Re: Variability of the Positive Predictive Value of PI-RADS for Prostate MRI across 26 Centers: Experience of the Society of Abdominal Radiology Prostate Cancer Disease-Focused Panel

Background: Prostate cancer incurs a substantial incidence and mortality burden, and it ranks among the top ten specific causes of death in males. Objectives: To explore the situation of prostate cancer in a cohort of healthy population in Eastern Nepal. Methods: This study was conducted in the Department of General surgery at B. P. Koirala Institute of Health Sciences, Dharan, Nepal in the department of surgery from July 2010 to June 2011. Males above 50 years visiting Surgical Outpatient Department in BPKIHS were enrolled in the study. Screening camps were organized in four Teaching district hospitals of BPKIHS in Eastern Nepal. Digital rectal examination (DRE) was done by the trained professionals after collecting blood for serum prostatic specific antigen (PSA). Trucut biopsy was done for all individuals with abnormal PSA, DRE or both findings. Results: A total of 1521 males more than 50 years of age were assessed and screened after meeting inclusion criteria. Maximum individuals 1452 (96.2% ) had PSA ≤ 4.0 ng/ml. Abnormal PSA ( > 4 ng/ml) was found in 58 (3.8%) individuals. Abnormal DRE was found in 26 (1.72%) individuals. Both DRE and PSA was abnormal in 26 (1.72%) individuals. On the basis of raised PSA or abnormal DRE 58 (3.84%) individuals were subjected to digitally guided trucut biopsy. Biopsy report revealed Benign Prostatic Hyperplasia in 47 (3.11%) individuals and adenocarcinoma prostate in 11 (0.73%) individuals. The specificity of DRE was 65.95% sensitivity 90.9% and positive predictive value 38.46%. The sensitivity of PSA more than 4ng/ml in detecting carcinoma prostate was 100% and the positive predictive value for serum PSA was 18.96%. Conclusion: The overall cancer detection rate in this study was 0.73% and those detected were locally advanced. Larger community-based studies are highly warranted specially among high-risk groups.

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Annual short report of the society of abdominal radiology prostate cancer disease-focused panel

Abdominal Radiology ◽

10.1007/s00261-019-02259-x ◽

2019 ◽

Vol 44 (12) ◽

pp. 4000-4001

Author(s):

Baris Turkbey ◽

Daniel Margolis

Keyword(s):

Prostate Cancer ◽

Short Report ◽

Cancer Disease ◽

Abdominal Radiology

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3T MRI of the prostate correlation to 3D reconstruction of transperineal mapping biopsies.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e15176 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e15176-e15176

Author(s):

Kyle O. Rove ◽

Thomas J. Pshak ◽

Nayana Patel ◽

Colin O'Donnell ◽

E. David Crawford

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Positive Predictive Value ◽

3D Reconstruction ◽

Predictive Value ◽

Three Dimensional ◽

3T Mri ◽

3 Dimensional ◽

Endorectal Coil ◽

Clinically Significant

e15176 Background: MRI is new tool in the diagnosis and surveillance of localized prostate cancer. Studies have examined the sensitivity and specificity of MRI for detecting and localizing prostate cancer as compared to radical prostatectomy specimens. We have previously demonstrated excellent correlation between 3-dimensional transperineal mapping biopsies (3DMB) to radical prostatectomy specimens. We hypothesize that MRI does not perform as well detecting smaller lesions of the prostate as larger ones. In this study, we retrospectively compare the correlation of 3DMB to 3T MRI-positive lesions. Methods: Between 2010 and 2011, 34 men with histologically-proven prostate cancer underwent 3T endorectal coil MRI and subsequent template-guided (5-mm grid) 3DMB. Three-dimensional computer models of the mapping biopsies were created using Proview software to identify clusters of positive biopsies likely belonging to a single lesion. MRIs were read by two trained radiologists blinded to 3DMB results. Disagreement between radiologists was settled by consensus. MRI and 3DMB were then compared in a retrospective fashion. Results: Median age and PSA were 65 years (49-76) and 4.3 ng/mL (0.7-15.0). Median prostate volume was 40 cm3 (21-105 cm3). Median total biopsy cores on 3DMB was 60 (26-151), and mean positive cores was 3 (0-13). 3D reconstruction of patient biopsy sets resulted in 58 distinct foci of cancer. MRI identified 64 individual lesions suspicious for cancer. Of these, 66% (n=42) could be correlated to a positive area on 3DMB consisting of one or more positive biopsies, and 34% (n=22) corresponded to negative regions on 3DMB. When two or more biopsies represented a positive lesion on 3DMB, the positive-predictive value of MRI was 100% (n=24). Conversely, only 72% (n=42) of positive 3DMB areas could be correlated to a lesion on MRI, and 28% (n=16) were not seen on MRI.. Conclusions: MRI has vast potential as a less-invasive method in the detection and surveillance of prostate cancer. While MRI does appear to have excellent positive predictive value, the number of false negatives and relevance to clinically-significant lesions require further illumination.

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Elastography Targeted Prostate Biopsy in Patients under Active Surveillance

Urologia Internationalis ◽

10.1159/000509256 ◽

2020 ◽

Vol 104 (11-12) ◽

pp. 948-953

Author(s):

Tobias Steinwender ◽

Lukas Manka ◽

Mircea Grindei ◽

Zhe Tian ◽

Alexander Winter ◽

...

Keyword(s):

Prostate Cancer ◽

Positive Predictive Value ◽

Active Surveillance ◽

Prostate Biopsy ◽

Predictive Value ◽

Individual Case ◽

Cancer Center ◽

Sensitivity Specificity ◽

Targeted Biopsies

Objective: The aim of this study was to examine elastography-based prostate biopsy in prostate cancer (PCa) patients under active surveillance. Patients and Methods: We relied on PCa patients who opted for active surveillance and underwent elastography targeted and systematic follow-up biopsy at the Braunschweig Prostate Cancer Center between October 2009 and February 2015. Each prostate sextant was considered as an individual case. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy (ACC) for elastography to predict follow-up biopsy results were analyzed, respectively, and 95 % confidence intervals (CIs) were carried out by using 2000 bootstrapping sample analyses. Results: Overall, 50 men and 300 sextants were identified. Overall, 27 (54%) men and 66 (22%) sextants harbored PCa at follow-up biopsy. Sensitivity, specificity, PPV, NPV, and ACC for elastography to predict follow-up biopsy results were: 19.7 (95% CI: 11.9–27.3), 86.8 (95% CI: 82.7–90.3), 29.6 (95% CI: 14.6–46.0), 79.3 (95% CI: 71.6–86.5), and 72.0% (95% CI: 65.7–78.3), respectively. Conclusions: We recorded limited reliability of elastography-based prediction of follow-up biopsy results in active surveillance patients. Based on our analyses, we can neither recommend to rely exclusively on elastography-based targeted biopsies nor to delay or to omit follow-up biopsies based on elastography results during active surveillance.

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