Technologies for localization and diagnosis of prostate cancer

Abstract

The gold standard for detecting prostate cancer (PCa), systematic biopsy, lacks sensitivity as well as grading accuracy. PSA screening leads to over-treatment of many men, and it is unclear whether screening reduces PCa mortality. This review provides an understanding of the difficulties of localizing and diagnosing PCa. It summarizes recent developments of ultrasound (including elastography) and MRI, and discusses some alternative experimental techniques, such as resonance sensor technology and vibrational spectroscopy. A comparison between the different methods is presented. It is concluded that new ultrasound techniques are promising for targeted biopsy procedures, in order to detect more clinically significant cancers while reducing the number of cores. MRI advances are very promising, but MRI remains expensive and MR-guided biopsy is complex. Resonance sensor technology and vibrational spectroscopy have shown promising results in vitro. There is a need for large prospective multicentre trials that unambiguously prove the clinical benefits of these new techniques.

Identification of a distinct luminal subgroup diagnosing and stratifying early stage prostate cancer by tissue-based single-cell RNA sequencing

“…PCa diagnosis, stratification and treatment selection is usually based on multiple factors such as serum prostate specific antigen (PSA) level, tumor size, and pathology grading [ 4 ]. However, PSA levels can also be detected in benign prostatic hyperplasia (BPH), prostatitis, and even after digital rectal examination (DRE), resulting in a high rate of overdiagnosis and overtreatment of PCa [ 5 ].…”

A Mechatronic Platform for Computer Aided Detection of Nodules in Anatomopathological Analyses via Stiffness and Ultrasound Measurements

“…Cancer is an abnormal and uncontrolled cell growth that invades healthy tissues, and that can spread via metastases to other locations in the body [1]. Various cancer treatments involve chemical and radiation therapies or surgery [2,3,4]. Following surgical intervention, biopsy is performed on the lymph nodes excised from the tissue to properly characterize cancer spread and examine whether it has developed the ability to spread to other lymph nodules or organs too.…”

Role of multiparametric magnetic resonance imaging in early detection of prostate cancer

“…Most prostate cancers (PC) are currently found on the basis of an elevated serum prostate specific antigen (PSA) level. At present, PSA is the best standard biomarker used for early detection of PC [ 1 – 4 ], although it has only moderate sensitivity (PC may still be present at low levels of PSA) and specificity (benign prostatic hyperplasia or prostatitis may cause false positive results) [ 1 , 2 , 5 , 6 ]. In patients with elevated PSA, histological confirmation is needed and this is traditionally obtained using random transrectal ultrasound (TRUS) guided prostate biopsy [ 7 ].…”

“…This approach, however, yields false negative results in up to 40 % of cases and may show underestimation of Gleason grade, especially in anteriorly located tumours [ 8 – 10 ]. Treatment selection is based on prognostic factors including serum PSA level, histological grading (Gleason score), tumour size, clinical staging (TNM), and patient’s life expectancy [ 1 , 4 , 5 ]. Population-based PC screening with PSA is discouraged by international guidelines, because of potential overdiagnosis and subsequently overtreatment of non-lethal disease [ 11 , 12 ].…”