scholarly journals A prospective study on inter-operator variability in semi-robotic software-based MRI/TRUS-fusion targeted prostate biopsies

2021 ◽  
Author(s):  
Fabian Derigs ◽  
Samuel Doryumu ◽  
Fabian Tollens ◽  
Dominik Nörenberg ◽  
Manuel Neuberger ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prospective Study ◽  
False Negative ◽  
Lesion Size ◽  
Negative Results ◽  
Prostate Biopsies ◽  
False Negative Results ◽  
Lesion Level ◽  
Clinically Significant ◽  
A Prospective Study

Abstract Purpose Magnetic resonance imaging (MRI)/ultrasound-fusion prostate biopsy (FB) comprises multiple steps each of which can cause alterations in targeted biopsy (TB) accuracy leading to false-negative results. The aim was to assess the inter-operator variability of software-based fusion TB by targeting the same MRI-lesions by different urologists. Methods In this prospective study, 142 patients eligible for analysis underwent software-based FB. TB of all lesions (n = 172) were carried out by two different urologists per patient (n = 31 urologists). We analyzed the number of mismatches [overall prostate cancer (PCa), clinically significant PCa (csPCa) and non-significant PCa (nsPCa)] between both performed TB per patient. In addition we evaluated factors contributing to inter-operator variability by uni- and multivariable analyses. Results In 11.6% of all MRI-lesions (10.6% of all patients) there was a mismatch between TB1 and TB2 in terms of overall prostate cancer (PCa detection. Regarding csPCa, patient-based mismatch occurred in 14.8% (n = 21). Overall PCa and csPCa detection rate of TB1 and TB2 did not differ significantly on a per-patient and per-lesion level. Analyses revealed a smaller lesion size as predictive for mismatches (OR 9.19, 95% CI 2.02–41.83, p < 0.001). Conclusion Reproducibility and precision of targeting particularly small lesions is still limited although using software-based FB. Further improvements in image-fusion, segmentation, needle-guidance, and automatization are necessary.

scholarly journals Sensitivity of prostate cancer foci using 1.5 T multiparametric magnetic resonance imaging

2020 ◽  
Author(s):  
Suguru Ito ◽  
SEI NAITO ◽  
Takafumi Narisawa ◽  
Mayu Yagi ◽  
Yuta Kurota ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
False Negative ◽  
Resonance Imaging ◽  
Prostate Imaging ◽  
Multiparametric Magnetic Resonance Imaging ◽  
Negative Results ◽  
False Negative Results ◽  
Clinically Significant

Abstract Background The detection of prostate cancer (CaP) has increasingly being carried out by multiparametric magnetic resonance imaging (mpMRI). Despite many previous studies, the sensitivity for clinically significant CaP (csCaP) was high, information on mpMRI false-negative lesions is limited. Therefore, the aim of this study was to evaluate the use and limitations of mpMRI in CaP. Methods A total of 228 CaP foci in 100 patients who underwent 1.5 T mpMRI and radical prostatectomy between December 2015 and June 2017 were retrospectively analyzed. The sensitivities of CaP foci, csCaP, and index tumors (ITs) were measured. Clinically significant CaP was defined into two categories based on the Gleason score (GS): csCaP/GS ≥ 3 + 4 (GS ≥ 3 + 4 or diameter > 10 mm) and csCaP/GS ≥ 4 + 3 (GS ≥ 4 + 3 or diameter > 10 mm). In addition, the characteristics of false-negative lesions were identified. The Prostate Imaging Reporting and Data System version 2 was used to determine an mpMRI positive lesion, defined as a lesion having a score of ≥ 3. Results The sensitivity of all legions, csCaP/GS ≥ 3 + 4, csCaP/GS ≥ 4 + 3, and ITs were 61.4%, 75.8%, 83.0%, and 91%, respectively. There were 91 lesions that were mpMRI false, 40% of which were csCaP/GS ≥ 3 + 4. There were three lesions with a GS of ≥ 8 and ≥ 10 mm in the false-negative results. Conclusions mpMRI can highly detect ITs and csCaP/GS ≥ 4 + 3; however, a few large and high-GS CaPs constitute undetectable lesions in 1.5 T mpMRI.

scholarly journals Sensitivity of Prostate Cancer Foci using 1.5 T Multiparametric Magnetic Resonance Imaging

2020 ◽  
Author(s):  
Suguru Ito ◽  
SEI NAITO ◽  
Takafumi Narisawa ◽  
Mayu Yagi ◽  
Yuta Kurota ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
False Negative ◽  
Resonance Imaging ◽  
Prostate Imaging ◽  
Multiparametric Magnetic Resonance Imaging ◽  
Negative Results ◽  
False Negative Results ◽  
Clinically Significant

Abstract Background: The detection of prostate cancer (CaP) has increasingly being carried out by multiparametric magnetic resonance imaging (mpMRI). Despite many previous studies, the sensitivity for clinically significant CaP (csCaP) was high, information on mpMRI false-negative lesions is limited. Therefore, the aim of this study was to evaluate the use and limitations of mpMRI in CaP.Methods: A total of 228 CaP foci in 100 patients who underwent 1.5 T mpMRI and radical prostatectomy between December 2015 and June 2017 were retrospectively analyzed. The sensitivities of CaP foci, csCaP, and index tumors (ITs) were measured. Clinically significant CaP was defined into two categories based on the Gleason score (GS): csCaP/GS ≥3 + 4 (GS ≥3 + 4 or diameter >10 mm) and csCaP/GS ≥4 + 3 (GS ≥4 + 3 or diameter >10 mm). In addition, the characteristics of false-negative lesions were identified. The Prostate Imaging Reporting and Data System version 2 was used to determine an mpMRI positive lesion, defined as a lesion having a score of ≥3.Results: The sensitivity of all legions, csCaP/GS ≥3 + 4, csCaP/GS ≥4 + 3, and ITs were 61.4%, 75.8%, 83.0%, and 91%, respectively. There were 91 lesions that were mpMRI false, 40% of which were csCaP/GS ≥3 + 4. There were three lesions with a GS of ≥8 and ≥10 mm in the false-negative results.Conclusions: mpMRI can highly detect ITs and csCaP/GS ≥4 + 3; however, a few large and high-GS CaPs constitute undetectable lesions in 1.5 T mpMRI.

scholarly journals Influence of biopsy cores number performed with targeted prostate biopsy on the likelihood of a positive result in patients with clinically significant prostate cancer

2020 ◽  
Vol 16 (3) ◽  
pp. 62-69
Author(s):  
A. V. Zyryanov ◽  
G. A. Gulin ◽  
N. A. Rubtsova ◽  
V. O. Mager ◽  
A. E. Putintsev ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
False Negative ◽  
Histological Structure ◽  
Targeted Biopsy ◽  
Resonance Imaging ◽  
Negative Results ◽  
False Negative Results ◽  
Clinically Significant

Background. Targeted biopsy is proposed as a method of choice in the algorithm of prostate cancer diagnosis, but not all the features of method has been evaluated.Objective: determine the rational number of targeted biopsy samples in patients with clinically significant prostate cancer.Materials and methods. The magnetic resonance imaging and fusion biopsy data of 156 patients with suspected prostate cancer were retrospectively evaluated.Results and conclusion. In the study statistically significant dependence of the positive histological results in patients with clinically significant prostate cancer from the number of biopsy samples was found. The potential probability of a false negative histological examination with an insufficient number of biopsy samples was noted. These results confirm the latest published data of potential targeted biopsy false in true positive patients after multiparametric magnetic resonance imaging. An increase in the number of biopsy samples in the target lesion reduces the likelihood of false-negative results. The main causes of such discrepancy are some technical laxity and the heterogeneous histological structure of prostate cancer. Increase the number of biopsy cores can reduce the likelihood of false-negative results. 

scholarly journals Comparison of Likert and PI-RADS version 2 MRI scoring systems for the detection of clinically significant prostate cancer

2020 ◽  
Vol 93 (1112) ◽  
pp. 20200298 ◽  
Author(s):  
Jeries P Zawaideh ◽  
Evis Sala ◽  
Maria Pantelidou ◽  
Nadeem Shaida ◽  
Brendan Koo ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Area Under The Curve ◽  
Scoring Systems ◽  
Detection Rates ◽  
Prostate Imaging ◽  
Prostate Biopsies ◽  
Threshold Score ◽  
Lesion Level ◽  
Clinically Significant ◽  
Histological Results

Objective: To compare the performance of Likert and Prostate Imaging–Reporting and Data System (PI-RADS) multiparametric (mp) MRI scoring systems for detecting clinically significant prostate cancer (csPCa). Methods: 199 biopsy-naïve males undergoing prostate mpMRI were prospectively scored with Likert and PI-RADS systems by four experienced radiologists. A binary cut-off (threshold score ≥3) was used to analyze histological results by three groups: negative, insignificant disease (Gleason 3 + 3; iPCa), and csPCa (Gleason ≥3 +4). Lesion-level results and prostate zonal location were also compared. Results: 129/199 (64.8%) males underwent biopsy, 96 with Likert or PI-RADS score ≥3, and 21 with negative MRI. A further 12 patients were biopsied during follow-up (mean 507 days). Prostate cancer was diagnosed in 87/199 (43.7%) patients, 65 with (33.6%) csPCa. 30/92 (32.6%) patients with negative MRI were biopsied, with an NPV of 83.3% for cancer and 86.7% for csPCa. Likert and PI-RADS score differences were observed in 92 patients (46.2%), but only for 16 patients (8%) at threshold score ≥3. Likert scoring had higher specificity than PI-RADS (0.77 vs 0.66), higher area under the curve (0.92 vs 0.87, p = 0.002) and higher PPV (0.66 vs 0.58); NPV and sensitivity were the same. Likert had more five score results (58%) compared to PI-RADS (36%), but with similar csCPa detection (81.0 and 80.6% respectively). Likert demonstrated lower proportion of false positive in the predominately AFMS-involving lesions. Conclusion: Likert and PI-RADS systems both demonstrate high cancer detection rates. Likert scoring had a higher AUC with moderately higher specificity and lower positive call rate and could potentially help to reduce the number of unnecessary biopsies performed. Advances in knowledge: This paper illustrates that the Likert scoring system has potential to help urologists reduce the number of prostate biopsies performed.

scholarly journals Primary Circulating Prostate Cells Are Not Detected in Men with Low Grade Small Volume Prostate Cancer

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Nigel P. Murray ◽  
Eduardo Reyes ◽  
Cynthia Fuentealba ◽  
Nelson Orellana ◽  
Omar Jacob
Keyword(s):  
Prostate Cancer ◽  
Prospective Study ◽  
Active Surveillance ◽  
Small Volume ◽  
Low Grade ◽  
Prostate Cells ◽  
Study Population ◽  
Initial Biopsy ◽  
Clinically Significant ◽  
A Prospective Study

Objective. To determine if primary circulating prostate cells (CPCs) are found in all men with prostate cancer.Methods and Patients. A prospective study, to analyze all men with an elevated PSA between 4.0 and 10.0 ng/mL undergoing initial biopsy. Primary CPCs were obtained by differential gel centrifugation and detected using standard immunocytochemistry using anti-PSA; positive samples underwent a second process with anti-P504S. A malignant primary CPC was defined as PSA (+) P504S (+) and a test positive if 1 cell/4 mL was detected. Biopsy results were registered as cancer/no-cancer, number of cores positive, and percent infiltration of the cores.Results. 328/1123 (29.2%) of the study population had prostate cancer diagnosed on initial biopsy, and 42/328 (12.8%) were negative for primary CPCs. CPC negative men were significantly older, and had lower PSA levels, lower Gleason scores, and fewer positive cores and with infiltration by the cancer. 38/42 (91%) of CPC negative men complied with the criteria for active surveillance in comparison with 34/286 (12%) of CPC positive men.Conclusions. Using primary CPC detection as a sequential test to select men with an elevated PSA for biopsy, the risk of missing clinically significant prostate cancer is minimal when the patient is primary CPC negative; less than 0.5% of all primary CPC negative men had a clinically significant prostate cancer.

scholarly journals The effect of information on prostate cancer screening decision process: a discrete choice experiment

2020 ◽  
Author(s):  
Maud Charvin ◽  
Guy Launoy ◽  
Célia Berchi
Keyword(s):  
Prostate Cancer ◽  
Cancer Screening ◽  
Discrete Choice ◽  
Choice Model ◽  
Prostate Cancer Screening ◽  
False Negative ◽  
Informed Choice ◽  
Negative Results ◽  
False Negative Results ◽  
History Of

Abstract Background: Prostate cancer screening is controversial because of uncertainty about its benefits and risks. The aim of this survey was to reveal preferences of men concerning prostate cancer screening and to test the effect of an informative video on these preferences. Methods: A stated preferences questionnaire was sent by e-mail to men aged 50-75 with no history of prostate cancer. Half of them were randomly assigned to view an informative video. A discrete choice model was established to reveal men’s preferences for six prostate cancer screening characteristics: mortality by prostate cancer, number of false positive and false negative results, number of overdiagnosis, out-of-pocket costs and recommended frequency. Results: 1024 men representative of the French general population filled in the entire questionnaire. Each attribute gave the expected sign except for overdiagnosis. The video seemed to increase the intention to abstain from prostate cancer screening. Conclusions: The participants attached greater importance to a decrease in the number of false negatives and a reduction in prostate cancer mortality than to other risks such as the number of false positives and overdiagnosis. Further research is needed to help men make an informed choice regarding screening.

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