scholarly journals MP30-05 CANCER DETECTION IN PIRADS 3 LESIONS: THE ADDED VALUE OF PSA DENSITY AND ANTERIOR LOCATION

2021 ◽  
Vol 206 (Supplement 3) ◽  
Author(s):  
Marco Oderda ◽  
Simone Albisinni ◽  
Daniel Benamran ◽  
Giorgio Calleris ◽  
Mauro Ciccariello ◽  
...  
Keyword(s):  
Cancer Detection ◽  
Added Value ◽  
Psa Density

scholarly journals Subsequent prostate cancer detection in patients with prostatic intraepithelial neoplasia or atypical small acinar proliferation

2012 ◽  
Vol 1 (3) ◽  
Author(s):  
Moamen A. Amin ◽  
Suganthiny Jeyaganth ◽  
Nader Fahmy ◽  
Louis Bégin ◽  
Samuel Aronson ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Detection ◽  
Specific Antigen ◽  
Intraepithelial Neoplasia ◽  
Prostatic Intraepithelial Neoplasia ◽  
Atypical Small Acinar Proliferation ◽  
Psa Density ◽  
Significant Difference ◽  
Initial Biopsy

Introduction: To evaluate the predictors of prostate cancer in follow-up of patientsdiagnosed on initial biopsy with high-grade prostatic intraepithelial neoplasia(HGPIN) or atypical small acinar proliferation (ASAP).Methods: We studied 201 patients with HGPIN and 22 patients with ASAPon initial prostatic biopsy who had subsequent prostatic biopsies. The meantime of follow-up was 17.3 months (range 1–62). The mean number of biopsy sessions was 2.5 (range 2–6), and the median number of biopsy cores was10 (range 6–14).Results: On subsequent biopsies, the rate of prostate cancer was 21.9% (44/201)in HGPIN patients. Of these, 32/201 patients (15.9%), 9/66 patients (13.6%)and 3/18 patients (16.6%) were found to have cancer on the first, second and third follow-up biopsy sessions, respectively. In ASAP patients, the cancer detectionrate was 13/22 (59.1%), all of whom were found on the first follow-upbiopsy. There was a statistically significant difference between the cancer detectionrate in ASAP and HGPIN patients (p < 0.001). Multivariate analysis showedthat the independent predictors of cancer were the number of cores in theinitial biopsy, the number of cores (> 10) in the follow-up biopsy and a prostate specific antigen (PSA) density of ≥ 0.15 (odds ratio 0.77, 3.46 and 2.7,8 respectively;p < 0.04). Conversely, in ASAP patients none of these variables werefound to be associated with cancer diagnosis.Conclusion: ASAP is a strong predictive factor associated with cancer when comparedwith HGPIN. The factors predictive of cancer on follow-up biopsy ofHGPIN are number of cores on initial biopsy, more than 10 cores in rebiopsyand elevated PSA density. As the cancer detection rate on repeated biopsy of HGPIN patients is the same as that of patients without HGPIN, perhaps the standard of repeat biopsy in all patients with HGPIN should be revisited.

scholarly journals Multiparametric Magnetic Resonance Imaging-Ultrasound Fusion Transperineal Prostate Biopsy: Diagnostic Accuracy from a Single Center Retrospective Study

Cancers ◽  
2021 ◽  
Vol 13 (19) ◽  
pp. 4833
Author(s):  
Andrea Fulco ◽  
Francesco Chiaradia ◽  
Luigi Ascalone ◽  
Vincenzo Andracchio ◽  
Antonio Greco ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Diagnostic Accuracy ◽  
Cancer Detection ◽  
Prostate Biopsy ◽  
Primary Outcome ◽  
Imaging Techniques ◽  
Added Value ◽  
Secondary Outcome ◽  
Transperineal Prostate Biopsy ◽  
Clinically Significant

The management of prostate biopsy in men with clinical suspicion of prostate cancer has changed in the last few years, especially with the introduction of imaging techniques, to overcome the low efficacy of risk stratification based on PSA levels. Here, we aimed to compare the diagnostic accuracy of multiparametric MRI with fusion ultrasound-guided prostate biopsy and standard biopsy, both performed through the transperineal route. To this end, we retrospectively analyzed 272 patients who underwent combined transperineal targeted and standard biopsy during the same session. The primary outcome was to compare the cancer detection rate between targeted and standard biopsy. The secondary outcome was to evaluate the added value of combined targeted and standard biopsy approach as compared to only targeted or standard biopsy. Results showed that a rate of 16.7% clinically significant tumors (International Society of Urological Pathology (ISUP) grade ≥ 2) would have been lost if only the standard biopsy had been used. The combined targeted and standard biopsy showed an added value of 10.3% and 9.9% in reducing the risk of prostate cancer missing after targeted or standard biopsy alone, respectively. The combined targeted and standard biopsy pathway is recommended to reduce the risk of missing clinically significant prostate cancer.

scholarly journals Zonal adjusted PSA density improves prostate cancer detection rates compared with PSA in Taiwanese males with PSA < 20 ng/mL

2020 ◽  
Author(s):  
Tsung-Hsin Chang ◽  
Wun-Rong Lin ◽  
Wei-Kung Tsai ◽  
Pai-Kai Chiang ◽  
Marcelo Chen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Detection ◽  
Operating Characteristic ◽  
Demographic Data ◽  
Transrectal Ultrasound ◽  
Roc Curves ◽  
Detection Rates ◽  
Prostate Cancer Detection ◽  
Psa Density ◽  
Taiwanese Men

Abstract Background: The current study aimed to compare the efficacy of transition zone PSA density (TZPSAD) with traditional PSA and PSA density (PSAD), for the diagnosis of prostate cancer (PCa) in Taiwanese males.Methods: Men with PSA between 4.0 and 20.0 ng/mL who underwent a transrectal ultrasound (TRUS) guided prostate biopsy between the studied period were retrospectively identified. The demographic data, PSAD and TZPSAD were calculated in all patients. Receiver operating characteristic (ROC) curves were used to analyze the accuracy of a positive PCa diagnosis.Results: The area under the ROC (AUC) was 0.615, 0.748 and 0.746 for PSA, PSAD and TZPSAD, respectively. The best cut-off of value for TZPSAD in predicting PCa in men with a PSA of 4.0–10.0 ng/ml was 0.367 ng/ml/ml with a sensitivity of 50% and a specificity of 77.5%. In men with a PSA of 10.1–20.0 ng/ml, the best cut-off value was 0.454 ng/ml, with a sensitivity of 74.8% and specificity of 70.9%.Conclusion: The use of TZPSAD can improve the efficiency and specificity of PSA for the diagnosis of PCa in Taiwanese men with PSA 4.0–20.0 ng/ml. TZPSAD efficiency was similar to PSAD but TZPSAD had better cancer specificity.

scholarly journals Zonal adjusted PSA density improves prostate cancer detection rates compared with PSA in Taiwanese males with PSA < 20 ng/mL

2020 ◽  
Author(s):  
Tsung-Hsin Chang ◽  
Wun-Rong Lin ◽  
Wei-Kung Tsai ◽  
Pai-Kai Chiang ◽  
Marcelo Chen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Detection ◽  
Operating Characteristic ◽  
Demographic Data ◽  
Transrectal Ultrasound ◽  
Roc Curves ◽  
Detection Rates ◽  
Prostate Cancer Detection ◽  
Psa Density ◽  
Taiwanese Men

Abstract Background: The current study aimed to compare the efficacy of transition zone PSA density (TZPSAD) with traditional PSA and PSA density (PSAD), for the diagnosis of prostate cancer (PCa) in Taiwanese males.Methods: Men with PSA between 4.0 and 20.0 ng/mL who underwent a transrectal ultrasound (TRUS) guided prostate biopsy between the studied period were retrospectively identified. The demographic data, PSAD and TZPSAD were calculated in all patients. Receiver operating characteristic (ROC) curves were used to analyze the accuracy of a positive PCa diagnosis.Results: The area under the ROC (AUC) was 0.615, 0.748 and 0.746 for PSA, PSAD and TZPSAD, respectively. The best cut-off of value for TZPSAD in predicting PCa in men with a PSA of 4.0–10.0 ng/ml was 0.367 ng/ml/ml with a sensitivity of 50% and a specificity of 77.5%. In men with a PSA of 10.1–20.0 ng/ml, the best cut-off value was 0.454 ng/ml, with a sensitivity of 74.8% and specificity of 70.9%.Conclusion: The use of TZPSAD may improve the efficacy and specificity of PSA for the diagnosis of PCa in Taiwanese men with PSA 4.0–20.0 ng/ml. TZPSAD efficacy was similar to PSAD but TZPSAD had better specificity.

scholarly journals The Study for Accuracy Assessment of Free PSA Density for Prostate Cancer Detection in Male Patients with High PSA

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Noppakulsatit P
Keyword(s):  
Prostate Cancer ◽  
Cancer Detection ◽  
Predictive Value ◽  
Screening Tool ◽  
Prostate Gland ◽  
Digital Rectal Examination ◽  
Serum Free ◽  
Prostate Cancer Detection ◽  
Psa Density ◽  
Free Psa

Background: Prostate cancer detection is currently based on serum PSA with a digital rectal examination which is neither specific nor sensitive, which caused many unnecessary prostate gland biopsies that are highly expensive and can result in unwanted complications. Serum free PSA increases with a larger prostate gland,yet declines with a gland that contains cancer cells, thus prompting the hypothesis that calculating the ratio of serum free PSA against prostate gland volume provides the so-called “free PSA density” which can be utilized to improve prostate cancer detection. Methods: Male participants were deemed eligible if they are at risk of prostate cancer with a PSA level of 4-10 ng/dL and aged between 50-75 years. Serum PSA and serum free PSA were obtained concurrently, followed by transrectal ultrasonography for prostate volume calculation and biopsy of the gland. Also reported are the sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and receiver operating characteristic(ROC) with area under the ROC curve(AUC) of serum PSA, %free PSA ratio, free PSA density and PSA density. The AUC of the variables were compared with the free PSA density and reported. Results: The free PSA density cut point values which provided the highest accuracy was 0.025mg/mL/cc, which had 61.5% sensitivity and 67.25% specificity. The ROC results indicate that %free PSA ratio had the best AUC at 0.86. Free PSA density and PSA density have AUC at 0.65 and 0.61, respectively. Meanwhile, serum PSA had the worst AUC of 0.54. The researchers also calculated different AUCs of other variables to free PSA density. Finally, the AUC of free PSA density was significantly better than the reference standard tool serum PSA (p=0.022). Conclusions: Prostate cancer is an emerging cancer among elderly men. Frequent use of serum PSA as a screening tool allows earlier diagnosis of this cancer but with the expensive of unnecessary further investigations. Most novel and promising tools are too expensive to be used as a generalized screening tool. From this study, free PSA density may be a reasonable alternative tool for detection of prostate cancer.

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