Gleason grading of prostate cancer in needle biopsies or radical prostatectomy specimens: contemporary approach, current clinical significance and sources of pathology discrepancies

Montironi, Rodolfo; Mazzuccheli, Roberta; Scarpelli, Marina; López-Beltrán, Antonio; Fellegara, Giovanni; Algaba, Ferrán

doi:10.1111/j.1464-410x.2005.05540.x

Cited by 114 publications

(105 citation statements)

References 50 publications

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“…Indeed, tumors of higher Gleason grade appear to have increased cellular density (24), which will likely result in lower ADC values. Higher-grade tumors also have fewer ducts, and since Noworolski et al (34) suggested that combined DW-and DCE-MRI can distinguish between highly ductal and less ductal tissues within the prostate (34), one would expect this technique to improve tumor grading.…”

Section: Discussionmentioning

confidence: 99%

“…The amount of carcinoma in the tissue section, by surface area, was microscopically semiquantitatively scored as follows: 0 ϭ no carcinoma; 1 ϭ Ͻ10% carcinoma; 2 ϭ 10 -25% carcinoma; 3 ϭ 25-75% carcinoma; and 4 ϭ Ͼ75% carcinoma. In addition, tumors identified with both biopsies and radical prostatectomy were assigned a Gleason score (24).…”

Section: Patient Selection and Histologymentioning

confidence: 99%

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Combined diffusion‐weighted and dynamic contrast‐enhanced MRI for prostate cancer diagnosis—Correlation with biopsy and histopathology

Kozłowski

Chang

Jones

et al. 2006

Magnetic Resonance Imaging

245

192

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Purpose:To determine whether the combination of diffusion-weighted (DW) and dynamic contrast-enhanced (DCE) MRI provides higher diagnostic sensitivity for prostate cancer than each technique alone. Materials and Methods:Fourteen patients with a clinical suspicion of prostate cancer underwent endorectal MRI on a 1.5T scanner prior to transrectal ultrasound (TRUS)-guided biopsies. The average values of the apparent diffusion coefficient (ADC, calculated from b-values of 0 and 600), K trans , v e , maximum gadolinium (Gd) concentration, onset time, mean gradient, and maximum enhancement were determined. Correlation with histology was based on biopsy (six patients) and prostatectomy specimen (eight patients) results. The Tukey-Kramer test was used for statistical analysis. Results:The average values of all MRI parameters, except v e and maximum Gd concentration, showed significant differences between tumor and normal prostate. The sensitivity and specificity values were respectively 54% (35-72%) and 100% (95-100%) for the ADC data, and 59% (39 -77%) and 74% (63-83%) for the DCE data. When both ADC and DCE results were combined, the sensitivity increased to 87% (68 -95%) and specificity decreased to 74% (62-83%). Conclusion:All but two DW-and DCE-MRI parameters showed significant differences between tumor and normal prostate. Combining both techniques provides better sensitivity, with a small decrease in specificity.

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Section: Discussionmentioning

confidence: 99%

Section: Patient Selection and Histologymentioning

confidence: 99%

Combined diffusion‐weighted and dynamic contrast‐enhanced MRI for prostate cancer diagnosis—Correlation with biopsy and histopathology

Kozłowski

Chang

Jones

et al. 2006

Magnetic Resonance Imaging

245

192

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“…Cancer grade is a key feature used to predict patient prognosis and in prescribing a treatment. Manual grading is time consuming and on account of its qualitative nature can lead to inter-and intra-observer variability [2], leading in turn to variable prognosis and suboptimal treatment.…”

Section: Introductionmentioning

confidence: 99%

Automated gland and nuclei segmentation for grading of prostate and breast cancer histopathology

Naik

Doyle

Agner

et al. 2008

2008 5th IEEE International Symposium on Biomedical Imaging: From Nano to Macro

261

176

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Automated detection and segmentation of nuclear and glandular structures is critical for classification and grading of prostate and breast cancer histopathology. In this paper, we present a methodology for automated detection and segmentation of structures of interest in digitized histopathology images. The scheme integrates image information from across three different scales: (1) lowlevel information based on pixel values, (2) high-level information based on relationships between pixels for object detection, and (3) domain-specific information based on relationships between histological structures. Low-level information is utilized by a Bayesian classifier to generate a likelihood that each pixel belongs to an object of interest. High-level information is extracted in two ways: (i) by a level-set algorithm, where a contour is evolved in the likelihood scenes generated by the Bayesian classifier to identify object boundaries, and (ii) by a template matching algorithm, where shape models are used to identify glands and nuclei from the low-level likelihood scenes. Structural constraints are imposed via domainspecific knowledge in order to verify whether the detected objects do indeed belong to structures of interest. In this paper we demonstrate the utility of our glandular and nuclear segmentation algorithm in accurate extraction of various morphological and nuclear features for automated grading of (a) prostate cancer, (b) breast cancer, and (c) distinguishing between cancerous and benign breast histology specimens. The efficacy of our segmentation algorithm is evaluated by comparing breast and prostate cancer grading and benign vs. cancer discrimination accuracies with corresponding accuracies obtained via manual detection and segmentation of glands and nuclei.

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“…11 Inal and colleagues 12 reported a better histological quality sampling using a 16G needle to perform transrectal prostate biopsy and McCormack and colleagues 5 recently showed that the 16G needle does not increase prostate cancer detection. The goal of this study was to evaluate whether using a larger needle, 16G, to perform a prostate biopsy might increase the concordance between clinical and pathological GS.…”

Section: Discussionmentioning

confidence: 99%

“…Although undergrading biopsy GS is the most common problem, 11 overgrading biopsy GS may also occur; we did not evaluate this issue for 2 reasons. The first reason is that we did not consider biopsy GS less than 6 because it is generally considered the cutoff for low-dying risk from prostate cancer 15,16 and because Gleason pattern one and two are usually rare and seen in the transition zone, so it is unlikely to find a biopsy GS less than 6.…”

Section: Discussionmentioning

confidence: 99%

Needle biopsy size and pathological Gleason Score diagnosis: No evidence for a link

Cicione

Cantiello

Nunzio³

et al. 2013

CUAJ

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Background: Biopsy Gleason score (GS), in combination with other clinical parameters, is important to take a therapeutic decision for patients with diagnosis of localized prostate cancer. However, preoperative GS is often upgraded after a radical prostatectomy. Increasing the amount of tissue in prostate biopsy may be a way to avoid this issue. We evaluate the influence of a larger biopsy needle size on the concordance between biopsy and pathological GS. Methods: We analyzed paired biopsies and prostatectomy specimens from 104 cases of men with clinically localized prostate cancer. At the time of prostate biopsy, the patients were prospectively randomized into two needle groups (16-Gauge [G] and 18G) using a 1:1 ratio. GS concordance was estimated performing kappa statistic testing, overall concordance rate and risk to under grade biopsy GS=6. A logistic regression analysis was performed to evaluate the patients' characteristics as possible risk factors. Results: The overall concordance between prostate biopsy and pathological GS was 76.9% and 75.6% (p = 0.875) and the k values were 0.821 and 0.811 (p = 0.424), respectively, for 16G and 18G needle study groups. The risk to undergrade a biopsy GS=6 was 21.1% and 15.4% (p = 0.709) using a 16G and 18G needle, respectively. Age, prostate-specific antigen, prostate volume and needle calibre were not independently associated with a higher risk of GS discordance. Conclusions: Needle size does not affect the concordance between biopsy and pathological GS. Although GS is not the only way to determine treatment, it is still an unresolved urological issue.

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Gleason grading of prostate cancer in needle biopsies or radical prostatectomy specimens: contemporary approach, current clinical significance and sources of pathology discrepancies

Cited by 114 publications

References 50 publications

Combined diffusion‐weighted and dynamic contrast‐enhanced MRI for prostate cancer diagnosis—Correlation with biopsy and histopathology

Combined diffusion‐weighted and dynamic contrast‐enhanced MRI for prostate cancer diagnosis—Correlation with biopsy and histopathology

Automated gland and nuclei segmentation for grading of prostate and breast cancer histopathology

Needle biopsy size and pathological Gleason Score diagnosis: No evidence for a link

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