Effects of Post Biopsy Digital Rectal Compression on Improving Prostate Cancer Staging Using Magnetic Resonance Imaging in Localized Prostate Cancer

Abstract

PurposeTo evaluate the effectiveness of digital rectal-compression immediately after transrectal prostate biopsy (P-bx) for improving the accuracy of prostate cancer (PCa) staging.Materials and MethodsBetween July 2008 and June 2010, 94 consecutive patients who had a radical prostatectomy were included in our retrospective analysis. The exclusion criteria included a history of previous P-bx and surgery, a biopsy performed in another hospital, a number of biopsy cores different from 12, or a condition interfering with bleeding assessment. The subjects were divided into two groups, compression and non-compression. All enrolled patients took magnetic resonance imaging (MRI) for PCa staging.ResultsThe compression and non-compression groups were comparable with respect to several baseline characteristics. However, the total hemorrhage score of intraprostatic bleeding was significantly different between the groups, even with adjustment for the time from biopsy to MRI (compression:15.4±2.32, non-compression: 24.9±2.43, p<0.001). The intra-prostatic cancer location matching rate was higher in the compression group (78.0%) than in the non-compression group (70.2%) (p=0.011). Overall accuracy of staging in compression and non-compression groups was 84.7% and 77.3%, respectively.ConclusionOur results demonstrate that digital rectal compression performed immediately after prostate biopsy to reduce intraprostatic hemorrhage improves the accuracy for detection of PCa using MRI.

Robotic Mechanical Localization of Prostate Cancer Correlates with Magnetic Resonance Imaging Scans

“…It has been shown that the suspicious areas on magnetic resonance imaging (MRI) scans correlate well with location of malignant lesions in post-radical prostatectomy pathological specimens 7,9. In our present study, we aim to evaluate the correlation of the tissue mapping from our robotic indentation system with suspicious areas suggestive of malignancy on MRI scans.…”

“…Technological advancement had led to mechanical systems providing tactile and kinesthetic feedback to the operator 7. Ahn, et al8 reported differences in the mean elastic modulus of regions containing cancer and normal prostate tissues, using a motorized indenter in ex vivo experiments.…”

The clinical value of dynamic contrast-enhanced magnetic resonance imaging at 3.0T to detect prostate cancer

“…T 2 -weighted imaging (T 2 WI), in which tumour tissue appears hypointense relative to the normal peripheral tissue, 2 has been used for morphological prostate tumour detection and localization, but the specificity of T 2 WI is low because benign prostatic hyperplasia, prostatitis, fibrosis and postbiopsy haemorrhage also cause T 2 hypointensities. [3][4][5] In addition, some prostate tumours appear normal on T 2 WI, leading to low sensitivity of this method. 6,7 Functional MR techniques (such as dynamic contrast-enhanced MRI [DCE-MRI], diffusion-weighted imaging [DWI], and magnetic resonance spectroscopy [MRS]) have been used to increase the diagnostic accuracy of MR in prostate cancer.…”