scholarly journals Peripheral Zone Enlargement: a newly described entity on MRI

2020 ◽  
Author(s):  
Neil F. Wasserman ◽  
Paari Murguan ◽  
Ben Spilseth ◽  
Gregory J. Metzger ◽  
Tina Sanghvi
Keyword(s):  
Transition Zone ◽  
Specific Antigen ◽  
Elevated Serum ◽  
Digital Rectal Examination ◽  
Inflammatory Cells ◽  
Peripheral Zone ◽  
Prostatic Specific Antigen ◽  
Prostatic Enlargement ◽  
Magnetic Resonance Imaging Mri ◽  
Microscopic Pathology

AbstractPurposeA retrospective study was performed to describe and characterize a previously unreported finding on T2-weighted magnetic resonance imaging (MRI) of peripheral zone enlargement (PZE) associated with total prostatic enlargement without necessary association with benign prostatic hyperplasia (BPH) or lower urinary tract symptoms.MethodsT2-weighted MRI were reviewed from 2012-2018. Patients were referred for elevated serum prostatic specific antigen (PSA) levels, prostatic enlargement, or abnormal digital rectal examination (DRE) suggestive of adenocarcinoma. Enlargement of the thickness of the peripheral zone (PZ) was defined as a measurement of postero-lateral thickness (PLPZ) of ≥ 15.8 mm in the maximal transaxial plane. Endorectal coils were used in 2 patients. Microscopic pathology was described in 3 patients.ResultsThere were 22 patients who met the criteria out of 2871 subjects (<1%). Mean age was 63 years, Mean PLPZ was 17.7 mm (CI=0.45, range, 15.8-21.3). mean total prostatic volume was 55.1 cc (range, 19.9-127.2 cc), mean transition zone volume was 20.6 cc (range, 2.7-71.9 cc), mean transition zone index (TZI) was 0.34 (range, 0.31-0.68), mean prostatic specific antigen (PSA) was 13.9 ng/mL (range, 0.28-144.7), mean body mass index was 28.9 (range 23.0-36.3).. Enlargement was described in 14 of 20 (70%). Pathological findings showed marked glandular distention and atrophy with interstitial edema and chronic inflammatory cells. Significance of these results is discussed.

Clinicopathological correlation of pre-biopsy quantitative PSMA uptake in patients with persistently raised serum PSA: initial experience in 74 patients with simultaneous 68-Ga PSMA PET/MRI

2020 ◽  
pp. 205141582095640
Author(s):  
Malik A Rouf ◽  
Rajesh Taneja ◽  
Venkatesh Kumar
Keyword(s):  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Whole Body ◽  
Characteristic Analysis ◽  
Positron Emission ◽  
Psma Pet ◽  
Significant Difference ◽  
Magnetic Resonance Imaging Mri ◽  
Normal Urine ◽  
Delayed Phase

Objective: To analyze 68-Ga prostate-specific membrane antigen (PSMA) uptake pattern of the prostate and its correlation with prostate-specific antigen (PSA), digital rectal examination (DRE), and Gleason’s score in the diagnosis of carcinoma of the prostate (CaP). Methods: This was a retrospective study conducted between June 2015 and August 2017. Patients who had undergone whole body 68-Ga PSMA HBED-CC simultaneous positron emission tomography (PET) or magnetic resonance imaging (MRI) for the diagnosis or staging of CaP were eligible. Patients who presented with persistently raised serum PSA (>4 ng/mL) and normal urine routine and negative culture were included in the study. Results: A total of 74 patients were included in the study. Significant positive correlation was observed between PSMA delayed uptake with the Prostate Imaging Reporting and Data System (PI-RADS) score ( p<0.001, ρ=0.750), PSA level ( p<0.001, ρ=0.414), DRE ( p<0.002, ρ=0.400), and Gleason’s score ( p<0.300, ρ=0.02). There was a significant difference between early and delayed phase of PSMA uptake in malignant prostatic lesions ( p<0.001). Delayed phase of PSMA uptake was able to characterize prostate lesions with an area under curve (AUC) of 0.91. Combined receiver operating characteristic analysis of PI-RADS score derived from multiparametric MRI and differential PSMA uptake to characterize prostatic lesions improved AUC to 0.94. Conclusion: Results demonstrated that the correlation with clinicopathological features (PSA, DRE, and Gleason’s score) could be used in prognostication of prostatic lesion along with PSMA PET/MRI.

scholarly journals Importance of prostate volume for detection of prostate cancer by first sextant biopsy in high-risk patients

Medicina ◽  
2007 ◽  
Vol 43 (4) ◽  
pp. 285 ◽  
Author(s):  
Kęstutis Vaičiūnas ◽  
Stasys Auškalnis ◽  
Aivaras Matjošaitis ◽  
Darius Trumbeckas ◽  
Mindaugas Jievaltas
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Transition Zone ◽  
Prostate Biopsy ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Transitional Zone ◽  
Antigen Level ◽  
Sextant Biopsy

The aim of this study was to evaluate the relevance of prostate gland volume, transitional zone volume, and transitional zone index for the detection of prostate cancer by the first sextant biopsy. Material and methods. A total of 121 men with high risk of prostate cancer were included in our study (prostate-specific antigen level higher than 4 ng/mL and/or pathological digital rectal examination). We consulted the patients in Outpatient Department of Kaunas University of Medicine Hospital during 2003–2006. Total prostate volume and transition zone volume were measured, and all patients underwent transrectal ultrasoundguided sextant biopsy of the prostate. According to histological results of prostate biopsy, patients were divided into two groups: benign group (benign prostate hyperplasia and high-grade intraepithelial neoplasia) and prostate cancer group. Statistical analysis was made by SPSS (Statistical Package for Social Sciences) 12.0.1 for Windows. Results. After histological examination, prostate cancer was detected in 20.7% of patients (n=25). Prostate cancer was found in 24.6% of patients with a total prostate volume of less than 60 cm3 and only in 8.2% of patients with a total prostate volume greater than 60 cm3 (P=0.026). Prostate cancer was found in 27.1% of patients with transition zone volume smaller than 30 cm3 and only in 7.5% of patients with transition zone volume greater than 30 cm3 (P=0.007). A statistically significant difference was found when patients were divided into the groups according to transition zone index: when transition zone index was lower than 0.45, prostate cancer was detected in 37.1% of patients, and when transition zone index was higher than 0.45, prostate cancer was observed in 9.1% of patients (P=0.001). The possibility to detect prostate cancer was 5.9 times higher in patients with transition zone index lower than 0.45. Conclusions. Prostate cancer detection rate by first sextant prostate biopsy in patients with elevated prostate-specific antigen level and/or pathological digital rectal examination was higher when total prostate volume was less than 60 cm3, transition zone was less than 30 cm3, and transition zone index was less than 0.45.

scholarly journals Gross Hematuria and Prostatic Cancer in Libyan Patients

2019 ◽  
pp. 1-5
Author(s):  
Abdsalme Elhony ◽  
Tarik El. Darat ◽  
Raouf Elkawafi ◽  
Walid Ramse ◽  
Adem Ibrahim Alzaghad ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Retrospective Study ◽  
Prostatic Cancer ◽  
Clinical Presentation ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Prostatic Specific Antigen ◽  
Gross Hematuria ◽  
Diagnosis And Management ◽  
Histopathology Result

Aim: Gross hematuria due to prostate cancer is an important clinical presentation and it is necessary to collect, analyze and determine certain criteria and data in the diagnosis and management of prostatic cancer. The aim of the present study is to find out the frequency of gross hematuria and to correlate it with gross hematuria and serum Prostatic Specific Antigen (PSA).in prostatic cancer patients. Materials and Methods: A retrospective study was done in patients diagnosed with prostatic cancer in Hawari center for urology in Benghazi Libya from 2011 up to 2017.  60 cases were taken for the present study. The data such as age of the patient, first complaint such as gross hematuria, serum PSA  levels, histopathology result, the types of therapy received (medical or surgical) were analyzed from these Libyan patients. Results: 25 percent cases in the present study had gross hematuria and there was positive correlation between gross hematuria, serum PSA levels and Gleason score. Conclusion: The result of this study indicate that the presentation of hematuria is not uncommon in prostate cancer. Therefore, it may be necessary to estimate serum PSA levels and do digital rectal examination (DRE) for men aged between 50-70 years old for early diagnosis and management of prostate cancer.

Transrectal Ultrasonography in the Diagnosis of Prostatic Carcinoma: Our Study on 365 Patients

1994 ◽  
Vol 61 (4) ◽  
pp. 270-276
Author(s):  
M. Calò ◽  
I. Malavolti ◽  
G. Cuscianna ◽  
F. Baldari ◽  
C.A. Pollastri ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Needle Biopsy ◽  
Prostatic Carcinoma ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Digital Rectal Examination ◽  
High Sensitivity ◽  
Transrectal Ultrasonography ◽  
Prostatic Specific Antigen ◽  
Clinical Exam

To evaluate the usefulness of transrectal ultrasound associated with needle biopsy of the prostate, 365 patients, with age ranging between 50 and 80 years, were studied for a total of 412 biopsies; the ultrasound exam was performed when the clinical or the prostate specific antigen findings were pathological. Our experience confirms the high sensitivity and specificity of transrectal ultrasonography in detecting prostate cancer. It is our opinion that all the patients with positive or negative digital rectal examination but altered prostatic specific antigen or clinical exam should undergo transrectal ultrasonography associated with needle biopsy. The elevated operability of the studied patients shows the capability of ultrasound to detect the pathology in the early stages and its value in screening diagnosis should therefore be considered.

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