Is Systematic Sextant Biopsy Suitable for the Detection of Clinically Significant Prostate Cancer?

Manseck, Andreas; Froehner, Michael; Oehlschlaeger, Sven; Hakenberg, O.; Friedrich, Katrin; Theissig, F; Wirth, Michael

doi:10.1159/000064844

Cited by 11 publications

(7 citation statements)

References 11 publications

(18 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is possible that some prostate cancer cases have remained undetected among the patients included in the group of noncancer diagnosis. However, all biopsies were obtained using a scheme of 12-14 cores, making false-negative results less likely than with the historical sextant biopsy protocol (Manseck et al, 2000). Furthermore, all participants were followed according to the routines established in the hospital, and those with a subsequent cancer diagnosis, within a 6-month period, were reclassified as cancer patients, minimizing misclassification.…”

Section: Discussionmentioning

confidence: 99%

Can serum angiogenin be used to improve the diagnostic performance in prostate cancer screening?

Pina

Botelho

Lopes

et al. 2014

European Journal of Cancer Prevention

View full text Add to dashboard Cite

Several biomarkers have been studied to avoid unnecessary biopsies resulting from suboptimal performance of prostate-specific antigen (PSA) testing. We aimed to assess the use of serum angiogenin as a prostate cancer diagnostic tool among candidates for biopsy. We selected 252 patients referred for ultrasound-guided transrectal prostate biopsy on the basis of an abnormal digital rectal examination and/or elevated total PSA. Serum angiogenin was quantitatively analyzed by solid-phase enzyme-linked immunosorbent assay. Results of the prostatic pathology assessment (cancer vs. noncancer) were defined by biopsy. The median serum angiogenin levels were significantly higher in patients with prostate cancer (median: 487,500 vs. 414,800 pg/ml, P=0.008). Among patients with baseline tPSA of 4.0 ng/ml or less, 37.5% had serum angiogenin less than 389,000 pg/ml (sensitivity: 88.9%; specificity: 45.2%), and the probability of having prostate cancer varied from 22.5% before testing to 6.7% among those with low angiogenin levels. When further restricting the analyses to a group of patients with even lower probability of having cancer, on the basis of tPSA and f/t PSA values, the evaluation of serum angiogenin did not contribute toward a meaningful variation in the post-test probability of cancer. In conclusion, serum angiogenin levels may be useful to distinguish between cancer and noncancer patients among the candidates for prostatic biopsy in regular clinical practice. Further investigation is needed among patients with low PSA levels and to understand the relation between this biomarker and the long-term survival of prostate cancer patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Can serum angiogenin be used to improve the diagnostic performance in prostate cancer screening?

Pina

Botelho

Lopes

et al. 2014

European Journal of Cancer Prevention

View full text Add to dashboard Cite

show abstract

“…As long as the cancer can't be detected by all these perturbed needle positions, it is regarded as being missed by the th needle in the optimization framework. Accordingly, the probability function in (1) is reformulated by replacing with , which is defined as (3) where is the number of random perturbation cases considered. Note that this is a very strict definition, which requires that, for a tentative needle configuration, if cancer is detected, cancer is also present in the vicinity of the needles.…”

Section: B Atlas-based Biopsy Optimizationmentioning

confidence: 99%

“…The most popular sampling method has been the sextant biopsy [2], which divides the left and right parts of the prostate into three regions each, then randomly samples each of them. This approach has been shown to have a large false negative detection rate ranging from 27% to 39%, depending on cancer stage [3], [4]. For example, the study in [5] showed that 23% of initially positive sextant biopsies were followed by a negative repeat biopsy, indicating the significant error of the technique.…”

mentioning

confidence: 99%

Targeted Prostate Biopsy Using Statistical Image Analysis

Zhan

Shen

Zeng

et al. 2007

IEEE Trans. Med. Imaging

View full text Add to dashboard Cite

In this paper, a method for maximizing the probability of prostate cancer detection via biopsy is presented, by combining image analysis and optimization techniques. This method consists of three major steps. First, a statistical atlas of the spatial distribution of prostate cancer is constructed from histological images obtained from radical prostatectomy specimen. Second, a probabilistic optimization framework is employed to optimize the biopsy strategy, so that the probability of cancer detection is maximized under needle placement uncertainties. Finally, the optimized biopsy strategy generated in the atlas space is mapped to a specific patient space using an automated segmentation and elastic registration method. Cross-validation experiments showed that the predictive power of the optimized biopsy strategy for cancer detection reached the 94%-96% levels for 6-7 biopsy cores, which is significantly better than standard random-systematic biopsy protocols, thereby encouraging further investigation of optimized biopsy strategies in prospective clinical studies.

show abstract

“…In most biopsy procedures, the sampling locations are determined in a random or empirical manner, leading to mis-detection of cancer and mis-estimation of surrogate markers [30, 14]. To cope with that, several computer-assisted approaches (e.g., [45, 42, 49]) have been developed.…”

Section: Introductionmentioning

confidence: 99%

Sampling the spatial patterns of cancer: Optimized biopsy procedures for estimating prostate cancer volume and Gleason Score

Shen

Zeng

et al. 2009

Medical Image Analysis

View full text Add to dashboard Cite

Prostate biopsy is the current gold-standard procedure for prostate cancer diagnosis. Existing prostate biopsy procedures have been mostly focusing on detecting cancer presence. However, they often ignore the potential use of biopsy to estimate cancer volume (CV) and Gleason Score (GS, a cancer grade descriptor), the two surrogate markers for cancer aggressiveness and the two crucial factors for treatment planning. To fill up this vacancy, this paper assumes and demonstrates that, by optimally sampling the spatial patterns of cancer, biopsy procedures can be specifically designed for estimating CV and GS. Our approach combines image analysis and machine learning tools in an atlas-based population study that consists of three steps. First, the spatial distributions of cancer in a patient population are learned, by constructing statistical atlases from histological images of prostate specimens with known cancer ground truths. Then, the optimal biopsy locations are determined in a feature selection formulation, so that biopsy outcomes (either cancer presence or absence) at those locations could be used to differentiate, at the best rate, between the existing specimens having different (high vs. low) CV/GS values. Finally, the optimized biopsy locations are utilized to estimate whether a new-coming prostate cancer patient has high or low CV/GS values, based on a binary classification formulation. The estimation accuracy and the generalization ability are evaluated by the classification rates and the associated receiver-operating-characteristic (ROC) curves in cross validations. The optimized biopsy procedures are also designed to be robust to the almost inevitable needle displacement errors in clinical practice, and are found to be robust to variations in the optimization parameters as well as the training populations. Keywords a b s t r a c tProstate biopsy is the current gold-standard procedure for prostate cancer diagnosis. Existing prostate biopsy procedures have been mostly focusing on detecting cancer presence. However, they often ignore the potential use of biopsy to estimate cancer volume (CV) and Gleason Score (GS, a cancer grade descriptor), the two surrogate markers for cancer aggressiveness and the two crucial factors for treatment planning. To fill up this vacancy, this paper assumes and demonstrates that, by optimally sampling the spatial patterns of cancer, biopsy procedures can be specifically designed for estimating CV and GS. Our approach combines image analysis and machine learning tools in an atlas-based population study that consists of three steps. First, the spatial distributions of cancer in a patient population are learned, by constructing statistical atlases from histological images of prostate specimens with known cancer ground truths. Then, the optimal biopsy locations are determined in a feature selection formulation, so that biopsy outcomes (either cancer presence or absence) at those locations could be used to differentiate, at the best rate, between the existing specimens hav...

show abstract

Is Systematic Sextant Biopsy Suitable for the Detection of Clinically Significant Prostate Cancer?

Cited by 11 publications

References 11 publications

Can serum angiogenin be used to improve the diagnostic performance in prostate cancer screening?

Can serum angiogenin be used to improve the diagnostic performance in prostate cancer screening?

Targeted Prostate Biopsy Using Statistical Image Analysis

Sampling the spatial patterns of cancer: Optimized biopsy procedures for estimating prostate cancer volume and Gleason Score

Contact Info

Product

Resources

About