their evaluation and make MRS available to a wider range of institutions.

  10. Proton MR spectroscopy of the prostate

    International Nuclear Information System (INIS)

    Purpose: To summarize current technical and biochemical aspects and clinical applications of proton magnetic resonance spectroscopy (MRS) of the human prostate in vivo. Material and methods: Pertinent radiological and biochemical literature was searched and retrieved via electronic media (medline, pubmed). Basic concepts of MRS of the prostate and its clinical applications were extracted. Results: Clinical MRS is usually based on point resolved spectroscopy (PRESS) or spin echo (SE) sequences, along with outer volume suppression of signals from outside of the prostate. MRS of the prostate detects indicator lines of citrate, choline, and creatine. While healthy prostate tissue demonstrates high levels of citrate and low levels of choline that marks cell wall turnover, prostate cancer utilizes citrate for energy metabolism and shows high levels of choline. The ratio of (choline + creatine)/citrate distinguishes between healthy tissue and prostate cancer. Particularly when combined with magnetic resonance (MR) imaging, three-dimensional MRS imaging (3D-CSI, or 3D-MRSI) detects and localizes prostate cancer in the entire prostate with high sensitivity and specificity. Combined MR imaging and 3D-MRSI exceed the sensitivity and specificity of sextant biopsy of the prostate. When MRS and MR imaging agree on prostate cancer presence, the positive predictive value is about 80-90%. Distinction between healthy tissue and prostate cancer principally is maintained after various therapeutic treatments, including hormone ablation therapy, radiation therapy, and cryotherapy of the prostate. Conclusions: Since it is non-invasive, reliable, radiation-free, and essentially repeatable, combined MR imaging and 3D-MRSI of the prostate lends itself to the planning of biopsy and therapy, and to post-therapeutic follow-up. For broad clinical acceptance, it will be necessary to facilitate MRS examinations and their evaluation and make MRS available to a wider range of institutions

  11. TRUS-guided transperineal biopsy with 1 2+X method for the diagnosis of prostate carcinoma:Retrospective analysis of 1 300 cases%直肠超声引导经会阴模版12+X 针前列腺穿刺活检术临床研究

    Institute of Scientific and Technical Information of China (English)

    郭刚; 许勇; 王岩; 丛冰; 张旭

    2014-01-01

    目的::评价直肠超声引导下经会阴模版12+X针前列腺穿刺活检术的临床价值和安全性.方法:2009年9月~2014年5月,对临床怀疑为前列腺癌的1300例患者行直肠超声引导下经会阴模板前列腺穿刺活检术.1300例患者平均年龄70.5岁,穿刺前均行血清PSA监测(不少于2次)、前列腺直肠指诊、经直肠前列腺超声及前列腺磁共振平扫加动态增强.所有患者取截石位,1%利多卡因注射液10~20 ml会阴皮下及前列腺尖部局部浸润麻醉973例,骶管阻滞麻醉75例,硬膜外麻醉252例.共937例采用12+X针穿刺,363例采用常规12针穿刺.结果:所有患者均顺利完成操作,活检针数12~24针,平均14.5针;活检时间15~30 min,平均20.4 min.术后发生一过性血尿201例,会阴部血肿14例,尿潴留21例,发热5例.穿刺病理结果:前列腺癌540例(41.5%),其中腺癌527例,其他类型肿瘤13例;前列腺上皮内瘤(PIN)57例(4.4%);前列腺增生及各类前列腺炎703例(54.1%).T-PSA<4μg/L、4~<10μg/L、10~20μg/L及>20μg/L组的穿刺阳性率分别为:13.1%、17.1%、31.9%、73.8%.T-PSA 4~<10μg/L组(灰区)293例患者分别以 F/T PSA 和 PSAD 分组, F/T≥0.16和<0.16组的穿刺阳性率分别为12.0%、18.8%,PSAD≥0.15和<0.15组的穿刺阳性率分别为9.8%、21.5%.直肠指诊异常、经直肠超声异常及前列腺 MRI 异常患者的穿刺阳性率分别为:24.0%、30.1%、59.2%.12+X针组穿刺阳性率为47.2%,12针组为34.5%.结论:直肠超声引导下经会阴12+X 针前列腺穿刺活检术阳性率高,并发症少,是诊断前列腺癌的理想方法.%Objective:To explore the clinical value and safety of TRUS-guided transperineal biopsy with the 12+X method in the diagnosis of prostate carcinoma.Methods:A total of 1300 men underwent TRUS-guided transperi-neal biopsy with the 12+X method for suspected prostate carcinoma from Sep.2009 to May 2014.The

  12. Active surveillance strategy for patients with localised prostate cancer

    DEFF Research Database (Denmark)

    Thomsen, Frederik Birkebæk

    2014-01-01

    BACKGROUND: Active surveillance - an initial observational strategy - offers a tailored management of patients with localised prostate cancer. The aim of the strategy is to appoint patients with potentially lethal prostate cancer to curatively intended treatment, while patients with slowly evolving...... criteria in the management of prostate cancer patients on active surveillance is emphasised....... measurements, repeated biopsies, and regular digital rectal examinations. The programme recommended change of management from active surveillance to curatively intended treatment based on PSA doubling time, deteriorating histopathology in repeated prostatic biopsies, and increased clinical tumour category...

  13. The impact of gastrointestinal and genitourinary toxicity on health related quality of life among irradiated prostate cancer patients

    International Nuclear Information System (INIS)

    Purpose: To determine the impact of late radiation-induced toxicity on health-related quality of life (HRQoL) among patients with prostate cancer. Patients and methods: The study sample was composed of 227 patients, treated with external beam radiotherapy. Common Terminology Criteria for Adverse Events version 3.0 were used to grade late genitourinary and gastrointestinal toxicity. The European Organization for Research and Treatment of Cancer Quality of life Questionnaire C30 (EORTC QLQ-C30) was used to assess HRQoL at baseline, and 6, 12 and 24 months after completion of radiotherapy. Statistical analysis was performed using a multivariate analysis of variance (MANOVA). Results: Urinary incontinence and rectal discomfort significantly affected HRQoL. The impact of urinary incontinence on HRQoL was most pronounced 6 months after radiotherapy and gradually decreased over time. The impact of rectal discomfort on HRQoL was predominant at 6 months after radiotherapy, decreased at 12 months and increased again 2 years after radiotherapy. No significant impact on HRQoL was observed for any of the other toxicity endpoints, or non-toxicity related factors such as hormonal therapy, radiotherapy technique or age. Conclusion: Urinary incontinence and rectal discomfort have a significant impact on HRQoL. Prevention of these side effects may likely improve quality of life of prostate cancer patients after completion of treatment

  14. The relation between severe density of Helicobacter pylori in biopsy with cigarette smoking and age in infected patients

    Directory of Open Access Journals (Sweden)

    Heshmat Shahi

    2015-04-01

    Full Text Available Background and Aim: Helicobacter pylori infection is currently endemic worldwide health problem. The infection causes variety of gastrointestinal (GI symptoms such as chronic gastritis, peptic ulcer, and gastric adenocarcinoma. It is clear that smoking is important to the development of disorders like intestinal disease. This study determines the relationship between H.pylori density and smoking. Materials and Methods: The study was performed in 247 patients (20-80 years both sexes, with dyspepsia symptoms referred to Hajar hospital. Demographic data were recorded, such as age and smoking history. Patients were checked by 16 SrRNA and glmM genes polymerase chain reaction for H. pylori. Density of H.pylori graded according to the number of H.pylori bacteria counted in light microscopy by (x1000 magnified.also patient had to have smoked for more than 1 year. Results: We observed 67.61% of patients (167 of 247 were positive for H. pylori, and 32.39% were negative (80 of 247. In patients with dyspepsia, 36.4% in 20-40 age range, 42.1% in 41-61 and 21.5% in 62-80. Of total patients, 57.1% were smokers and in this number, 78.01% were H. pylori positive. Also study showed, in smokers and 3th age range, sever density of H.pylori was more than nonsmokers and other ranges. A significant difference (P<0.05 was observed when we compared density of bacteria by age and smoker with nonsmoker groups. Conclusions: H.pylori sever density can be related by cigarette smoking and age.

  15. Prostate Brachytherapy in Men ≥75 Years of Age

    International Nuclear Information System (INIS)

    Purpose: To evaluate cause-specific survival (CSS), biochemical progression-free survival (bPFS), and overall survival (OS) in prostate cancer patients aged ≥75 years undergoing brachytherapy with or without supplemental therapies. Methods and Materials: Between April 1995 and August 2004, 145 consecutive patients aged ≥75 years underwent permanent prostate brachytherapy. Median follow-up was 5.8 years. Biochemical progression-free survival was defined by a prostate-specific antigen level ≤0.40 ng/mL after nadir. Patients with metastatic prostate cancer or hormone-refractory disease without obvious metastases who died of any cause were classified as dead of prostate cancer. All other deaths were attributed to the immediate cause of death. Multiple clinical, treatment, and dosimetric parameters were evaluated for impact on survival. Results: Nine-year CSS, bPFS, and OS rates for the entire cohort were 99.3%, 97.1%, and 64.5%, respectively. None of the evaluated parameters predicted for CSS, whereas bPFS was most closely predicted by percentage positive biopsies. Overall survival and non-cancer deaths were best predicted by tobacco status. Thirty-seven patients have died, with 83.8% of the deaths due to cardiovascular disease (22 patients) or second malignancies (9 patients). To date, only 1 patient (0.7%) has died of metastatic prostate cancer. Conclusions: After brachytherapy, high rates of CSS and bPFS are noted in elderly prostate cancer patients. Overall, approximately 65% of patients are alive at 9 years, with survival most closely related to tobacco status. We believe our results support an aggressive locoregional approach in appropriately selected elderly patients

  16. Battling Prostate Cancer with 5-Alpha-Reductase Inhibitors: a Pyrrhic Victory?

    OpenAIRE

    Hoffman, Richard M.; Richard G. Roberts; Barry, Michael J.

    2011-01-01

    Given the relatively small impact of prostate cancer screening on cancer mortality, experts are now suggesting that chemoprevention with 5-alpha-reductase inhibitors (5-ARI) may be a more effective strategy for cancer control. Two large placebo-controlled randomized trials found that men receiving 5-ARI were about 25% less likely than controls to be detected with cancer. However, most cancers were detected on routine biopsies required by study protocols. The benefit from receiving 5-ARI was m...

  17. Computed tomography in the evaluation of the suspected carcinomatous prostate

    International Nuclear Information System (INIS)

    Twenty-six patients with physical findings suspicious for prostatic cancer were examined by contrast-enhanced computed tomography (CT) of the prostate region prior to prostatic biopsy or resection. Twelve had benign hypertrophy and/or prostatitis and fourteen had adenocarcinoma. Prostatic contour, density, seminal vesicle 'angle,' extraprostatic soft tissue 'mass,' and the pelvic fat planes were evaluated. A nodular prostatic contour was found only in patients with adenocarcinoma of the prostate, indicating a role for CT in the diagnosis of this disease. Two patients with benign prostatic disease had extraprostatic soft tissue 'masses' identical to those seen in six patients with adenocarcinoma of the prostate, suggesting limited usefulness of CT in staging patients with known tumor. (orig.)

  18. A case of prostate cancer in 34 year old man presenting with generalized lymphadenopathy mimicking malignant lymphoma.

    OpenAIRE

    Ahn, M. J.; Oh, S. J.; Lee, Y. Y.; Jung, T. J.; Kim, I. S.; Choi, I. Y.; Jang, S. J.; Park, Y. W.; Shin, K. Y.; Kim, Y. S.

    1997-01-01

    We report a case of prostate cancer in 34 year old man presenting with generalized lymphadenopathy mimicking malignant lymphoma without any urinary symptoms. Lymph node biopsy revealed metastatic adenocarcinoma and immunohistochemical stain was strongly positive to prostate antigen (PSA). Serum PSA level was also markedly elevated. Transrectal ultrasonogram showed mild enlargement in right lobe of prostate. Needle biopsy finding of prostate also was consistent with adenocarcinoma. Bone scan r...

  19. Heat shock and other apoptosis-related proteins as therapeutic targets in prostate cancer

    Institute of Scientific and Technical Information of China (English)

    Costantine Albany; Noah M Hahn

    2014-01-01

    Defects within apoptotic pathways have been implicated in prostate cancer (PCa) tumorigenesis, metastatic progression and treatment resistance. A hallmark of cancers is the ability to derail apoptosis by inhibiting the apoptotic signal, reducing the expression of apoptotic proteins and/or amplifying survival signals through increased production of antiapoptotic molecule. This review describes associations between heat shock proteins (HSPs) and the human androgen receptor (AR), the role of HSPs and other stress-induced proteins in PCa development and emerging strategies in targeting these protective proteins to treat PCa.

  20. Development and Validation of the Korean Version of Expanded Prostate Cancer Index Composite: Questionnaire Assessing Health-Related Quality of Life after Prostate Cancer Treatment

    OpenAIRE

    Chung, Kyung Jin; Kim, Jung Jun; Lim, Soo Hyun; Kim, Tae Heon; Han, Deok Hyun; Lee, Sung Won

    2010-01-01

    Purpose Although the quality of life (QoL) of prostate cancer (PCa) patients is a major issue, there is no unified and useful methodology for assessing QoL. The Expanded Prostate Cancer Index Composite (EPIC) is a globally used tool to measure QoL after PCa treatment that comprises urinary, bowel, sexual, and hormonal domains. Acknowledging the need for such a tool applicable to Korean PCa patients, we translated EPIC into Korean and validated the new version. Materials and Methods The Korean...

  1. Application of statistical cancer atlas for 3D biopsy

    Science.gov (United States)

    Narayanan, Ramkrishnan; Shen, Dinggang; Davatzikos, Christos; Crawford, E. David; Barqawi, Albaha; Werahera, Priya; Kumar, Dinesh; Suri, Jasjit S.

    2008-02-01

    Prostate cancer is the most commonly diagnosed cancer in males in the United States and the second leading cause of cancer death. While the exact cause is still under investigation, researchers agree on certain risk factors like age, family history, dietary habits, lifestyle and race. It is also widely accepted that cancer distribution within the prostate is inhomogeneous, i.e. certain regions have a higher likelihood of developing cancer. In this regard extensive work has been done to study the distribution of cancer in order to perform biopsy more effectively. Recently a statistical cancer atlas of the prostate was demonstrated along with an optimal biopsy scheme achieving a high detection rate. In this paper we discuss the complete construction and application of such an atlas that can be used in a clinical setting to effectively target high cancer zones during biopsy. The method consists of integrating intensity statistics in the form of cancer probabilities at every voxel in the image with shape statistics of the prostate in order to quickly warp the atlas onto a subject ultrasound image. While the atlas surface can be registered to a pre-segmented subject prostate surface or instead used to perform segmentation of the capsule via optimization of shape parameters to segment the subject image, the strength of our approach lies in the fast mapping of cancer statistics onto the subject using shape statistics. The shape model was trained from over 38 expert segmented prostate surfaces and the atlas registration accuracy was found to be high suggesting the use of this method to perform biopsy in near real time situations with some optimization.

  2. Image guided prostate cancer treatments

    Energy Technology Data Exchange (ETDEWEB)

    Bard, Robert L. [Bard Cancer Center, Biofoundation for Angiogenesis Research and Development, New York, NY (United States); Fuetterer, Jurgen J. [Radboud Univ. Nijmegen, Medical Centre (Netherlands). Dept. of Radiology; Sperling, Dan (ed.) [Sperling Prostate Center, Alpha 3TMRI, New York, NY (United States)

    2014-07-01

    Systematic overview of the application of ultrasound and MRI in the diagnosis and treatment of diseases of the lower urinary tract. Detailed information on image-guided therapies, including focused ultrasound, photodynamic therapy, and microwave and laser ablation. Numerous high-quality illustrations based on high-end equipment. Represents the state of the art in Non Invasive Imaging and Minimally Invasive Ablation Treatment (MIAT). Image-Guided Prostate Cancer Treatments is a comprehensive reference and practical guide on the technology and application of ultrasound and MRI in the male pelvis, with special attention to the prostate. The book is organized into three main sections, the first of which is devoted to general aspects of imaging and image-guided treatments. The second section provides a systematic overview of the application of ultrasound and MRI to the diagnosis and treatment of diseases of the lower urinary tract. Performance of the ultrasound and MRI studies is explained, and the normal and abnormal pathological anatomy is reviewed. Correlation with the ultrasound in the same plane is provided to assist in understanding the MRI sequences. Biopsy and interventional procedures, ultrasound-MRI fusion techniques, and image-guided therapies, including focused ultrasound, photodynamic therapy, microwave and laser ablation, are all fully covered. The third section focuses on securing treatment effectiveness and the use of follow-up imaging to ensure therapeutic success and detect tumor recurrence at an early stage, which is vital given that prompt focal treatment of recurrence is very successful. Here, particular attention is paid to the role of Doppler ultrasound and DCE-MRI technologies. This book, containing a wealth of high-quality illustrations based on high-end equipment, will acquaint beginners with the basics of prostate ultrasound and MRI, while more advanced practitioners will learn new skills, means of avoiding pitfalls, and ways of effectively

  3. Image guided prostate cancer treatments

    International Nuclear Information System (INIS)

    Systematic overview of the application of ultrasound and MRI in the diagnosis and treatment of diseases of the lower urinary tract. Detailed information on image-guided therapies, including focused ultrasound, photodynamic therapy, and microwave and laser ablation. Numerous high-quality illustrations based on high-end equipment. Represents the state of the art in Non Invasive Imaging and Minimally Invasive Ablation Treatment (MIAT). Image-Guided Prostate Cancer Treatments is a comprehensive reference and practical guide on the technology and application of ultrasound and MRI in the male pelvis, with special attention to the prostate. The book is organized into three main sections, the first of which is devoted to general aspects of imaging and image-guided treatments. The second section provides a systematic overview of the application of ultrasound and MRI to the diagnosis and treatment of diseases of the lower urinary tract. Performance of the ultrasound and MRI studies is explained, and the normal and abnormal pathological anatomy is reviewed. Correlation with the ultrasound in the same plane is provided to assist in understanding the MRI sequences. Biopsy and interventional procedures, ultrasound-MRI fusion techniques, and image-guided therapies, including focused ultrasound, photodynamic therapy, microwave and laser ablation, are all fully covered. The third section focuses on securing treatment effectiveness and the use of follow-up imaging to ensure therapeutic success and detect tumor recurrence at an early stage, which is vital given that prompt focal treatment of recurrence is very successful. Here, particular attention is paid to the role of Doppler ultrasound and DCE-MRI technologies. This book, containing a wealth of high-quality illustrations based on high-end equipment, will acquaint beginners with the basics of prostate ultrasound and MRI, while more advanced practitioners will learn new skills, means of avoiding pitfalls, and ways of effectively

  4. Determinants of mild clinical symptoms in cystic fibrosis patients. Residual chloride secretion measured in rectal biopsies in relation to the genotype

    NARCIS (Netherlands)

    H.J. Veeze; D.J.J. Halley (Dicky); J. Bijman (Jan); J.C. de Jongste (Johan); H.R. de Jonge (Hugo); M. Sinaasappel (Maarten)

    1994-01-01

    textabstractPrevious Ussing chamber measurements of secretagogue-provoked changes in short circuit current in rectal suction biopsies of cystic fibrosis (CF) patients showed that in a minority of patients chloride secretion in response to cholinergic agonists is reduced

  5. Prostate cancer outcome in Burkina Faso

    Directory of Open Access Journals (Sweden)

    Yameogo Clotaire

    2011-09-01

    Full Text Available Abstract Introduction African-American black men race is one of non-modifiable risk factors confirmed for prostate cancer. Many studies have been done in USA among African- American population to evaluate prostate cancer disparities. Compared to the USA very few data are available for prostate cancer in Sub-Saharan African countries. The objective of this study was to describe incident prostate cancer (PC diagnosis characteristics in Burkina Faso (West Africa. Methods We performed a prospective non randomized patient’s cohort study of new prostate cancer cases diagnosed by histological analysis of transrectal prostate biopsies in Burkina Faso. Study participants included 166 patients recruited at the urology division of the university hospital of Ouagadougou. Age of the patients, clinical symptoms, digital rectal examination (DRE result, serum prostate-specific antigen (PSA level, histological characteristics and TNM classification were taking in account in this study. Results 166 transrectal prostate biopsies (TRPB were performed based on high PSA level or abnormal DRE. The prostate cancer rate on those TRPB was 63, 8 % (n=106. The mean age of the patients was 71, 5 years (52 to 86. Urinary retention was the first clinical patterns of reference in our institution (55, 7 %, n = 59. Most patients, 56, 6 % (n = 60 had a serum PSA level over than 100 ng/ml. All the patients had adenocarcinoma on histological study of prostate biopsy cores. The majority of cases (54, 7 % n = 58 had Gleason score equal or higher than 7. Conclusion Prostate cancer is diagnosed at later stages in our country. Very high serum PSA level and poorly differentiated tumors are the two major characteristics of PC at the time of diagnosis.

  6. Prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Murphy, G.P.; Kuss, R., Khoury, S.; Chatelain, C.; Denis, L.

    1987-01-01

    This book contains over 70 selections. Some of the titles are: Place of the Computed Tomography in the Staging of Prostatic Cancer; Magnetic Resonance Imaging (MRI) in Staging of the Prostatic Cancer; Magnetic Resonance Imaging of the Prostate; Long-Term Results in Radiotherapy of Prostatic Cancer; Interstitial Irradiation Using I-125 Seeds; and Treatment of Cancer of the Prostate by Use of Physiotherapy: Long-Term Results.

  7. Prostate cancer

    International Nuclear Information System (INIS)

    This book contains over 70 selections. Some of the titles are: Place of the Computed Tomography in the Staging of Prostatic Cancer; Magnetic Resonance Imaging (MRI) in Staging of the Prostatic Cancer; Magnetic Resonance Imaging of the Prostate; Long-Term Results in Radiotherapy of Prostatic Cancer; Interstitial Irradiation Using I-125 Seeds; and Treatment of Cancer of the Prostate by Use of Physiotherapy: Long-Term Results

  8. Glycoprotein Biomarkers for the Early Detection of Aggressive Prostate Cancer — EDRN Public Portal

    Science.gov (United States)

    The Early Detection Research Network of the NCI is charged with the discovery, development and validation of biomarkers for early detection and prognosis related to neoplastic disease. Our laboratory is an NCI EDRN (U01CA152813) working on "Glycoprotein biomarkers for the early detection of aggressive prostate cancer". This EDRN administratiVE! supplement is a collaboration with Robert Veltri on his project to identify men with very low risk (indolent) prostate cancer (CaP) at the diagnostic biopsy at selection for active surveillance (AS). We will assess biopsy tissue using quantitative nuclear histomorphometric measurements and molecular biomarkers to predict an unexpected catastrophic CaP in such men with indolent CaP. At Johns Hopkins Hospital w1e use the Epstein criteria that includes; PSA density (PSAD) aggressive disease from a AS diagnostic biopsy. Our approach will combine nuclear morphometry measured by digital microscopy with a unique biopsy tissue biomarker profile (DNA content, Ki67, Her2neu, CACND1 and periostin). Fc•r the molecular targets we will us•e a multiplex tissue blot (MTB) immunohistochemistry method. The Aims o'f our work include 1) to utilize retrospective archival biopsy material from 70 AS cases where the outcome was unexpected and disastrous and collect an equal number of AS cases (n=140) and perform assays for morphology and biomarker targi ts proposed, 2) and predict failure using Cox proportional hazards statistical modeling.

  9. Determinants of mild clinical symptoms in cystic fibrosis patients. Residual chloride secretion measured in rectal biopsies in relation to the genotype

    OpenAIRE

    Veeze, H J; Halley, Dicky; Bijman, Jan; de Jongste, Johan; de Jonge, Hugo; Sinaasappel, Maarten

    1994-01-01

    textabstractPrevious Ussing chamber measurements of secretagogue-provoked changes in short circuit current in rectal suction biopsies of cystic fibrosis (CF) patients showed that in a minority of patients chloride secretion in response to cholinergic agonists is reduced but not completely absent. To assess a possible relationship between this phenomenon and both the genotype and the phenotype, we performed Ussing chamber experiments on rectal suction biopsies of 51 CF patients. The CF mutatio...

  10. Multiparametric Magnetic Resonance Imaging in the Diagnosis of Prostate Cancer: A Systematic Review.

    Science.gov (United States)

    Haider, M A; Yao, X; Loblaw, A; Finelli, A

    2016-09-01

    A systematic review was conducted to investigate the use of multiparametric magnetic resonance imaging (MPMRI) followed by targeted biopsy in the diagnosis of clinically significant prostate cancer (CSPC) and to compare it with transrectal ultrasound-guided (TRUS-guided) systematic biopsy in patients with an elevated risk of prostate cancer who are either biopsy-naive or who have a previous negative TRUS-guided biopsy. MEDLINE, PubMed and EMBASE (1997 to April 2014), the Cochrane Library and six relevant conferences were searched to find eligible studies. Search terms indicative of 'prostate cancer' and 'magnetic resonance imaging' with their alternatives were used. Twelve systematic reviews, 52 full texts and 28 abstracts met the preplanned study selection criteria; data from 15 articles were extracted. In patients with an elevated risk of prostate cancer who were biopsy-naive, MPMRI followed by targeted biopsy could detect 2-13% of CSPC patients whom TRUS-guided systematic biopsy missed; TRUS-guided systematic biopsy could detect 0-7% of CSPC patients whom MPMRI followed by targeted biopsy missed. In patients with an elevated risk of prostate cancer who had a previous negative TRUS-guided biopsy, MPMRI followed by targeted biopsy detected more CSPC patients than repeated TRUS-guided systematic biopsy in all four studies, with a total of 516 patients, but only one study reached a statistically significant difference. In patients with an elevated risk of prostate cancer who are biopsy-naive, there is insufficient evidence for MPMRI followed by targeted biopsy to be considered the standard of care. In patients who had a prior negative TRUS-guided systematic biopsy and show a growing risk of having CSPC, MPMRI followed by targeted biopsy may be helpful to detect more CSPC cases as opposed to a repeat TRUS-guided systematic biopsy. PMID:27256655