A comparison of the diagnostic performance of systematic versus ultrasound-guided biopsies of prostate cancer

Heijmink, Stijn W. T. P. J.; Moerkerk, Hilco van; Kiemeney, L.A.L.M.; Witjes, J. Alfred; Frauscher, Ferdinand; Barentsz, Jelle O.

doi:10.1016/j.clinimag.2006.05.019

Cited by 23 publications

(23 citation statements)

References 83 publications

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“…Prostate cancer tissue is associated with an increased microvessel density due to the proliferation of neovessels [16][17][18]. Since the parameter for peak intensity was defined as reflecting the blood volume in the ROIs [6], the development of neovascularity in the prostate cancer is demonstrated as increased peak intensity on CEUS imaging.…”

Section: Discussionmentioning

confidence: 99%

Factors influencing the degree of enhancement of prostate cancer on contrast-enhanced transrectal ultrasonography: correlation with biopsy and radical prostatectomy specimens

Jiang

Yq²,

Yk³

et al. 2012

The British Journal of Radiology

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Objectives: This study was designed to identify factors that influenced the degree of enhancement of prostate cancer on contrast-enhanced transrectal ultrasonography (CETRUS). Methods: 139 patients suspected of prostate cancer were evaluated with CETRUS followed by systematic and targeted transrectal ultrasound-guided biopsies. The degree of enhancement of the lesions was objectively measured using peak intensity with time-intensity curve analysis software. Ultrasound findings were correlated with clinical characteristics as well as biopsy and radical prostatectomy findings. Results: Prostate cancers were detected in 230 biopsy sites from 91 patients. The mean peak intensity value of prostate cancer was significantly higher than that of the benign lesions (9.82¡3.73 vs 7.51¡2.97; p,0.001), and the peak intensity value of the cancer foci varied across the prostate. The mixed model analysis revealed that the location and Gleason score of tumour foci were the influencing factors of the peak intensity value, and the former had a stronger influence upon peak intensity than the latter (p50.000 and 0.040, respectively). However, age, prostate volume or serum prostate-specific antigen of the patient had no significant influence on the peak intensity value (p.0.05). Furthermore, the peak intensity value of tumours larger than 5 mm diameter was significantly higher than tumours of 5 mm or smaller diameter (9.28¡2.46 vs 6.69¡2.65; p,0.001). Conclusions: The prostate cancer lesions with a higher Gleason score and larger tumour size which were located in the lateral peripheral zone (PZ) were more likely to show a marked enhancement. Lesions with lower peak intensity that are located in the medial PZ should also be treated as suspicious. Prostate cancer is the most commonly diagnosed cancer in males, accounting for 28% of new cancer diagnoses in males and 11% of cancer-related deaths, with an expected 32 050 prostate cancer-specific mortalities in 2010 [1]. The imaging of prostate cancer is central to early detection and staging. However, it is generally acknowledged that detection and localisation of prostate tumours using greyscale ultrasound is poor, because suspicious hypoechoic areas represent cancer in only 9-53% of cases [2][3]. Furthermore, up to 30% of prostate cancers are isoechoic [4][5]. Conventional prostate ultrasound has little advantage over digital rectal examination for detecting malignant areas. Consequently, new strategies for prostate cancer detection are required. Contrast-enhanced ultrasound (CEUS) is a real-time imaging technique with the capability of visualising perfusion patterns [6][7][8]. This imaging technology has revealed promising perspectives in the diagnosis of prostate cancer owing to its ability to improve the visualisation of tumour vascularity. Several studies have reported that CEUS-targeted biopsy detected more cancer than systematic biopsy by identifying the area with greatest enhancement of the prostate [9][10][11][12]. In a recent study reported by Tang et al [13], the haemodynamic ...

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Section: Discussionmentioning

confidence: 99%

Factors influencing the degree of enhancement of prostate cancer on contrast-enhanced transrectal ultrasonography: correlation with biopsy and radical prostatectomy specimens

Jiang

Yq²,

Yk³

et al. 2012

The British Journal of Radiology

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“…Recently, methods of fusion between TRUS and preoperative MRI have been introduced in order to perform targeted biopsies whose guidance includes the discrimination information provided by MRI. Using as target the lesion detected by MRI, the TRUS tracks in real-time the position of the needle and it is fused to MRI images to have an intra-operative visualization of the target [Moore et al 2013;Heijmink et al 2006]. What make this approach computationally costly are the elastic properties of prostate and surrounding tissues.…”

Section: Targeted Biopsymentioning

confidence: 99%

Virtual reality navigation system for prostate biopsy

Rapetti

Crivellaro

Momi

et al. 2017

Proceedings of the 23rd ACM Symposium on Virtual Reality Software and Technology

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Prostate cancer is the most common non-cutaneous cancer in America. Tumor detection involves non-invasive screening tests, but positive results must be confirmed by a prostate biopsy. About twelve random samples are obtained during the biopsy, which is a systematic procedure traditionally performed with trans-rectal ultrasound (TRUS) guidance to determine prostate location. Recently, methods of fusion between TRUS and preoperative MRI have been introduced in order to perform targeted biopsies aimed to reduce the number of samples to few suspicious areas. Since the TRUS displaces the prostate during the procedure, the preoperative MRI does not match patient anatomy. Therefore, complex MRI deformation algorithms are needed. However, despite the substantial increase in complexity and cost, there is no strong evidence that the TRUS-MRI fusion actually improves accuracy and surgical outcomes. This paper presents an innovative virtual reality surgical navigation system for performing targeted prostate biopsies, without the need of the uncomfortable TRUS. Both biopsy needle and patient anatomy are constantly tracked by an electromagnetic tracking system that provides their 3D position and orientation with respect to the surgical bed. Multiple fiducial markers are placed on the patient skin (at the iliac crest and pubic bone) during MRI scanning. Once in the operative room, the surgeon is presented a stereoscopic 3D volumetric rendering and multiple orthogonal views of the patient anatomy, as well as a virtual representation of the tracked needle. After a simple registration process between the MRI and the tracker coordinate system, the navigation system guides the needle insertion in the patient perineum through several anatomical layers towards the biopsy targets.

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“…The current standard technique for prostate cancer detection is trans-rectal ultrasound (TRUS) guided biopsy of the prostate [3,4]. TRUS guided biopsy has its limitation due to the inability of grey-scale ultrasonography to distinguish prostate cancer from benign prostate tissue [4,5]. Consequently TRUS-guided biopsies are performed in a systematic manner in contrast to targeted biopsies, typically by taking 8-12 biopsy cores from the peripheral zone of the prostate.…”

Section: Introductionmentioning

confidence: 99%

Fusion Target Biopsy of the Prostate Using Real-Time Ultrasound and MR Images. A Multicenter RCT on Target Biopsy Techniques in the Diagnosis of Prostate Cancer

Wegelin¹,

Melick²

2015

J Clin Trials

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Background: The current standard technique for prostate cancer detection is trans-rectal ultrasound (TRUS) guided biopsy, and is renowned for its low sensitivity. Developments of multiparametric MRI techniques have increased the detection of significant prostate cancer. Currently there are three techniques utilizing MRI for targeted biopsy: MRI-TRUS fusion, 'cognitive' TRUS, and in-bore MRI guided biopsy. There is no consensus which should be preferred. The current study aims to compare prostate cancer detection rates of three target biopsy procedures.

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A comparison of the diagnostic performance of systematic versus ultrasound-guided biopsies of prostate cancer

Cited by 23 publications

References 83 publications

Factors influencing the degree of enhancement of prostate cancer on contrast-enhanced transrectal ultrasonography: correlation with biopsy and radical prostatectomy specimens

Factors influencing the degree of enhancement of prostate cancer on contrast-enhanced transrectal ultrasonography: correlation with biopsy and radical prostatectomy specimens

Virtual reality navigation system for prostate biopsy

Fusion Target Biopsy of the Prostate Using Real-Time Ultrasound and MR Images. A Multicenter RCT on Target Biopsy Techniques in the Diagnosis of Prostate Cancer

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