scholarly journals Hypoehoic lesions on Transrectal Ultrasound and its correlation to Gleason grade in the diagnosis of Clinically Significant Prostate Cancer: A Prospective Study

2021 ◽  
Author(s):  
Manas Sharma ◽  
Rajendra B. Nerli ◽  
Sree Harsha Nutalapati ◽  
Shridhar C. Ghagane
Keyword(s):  
Prostate Cancer ◽  
Statistical Analysis ◽  
Prospective Study ◽  
Tertiary Care ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Gleason Grade ◽  
Psa Testing ◽  
Hypoechoic Lesion ◽  
Clinically Significant

Abstract Context The importance of hypoechoic lesions on transrectal ultrasound (TRUS) merits re-assessment in the present era of widespread prostate-specific antigen (PSA) testing. Aims We aimed to investigate the predictive accuracy of hypoechoic lesions on TRUS of prostate in the diagnosis of prostate cancer and to examine the association of hypoechoic lesions with the aggressiveness of prostate cancer. Settings and Design This prospective study was conducted in a tertiary care center in South India from November 2017 to December 2019. Methods and Material We included 151 patients undergoing TRUS-guided 12-core prostate biopsy in view of raised serum PSA with or without suspicious digital rectal examination (DRE) findings in the study. Age, DRE findings, serum PSA level, TRUS findings, and histopathology reports were documented. These were compared between patients with and without hypoechoic lesions on TRUS. Statistical Analysis Used The statistical analysis for this study was performed using SPSS v20.0 software. Results Among 151 men, prostate cancer was diagnosed in 68 (45.03%) with mean age at presentation 69.81 ± 6.49 years. Fifty-eight cases (38.41%) had hypoechoic lesion on TRUS and the cancer detection rate (68.96%) amongst this group was significantly higher than in those without hypoechoic lesion (p <0.0001). Patients with hypoechoic lesion were more likely to have higher grade cancer. Abnormal DRE findings and hypoechoic lesion on TRUS were independent predictors of a clinically significant cancer (p <0.05). Conclusion Hypoechoic lesion on TRUS can be considered as an indicator of clinically significant prostate cancer.

scholarly journals Accuracy of Tumour-Associated Circulating Endothelial Cells as a Screening Biomarker for Clinically Significant Prostate Cancer

Cancers ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1064 ◽  
Author(s):  
Sebastian Chakrit Bhakdi ◽  
Prapat Suriyaphol ◽  
Ponpan Thaicharoen ◽  
Sebastian Tobias Karl Grote ◽  
Chulaluk Komoltri ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Endothelial Cells ◽  
Predictive Value ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Circulating Endothelial Cells ◽  
Index Test ◽  
Psa Testing ◽  
Diagnostic Potential ◽  
Clinically Significant

Even though more than 350,000 men die from prostate cancer every year, broad-based screening for the disease remains a controversial topic. Guidelines demand that the only commonly accepted screening tool, prostate-specific antigen (PSA) testing, must be followed by prostate biopsy if results are elevated. Due to the procedure’s low positive predictive value (PPV), however, over 80% of biopsies are performed on healthy men or men with clinically insignificant cancer—prompting calls for new ways of vetting equivocal PSA readings prior to the procedure. Responding to the challenge, the present study investigated the diagnostic potential of tumour-associated circulating endothelial cells (tCECs), which have previously been described as a novel, blood-based biomarker for clinically significant cancers. Specifically, the objective was to determine the diagnostic accuracy of a tCEC-based blood test to detect clinically significant prostate cancer (defined as Gleason score ≥ 3 + 4) in high-risk patients. Performed in a blinded, prospective, single-centre set-up, it compared a novel tCEC index test with transrectal ultrasound-guided biopsy biopsy as a reference on a total of 170 patients and found that a tCEC add-on test will almost double the PPV of a standalone PSA test (32% vs. 17%; p = 0.0012), while retaining a negative predictive value above 90%.

scholarly journals Who’s too old to screen? Prostate cancer in elderly men

2013 ◽  
Vol 3 (3) ◽  
pp. 205 ◽  
Author(s):  
Sandeep Mistry ◽  
Wesley Mayer ◽  
Rose Khavari ◽  
Gustavo Ayala ◽  
Brian Miles
Keyword(s):  
Prostate Cancer ◽  
Specific Antigen ◽  
Threshold Value ◽  
The Elderly ◽  
Cancer De La Prostate ◽  
Gleason Grade ◽  
Elderly Men ◽  
Patients Âgés ◽  
Positive Core ◽  
Clinically Significant

Introduction: Prostate cancer is the most common nonskin malignancyaffecting men and is the second leading cause of cancerrelateddeath in North America. The incidence of prostate cancerincreases dramatically with age. However, many healthauthorities advocate the cessation of routine prostate cancer testingin men older than 75 because of the belief that most patientswill have a clinically insignificant cancer and will not benefit fromtherapy. The true prevalence of clinically significant prostate cancerin elderly men is not known.Methods: We analyzed 1446 needle biopsies of the prostate inmen aged 75 or older. All pathological reviews were conductedby the pathology department at the Methodist Hospital in Houston,Tex. Data were collected from pathology reports, hospital andclinic databases, and medical records when available. Dataobtained included age at biopsy, serum prostate-specific antigen(PSA) levels, number of positive core biopsies and Gleasongrade. Statistical analysis was performed using Stata. Clinicallysignificant cancer was defined by the pathological presence ofGleason grade 6 adenocarcinoma in more than 1 biopsy coreor the presence of any Gleason 4 or 5 component in the biopsy.Results: The median age of the patients included in the studywas 78.8 and 95% of the patients were between the ages of 75and 85. The mean serum PSA level for patients biopsied was10.4 μg/L. Of all biopsies reviewed, 53% were positive for prostatecancer and 78% of these would be defined as clinically significantcancer. Regression analysis revealed age to be a significant(p < 0.05) factor for increased Gleason grade in positive biopsies.Logistic regression revealed age as a significant factor (p <0.05) for clinically significant prostate cancer even when controllingfor PSA. A serum PSA threshold value of 6.5 μg/L would havemissed 38% of significant cancers and a threshold of 4.0 μg/Lwould have missed 8% of significant cancers.Conclusion: Our findings suggest that the prevalence of clinicallysignificant prostate cancer in the elderly population may be higherthan previously thought. As the population continues to livelonger and healthier lives, it will become more common to confrontprostate cancer morbidity in the eldery population. Usinghigher serum PSA thresholds to eliminate unnecessary biopsies inolder men does not appear to help identify patients at greaterrisk of having clinically significant prostate cancer. Patients withprostate cancer having aggressive clinical features may benefitfrom treatment of their prostate cancer well into their eighth andninth decades of life. Testing and diagnostic recommendationsshould reflect the potential benefit of identifying patients withaggressive prostate cancer even after age 75.Introduction : Le cancer de la prostate est le type de cancer noncutané le plus fréquent chez les hommes et la seconde causede décès lié au cancer en importance en Amérique du Nord.L’incidence du cancer de la prostate augmente grandement avecl’âge. Néanmoins, de nombreuses autorités en matière de santéavancent l’idée de mettre fin au dépistage systématique du cancerde la prostate chez les hommes de plus de 75 ans en raisonde la croyance selon laquelle la plupart des patients présenterontun cancer non significatif sur le plan clinique et ne bénéficierontpas d’un traitement. La véritable prévalence des cas decancer de la prostate cliniquement significatif chez les hommesâgés n’est pas établie.Méthodes : Nous avons analysé 1446 échantillons de biopsie àl’aiguille prélevés au niveau de la prostate chez des patients de75 ans ou plus. Toutes les analyses de pathologie ont été effectuéespar le service de pathologie du Methodist Hospital deHouston, au Texas. Les données ont été tirées des rapports depathologie, des bases de données des hôpitaux et des cliniques,et des dossiers médicaux lorsque possible. Les données obtenuesincluaient l’âge au moment de la biopsie, les valeurs d’antigèneprostatique spécifique (APS), le nombre de microbiopsies positiveset le score de Gleason. Les analyses statistiques ont été effectuéesà l’aide du système Stata. Le cancer cliniquement significatifest défini comme la présence d’un adénocarcinome avec un scorede Gleason de 6 dans plus d’une zone de biopsie ou un scorede Gleason de 4 ou 5 dans toute partie de l’échantillon.Résultats : L’âge moyen des patients inclus était de 78,8 ans et95 % des patients avaient entre 75 et 85 ans. La valeur moyennede l’APS chez les patients ayant subi une biopsie était de 10,4 μg/L.De tous les échantillons examinés, 53 % confirmaient la présenced’un cancer de la prostate, et le cancer était défini comme étantcliniquement significatif dans 78 % de ces cas. Une analyse derégression a révélé que l’âge était un facteur significatif (p <0,05) lié à un score de Gleason plus élevé dans les biopsies positives.Une analyse de régression logistique a révélé que l’âge étaitaussi un facteur significatif (p < 0,05) lié à un cancer de la prostatecliniquement significatif même en tenant compte du taux d’APS.Une valeur seuil d’APS de 6,5 μg/L serait passée à côté de 38 %des cas de cancer significatif, alors qu’une valeur seuil d’APSde 4,0 μg/L serait passée à côté de 8 % des cancers significatifs.Conclusion : Nos observations portent à croire que la prévalencedu cancer de la prostate significatif sur le plan clinique chezles patients âgés pourrait être plus élevée qu’on le croit. Avecl’augmentation de l’espérance de vie, l’incidence de la morbiditéliée au cancer de la prostate augmentera. Le recours àdes valeurs seuils d’APS plus élevées pour éliminer les cas debiopsies non nécessaires chez les hommes âgés ne semble pasaider à cerner les patients présentant un risque plus élevé de cancerde la prostate cliniquement significatif. Les patients atteintsde cancer de la prostate cliniquement agressif peuvent bénéficierd’un traitement contre le cancer même lorsqu’ils dépassentlargement les 80 ou les 90 ans. Les recommandations concernantle dépistage et le diagnostic devraient refléter les avantages potentielsliés au dépistage d’un cancer de la prostate agressif, mêmeaprès 75 ans.

Multiparametric ultrasound and micro-ultrasound in prostate cancer: a comprehensive review

2021 ◽  
Author(s):  
Adriano Basso Dias ◽  
Ciara O’Brien ◽  
Jean-Michel Correas ◽  
Sangeet Ghai
Keyword(s):  
Prostate Cancer ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Digital Rectal Examination ◽  
High Sensitivity ◽  
Cost Effective ◽  
Cognitive Fusion ◽  
Clinically Significant ◽  
Multiparametric Ultrasound ◽  
Targeted Biopsies

Prostate cancer (PCa) is the most common non-cutaneous cancer diagnosed in males. Traditional tools for screening and diagnosis, such as prostate-specific antigen, digital rectal examination and conventional transrectal ultrasound (TRUS), present low accuracy for PCa detection. Multiparametric MRI has become a game changer in the PCa diagnosis pathway and MRI-targeted biopsies are currently recommended for males at risk of clinically significant PCa, even in biopsy-naïve patients. Recent advances in ultrasound have also emerged with the goal to provide a readily accessible and cost-effective tool for detection of PCa. These newer techniques include elastography and contrast-enhanced ultrasound, as well as improved B-mode and Doppler techniques. These modalities can be combined to define a novel ultrasound approach, multiparametric ultrasound. High frequency Micro-ultrasound has emerged as a promising imaging technology for PCa diagnosis. Initial results have shown high sensitivity of Micro-ultrasound in detecting PCa in addition to its potential in improving the accuracy of targeted biopsies, based on targeting under real-time visualization, rather than relying on cognitive/fusion software MRI-transrectal ultrasound-guided biopsy.

scholarly journals Independent Validation of a Diagnostic Noninvasive 3-MicroRNA Ratio Model (uCaP) for Prostate Cancer in Cell-Free Urine

2019 ◽  
Vol 65 (4) ◽  
pp. 540-548 ◽  
Author(s):  
Jacob Fredsøe ◽  
Anne K I Rasmussen ◽  
Emma B Laursen ◽  
Yunpeng Cai ◽  
Kenneth A Howard ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Area Under The Curve ◽  
Extracellular Vesicle ◽  
Urine Samples ◽  
Ratio Model ◽  
Psa Testing ◽  
Diagnostic Potential

Abstract BACKGROUND Detection of prostate cancer (PC) based on serum prostate-specific antigen (PSA) testing leads to many unnecessary prostate biopsies, overdiagnosis, and overtreatment of clinically insignificant tumors. Thus, novel and more accurate molecular biomarkers are required. METHODS Using reverse transcription quantitative PCR, we measured the concentrations of 45 preselected microRNAs (miRNAs) in extracellular vesicle-enriched cell-free urine samples from 4 independent patient cohorts from Spain and Denmark, including 758 patients with clinically localized PC, 289 noncancer controls with benign prostatic hyperplasia (BPH), and 233 patients undergoing initial transrectal ultrasound (TRUS)-guided prostate biopsy owing to PC suspicion (101 with benign and 132 with malignant outcome). Diagnostic potential was assessed by ROC and decision curve analysis. RESULTS We identified and successfully validated 8 upregulated and 21 downregulated miRNAs in urine from PC patients. Furthermore, we validated a previously identified 3-miRNA diagnostic ratio model, uCaP (miR-222–3p*miR-24–3p/miR-30c-5p). High uCaP scores were distinctive of PC in urine samples from BPH vs PC patients in 3 independent cohorts [area under the curve (AUC) = 0.84, 0.71, 0.72]. Additionally, uCaP predicted TRUS biopsy results with greater accuracy than PSA (AUC uCaP = 0.644; AUC PSA = 0.527) for patients within the diagnostic gray zone (PSA ≤ 10 ng/mL). CONCLUSIONS We successfully validated a urine-based diagnostic 3-miRNA signature for PC (uCaP) in 3 independent patient cohorts from 2 countries. In the future, the simple and noninvasive uCaP test may be used to help more accurately select patients for prostate biopsy. Prospective clinical validation is warranted.

scholarly journals Profiling of Circulating microRNAs in Prostate Cancer Reveals Diagnostic Biomarker Potential

Diagnostics ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 188 ◽  
Author(s):  
Jacob Fredsøe ◽  
Anne K. I. Rasmussen ◽  
Peter Mouritzen ◽  
Marianne T. Bjerre ◽  
Peter Østergren ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Minimally Invasive ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Digital Rectal Examination ◽  
Area Under The Curve ◽  
Diagnostic Tools ◽  
Test Set ◽  
Localized Disease ◽  
Clinically Significant

Early detection of prostate cancer (PC) is paramount as localized disease is generally curable, while metastatic PC is generally incurable. There is a need for improved, minimally invasive biomarkers as current diagnostic tools are inaccurate, leading to extensive overtreatment while still missing some clinically significant cancers. Consequently, we profiled the expression levels of 92 selected microRNAs by RT-qPCR in plasma samples from 753 patients, representing multiple stages of PC and non-cancer controls. First, we compared plasma miRNA levels in patients with benign prostatic hyperplasia (BPH) or localized prostate cancer (LPC), versus advanced prostate cancer (APC). We identified several dysregulated microRNAs with a large overlap of 59 up/down-regulated microRNAs between BPH versus APC and LPC versus APC. Besides identifying several novel PC-associated dysregulated microRNAs in plasma, we confirmed the previously reported upregulation of miR-375 and downregulation of miR-146a-5p. Next, by randomly splitting our dataset into a training and test set, we identified and successfully validated a novel four microRNA diagnostic ratio model, termed bCaP (miR-375*miR-33a-5p/miR-16-5p*miR-409-3p). Combined in a model with prostate specific antigen (PSA), digital rectal examination status, and age, bCaP predicted the outcomes of transrectal ultrasound (TRUS)-guided biopsies (negative vs. positive) with greater accuracy than PSA alone (Training: area under the curve (AUC), model = 0.84; AUC, PSA = 0.63. Test set: AUC, model = 0.67; AUC, PSA = 0.56). It may be possible in the future to use this simple and minimally invasive bCaP test in combination with existing clinical parameters for a more accurate selection of patients for prostate biopsy.

Increasing use of radical prostatectomy for lower-risk prostate cancer in Denmark.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 149-149
Author(s):  
M. Andreas Roeder ◽  
Klaus Brasso ◽  
Ib Jarle Christensen ◽  
Jorgen Johansen ◽  
Niels Christian Langkilde ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Lower Risk ◽  
Nordic Country ◽  
Specific Antigen ◽  
Trend Test ◽  
Gleason Grade ◽  
Psa Testing ◽  
Age At Surgery ◽  
Over Time

149 Background: Denmark introduced radical prostatectomy (RP) as the last Nordic country in 1995. Since then, a rapid increment in the Danish incidence of prostate cancer (PCa) is indicative of increasing opportunistic prostate-specific antigen (PSA) testing. We hypothesized that an increasing proportion of men undergo RP for lower-risk PCa. Methods: All patients undergoing RP in Denmark between 1995 and 2011 were included. Changes over time in age at surgery, preoperative PSA, clinical T-category, biopsy Gleason score (GS) are described. Tests for statistically significant changes in trends were performed using linear regression and Cochran-Armitage trend test. Results: Median age at surgery increased from 61.4 to 64.8 (p<0.0001) during the 16 year period. Median preoperative PSA declined from 11.5 to 7.9 ng/ml (p<0.0001). Distribution of biopsy GS changed significantly, especially after 2005. Biopsy GS=7 was found in 20.2% of the patients in 2005 compared to 57.1% in 2011. The proportion of T1 disease increased from 32% to 56%. The proportion of patients above age 65 increased from 26.8% to 48.3% in the 16 year period studied. To adjust for grade, PSA, and age migration, we analyzed changes in the proportion of men age over age 65, with PSA less than or equal to 10 ng/ml, biopsy GS≤3+4, and clinical T1 disease over time. In the 16 year period, this proportion increased from 2% to 16% (p<0-001) of the cohort undergoing RP in Denmark. Conclusions: Significant preoperative age, stage, and Gleason grade migration was found in this complete Danish nation-wide cohort of patients undergoing RP during the past 16 years. This has occurred in the absence of any major changes to the national Danish guidelines for diagnosis and treatment of localized PCa. This effect is likely attributed to an increasing use of PSA although national guidelines recommend against PSA screening. Further, new guidelines from the International Society of Urological Pathology have had a major impact on risk classification. According to recently published randomized trials, the risk of overtreatment of localized PCa with RP is an increasing problem in Denmark.

Multiparametric MRI in men with clinical suspicion of prostate cancer undergoing repeat biopsy: a prospective comparison with clinical findings and histopathology

2017 ◽  
Vol 59 (3) ◽  
pp. 371-380 ◽  
Author(s):  
Lars Boesen ◽  
Nis Nørgaard ◽  
Vibeke Løgager ◽  
Ingegerd Balslev ◽  
Henrik S Thomsen
Keyword(s):  
Prostate Cancer ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Clinical Findings ◽  
High Association ◽  
Prospective Comparison ◽  
Insignificant Cancer ◽  
Lesion Level ◽  
Clinically Significant ◽  
Better Than

Background Multiparametric magnetic resonance imaging (mpMRI) can improve detection of clinically significant prostate cancer (csPCa). Purpose To compare mpMRI score subgroups to systematic transrectal ultrasound-guided biopsies (TRUSbx) and prostate-specific antigen (PSA)-based findings for detection of csPCa in men undergoing repeat biopsies. Material and Methods MpMRI was performed prior to re-biopsy in 289 prospectively enrolled patients. All underwent repeat TRUSbx followed by targeted biopsies (MRITB) of any mpMRI-identified lesion. MpMRI suspicion grade, PSA level, and density (PSAd) were compared with biopsy results and further matched to the radical prostatectomy (RP) specimen if available. Results PCa was detected in 128/289 (44%) patients with median age, PSA, and prior negative TRUSbx of 64 (interquartile range [IQR] = 59–67), 12.0 ng/mL (IQR = 8.3–19.1), and 2 (IQR = 1–3), respectively. TRUSbx detected PCa in 108/289 (37%) patients, of which 49 (45%) had insignificant cancer. MRITB was performed in 271/289 (94%) patients and detected PCa in 96 (35%) with 78 (81%) having csPCa. MpMRI scores showed a high association between suspicion level and biopsy results on both lesion and patient level ( P < 0.001). MpMRI was better than PSA and PSAd ( P < 0.001) to identify patients with missed csPCa. In total, 64/128 (50%) patients underwent RP; 60/64 had csPCa. MpMRI was significantly better in predicting csPCa on RP compared with TRUSbx ( P = 0.019) as MRITB and TRUSbx correctly identified 47/60 (78%) and 35/60 (58%) patients, respectively. Conclusion MpMRI improves detection of missed csPCa and suspicion scores correlate well with biopsy and RP results on both patient and lesion level.

scholarly journals Systematic and MRI-Cognitive Targeted Transperineal Prostate Biopsy Accuracy in Detecting Clinically Significant Prostate Cancer after Previous Negative Biopsy and Persisting Suspicion of Malignancy

Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 57
Author(s):  
Alvydas Vėželis ◽  
Gediminas Platkevičius ◽  
Marius Kinčius ◽  
Liutauras Gumbys ◽  
Ieva Naruševičiūtė ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Targeted Biopsy ◽  
Negative Biopsy ◽  
Prostate Biopsies ◽  
Clinically Significant ◽  
Systematic Biopsy ◽  
Targeted Biopsies

Background and objectives: Overdiagnosis, overtreatment, and the need for repeated procedures caused by transrectal ultrasound guided prostate biopsies and their related complications places a heavy burden on healthcare systems. This was a prospective cohort validating study to access the clinical accuracy of systematic and MRI-cognitive targeted transperineal prostate biopsies in detecting clinically significant prostate cancer after a previous negative biopsy and persistent suspicion of malignancy. The primary goal was to assess the ability of multiparametric magnetic resonance imaging (mpMRI) to detect clinically significant prostate cancer with an additional goal to assess the diagnostic value of systematic and MRI-cognitive transperineal biopsies. Materials and Methods: In total, 200 patients were enrolled who had rising serum prostate specific antigen (PSA) levels for at least 4 months after a previous negative transrectal ultrasound (TRUS) biopsy. All eligible men underwent 1.5T prostate mpMRI, reported using the Prostate Imaging Reporting and Data System version 2 (PI-RADS v2), followed by a 20-region transperineal prostate systematic biopsy and additional targeted biopsies. Results: Systematic 20-core transperineal prostate biopsies (TPBs) were performed for 38 (19%) patients. Systemic 20-core TPB with additional cognitive targeted biopsies were performed for 162 (81%) patients. Clinically significant prostate cancer (csPC) was detected for 31 (15.5%) patients, of which 20 (64.5%) cases of csPC were detected by systematic biopsy, eight (25.8%) cases were detected by targeted biopsy, and three (9.7%) both by systematic and targeted biopsies. Conclusions: Cognitive mpMRI guided transperineal target biopsies increase the detection rate of clinically significant prostate cancer after a previously negative biopsy. However, in a repeat prostate biopsy setting, we recommend applying a cognitive targeted biopsy with the addition of a systematic biopsy.

scholarly journals Current Status of MRI and PET in the NCCN Guidelines for Prostate Cancer

2019 ◽  
Vol 17 (5) ◽  
pp. 506-513 ◽  
Author(s):  
Brandon R. Mason ◽  
James A. Eastham ◽  
Brian J. Davis ◽  
Lance A. Mynderse ◽  
Thomas J. Pugh ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
The United States ◽  
Current Status ◽  
Low Grade ◽  
Nccn Guidelines ◽  
Psa Testing ◽  
Pet Ct

Prostate cancer (PCa) represents a significant source of morbidity and mortality for men in the United States, with approximately 1 in 9 being diagnosed with PCa in their lifetime. The role of imaging in the evaluation of men with PCa has evolved and currently plays a central role in diagnosis, treatment planning, and evaluation of recurrence. Appropriate use of multiparametric MRI (mpMRI) and MRI-guided transrectal ultrasound (MR-TRUS) biopsy increases the detection of clinically significant PCa while decreasing the detection of clinically insignificant PCa. This process may help patients with clinically insignificant PCa avoid the adverse effects of unnecessary therapy. In the setting of a known PCa, patients with low-grade disease can be observed using active surveillance, which often includes a combination of prostate-specific antigen (PSA) testing, serial mpMRI, and, if indicated, follow-up systematic and targeted TRUS-guided tissue sampling. mpMRI can provide important information in the posttreatment setting, but PET/CT is creating a paradigm shift in imaging standards for patients with locally recurrent and metastatic PCa. This article examines the strengths and limitations of mpMRI for initial PCa diagnosis, active surveillance, recurrent disease evaluation, and image-guided biopsies, and the use of PET/CT imaging in men with recurrent PCa. The goal of this review is to provide a rational basis for current NCCN Clinical Practice Guidelines in Oncology for PCa as they pertain to the use of these advanced imaging modalities.

scholarly journals The Prostate Gland and PSA (Prostate Specific Antigen)

2016 ◽  
Vol 2 (2) ◽  
pp. 74
Author(s):  
Serfa Faja ◽  
Amir Shoshi
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Quantitative Measurement ◽  
Prostate Gland ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
High Sensitivity ◽  
Psa Test ◽  
Psa Testing ◽  
Very High

The PSA test is used primarily to screen for prostate cancer. A PSA test measures the amount of prostate-specific antigen (PSA) in your blood. PSA is a protein produced in the prostate, a small gland that sits below a man's bladder. PSA is mostly found in semen, which also is produced in the prostate. Small amounts of PSA ordinarily circulate in the blood. The PSA test can detect high levels of PSA that may indicate the presence of prostate cancer. However, many other conditions, such as an enlarged or inflamed prostate, can also increase PSA levels. We use ImmunoAssay for Quantitative Measurement of PSA in Human Blood / Serum / Plasma with i-CHROMA TM Reader System with high sensitivity and specifity. We have analysed 120 patients and only 2 of them had very high value of PSA so we can determine for a prostate cancer. Additional factors increase the accuracy of PSA testing and it is not sufficient only the PSA to determine a prostate cancer so we need a rectal examination and transrectal ultrasound.

Sign in / Sign up

Export Citation Format

Share Document