scholarly journals Quantitative measurements of prostatic zones by MRI and their dependence on prostate size: possible clinical implications in prostate cancer

2021 ◽  
Vol 13 ◽  
pp. 175628722110008
Author(s):  
Jake Sellers ◽  
Rachel G. Wagstaff ◽  
Naseem Helo ◽  
Werner T. W. de Riese
Keyword(s):  
Prostate Cancer ◽  
Inverse Correlation ◽  
Peripheral Zone ◽  
Causal Link ◽  
Glandular Tissue ◽  
Benign Prostate Hypertrophy ◽  
Quantitative Measurements ◽  
Mri Scans ◽  
Male Patients ◽  
Magnetic Resonance Imaging Mri

Aim: Many studies support an inverse relationship between benign prostate hypertrophy (BPH) size and incidence of prostate cancer (PCa), but the causal link between these conditions is poorly understood. Recent studies suggest that a growing transition zone (TZ) in the prostate may induce pressure on the outer peripheral zone (PZ), leading to atrophy of the glandular tissue where PCa often originates, providing a possible explanation for this interaction. To further investigate this phenomenon, our pilot study uses magnetic resonance imaging (MRI) to examine quantitative zonal changes in a consecutive cohort of prostates. Methods: MRI scans of male patients [ n = 204, 61.57 ± 13.90 years, average body mass index (BMI) 29.05 kg/m2] with various prostate sizes were analyzed statistically to identify possible associations between prostate parameters, such as total prostate volume (TPV) and peripheral zone thickness (PZT). Results: TPV and PZT demonstrated a weak, inverse correlation ( r = −0.21, p = 0.002). However, when examining the plotted data, the relationship between TPV and PZT was significantly different when the cohort was divided into two groups; lower TPV: ⩽87.5 ml ( n = 188, TPV xˉ = 36.01 ± 18.18 ml), and higher TPV: >87.5 ml ( n = 17, TPV xˉ = 125.69 ± 41.13 ml). Average PZT differed significantly between these groups (z = −3.5554, p = 0.0004). Conclusions: PZT was significantly different for patients with lower versus higher TPVs, suggesting that, above a certain point of BPH growth, the PZ is unable to withstand pressure from an expanding TZ, supporting the notion that growing BPH causes compression of the PZ glandular tissue, and, therefore, BPH may be protective against PCa.

scholarly journals D-dimer in the Diagnosis of Prostate Cancer

2021 ◽  
Author(s):  
Hasan Salih Sağlam ◽  
Hacı Bayram Çimen
Keyword(s):  
Prostate Cancer ◽  
Metastatic Prostate Cancer ◽  
Benign Prostate Hyperplasia ◽  
Specific Antigen ◽  
Prostate Hyperplasia ◽  
Mri Scans ◽  
Male Patients ◽  
Magnetic Resonance Imaging Mri ◽  
Benign Prostate ◽  
D Dimer

Objective: To investigate the value of D-dimer, a marker of fibrinolysis, in metastatic and non-metastatic prostate cancer. Materials and Methods: A retrospective analysis was performed on 138 male patients including 52 patients with prostate cancer and 86 with benign prostatic hyperplasia. Participants who had factors that altered D-dimer levels were excluded. The mean ages of the groups were similar (70 ± 8 vs 68 ± 8, p= NS). In addition, data regarding biochemical findings, prostate-specific antigen and hemostatic markers, including D-dimer, were retrieved from the database of our hospital. The cut-off point of D-dimer was 0.5 mg/L. Data from scintigraphy and magnetic resonance imaging (MRI) scans related to metastasis were also considered. Patients who showed findings of metastasis according to scintigraphy and lumbosacral MRI were accepted as having metastases. Positive findings in only scintigraphy in any area were considered suspicious for metastasis. Results: Patients with prostate cancer had higher D-dimer levels than benign prostate hyperplasia patients (p= 0.024). Sixteen patients with metastatic prostate cancer and suspicious for metastasis had markedly high D-dimer levels compared to benign prostate hyperplasia and non-metastatic prostate cancer patients.

scholarly journals Correlation between Intraprostatic PSMA Uptake and MRI PI-RADS of [68Ga]Ga-PSMA-11 PET/MRI in Patients with Prostate Cancer: Comparison of PI-RADS Version 2.0 and PI-RADS Version 2.1

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3523
Author(s):  
Jing Zhao ◽  
Dilyana B. Mangarova ◽  
Julia Brangsch ◽  
Avan Kader ◽  
Bernd Hamm ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Peripheral Zone ◽  
Transitional Zone ◽  
Regions Of Interest ◽  
Resonance Imaging ◽  
Standardized Uptake Values ◽  
Kappa Value ◽  
Version 2.0 ◽  
The Difference ◽  
Magnetic Resonance Imaging Mri

Purpose: We aimed to evaluate the correlation between PSMA uptake and magnetic resonance imaging (MRI) PI-RADS of simultaneous [68Ga]Ga-PSMA-11 PET/MRI regarding PI-RADS version 2.0 and 2.1 respectively and compared the difference between these two versions. Materials and Methods: We retrospectively analyzed a total of forty-six patients with biopsy-proven prostate cancer who underwent simultaneous [68Ga]Ga-PSMA-11 PET/MRI. We classified the lesions regarding PI-RADS version 2.0 and 2.1, peripheral zone (PZ), and transitional zone (TZ), respectively. Based on regions of interest (ROI), standardized uptake values maximum (SUVmax), and corresponding lesion-to-background ratios (LBR) of SUVmax of each category, PI-RADS score 1 to 5, were measured. A comparison between PI-RADS version 2.0 and PI-RADS version 2.1 was performed. Results: A total of 215 focal prostate lesions were analyzed, including two subgroups, 125 TZ and 90 PZ. Data are reported as median and interquartile range (IQR). Regarding PI-RADS version 2.1, TZ SUVmax of each category were 1.5 (0.5, 1.9), 1.9 (0.8, 2.3), 3.3 (2.1, 4.6), 4.2 (3.1, 5.7), 7.3 (5.2, 9.7). PZ SUVmax of each category were 1.0 (0.8, 1.6), 2.5 (1.5, 3.2), 3.3 (1.9, 4.5), 4.3 (3.0, 5.4), 7.4 (5.0, 9.3). Regarding the inter-reader agreement of the overall PI-RADS assessment category, the kappa value was 0.723 for version 2.0 and 0.853 for version 2.1. Conclusion: Revisions of PI-RADS version 2.1 results in variations in lesions classification. Lesions with the PI-RADS category of 3, 4, and 5 present relatively higher intraprostatic PSMA uptake, while lesions with the PI-RADS category of 1 and 2 present relatively lower and similar uptake. Version 2.1 has higher inter-reader reproducibility than version 2.0.

Location of local recurrence after MRI-guided partial prostate brachytherapy targeting only the peripheral zone: Implications for focal therapy.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 149-149 ◽  
Author(s):  
Konstantin Kovtun ◽  
Tobias Penzkofer ◽  
Neha Agrawal ◽  
Tina Kapur ◽  
Andriy Fedorov ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Local Recurrence ◽  
Central Zone ◽  
Peripheral Zone ◽  
Focal Therapy ◽  
Prostate Brachytherapy ◽  
Local Recurrences ◽  
Endorectal Coil ◽  
Mri Scans ◽  
Mri Guided

149 Background: Prostate cancer local recurrences usually occur at the same site as the dominant primary tumor in patients treated with radiation therapy to the whole gland. We characterized location of local recurrences in patients who were treated with MRI Guided Partial Brachytherapy in which only the peripheral zone was targeted. Methods: We retrospectively reviewed ten patients with initial cT1c, Gleason score 3+4 or less prostate cancer who developed biopsy proven local recurrences and had available imaging after MRI Guided Partial Brachytherapy targeting the peripheral zone from 1998 to 2006. All 10 patients had 1.5T endorectal coil MRI at diagnosis, performed primarily for staging and not for tumor localization, while at recurrence 8 had 3T endorectal coil MRI and 2 had 1.5T endorectal coil MRI. Scans consisted of at least T1 and T2 sequences. Two radiologists (C.T. and T.P.) blinded to clinical data reviewed diagnosis MRI scans together and quantified likelihood of tumor on a 1 to 5 scale in each section of an eight part prostate in both pre-treatment and recurrence scans. Local recurrence was judged to be in the same location as the baseline tumor if at least 50% of the tumor location overlapped. Results: Only 3 of 10 patients had local recurrences at the same location as the baseline tumor with a mean overlap of 64%. 7 of 10 patients had local recurrences at a different location with a mean overlap of 5%. 5 of 10 patients had recurrences in the central zone of the prostate which did not definitively show tumor on review of the initial 1.5T staging scan. Conclusions: After MRI-guided brachytherapy targeting only the peripheral zone in men initially staged with 1.5T MRI, 50% of the local recurrences occurred at the non-targeted central zone, raising the possibility that focal therapy directed only at the dominant tumor will result in increased out-of-field recurrences. Whether the superior ability of modern 3T multiparametric MRI to detect and precisely localize occult prostate cancer foci will reduce this risk is the subject of current study.

scholarly journals Does urethral length affect continence outcomes following robot assisted laparoscopic radical prostatectomy (RALP)?

2019 ◽  
Author(s):  
Diwei Lin ◽  
Michael E O'Callaghan ◽  
Rowan David ◽  
Andrew Fuller ◽  
Richard Wells ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Short Form ◽  
High Volume ◽  
Urinary Continence ◽  
Resonance Imaging ◽  
Robot Assisted ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
Radiotherapy Treatment

Abstract Purpose Post-operative urinary incontinence is a significant concern for patients choosing to undergo a radical prostatectomy (RP) for treatment of prostate cancer. The aim of our study was to determine the effect of pre-operative MUL on 12 month continence outcomes in men having robot-assisted laparoscopic prostatectomy (RALP).Methods We use the South Australian Prostate Cancer Clinical Outcomes Collaborative (SA-PCCOC) database, to identify 602 patients who had undergone RALP by a high volume surgeon. Only patients who received an assessment and education by a specialist pelvic floor physiotherapist, had completed EPIC questionnaires before treatment and did not have radiotherapy treatment within 12 months of surgery were included. MUL measurements were taken from pre-operative magnetic resonance imaging (MRI) scans. The short-form version of the Expanded Prostate Cancer Index Composite (EPIC-26) was used to measure continence outcomes. Continence was defined as 100/100 in the EPIC-26 Urinary Continence domain score.Results The observed median MUL in this study was 14.6mm. There was no association between MUL and baseline continence. MUL was associated with continence at 12 months post RALP (OR 1.13, 95% CI 1.03-1.21, p=0.0098). In men who were continent before surgery, MUL was associated with return to continence at 12 months after RALP (OR 1.15, 1.05-1.28, p=0.006). MUL was also associated with change in continence after surgery (β=1.22, p=0.002).Conclusions MUL had no effect on baseline continence but had a positive and significant association with continence outcomes over 12 months post RALP.

Is There a Role for MRI in Plantar Heel Pain

2017 ◽  
Vol 11 (3) ◽  
pp. 242-245 ◽  
Author(s):  
Muhammad Ali Fazal ◽  
Demetris Tsekes ◽  
Irshad Baloch
Keyword(s):  
Plantar Fasciitis ◽  
Case Series ◽  
Heel Pain ◽  
Retrospective Case ◽  
Mri Scan ◽  
Plantar Heel Pain ◽  
Mri Features ◽  
Mri Scans ◽  
Male Patients ◽  
Magnetic Resonance Imaging Mri

Introduction. There is an increasing trend to investigate plantar heel pain with magnetic resonance imaging (MRI) scan though plantar fasciitis is the most common cause. The purpose of our study was to evaluate the role of MRI in patients presenting with plantar heel pain. Methods. Case notes and MRI scans of 141 patients with a clinical diagnosis of plantar fasciitis were reviewed retrospectively. There were 98 females and 43 males patients. Fourteen patients had bilateral symptoms. Average age for male patients was 51 years (range = 26-78 years), and for female patients the average age was 52 years (range = 29-76 years). Results. A total of 121 feet had MRI features suggestive of plantar fasciitis. MRI was normal in 32 feet. There was one case of stress fracture of calcaneus and another of a heel fibroma diagnosed on MRI scan. Conclusions. In our study, MRI scan was normal in 20.7% of the cases; 1.3% had a diagnosis other than plantar fasciitis but no sinister pathology. We therefore conclude that MRI scan is not routinely indicated and key is careful clinical assessment. Levels of Evidence: Therapeutic, Level IV: Retrospective, Case series.

scholarly journals Diagnosis and Localization of Prostate Cancer via Automated Multiparametric MRI Equipped with Artificial Intelligence

Uro ◽  
2022 ◽  
Vol 2 (1) ◽  
pp. 21-29
Author(s):  
Yuichiro Oishi ◽  
Takeya Kitta ◽  
Takahiro Osawa ◽  
Takashige Abe ◽  
Nobuo Shinohara ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Artificial Intelligence ◽  
Radical Prostatectomy ◽  
Roc Curve ◽  
Texture Features ◽  
Peripheral Zone ◽  
Multiparametric Mri ◽  
Shape Estimation ◽  
Chi Square ◽  
Mri Scans

Prostate MRI scans for pre-biopsied patients are important. However, fewer radiologists are available for MRI diagnoses, which requires multi-sequential interpretations of multi-slice images. To reduce such a burden, artificial intelligence (AI)-based, computer-aided diagnosis is expected to be a critical technology. We present an AI-based method for pinpointing prostate cancer location and determining tumor morphology using multiparametric MRI. The study enrolled 15 patients who underwent radical prostatectomy between April 2008 and August 2017 at our institution. We labeled the cancer area on the peripheral zone on MR images, comparing MRI with histopathological mapping of radical prostatectomy specimens. Likelihood maps were drawn, and tumors were divided into morphologically distinct regions using the superpixel method. Likelihood maps consisted of pixels, which utilize the cancer likelihood value computed from the T2-weighted, apparent diffusion coefficient, and diffusion-weighted MRI-based texture features. Cancer location was determined based on the likelihood maps. We evaluated the diagnostic performance by the area under the receiver operating characteristic (ROC) curve according to the Chi-square test. The area under the ROC curve was 0.985. Sensitivity and specificity for our approach were 0.875 and 0.961 (p < 0.01), respectively. Our AI-based procedures were successfully applied to automated prostate cancer localization and shape estimation using multiparametric MRI.

scholarly journals Does urethral length affect continence outcomes following robot assisted laparoscopic radical prostatectomy (RALP)?

2020 ◽  
Author(s):  
Diwei Lin ◽  
Michael E O'Callaghan ◽  
Rowan David ◽  
Andrew Fuller ◽  
Richard Wells ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Short Form ◽  
High Volume ◽  
Urinary Continence ◽  
Resonance Imaging ◽  
Robot Assisted ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
Radiotherapy Treatment

Abstract Background: Post-operative urinary incontinence is a significant concern for patients choosing to undergo a radical prostatectomy (RP) for treatment of prostate cancer. The aim of our study was to determine the effect of pre-operative MUL on 12 month continence outcomes in men having robot-assisted laparoscopic prostatectomy (RALP). Methods: We use the South Australian Prostate Cancer Clinical Outcomes Collaborative (SA-PCCOC) database, to identify 602 patients who had undergone RALP by a high volume surgeon. Only patients who received an assessment and education by a specialist pelvic floor physiotherapist, had completed EPIC questionnaires before treatment and did not have radiotherapy treatment within 12 months of surgery were included. MUL measurements were taken from pre-operative magnetic resonance imaging (MRI) scans. The short-form version of the Expanded Prostate Cancer Index Composite (EPIC-26) was used to measure continence outcomes. Continence was defined as 100/100 in the EPIC-26 Urinary Continence domain score. Results: The observed median MUL in this study was 14.6mm. There was no association between MUL and baseline continence. MUL was associated with continence at 12 months post RALP (OR 1.13, 95% CI 1.03-1.21, p=0.0098). In men who were continent before surgery, MUL was associated with return to continence at 12 months after RALP (OR 1.15, 1.05-1.28, p=0.006). MUL was also associated with change in continence after surgery (β=1.22, p=0.002). Conclusions: MUL had no effect on baseline continence but had a positive and significant association with continence outcomes over 12 months post RALP.

scholarly journals Does urethral length affect continence outcomes following robot assisted laparoscopic radical prostatectomy (RALP)?

2020 ◽  
Author(s):  
Diwei Lin ◽  
Michael E O'Callaghan ◽  
Rowan David ◽  
Andrew Fuller ◽  
Richard Wells ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Short Form ◽  
High Volume ◽  
Urinary Continence ◽  
Resonance Imaging ◽  
Robot Assisted ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
Radiotherapy Treatment

Abstract Background : Post-operative urinary incontinence is a significant concern for patients choosing to undergo a radical prostatectomy (RP) for treatment of prostate cancer. The aim of our study was to determine the effect of pre-operative MUL on 12 month continence outcomes in men having robot-assisted laparoscopic prostatectomy (RALP). Methods : We use the South Australian Prostate Cancer Clinical Outcomes Collaborative (SA-PCCOC) database, to identify 602 patients who had undergone RALP by a high volume surgeon. Only patients who received an assessment and education by a specialist pelvic floor physiotherapist, had completed EPIC questionnaires before treatment and did not have radiotherapy treatment within 12 months of surgery were included. MUL measurements were taken from pre-operative magnetic resonance imaging (MRI) scans. The short-form version of the Expanded Prostate Cancer Index Composite (EPIC-26) was used to measure continence outcomes. Continence was defined as 100/100 in the EPIC-26 Urinary Continence domain score. Results : The observed median MUL in this study was 14.6mm. There was no association between MUL and baseline continence. MUL was associated with continence at 12 months post RALP (OR 1.13, 95% CI 1.03-1.21, p=0.0098). In men who were continent before surgery, MUL was associated with return to continence at 12 months after RALP (OR 1.15, 1.05-1.28, p=0.006). MUL was also associated with change in continence after surgery (β=1.22, p=0.002). Conclusions : MUL had no effect on baseline continence but had a positive and significant association with continence outcomes over 12 months post RALP.

scholarly journals Regional medical practice variation in high-cost healthcare services

2021 ◽  
Author(s):  
Michael Berger ◽  
Thomas Czypionka
Keyword(s):  
Medical Practice ◽  
Regional Variation ◽  
Multivariate Regression ◽  
Healthcare Services ◽  
Practice Variation ◽  
District Level ◽  
Healthcare Data ◽  
Regional Medical ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri

AbstractMagnetic resonance imaging (MRI) is a popular yet cost-intensive diagnostic measure whose strengths compared to other medical imaging technologies have led to increased application. But the benefits of aggressive testing are doubtful. The comparatively high MRI usage in Austria in combination with substantial regional variation has hence become a concern for its policy makers. We use a set of routine healthcare data on outpatient MRI service consumption of Austrian patients between Q3-2015 and Q2-2016 on the district level to investigate the extent of medical practice variation in a two-step statistical analysis combining multivariate regression models and Blinder–Oaxaca decomposition. District-level MRI exam rates per 1.000 inhabitants range from 52.38 to 128.69. Controlling for a set of regional characteristics in a multivariate regression model, we identify payer autonomy in regulating access to MRI scans as the biggest contributor to regional variation. Nevertheless, the statistical decomposition highlights that more than 70% of the regional variation remains unexplained by differences between the observable district characteristics. In the absence of epidemiological explanations, the substantial regional medical practice variation calls the efficiency of resource deployment into question.

Sign in / Sign up

Export Citation Format

Share Document