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Our preliminary experience suggests that performing Ga-PSMA PET/CT in patients with prostate cancer with rising PSA after treatment with curative intent can be clinically useful as it changes the treatment strategy in a significant proportion of patients. However, larger prospective trials are needed to validate our present findings.

Hemiablation HIFU therapy, delivered with intention to treat, for carefully selected patients affords mid-term promising functional and oncological outcomes. The effectiveness of this technique should be now compared with whole-gland radical therapy.

What ' s known on the subject? and What does the study add?Prostate cancer is one of the few solid-organ cancers in which imaging is not used in the diagnostic process. Novel functional magnetic resonance imaging techniques offer promise but may not be cost-effective.Prostate HistoScanning TM (PHS) is an ultrasound-based tissue characterisation technique that has previously shown encouraging results in the detection of clinically signifi cant prostate cancer. The present study reports on the open ' unblinded ' phase of a European multicentre study. The prospective ' blind ' phase is currently in progress and will determine the value of PHS in a robust fashion overcoming many of the biases inherent in evaluating prostate imaging. OBJECTIVE• To evaluate the ability of prostate HistoScanning TM (PHS) an ultrasound (US)-based tissue characterization application, to detect cancer foci by correlating results with detailed radical prostatectomy (RP) histology. PATIENT AND METHODS• In all, 31 patients with organ-confi ned prostate cancer, diagnosed on transrectal biopsies taken using US guidance, and scheduled for RP were recruited from six European centres.• Before RP three-dimensional (3D) US raw data for PHS analysis was obtained. Histology by Bostwick Laboratories (London) examined sections obtained from whole mounted glands cut every 3 -4 mm.• Location and volume estimation of cancer foci by PHS were undertaken using two methods; a manual method and an embedded software tool.• In this report we evaluate data obtained from a planned open study phase. The second phase of the study is ' blinded ' , and currently in progress. RESULTS• 31 patients were eligible for this phase. Three patients were excluded from analysis due to inadequate scan acquisition and pathology violations of the standard operating procedure. One patient withdrew from the study after 3D TRUS examination.• PHS detected cancer ≥ 0.20 mL in 25/27 prostates (sensitivity 93%).• In all, 23 patients had an index focus ≥ 0.5 mL at pathology, of which 21 were identifi ed as ≥ 0.5 mL by PHS using the manual method (sensitivity 91%) and 19 were correctly identifi ed as ≥ 0.5 mL by the embedded tool (sensitivity 83%).• In 27 patients, histological analysis found 32 cancerous foci ≥ 0.2 mL, located in 97 of 162 sextants. After sextant analysis, PHS showed a 90% sensitivity and 72% specifi city for the localisation of lesions ≥ 0.2 mL within a sextant. CONCLUSIONS• PHS has the ability to identify and locate prostate cancer and consequently may aid in pre-treatment and pre-surgical planning.• In men with a lesion identifi ed, it has potential to enable improved targeting, allowing better risk stratifi cation by obtaining more representative cores.• However further verifi cation from the results of the blinded phase of this study are awaited.

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The South Pacific Convergence Zone (SPCZ) is poorly represented in global coupled simulations from the Coupled Model Intercomparison Project Phase 5 (CMIP5), with trademark biases such as the tendency to form a "double Intertropical convergence zone" and an equatorial cold tongue that extends too far westward. Such biases limit our confidence in projections of the future climate change for this region. In this study, we use a downscaling strategy based on a regional atmospheric general circulation model that accurately captures the SPCZ present-day climatology and interannual variability. More specifically, we investigate the sensitivity of the projected rainfall response to either just correcting present-day CMIP5 Sea Surface Temperature (SST) biases or correcting projected SST changes using an emergent constraint approach. While the equatorial western Pacific projected rainfall increase is robust in our experiments and CMIP5, correcting the projected CMIP5 SST changes yields a considerably larger reduction (~ 25%) than in CMIP5 simulations (~ + 3%) in the southwestern Pacific. Indeed, correcting the projected CMIP5 warming pattern yields stronger projected SST gradients, and more humidity convergence reduction under the SPCZ. Finally, our bias-corrected set of experiments yields an increase in equatorial rainfall and SPCZ variability in the future, but does not support the future increase in the frequency of zonal SPCZ events simulated by CMIP5 models. This study hence suggests that atmospheric downscaling studies should not only correct CMIP5 present-day SST biases but also projected SST changes to improve the reliability of their projections. Additional simulations with different physical parameterizations yield robust results.

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In this matched pair analysis, HIFU hemiablation was comparable to RALP in controlling localized unilateral PCa, with no significant differences in the need for salvage therapies. HIFU was also associated to significantly better functional outcomes. Accurate patient selection remains vital, and larger prospective trials are needed to confirm our findings.