Impact of magnetic resonance imaging-guided prostate biopsy in the supine position on the detection of significant prostate cancer in an inhomogeneous patient cohort

Engelhard, Karl; Kühn, Reinhart; Osten, Artur; Bogner, Katja; Dworak, Anton; Lübke, Lars; Schneider, Florian

doi:10.3109/21681805.2015.1103782

Cited by 5 publications

(8 citation statements)

References 22 publications

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“…Thompson and colleagues (2016) found that when PIRADS score was used for predicting CSPCa, mp-MRI had sensitivity, specificity, PPV and NPV of 96%, 36%, 52% and 92%, respectively [16]. A very recent study revealed that in patients with PSA between 4 and 10 ng/mL, a PIRADS score ≥ 4 was the cut-off for predicting CSPCa [18, 20].…”

Section: Discussionmentioning

confidence: 99%

“…The PIRADS is mainly designed to improve detection, localization, characterization and risk stratification in patients with suspected CSPCa and its categories are based on the findings of mp-MRI (a combination of T2-weighted (T2W), diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) imaging). The PIRADS assesses the probability of finding CSPCa on a five-point Likert scale for each lesion [16-18]: PIRADS 1, very low (clinically significant cancer is highly unlikely to be present); PIRADS 2, low (clinically significant cancer is unlikely to be present); PIRADS 3, intermediate (the presence of clinically significant cancer is equivocal); PIRADS 4, high (clinically significant cancer is likely to be present); PIRADS 5, very high (clinically significant cancer is highly likely to be present). PIRADS scores 1 and 2 are considered as negative test and PIRADS scores 4 and 5 are considered as positive test.…”

Section: Methodsmentioning

confidence: 99%

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Combining Prostate-Specific Antigen Parameters With Prostate Imaging Reporting and Data System Score Version 2.0 to Improve Its Diagnostic Accuracy

et al. 2019

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BackgroundAny non-invasive test that can predict the absence of prostate cancer (PCa) or absence of clinically significant PCa (CSPCa) is necessary, as it can reduce the number of unnecessary biopsies in patients with gray zone prostate-specific antigen (PSA, 4 - 10 ng/mL). This study evaluated the diagnostic performance of free PSA% and PSA density (PSAD), and Prostate Imaging Reporting and Data System (PIRADS) score (version 2.0) alone and combined in predicting CSPCa in patients with PSA between 4 and 10 ng/mL.MethodsThis prospective study included a total of 104 consecutive patients with lower urinary tract symptoms (LUTS) and serum PSA between 4 and 10 ng/mL, with or without abnormal digital rectal examination (DRE) findings or any hypoechoic lesion on ultrasound sonography of prostate and without prior transrectal ultrasound (TRUS) biopsy of prostate. PIRADS score was calculated using multi-parametric magnetic resonance imaging (mp-MRI) before TRUS biopsy of prostate. Relationships among PIRADS score, PSAD, free PSA% and presence of CSPCa in TRUS biopsy were statistically analyzed.ResultsIn patients with CSPCa, significantly higher median age (P = 0.001), PSA level (P < 0.001), PSAD (P < 0.001) and significantly lower prostate volume (P < 0.001) and free PSA% were observed as compared to patients with non-CSPCa. Significantly higher proportion of patients with CSPCa showed PIRADS positive test compared to those with non-CSPCa (86.4% vs. 53.3%, P < 0.001). Cut-off values for PSAD and free PSA% were 0.12 ng/mL2 and 25%, respectively. Age, PSAD and free PSA% were significant predictors of PCa, while age and PSAD were significant predictors of CSPCa. Criteria 2, 3 and 4 demonstrated higher specificity and positive predictive value (PPV) in predicting CSPCa as compared to criterion 1. The overall accuracies of criterion 1, 2, 3 and 4 were 64.42%, 85.58%, 80.77% and 79.81%, respectively. The area under the curve (AUC) values of criterion 2, 3 and 4 were higher (0.827, 0.732 and 0.792) than criterion 1 (0.665).ConclusionUsing PIRADS score for predicting CSPCa as a screening test, criteria 2, 3 and 4 have much higher diagnostic performance and present accuracy of mp-MRI to predict CSPCa can be increased with addition of PSAD and free PSA%.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Combining Prostate-Specific Antigen Parameters With Prostate Imaging Reporting and Data System Score Version 2.0 to Improve Its Diagnostic Accuracy

et al. 2019

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“…A recent study evocated the benefit of a TRUS-MRI fusion platform that corrects for deformation on ultrasound due to the probe insertion, as compared to "cognitive registration" 55 . Such implementation could also be used for in MR bore biopsy procedure 56 . Using longitudinal coregistration, one could consistently re-visit the same gland location 57 , without limitations of implantable/imageable pellets proposed recently by Ghai et Tranchtenberg 58 .…”

Section: Discussionmentioning

confidence: 99%

3D Registration of mpMRI for Assessment of Prostate Cancer Focal Therapy

et al. 2017

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Purpose To assess a novel method of 3D co-registration of prostate MRI exams performed before and after prostate cancer focal therapy. Material and method We developed a software platform for automatic 3D deformable coregistration of prostate MRI at different time points and applied this method to ten patients who underwent focal ablative therapy. MRI exams were performed preoperatively, as well as one week and six months posttreatment. Rigid registration served as reference for assessing coregistration accuracy and precision. Results Segmentation of preoperative and postoperative prostate revealed a significant post-operative volume decrease of the gland that averaged 6.49 cc (p=0.017). Applying deformable transformation based upon Mutual Information (MI) from 120 pairs of MRI slices, we refined by 2.9 mm (max 6.25mm) the alignment of the ablation zone (AZ), segmented from contrastenhanced images on the one-week post-operative exam, to the 6-month postoperative T2-weighted images. This represented a 500% improvement over the rigid approach (p=0.001), corrected by volume. The dissimilarity by Dice index of the mapped AZ using deformable transformation vs. rigid control was significantly (p=0.04) higher at the ablation site compared to the whole gland. Conclusion Our findings illustrate our method's ability to correct for deformation at the ablation site. The preliminary analysis suggests that deformable transformation computed from MI of preoperative and follow-up MRI is accurate in co-registration of MRI exams performed before and after focal therapy. The ability to localize the previously ablated tissue in 3D space may improve targeting for image-guided follow-up biopsy within focal therapy protocols.

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“…PCR products (500 ng/µl) 10 µl were mixed with sample buffer and separated by 0.8% agarose gel electrophoresis at 80 mV for 15 min. The electrophoresis gel was stained by ethidium bromide and analyzed using a gel imaging system (26).…”

Section: Clinical Study Of Prenatal Ultrasonography Combined With T-bmentioning

confidence: 99%

Clinical study of prenatal ultrasonography combined with T‑box transcription factor 1 as a biomarker for the diagnosis of congenital heart disease

Guo¹,

Xiao²,

Li³

et al. 2018

Mol Med Report

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Congenital heart disease (CHD) seriously threatens fetal health. Therefore, prenatal examination to detect deformity is extremely important. The present study aimed to investigate the clinical application value of prenatal ultrasonography combined with molecular biology methods in the diagnosis of fetal CHD. A total of 1,000 pregnant women who had received fetal ultrasonography to examine fetal CHD were enrolled. Ultrasounds were performed for fetal heart examination and diagnosis, mainly on fetal heart position, size, structure and function, and heart valve morphology and function. These indexes were tested again 2 weeks after birth. Blood samples were collected from pregnant women with fetal CHD. Polymerase chain reaction (PCR) and western blotting were performed to detect the association between heart development and T‑box transcription factor 1 (TBX1) expression. The results revealed that 10 fetuses had CHD (1%), of which ultrasound detected 9 cases. The specificity and sensitivity of ultrasounds were 100 and 90%, respectively. Of the 9 cases were identified by prenatal ultrasound screening, including 2 cases had endocardial cushion defect, 1 case had pulmonary stenosis combined with right ventricular dysplasia, 1 case had tetralogy of Fallot combined with a cleft lip and palate, 2 cases had ventricular septal defect, 1 case had a single ventricle defect, 1 case had Ebstein and 1 case had a triatrial heart. One case of ventricular septal defect was missed prior to delivery. PCR and western blotting demonstrated that TBX1 expression may be associated with CHD. Therefore, ultrasonography combined with laboratory examinations represent efficient, economic and safe methods for fetal CHD detection. These methods may be significant to improve the rate of CHD diagnosis, and require further investigation.

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Impact of magnetic resonance imaging-guided prostate biopsy in the supine position on the detection of significant prostate cancer in an inhomogeneous patient cohort

Abstract: MRGB in the supine position can be a valuable tool to detect significant prostate cancer, even in a patient cohort with different prebiopsy pathways. The biopsy method could be a reasonable alternative to MRGB in the prone position.

Cited by 5 publications

References 22 publications

Combining Prostate-Specific Antigen Parameters With Prostate Imaging Reporting and Data System Score Version 2.0 to Improve Its Diagnostic Accuracy

Combining Prostate-Specific Antigen Parameters With Prostate Imaging Reporting and Data System Score Version 2.0 to Improve Its Diagnostic Accuracy

3D Registration of mpMRI for Assessment of Prostate Cancer Focal Therapy

Clinical study of prenatal ultrasonography combined with T‑box transcription factor 1 as a biomarker for the diagnosis of congenital heart disease

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