The transverse and vertical distribution of prostate cancer in biopsy and radical prostatectomy specimens

Mai, Zhipeng; Zhou, Zhien; Yan, Weigang; Xiao, Yu; Zhou, Yi; Liang, Zhiyong; Ji, Zhigang; Li, Hanzhong

doi:10.1186/s12885-018-5124-9

Cited by 22 publications

(17 citation statements)

References 25 publications

(34 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We believe the best explanation for the cancer detection rate difference we observed is rooted in spatial alignment between tumor-3D configuration and needle trajectory. The largest diameter of most prostate tumors is along the longitudinal axis (apex to base) [20]. The TP needle is inserted along the same axis.…”

Section: Discussionmentioning

confidence: 99%

A noninferiority within-person study comparing the accuracy of transperineal to transrectal MRI–US fusion biopsy for prostate-cancer detection

Ber

Segal

Tamir

et al. 2020

Prostate Cancer Prostatic Dis

View full text Add to dashboard Cite

Background Magnetic resonance imaging (MRI) and ultrasound (US) fusion prostate-biopsies can be performed in a transrectal (TR-fusion) or transperineal (TP-fusion) approach. Prospective comparative evidence is limited. In this study we compared the detection rate of clinically-significant prostate-cancer (csPCa) within an index lesion between TR and TP-fusion. Patients and methods This was a prospective, noninferiority, and within-person trial. Men scheduled for MRI-US-fusion with a discrete MRI PI-RRAD ≥ 3 lesion were included. A dominant index lesion was determined for each subject and sampled by TR and TP-fusion during the same session. The order of biopsies was randomized and equipment was reset to avoid chronological and incorporation bias. For each subject, the index lesion was sampled 4-6 times in each approach. All biopsies were performed using Navigo fusion software (UC-Care, Yokneam, Israel). csPCa was defined as: Grade Group ≥ 2 or cancer-core length ≥ 6 mm. We used a noninferiority margin of 10% and a one-sided alpha level of 5%. Results Seventy-seven patients completed the protocol. Median age was 68.2 years (IQR:64.2-72.2), median PSA was 8.9 ng/ml (IQR:6.18-12.2). Ten patients (13%) were biopsy naive, others (87%) had a previous biopsy. csPCa was detected in 32 patients (42%). All of these cases were detected by TP-fusion, while only 20 (26%) by TR-fusion. Absolute difference for csPCa diagnosis was 15.6 (CI 90% 27.9-3.2%) in favor of TP-fusion (p = 0.029). TP-fusion was noninferior to TR-fusion. The lower boundary of the 90% confidence-interval between TP-fusion and TR-fusion was greater than zero, therefore TPfusion was also found to be superior. Exploratory subgroup analyses showed TP-fusion was consistently associated with higher detection rates of csPCa compared with TR-fusion in patient and index-lesion derived subgroups (size, location, PI-RADS, PSA, and biopsy history). Conclusions In this study, TP-fusion biopsies were found to be noninferior and superior to TR-fusion biopsies in detecting csPCa within MRI-visible index lesion. Centers experienced in both TP and TR-fusion should consider these results when choosing biopsy method.

show abstract

Section: Discussionmentioning

confidence: 99%

A noninferiority within-person study comparing the accuracy of transperineal to transrectal MRI–US fusion biopsy for prostate-cancer detection

Ber

Segal

Tamir

et al. 2020

Prostate Cancer Prostatic Dis

View full text Add to dashboard Cite

show abstract

“…Therefore, it should not be overlooked [14,24]. To determine the appropriate treatment, whole gland evaluation is required [25,26]. Compared to the whole mount gland specimen after prostatectomy, there were missed csPCa with transrectal biopsy.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy and Value of Magnetic Resonance Imaging–Ultrasound Fusion Transperineal Targeted and Template Systematic Prostate Biopsy Based on Bi-parametric Magnetic Resonance Imaging

et al. 2020

View full text Add to dashboard Cite

Purpose The purpose of this study was to investigate the diagnostic value of magnetic resonance imaging (MRI)–ultrasound (US) fusion transperineal targeted biopsy (FTB) and fusion template systematic biopsy (FSB) for prostate cancer (PCa) and clinically significant prostate cancer (csPCa) (intermediate/high grade [Gleason score ≥ 3+4]) based on bi-parametric MRI (bpMRI).Materials and methodsRetrospectively, we analyzed 300 patients with elevated prostate-specific antigen (≥ 4.0 ng/mL) and/or abnormal findings in a digital rectal examination at the Korea University Hospital. All 300 men underwent bpMRI-US fusion transperineal FTB and FSB in the period from April 2017 to March 2019.ResultsPCas were detected in 158 of 300 men (52.7%), and the prevalence of csPCa was 34.0%. CsPCas were detected in 12 of 102 (11.8%) with Prostate Imaging-Reporting and Data System (PI-RADS) 3, 42 of 92 (45.7%) with PI-RADS 4, respectively; and 45 of 62 (72.6%) men with PI-RADS 5, respectively. BpMRI showed a sensitivity of 95.1% and negative predictive value of 89.6% for csPCa. FTB detected additional csPCa in 33 men (12.9%) compared to FSB. Compared to FTB, FSB detected additional csPCa in 10 men (3.9%).ConclusionBpMRI-US FTB and FSB improved detection of PCa and csPCa. The accuracy of bi-parametric MRI is comparable with that of multi-parametric MRI. Further, it is rapid, simpler, cheaper, and no side effects of contrast media. Therefore, it is expected that bpMRI-US transperineal FTB and FSB could be a good alternative to conventional US-guided transrectal biopsy, which is the current gold standard.

show abstract

“…Anatomical landmarks and visual coregistration was used to find the corresponding slices, as the slice thickness of the radical prostatectomy specimens and mp‐MRI images were similar. As the tumor spatial distribution generated by template‐guided transperineal prostate biopsy was generally consistent with that of radical prostatectomy specimens, GS of each tumor was compared . MR‐reported tumor diameter and prostate volume were measured and the average values were recorded.…”

Section: Methodsmentioning

confidence: 99%

Radiomics Based on MRI as a Biomarker to Guide Therapy by Predicting Upgrading of Prostate Cancer From Biopsy to Radical Prostatectomy

Zhang

Han

Wei

et al. 2020

Magnetic Resonance Imaging

Self Cite

View full text Add to dashboard Cite

Background Biopsy Gleason score (GS) is crucial for prostate cancer (PCa) treatment decision‐making. Upgrading in GS from biopsy to radical prostatectomy (RP) puts a proportion of patients at risk of undertreatment. Purpose To develop and validate a radiomics model based on multiparametric magnetic resonance imaging (mp‐MRI) to predict PCa upgrading. Study Type Retrospective, radiomics. Population A total of 166 RP‐confirmed PCa patients (training cohort, n = 116; validation cohort, n = 50) were included. Field Strength/Sequence 3.0T/T2‐weighted (T2W), apparent diffusion coefficient (ADC), and dynamic contrast enhancement (DCE) sequences. Assessment PI‐RADSv2 score for each tumor was recorded. Radiomic features were extracted from T2W, ADC, and DCE sequences and Mutual Information Maximization criterion was used to identify the optimal features on each sequence. Multivariate logistic regression analysis was used to develop predictive models and a radiomics nomogram and their performance was evaluated. Statistical Tests Student's t or chi‐square were used to assess the differences in clinicopathologic data between the training and validation cohorts. Receiver operating characteristic (ROC) curve analysis was performed and the area under the curve (AUC) was calculated. Results In PI‐RADSv2 assessment, 67 lesions scored 5, 70 lesions scored 4, and 29 lesions scored 3. For each sequence, 4404 features were extracted and the top 20 best features were selected. The radiomics model incorporating signatures from the three sequences achieved better performance than any single sequence (AUC: radiomics model 0.868, T2W 0.700, ADC 0.759, DCE 0.726). The combined mode incorporating radiomics signature, clinical stage, and time from biopsy to RP outperformed the clinical model and radiomics model (AUC: combined model 0.910, clinical model 0.646, radiomics model 0.868). The nomogram showed good performance (AUC 0.910) and calibration (P‐values: training cohort 0.624, validation cohort 0.294). Data Conclusion Radiomics based on mp‐MRI has potential to predict upgrading of PCa from biopsy to RP. Level of Evidence 3 Technical Efficacy Stage 5 J. Magn. Reson. Imaging 2020;52:1239–1248.

show abstract

The transverse and vertical distribution of prostate cancer in biopsy and radical prostatectomy specimens

Cited by 22 publications

References 25 publications

A noninferiority within-person study comparing the accuracy of transperineal to transrectal MRI–US fusion biopsy for prostate-cancer detection

A noninferiority within-person study comparing the accuracy of transperineal to transrectal MRI–US fusion biopsy for prostate-cancer detection

Diagnostic Accuracy and Value of Magnetic Resonance Imaging–Ultrasound Fusion Transperineal Targeted and Template Systematic Prostate Biopsy Based on Bi-parametric Magnetic Resonance Imaging

Radiomics Based on MRI as a Biomarker to Guide Therapy by Predicting Upgrading of Prostate Cancer From Biopsy to Radical Prostatectomy

Contact Info

Product

Resources

About