This study aimed to evaluate the learning curve of transperineal magnetic resonance imaging (MRI)/ultrasound (US) fusion biopsy in a team composed of a single surgeon, a single radiologist, and a single pathologist. We prospectively enrolled 206 patients undergoing MRI/US fusion prostate biopsy and divided them into four cohorts by the year of biopsy. We analyzed temporal changes in clinically significant prostate cancer (csPC) detection rate, percentage of positive cores on biopsy, and Gleason upgrading rate after radical prostatectomy. The csPC detection rate by MRI/US fusion targeted biopsy (TB) increased significantly (from 35.3% to 60.0%, p = 0.01). With increased experience, the csPC detection rates for small (≤1 cm) and anterior target lesions gradually increased (from 41.2% to 51.6%, p = 0.5; from 54.5% to 88.2%, p = 0.8, respectively). The percentage of positive cores on TB increased significantly (from 18.4% to 44.2%, p = 0.001). The Gleason upgrading rate gradually decreased (from 22.2% to 11.1%, p = 0.4). In conclusion, with accumulated experience and teamwork, the csPC detection rate by TB significantly increased. Multidisciplinary team meetings and a free-hand biopsy technique were the key factors for overcoming the learning curve.

<p>A unified geodetic data-based earthquake catalog may provide the asperity information to improve the seismic hazard assessment. Therefore, we propose a unified geodetic data-based earthquake catalog in Taiwan from 2006-2018 using the geodetic data from 333 campaign-mode GNSS stations and 19 precise leveling routes and the published continuous GNSS data to improve the spatial resolution and reliability of vertical component in coseismic displacement fields. The coordinate time series analysis was used to derive the coseismic displacements of each earthquake from the sGNSS and precise leveling data by using the least square method. This earthquake catalog involves 2006 M<sub>L</sub> 7.0 Pingtung offshore earthquake, 2010 M<sub>L</sub> 6.4 Jiashian earthquake, March 2013 M<sub>L</sub> 6.2 Nantou earthquake, June 2013 M<sub>L</sub> 6.5 Nantou earthquake, 2013 M<sub>L</sub> 6.4 Ruisui earthquake, 2016 M<sub>L</sub> 6.6 Meinong earthquake, and 2018 M<sub>L</sub> 6.2 Hualien earthquake. Then the coseismic source models of these events were evaluated by inverting the coseismic displacement fields. Based on this earthquake catalog, we provided high spatial resolution and precision in the vertical deformation and the resolution of the modeled fault dip angle is also improved. In addition, unknown coseismically reactivated anticlinal structures in SW Taiwan were discovered in this study, which may be associated with the active mud diapirs. Finally, because of abundant coseismic geodetic data adopted in this study, the spatial resolution of coseismic slip distribution is also increased in those earthquake events.</p>

The effectiveness of radical prostatectomy alone for locally advanced prostate cancer is controversial owing to an increased complication rate and treatment-related morbidity. With technical advances and refinements in surgical techniques, robotic-assisted radical prostatectomy (RARP) has improved the outcomes of patients with locally advanced prostate cancer. RARP therefore plays a role in the treatment of locally advanced prostate cancer. In this study, we enrolled a total of 76 patients with pathologic stage pT3a, pT3b, pT4, or pN1. All patients were followed from surgery to June 2022, and their characteristics, perioperative outcomes, complications, adjuvant therapies and outcomes were analyzed. The median age of the patients was 69 years, and the initial PSA level was 20.5 (IQR 10.8–31.6) ng/mL. The median operative time was 205 (IQR 182–241) minutes. Sixty-six patients (86.8%) regained continence within 1 year, and the continence rate within 3 years of follow-up was 90.8% (69 patients). The overall survival rate was 100%. Twenty-two patients had BCR, of whom 13 received salvage androgen deprivation therapy (ADT), 2 received salvage external beam radiation therapy (EBRT) alone, and 7 received combined ADT and EBRT. No patient had disease progression to castration-resistant prostate cancer during a median 36 months of follow-up after salvage therapy. Our results suggest that RARP can also decrease tumor burden and allow for accurate and precise pathological staging with the need for subsequent treatment. Therefore, we recommend that RARP represents a well-standardized, safe, and oncologically effective option for patients with locally advanced prostate cancer.