Effectiveness of the “cognitive” biopsy in the diagnosis of prostate cancer in patients with a previous negative biopsy

ConclusionsThe diagnostic performance of CB in patients with at least one previous negative biopsy was 44%, increasing according to the PI-RADS grade, and low in PI-RADS 3. No clinical variable predictive of cancer was found in patients with PI-RADS 3.ResumenIntroducciónEvaluación de la efectividad de la biopsia cognitiva (BC) en los pacientes con sospecha clínica de cáncer de próstata (caP) y al menos una biopsia negativa (BTR).Material y métodoAnálisis retrospectivo de 144 pacientes con al menos una BTR y una resonancia magnética nuclear (RMN) previa. Los nódulos de la RMN se clasificaron según la clasificación PI-RADS v2 agrupando pZa, pZpl y pZpm como zona periférica (ZP), Tza, Tzp y CZ como zona transicional (ZT) y áreas AS como zona anterior (ZA). Se indicó biopsia en nódulos ≥ PI-RADS 3. Se llevó a cabo análisis uni y multivariante (regresión logística) tratando de identificar variables relacionadas con tumor en biopsia de PI-RADS 3.ResultadosLa mediana de edad fue de 67 (IQR: 62-72) años, la de PSA 8,2 (IQR: 6,2-12) ng/ml. Se identificó nódulo en la RMN en la ZP en 97 (67,4%) casos, en la ZT en 29 (20,1%) casos y en ZA en 41 (28,5%) casos. Se diagnosticó caP en la biopsia en 64 (44%) pacientes. En PI-RADS 3 se obtuvo un 17,5% (7/40) de cáncer, PI-RADS 4 un 47,3% (35/73) y en los PI-RADS 5 u...
Source: Actas Urologicas Espanolas - Category: Urology & Nephrology Source Type: research

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We present a case of a 79 year old patient with a medical history of unilateral nerve-sparing radical prostatectomy due to a pT3aN0 (Gleason score 7) prostate carcinoma. Because of slightly elevated prostate specific antigen (PSA) level (0.35ng/dL), a fluorine-18-prostate specific membrane antigen (18F-PSMA)-1007 positron emission tomography/computed tomography (PET/CT) scan was performed, showing no signs of malignant recurrence. However, a moderately PSMA-avid nodular lesion was observed in the left occipital region with homogeneous contrast enhancement, suggestive for a meningioma, which was confirmed on magnetic resona...
Source: Hellenic Journal of Nuclear Medicine - Category: Nuclear Medicine Tags: Hell J Nucl Med Source Type: research
ConclusionsmpMRI detected the majority of high-grade and large cancers, but had low sensitivity in the PZ, posterior, and apex and base of the gland. The high prevalence of low-volume, low-Gleason score index tumors, as well as satellite tumors in those areas, accounted for the difference.
Source: International Journal of Clinical Oncology - Category: Cancer & Oncology Source Type: research
This study evaluated the efficacy of MRI-TB between African American patients with additional consideration for lesion location on MRI.
Source: The Journal of Urology - Category: Urology & Nephrology Authors: Source Type: research
CONCLUSIONS: The diagnostic performance of CB in patients with at least one previous negative biopsy was 44%, increasing according to the PI-RADS grade, and low in PI-RADS 3. No clinical variable predictive of cancer was found in patients with PI-RADS 3. PMID: 30131167 [PubMed - as supplied by publisher]
Source: Actas Urologicas Espanolas - Category: Urology & Nephrology Authors: Tags: Actas Urol Esp Source Type: research
CONCLUSIONS: PB is the cornerstone in diagnosis and management of PCa. Although ultrasound transrectal and transperineal prostate biopsy are still considered as the standard, emerging data confirmed the role of MRI guided biopsy, particularly in patients with a previous negative biopsy. However, MRI costs and the moderate inter-reader reproducibility of the exam are still significant concerns requiring further studies to define the right role of MRI in the PCa diagnostic pathway. PMID: 29595039 [PubMed - as supplied by publisher]
Source: Minerva Urologica e Nefrologica - Category: Urology & Nephrology Tags: Minerva Urol Nefrol Source Type: research
Authors: Harvey H, Morgan V, Fromageau J, O'Shea T, Bamber J, deSouza NM Abstract The purpose of this study was to establish interobserver reproducibility of Young's modulus (YM) derived from ultrasound shear wave elastography (US-SWE) in the normal prostate and correlate it with multiparametric magnetic resonance imaging (mpMRI) tissue characteristics. Twenty men being screened for prostate cancer underwent same-day US-SWE (10 done by two blinded, newly-trained observers) and mpMRI followed by 12-core biopsy. Bland-Altman plots established limits of agreement for YM. Quantitative data from the peripheral zone (PZ)...
Source: Ultrasonic Imaging - Category: Radiology Tags: Ultrason Imaging Source Type: research
BackgroundT2‐weighted imaging (T2‐WI) information has been used in a qualitative manner in the assessment of prostate cancer. Quantitative derivatives (T2 relaxation time) can be generated from T2‐WI. These outputs may be useful in helping to discriminate clinically significant prostate cancer from background signal. Purpose/HypothesisTo investigate changes in quantitative T2 parameters in lesions and noncancerous tissue of men on active surveillance for prostate cancer taking dutasteride 0.5 mg or placebo daily for 6 months. Study TypeRetrospective. Population/SubjectsForty men randomized to 6 months of daily...
Source: Journal of Magnetic Resonance Imaging - Category: Radiology Authors: Tags: Original Research Source Type: research
Use of magnetic resonance imaging (MRI)/transrectal ultrasound fusion biopsies to determine the accuracy of multiparametric MRI (mpMRI), using Prostate Imaging-Reporting and Data System version 2 (PI-RADSv2), for detecting clinically significant prostate cancer in the overall gland and specifically the peripheral zone (PZ) and transitional zone (TZ).
Source: Current Problems in Diagnostic Radiology - Category: Radiology Authors: Source Type: research
Conclusions The average prostate diameter decreased by approximately 10% during the 12 months after IMRT; thereafter remained unchanged.
Source: Reports of Practical Oncology and Radiotherapy - Category: Cancer & Oncology Source Type: research
Conclusion Detection rate of prostate cancer did not show significant differences between a TB and a SB technique in biopsy-naïve patients. However, targeted prostate biopsies demonstrated a better sampling effectiveness thus reducing the cores needed to diagnose clinically significant tumors.
Source: Diagnostic and Interventional Imaging - Category: Radiology Source Type: research
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