scholarly journals A Prospective Study Comparing Cancer Detection Rates of Transperineal Prostate Biopsies Performed by Junior Urologists versus a Senior Consultant in a Real-World Setting

2021 ◽  
pp. 1-7
Author(s):  
Jia-ao Song ◽  
Bi-ming He ◽  
Hu-sheng Li ◽  
Xiao-wen Yu ◽  
Zhen-kai Shi ◽  
...  
Keyword(s):  
Specific Antigen ◽  
Daily Practice ◽  
Secondary Outcome ◽  
Complication Rates ◽  
Detection Rates ◽  
Prostate Biopsies ◽  
Significant Difference ◽  
Procedural Time ◽  
Practice Method ◽  
A Prospective Study

<b><i>Introduction:</i></b> Prostate biopsy (PB) is a typical daily practice method for the diagnosis of prostate cancer (PCa). This study aimed to compare the PCa detection rates and peri- and postoperative complications of PB among 3 residents and a consultant. <b><i>Patients and Methods:</i></b> A total of 343 patients who underwent PB between August 2018 and July 2019 were involved in this study. Residents were systematically trained for 2 weeks by a consultant for performing systematic biopsy (SB) and targeted biopsy (TB). And then, 3 residents and the consultant performed PB independently every quarter due to routine rotation in daily practice. The peri- and postoperative data were collected from a prospectively maintained database (www.pc-follow.cn). The primary outcome and secondary outcome were to compare the PCa detection rates and complications between the residents and consultant, respectively. <b><i>Results:</i></b> There was no significant difference between the residents and consultant in terms of overall PCa detection rates of SB and TB or further stratified by prostate-specific antigen value and prostate imaging reporting and data system (PI-RADS) scores. We found the consultant had more TB cores (175 cores vs. 86–114 cores, <i>p</i> = 0.043) and shorter procedural time (mean 16 min vs. 19.7–20.1 min, <i>p</i> &#x3c; 0.001) versus the residents. The complication rate for the consultant was 6.7% and 5%–8.2% for the residents, respectively (<i>p</i> = 0.875). <b><i>Conclusions:</i></b> The residents could get similar PCa detection and complication rates compared with that of the consultant after a 2-week training. However, the residents still need more cases to shorten the time of the biopsy procedure.

A Prospective Study Comparing Cancer Detection Rates of Transperineal Prostate Biopsies Performed by Junior Urologists Versus a Senior Consultant in a Real World-setting

2020 ◽  
Author(s):  
Jiaao Song ◽  
Bi-ming He ◽  
Hu-sheng Li ◽  
Zhen-kai Shi ◽  
Guan-yu Ren ◽  
...  
Keyword(s):  
Specific Antigen ◽  
Daily Practice ◽  
Secondary Outcome ◽  
Complication Rates ◽  
Detection Rates ◽  
Prostate Biopsies ◽  
Significant Difference ◽  
Procedural Time ◽  
Practice Method ◽  
A Prospective Study

Abstract Background: Prostate biopsy (PB) is a typical daily practice method for the diagnosis of prostate cancer (PCa). This study was to compare the PCa detection rate and peri- and post-operative complications of PB among three residents and a consultant.Methods: A total of 343 patients who underwent PB between August 2018 with July 2019 were involved in this study. Residents were systematically trained two weeks by the consultant for performing systemic biopsy (SB) and targeted biopsy (TB). And then, three residents and the consultant performed PB independently every quarter due to routine rotation in daily practice. The peri- and post-operative data was prospectively collected. The primary outcome and secondary outcome were to compare the PCa-detection rates and complications between residents and consultant, respectively. Results: There was no significant difference between the residents and consultant in terms of overall PCa-detection rates of SB, TB or further stratified by prostate specific antigen value, prostate imaging reporting and data system (PI-RADS) scores. We found the consultant had more TB cores compared with residents (175 cores versus 86 to 114 cores, P=0.043) and shorter procedural time versus residents (mean 16 min versus 19.7 to 20.1 min, P <0.001). The complication rate for consultant was 6.7%, and 5% to 8.2% for residents, respectively (P = 0.875).Conclusions: The residents could get a similar PCa detection and complication rates compared with the consultant after a two-week training. However, the residents still need more cases to shorten the time of biopsy procedure.

scholarly journals Are outpatient transperineal prostate biopsies without antibiotic prophylaxis equivalent to standard transrectal biopsies for patient safety and cancer detection rates?A retrospective cohort study in 222 patients

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Majdee Islam ◽  
Rodrigo Donalisio Da Silva ◽  
Alan Quach ◽  
Diedra Gustafson ◽  
Leticia Nogueira ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Prophylaxis ◽  
Cancer Detection ◽  
Retention Rate ◽  
Daily Practice ◽  
Oral Antibiotics ◽  
Detection Rates ◽  
Prostate Biopsies ◽  
Post Procedure ◽  
Significant Difference

Abstract Background To describe our experience with outpatient transperineal biopsy (TPB) without antibiotics compared to transrectal biopsy (TRB) with antibiotics and bowel preparation. The literature elicits comparable cancer detection, time, and cost between the two. As antibiotic resistance increases, antimicrobial stewardship is imperative. Methods In our retrospective review, we compared the TPB to TRB in our institution for outpatient prostate biopsies with local anesthesia from June 1st, 2017 to June 1st, 2019. Patients had negative urinalysis on day of procedure. Patients presenting with symptoms concerning for UTI followed by positive urine culture were determined to have a UTI. Results Two hundred twenty-two patients met inclusion criteria. Age, race, BMI, pre-procedure PSA, history of UTI, BPH or other GU history were similar between both groups. Two TPB patients (1.8%) had post-procedure UTI; one received oral antibiotics and one received a dose of intravenous and subsequent oral antibiotics. There were no sepsis events or admissions. Six TRB patients (5.4%) had post-procedure UTI; five received oral antibiotics, and one received intravenous antibiotics and required admission for sepsis. One TPB patient (0.9%) had post-procedure retention and required catheterization, while four TRB patients (3.6%) had retention requiring catheterization. No significant difference noted in cancer detection between the two groups. Conclusion Outpatient TPB without antibiotic prophylaxis/bowel prep is comparable to TRB in regard to safety and cancer detection. TPB without antibiotics had a lower infection and retention rate than TRB with antibiotics. Efforts to reduce antibiotic resistance should be implemented into daily practice. Future multi-institutional studies can provide further evidence for guideline changes.

Is a sampling transition zone important to increase the detection of prostate cancer in systematic prostatic biopsies?

2020 ◽  
pp. 028418512093836
Author(s):  
Marcos RG Queiroz ◽  
Priscila M Falsarella ◽  
Leonardo G Moreira Valle ◽  
Guilherme Cayres Mariotti ◽  
Gustavo C Lemos ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Transition Zone ◽  
Active Surveillance ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Complication Rates ◽  
Treatment Change ◽  
Detection Rates ◽  
Prostate Biopsies ◽  
Biopsy Protocol

Background Use of transrectal ultrasound (US)-guided biopsies improved diagnosis and treatment for patients with high prostate-specific antigen (PSA) or abnormal digital rectal exam (DRE). Purpose To investigate whether taking two transition zone (TZ) biopsies in addition to routine prostate double-sextant biopsies (12-cores) would improve detection rates of prostate cancer (PCa). Material and Methods A retrospective analysis of 1107 in a single institution database after Institutional Review Board approval, which underwent US-guided prostate biopsies from January 2014 to June 2016. All patients with suspected PCa based on positive DRE or high PSA submitted to US-guided prostate biopsy (double-sextant 12-cores alone and 12-cores with two TZ extra cores) were included. Results A total of 1107 patients were included; 120 patients underwent double-sextant 12-cores alone and 987 underwent 12-cores with two TZ extra cores. Among patients submitted to two TZ extra cores, TZs of 755 (76.5%) patients were negative to neoplasia and 232 (23.5%) were positive to neoplasia. Among these patients, 26 (2.6%) had their final Gleason score increased with TZ core; TZ fragments of 20 (2.0%) patients led to a treatment change (re biopsy, active surveillance or from active surveillance to radiation therapy or radical prostatectomy). When the complication rate is analyzed (with or without hospital admission), among the patients submitted to TZ cores, 259 (26.2%) complications were observed; between those submitted to double-sextant 12-cores, 26 (21.7%) complications were observed ( P=0.279). Conclusion Extended core biopsy protocol with two TZ extra fragments improves detection rates of cancer when compared to double-sextant biopsy protocol without increasing complication rates. TZ routine cores should be considered.

scholarly journals Analysis of risk factors for determining the need for prostate biopsy in patients with negative MRI

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Linghui Liang ◽  
Feng Qi ◽  
Yifei Cheng ◽  
Lei Zhang ◽  
Dongliang Cao ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Detection Efficiency ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Multivariable Logistic Regression Analysis ◽  
Detection Rates ◽  
Prostate Biopsies ◽  
Clinically Significant ◽  
Definition Of ◽  
Medical University

AbstractTo analyze the clinical characteristics of patients with negative biparametric magnetic resonance imaging (bpMRI) who didn’t need prostate biopsies (PBs). A total of 1,012 male patients who underwent PBs in the First Affiliated Hospital of Nanjing Medical University from March 2018 to November 2019, of 225 had prebiopsy negative bpMRI (defined as Prostate Imaging Reporting and Data System (PI-RADS 2.1) score less than 3). The detection efficiency of clinically significant prostate cancer (CSPCa) was assessed according to age, digital rectal examination (DRE), prostate volume (PV) on bpMRI, prostate-specific antigen (PSA) and PSA density (PSAD). The definition of CSPCa for Gleason score > 6. Univariate and multivariable logistic regression analysis were used to identify predictive factors of absent CSPCa on PBs. Moreover, absent CSPCa contained clinically insignificant prostate cancer (CIPCa) and benign result. The detection rates of present prostate cancer (PCa) and CSPCa were 27.11% and 16.44%, respectively. Patients who were diagnosed as CSPCa had an older age (P < 0.001), suspicious DRE (P < 0.001), a smaller PV (P < 0.001), higher PSA value (P = 0.008) and higher PSAD (P < 0.001) compared to the CIPCa group and benign result group. PSAD < 0.15 ng/ml/cm3 (P = 0.004) and suspicious DRE (P < 0.001) were independent predictors of absent CSPCa on BPs. The negative forecast value of bpMRI for BP detection of CSPCa increased with decreasing PSAD, mainly in patients with naive PB (P < 0.001) but not in prior negative PB patients. 25.33% of the men had the combination of negative bpMRI, PSAD < 0.15 ng/ml/cm3 and PB naive, and none had CSPCa on repeat PBs. The incidence of PB was determined, CSPCa was 1.59%, 0% and 16.67% in patients with negative bpMRI and PSAD < 0.15 ng/ml/cm3, patients with negative bpMRI, PSAD < 0.15 ng/ml/cm3 and biopsy naive and patients with negative bpMRI, PSAD < 0.15 ng/ml/cm3 and prior negative PB, separately. We found that a part of patients with negative bpMRI, a younger age, no suspicious DRE and PSAD < 0.15 ng/ml/cm3 may securely avoid PBs. Conversely PB should be considered in patients regardless of negative bpMRI, especially who with a greater age, obviously suspicious DRE, significantly increased PSA value, a significantly small PV on MRI and PSAD > 0.15 ng/ml/cm3.

Abstract WP341: Difference in Acute Ischemic Post Thrombolytic Stroke Outcomes in Pre Comprehensive and Post Comprehensive Status: Single Center Experience

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Vishal B Jani ◽  
Achint Patel ◽  
Jillian Schurr ◽  
Erin Shell ◽  
Julie Bey ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Secondary Outcome ◽  
Rank Test ◽  
Stroke Severity ◽  
Complication Rates ◽  
Single Center ◽  
Stroke Treatment ◽  
Significant Difference ◽  
Multivariable Regression ◽  
Iv Tpa

Background: In last decade there is a significant change in stroke care especialy with newer data for ischemic stroke treatment there is a movement to obtain comprehensive stroke center certification (CSCC) to provide enhanced complex care for stroke. This study aims to assess the single center quality matrix assessment pre and post CSC status Methods: We reviewed single center cohort of IV tPA (tissue plasminogen activator) in-between year 2010 to 2014 at sparrow health system in mid Michigan region. This cohort was dichotomized in pre CSCC and post CSCC era. Stroke quality matrics data was collected for these patients. Severity of stroke was categorized in mild-moderate vs moderate-severe based on NIH stroke scale (NIHSS) scale. Primary out come for this study was any complication, which is composite end point of in-hospital mortality, and hemorrhage and secondary outcome was hospital stay. Chi square, student’s t test and wilcoxon sum rank test was used to compare both groups. Multivariable regression models were utilized to calculate odd ratios after adjusting with stroke severity. Results: Cohort of IV tPA was identified in-between year 2010 to 2014 (332 hospitalizations off which 241 were pre CSCC and 91 were Post CSCC ). In- hospital complication was lower after receiving CSCC (9.89% vs. 21.99%; p:0.011). In multivariable regression analysis the trend for in hospital complication persisted [Adjusted Odds ratio (OR):0.43–95%confidence-Interval(CI):0.20-0.93–p:0.032] but there was no significant difference in hospital stay (Median days 5 vs. 5; P:673) Conclusion: There is a clear and persistent trend of low in-hospital complication rates after acquiring CSCC quality matrics.

scholarly journals Cancer Detection Rates of Systematic and Targeted Prostate Biopsies after Biparametric MRI

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Maudy C. W. Gayet ◽  
Anouk A. M. A. van der Aa ◽  
Harrie P. Beerlage ◽  
Bart Ph Schrier ◽  
Maaike Gielens ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Detection ◽  
Prostate Biopsy ◽  
Detection Rates ◽  
Prostate Biopsies ◽  
Significant Difference ◽  
Significant Pathology ◽  
Study Population ◽  
Clinically Significant ◽  
Control Study

Objective. To compare prostate cancer detection rates (CDRs) and pathology results with targeted prostate biopsy (TB) and systematic prostate biopsy (SB) in biopsy-naive men. Methods. An in-patient control study of 82 men undergoing SB and subsequent TB in case of positive prostate MRI between 2015 and 2017 in the Jeroen Bosch Hospital, the Netherlands. Results. Prostate cancer (PCa) was detected in 54.9% with 70.7% agreement between TB and SB. Significant PCa (Gleason score ≥7) was detected in 24.4%. The CDR with TB and SB was 35.4% and 48.8%, respectively (p=0.052). The CDR of significant prostate cancer with TB and SB was both 20.7%. Clinically significant pathology upgrading occurred in 7.3% by adding TB to SB and 22.0% by adding SB to TB. Conclusions. There is no statistically significant difference between CDRs of SB and TB. Both SB and TB miss significant PCas. Moreover, pathology upgrading occurred more often by adding SB to TB than vice versa. This indicates that the omission of SB in this study population might not be justified.

scholarly journals 3D versus 2D Systematic Transrectal Ultrasound-Guided Prostate Biopsy: Higher Cancer Detection Rate in Clinical Practice

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Alexandre Peltier ◽  
Fouad Aoun ◽  
Fouad El-Khoury ◽  
Eric Hawaux ◽  
Ksenija Limani ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Detection ◽  
Prostate Biopsy ◽  
Detection Rate ◽  
Transrectal Ultrasound ◽  
Daily Practice ◽  
Cancer Detection Rate ◽  
Prior History ◽  
Detection Rates ◽  
Significant Difference

Objectives. To compare prostate cancer detection rates of extended 2D versus 3D biopsies and to further assess the clinical impact of this method in day-to-day practice.Methods. We analyzed the data of a cohort of 220 consecutive patients with no prior history of prostate cancer who underwent an initial prostate biopsy in daily practice due to an abnormal PSA and/or DRE using, respectively, the classical 2D and the new 3D systems. All the biopsies were done by a single experienced operator using the same standardized protocol.Results. There was no significant difference in terms of age, total PSA, or prostate volume between the two groups. However, cancer detection rate was significantly higher using the 3D versus the 2D system, 50% versus 34% (P<0.05). There was no statistically significant difference while comparing the 2 groups in term of nonsignificant cancer detection.Conclusion. There is reasonable evidence demonstrating the superiority of the 3D-guided biopsies in detecting prostate cancers that would have been missed using the 2D extended protocol.

scholarly journals C-reactive protein/albumin ratio as a predictor of 28 day mortality in patients with sepsis

2020 ◽  
Vol 8 (2) ◽  
pp. 503
Author(s):  
Hamsa B. T. ◽  
Srinivasa S. V. ◽  
Raveesha A.
Keyword(s):  
Inotropic Support ◽  
Secondary Outcome ◽  
P Value ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Reactive Protein ◽  
Significant Difference ◽  
Life Threatening ◽  
Sepsis And Septic Shock ◽  
A Prospective Study

Background: Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Sepsis remains a major cause of morbidity and mortality worldwide. Important biomarkers that can be used as prognostic markers in sepsis are C Reactive Protein (CRP) and serum Albumin levels. CRP levels markedly elevate in response to infection whereas albumin levels decrease in response to acute phase infection. We want to ascertain the value of CRP/albumin ratio as an independent predictor of 28-day mortality in sepsis patients.Methods: A prospective study was conducted including 150 patients satisfying the criteria for sepsis according to SOFA score of more than 2. Initial CRP/Albumin ratio was assessed to determine its significance in assessing the 28-day mortality, primary end point of our study. Secondary end points assessed were length of ICU stay, need for inotropic support, need for ventilator support and renal replacement therapy.Results: In the analysis of CRP/Albumin ratio as a predictor of 28-day mortality, patients were followed up from day of admission till 28 days to assess primary outcome. Among study subjects survivors were 92 in whom mean CRP/ALB ratio was 0.1197 and non survivors were 58 patients with mean CRP/ALB ratio was 0.0426. p-value <0.001, there was statistically significant difference found between survivor and Non-Survivor with respect to CRP/Albumin ratio. In assessing secondary outcome statistically significant association was found for need for ventilator and inotropic support, whereas it was insignificant in assessing need for dialysis and length of ICU stay.Conclusions: CRP/albumin ratio, which indicates the extent of residual inflammation, could be used as a prognostic marker in predicting mortality in patients with sepsis and septic shock.

scholarly journals Virtual embryoscope for detection of structural abnormalities in first trimester pregnancy

2017 ◽  
Vol 6 (5) ◽  
pp. 1924
Author(s):  
Sumesh Choudhary ◽  
Vineet Mishra ◽  
Rohina Aggarwal
Keyword(s):  
First Trimester ◽  
3D Ultrasound ◽  
P Value ◽  
Detection Rates ◽  
Significant Difference ◽  
Structural Abnormalities ◽  
Innovative Tool ◽  
2D Ultrasound ◽  
Additional Value ◽  
A Prospective Study

Background: To determine whether there is an additional value of virtual embryoscopy with 3Dimensional (3D) ultrasound above (2D) ultrasound regarding detection rates of structural abnormalities in first trimester pregnancy.Methods: This was a prospective study consisting of 52 pregnant women with gestational age ranging from 6 to 12 weeks. 2D and 3D ultrasound scan was performed using GE voluson E8 transvaginal probe. All scans were evaluated by ten gynecologists trained in USG. The observations were noted and compared for anatomical details and detection of structural defects.Results: It was found that images were seen well with 3D (virtual embryoscope). i.e. maximum count 19 in the table and there is statistically significant difference between 3D and 2D images with a p-value <0.01 at 95% confidence interval (CI).Conclusions: Virtual embryoscope is an innovative tool for evaluation of developing embryo and early foetal morphology. The advantages are the ability to reconstruct 3D images with the stored scanned volume and examine without having to rescan the patient.

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