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Early, noninvasive physical treatment with biofeedback and pelvic floor electrical stimulation has a significant positive impact on the early recovery of urinary continence after radical prostatectomy.

Purpose: This study aimed to prospectively analyze the role of magnetic resonance spectroscopy imaging (MRSI) and dynamic-contrast enhancement magnetic resonance (DCEMR) in the detection of prostate tumor foci in patients with persistently elevated prostate-specific antigen levels (in the range of ≥4 ng/mL to <10 ng/mL) and prior negative random trans-rectal ultrasound (TRUS)-guided biopsy.Experimental Design: This was a prospective randomized single-center study. One hundred and eighty eligible cases were included in the study. Patients in group A were submitted to a second random prostate biopsy, whereas patients in group B were submitted to a 1 H-MRSI-DCEMR examination and samples targeted on suspicious areas were associated to the random biopsy.Results: At the second biopsy, a prostate adenocarcinoma histologic diagnosis was found in 22 of 90 cases (24.4%) in group A and in 41 of 90 cases (45.5%) in group B (P = 0.01). On a patient-by-patient basis, MRSI had 92.3% sensitivity, 88.2% specificity, 85.7% positive predictive value (PPV), 93.7% negative predictive value (NPV), and 90% accuracy; DCEMR had 84.6 % sensitivity, 82.3% specificity, 78.5% PPV, 87.5% NPV, and 83.3% accuracy; and the association MRSI plus DCEMR had 92.6% sensitivity, 88.8% specificity, 88.7% PPV, 92.7% NPV, and 90.7% accuracy, for predicting prostate cancer detection.Conclusions: The combination of MRSI and DCEMR showed the potential to guide biopsy to cancer foci in patients with previously negative TRUS biopsy. To avoid a potential bias, represented from having taken more samples in group B (mean of cores, 12.17) than in group A (10 cores), in the future a MRSI/ DCEMR directed biopsy could be prospectively compared with a saturation biopsy procedure. Clin Cancer Res; 16(6); 1875-83. ©2010 AACR.At present, suspicion of prostate adenocarcinoma is mainly based on three tests: digital rectal examination, prostate-specific antigen (PSA), and trans-rectal ultrasound (TRUS), and is confirmed by TRUS-guided biopsies. The latter is recognized by urologists as the first choice in the diagnosis of prostate pathologies (1). All three modern imaging modalities, namely, computer tomography, ultrasonography, and magnetic resonance (MR), have been considered to have limitations in the diagnosis of prostate adenocarcinoma. Recently some studies (2-5) revealed the high diagnostic accuracy of combined proton 1H-magnetic resonance spectroscopic imaging (1H-MRSI) and dynamic contrast-enhanced imaging magnetic resonance (DCEMR) in the management of prostate cancer. The advantage of MRSI is that the spectroscopic analysis provides metabolic information regarding prostatic tissue by displaying the relative concentrations of chemical compounds within contiguous small volumes of interest (voxels). In the prostate the substances analyzed by MRSI are citrate, creatine, and choline. For practical purposes, prostate adenocarcinoma can be distinguished from healthy peripheral zone tissue on the basis of the (choline + creatine)/citrate ratio (5-7). Normal per...

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Introduction To obtain the best results with radical prostatectomy, either from an oncological or a functional point of view, a correct selection of cases and planning of surgery are crucial. Multiparametric magnetic resonance imaging (MRI) promises to make it a successful imaging tool for improving many aspects of prostate cancer management. Aim The aim of this study is to evaluate whether a modern multiparametric MRI can help either to better select prostate cancer cases for a nerve-sparing radical prostatectomy or to improve the functional evaluation related to neurovascular bundles preservation. Main Outcome Measures The effect of preoperative MRI on neurovascular bundle management was examined for the frequency and the appropriateness of changes of the surgical plane on the basis of MRI indications. Methods In a prospective study, 125 consecutive patients with biopsy proven prostate cancer who were scheduled to undergo bilateral nerve-sparing surgery. All patients included into the study were submitted to a preoperative multiparametric MRI. On the basis of MRI evaluation, patients were divided into two groups. Patients in group A were then submitted to a bilateral nerve-sparing (NS) radical prostatectomy (RP), whereas patients in group B were submitted to unilateral NS or non-NS RP. Results In group A, the confirmation from the MRI study to perform a bilateral NS procedure was appropriate in 70 of 73 cases (95.9%), whereas in group B, the surgical plan was appropriate in 28 of 32 cases (87.5%). On the contrary, MRI findings suggested a change in the initial surgical plan (group B) for 32 of 105 cases (30.5%). Of these 32 cases in group B, MRI suggested to perform a unilateral NS procedure in 21 of 32 cases (65.6%) and a non-NS procedure in 11 of 32 cases (34.4%). Conclusions Multiparametric MRI analysis can significantly improve the standard selection and management of prostate carcinoma cases considered for an NS RP.

A prototype version of the Q & U bolometric interferometer for cosmology (QUBIC) underwent a campaign of testing in the laboratory at Astroparticle Physics and Cosmology laboratory in Paris (APC). The detection chain is currently made of 256 NbSi transition edge sensors (TES) cooled to 320 mK. The readout system is a 128:1 time domain multiplexing scheme based on 128 SQUIDs cooled at 1 K that are controlled and amplified by a SiGe application specific integrated circuit at 40 K. We report the performance of this readout chain and the characterization of the TES. The readout system has been functionally tested and characterized in the lab and in QUBIC. The low noise amplifier demonstrated a white noise level of 0.3 nV/√Hz. Characterizations of the QUBIC detectors and readout electronics includes the measurement of I-V curves, time constant and the noise equivalent power. The QUBIC TES bolometer array has approximately 80% detectors within operational parameters. It demonstrated a thermal decoupling compatible with a phonon noise of about 5 × 10-17 W/√Hz at 410 mK critical temperature. While still limited by microphonics from the pulse tubes and noise aliasing from readout system, the instrument noise equivalent power is about 2 × 10-16 W/√Hz, enough for the demonstration of bolometric interferometry.

Abbreviations & AcronymsObjectives: To describe our 10-year experience with the use of oral ethinylestradiol in the treatment of metastatic castration-resistant prostate cancer. Methods: From February 2000 to April 2010, 116 patients with a metastatic castrationresistant prostate cancer were prospectively submitted to oral ethinylestradiol monotherapy. Inclusion criteria were: diagnosis of castration-resistant prostate cancer after failure of at least two lines of androgen deprivation therapy and radiological evidence of metastases. Exclusion criteria were: symptomatic cases with a European Cooperative Oncology Group score >2 and severe or uncontrolled cardiovascular diseases. At inclusion in the study, all patients discontinued the previous androgen deprivation therapy and started oral ethinylestradiol at the daily dose of 1 mg. Aspirin (100 mg/daily) was concomitantly given. Results: The median ethinylestradiol therapy duration was 15.9 months (range 8-36 months), whereas the median follow up of patients was 28 months (range 13-36 months). During ethinylestradiol therapy, a confirmed prostate-specific antigen response was found in 79 patients (70.5%). The median time to prostate-specific antigen progression was 15.10 months (95% confidence interval 13.24-18.76 months). A toxicity requiring treatment cessation was observed in 26 patients (23.2%) at a median time of 16 months (mainly thromboembolism). Conclusions:Our 10-year experience shows that ethinylestradiol provides a prostatespecific antigen response in a high percentage of patients with metastatic castrationresistant prostate cancer. Cardiovascular toxicity can be managed through accurate patient selection, close follow up and a concomitant anticoagulation therapy.

Purpose\ud \ud Our aim was to assess whether multiparametric magnetic resonance and PET-CT can have a role in detecting local recurrence in patients with biochemical recurrence after radical prostatectomy.\ud \ud Methods\ud \ud We reviewed the recent international literature by carrying out a PUBMED search.\ud \ud Results\ud \ud We critically reviewed 11 recent original studies about the use of PET-CT and 5 recent studies about the use of multiparametric magnetic resonance. PET-CT has not shown significant results in terms of detection rate for local recurrence in patients with low level of PSA. Multiparametric magnetic resonance showed encouraging results to detect local recurrence in patients with low PSA and with small diameter lesions.\ud \ud Conclusions\ud \ud Currently, most important urological societies do not consider multiparametric magnetic resonance and PET-CT in the follow-up of patients with suspected local recurrence after radical prostatectomy. We can assert that multiparametric magnetic resonance seems to have excellent results in detecting local recurrence in patients submitted to radical prostatectomy and PSA < 1.5 ng/ml