Comparative Analysis of Transperineal Template Saturation Prostate Biopsy Versus Magnetic Resonance Imaging Targeted Biopsy with Magnetic Resonance Imaging-Ultrasound Fusion Guidance

Radtke, Jan Philipp; Kuru, Timur H.; Boxler, Silvan; Alt, Céline D.; Popeneciu, Ionel Valentin; Huettenbrink, Clemens; Klein, Tilman; Steinemann, Sarah; Bergstraesser, Claudia; Roethke, Matthias; Roth, Wilfried; Schlemmer, Heinz Peter; Hohenfellner, Markus; Hadaschik, Boris

doi:10.1016/j.juro.2014.07.098

Cited by 189 publications

(148 citation statements)

References 30 publications

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“…More biopsies were found positive in the fused group and more malignant tissue was found per biopsy, 40 even accomplishing results similar to transperineal 3-D prostate mapping biopsy. 41 Our hypothesis is that integrating OCT in the combined results of MRI/TRUS fusion will further improve the diagnostic accuracy. Moreover, results will become objective and real time.…”

Section: Discussionmentioning

confidence: 99%

Prostate cancer diagnosis: the feasibility of needle-based optical coherence tomography

et al. 2015

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Abstract. The objective of this study is to demonstrate the feasibility of needle-based optical coherence tomography (OCT) and functional analysis of OCT data along the full pullback trajectory of the OCT measurement in the prostate, correlated with pathology. OCT images were recorded using a commercially available C7-XR™ OCT Intravascular Imaging System interfaced to a C7 Dragonfly™ intravascular 0.9-mm-diameter imaging probe. A computer program was constructed for automated image attenuation analysis. First, calibration of the OCT system for both the point spread function and the system roll-off was achieved by measurement of the OCT signal attenuation from an extremely weakly scattering medium (Intralipid® 0.0005 volume%). Second, the data were arranged in 31 radial wedges (pie slices) per circular segments consisting of 16 A-scans per wedge and 5 axial B-scans, resulting in an average A-scan per wedge. Third, the decay of the OCT signal is analyzed over 50 pixels (500 μm) in depth, starting from the first found maximum data point. Fourth, for visualization, the data were grouped with a corresponding color representing a specific μ oct range according to their attenuation coefficient. Finally, the analyses were compared to histopathology. To ensure that each single use sterile imaging probe is comparable to the measurements of the other imaging probes, the probe-to-probe variations were analyzed by measuring attenuation coefficients of 0.03, 6.5, 11.4, 17, and 22.7 volume% Intralipid®. Experiments were repeated five times per probe for four probes. Inter-and intraprobe variation in the measured attenuation of Intralipid samples with scattering properties similar to that of the prostate was <8% of the mean values. Mean attenuation coefficients in the prostate were 3.8 mmfor parts of the tissue that were classified as benign (SD: 0.8 mm −1 , minimum: 2.2 mm −1 , maximum: 8.9 mm −1 ) and 4.1 mm −1 for parts of tissue that were classified as malignant (SD: 1.2 mm −1 , minimum: 2.5 mm −1 , maximum: 9.0 mm −1 ). In benign areas, the tissue looked homogeneous, whereas in malignant areas, small glandular structures were seen. However, not all areas in which a high attenuation coefficient became apparent corresponded to areas of prostate cancer. This paper describes the first in-tissue needle-based OCT imaging and three-dimensional optical attenuation analysis of prostate tissue that indicates a correlation with pathology. Fully automated attenuation coefficient analysis was performed at 1300 nm over the full pullback. Correlation with pathology was achieved by coregistration of three-dimensional (3-D) OCT attenuation maps with 3-D pathology of the prostate. This may contribute to the current challenge of prostate imaging and the rising interest in focal therapy for reduction of side effects occurring with current therapies.

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Section: Discussionmentioning

confidence: 99%

Prostate cancer diagnosis: the feasibility of needle-based optical coherence tomography

et al. 2015

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“…This subgroup of low-risk PCa seems to be a tough challenge for diagnostic tools. Radtke et al [3] reported 12% missed Gleason score 6 tumors, when only mp-MRI PIRADS 3-5 lesions [17] are targeted for biopsy. This limitation seems to be the same for elastography, in which in case of a ‘negative elastogram' around 20% harbor cancerous tissue (most of them Gleason score <7) in the systematic biopsy (unpublished data of the Hamburg group).…”

Section: Discussionmentioning

confidence: 99%

“…He was not able to show a significant correlation between tumor volume by HS and radical prostatectomy (RP) specimen in a cohort of 148 patients. In the mean time, other diagnostic tools like elastography, multiparametric magnetic-resonance imaging (mp-MRI) and MRI/transrectal ultrasound (TRUS) fusion biopsies showed promising results in PCa detection [3,4,5,6,7,8]. This study aims at validating the previous results of HS on the gold standard of RP specimen and put them into the context of other available diagnostic modalities for PCa detection.…”

Section: Introductionmentioning

confidence: 91%

Sextant-Specific Analysis of Detection and Tumor Volume by HistoScanning™

Porres

Kuru²,

Epplen³

et al. 2015

Urol Int

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Introduction: Published results of HistoScanning™ (HS) for prostate cancer (PCa) diagnostics are inconsistent and their value remains unclear. We prospectively analyzed the detection rate and tumor volume concordance in PCa patients. Material and Methods: Two hundred and eighty-two patients with biopsy-proven PCa scheduled for radical prostatectomy (RP) were included. All patients underwent ultrasonographical examination by HS prior to surgery. HS was evaluated compared to RP specimen as to (1) the prediction of overall tumor volume and (2) accuracy of HS in detection of PCa lesions larger than 0.2/0.5 ml, separated for each sextant. For each sextant, receiver operating characteristic (ROC)-analysis and area under the curve were determined. Sensitivity and specificity were calculated and visualized in ROC-curves. Results: HS tends to underestimate volume of cancerous lesions, particularly larger lesions >8 ml. Using a 0.2 ml detection threshold, specificity and sensitivity of HS were between 29-68% and 46-78%. For a 0.5 ml detection threshold, sextant-specific specificity increased to 59-92% and sensitivity decreased to 16-54%. Stratification according to pre-operational PSA values did not improve performance characteristics of HS. Conclusions: Our results do not support a significant contribution of HS to PCa diagnostics.

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“…Consequently, the significantly lower performance of the systematic biopsy should have been anticipated. A more extended biopsy approach was followed by Radtke et al [3]; in their study a transperineal template saturation biopsy (median 24 cores) was combined with MRI-ultrasound fusion guided targeted biopsy and lead to detection of 11 (7%) additional cases of csPCa (a total of 153 patients with a PIRADS score >=3). A PIRADS score of <3 on mpMRI was present in 141 patients (48%) with 17 (12%) of them being diagnosed with a csPCa detected by systematic biopsy.…”

Section: Cancer 2016 Mar 15;122(6):884-92mentioning

confidence: 99%

Re: Prostate Cancer Detection with Magnetic Resonance-ultrasound Fusion Biopsy: The Role of Systematic and Targeted Biopsies

Mortezavi

Eberli

2016

European Urology

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Comparative Analysis of Transperineal Template Saturation Prostate Biopsy Versus Magnetic Resonance Imaging Targeted Biopsy with Magnetic Resonance Imaging-Ultrasound Fusion Guidance

Cited by 189 publications

References 30 publications

Prostate cancer diagnosis: the feasibility of needle-based optical coherence tomography

Prostate cancer diagnosis: the feasibility of needle-based optical coherence tomography

Sextant-Specific Analysis of Detection and Tumor Volume by HistoScanning™

Re: Prostate Cancer Detection with Magnetic Resonance-ultrasound Fusion Biopsy: The Role of Systematic and Targeted Biopsies

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