Diagnostic yields in patients with suspected prostate cancer undergoing MRI as the first-line investigation in routine practice.

Diagnostic yields in patients with suspected prostate cancer undergoing MRI as the first-line investigation in routine practice. Clin Radiol. 2020 Sep 09;: Authors: Sokhi HK, Padhani AR, Patel S, Pope A Abstract AIM: To document cancer yields of magnetic resonance imaging (MRI)-directed biopsies in men with suspected prostate cancer referred to secondary care. MATERIALS AND METHODS: Men with suspected cancer undergoing multiparametric prostate MRI as the first-line investigation were included in the present study. Systematic transrectal prostate biopsies with/without cognitive targeted biopsies were performed. Diagnostic yields of International Society of Urological Pathology (ISUP) ≥2 cancers by the Prostate Imaging Reporting and Data System (PI-RADS) category were recorded. Impacts of prostate-specific antigen (PSA) density on biopsy results and yields of non-targeted biopsies in MRI non-suspicious prostate sextants assessed. RESULTS: Of 262 men (90.5% biopsy naive), 86 (33%) MRI examinations were negative (PI-RADS 1-2) and 176 (67%) positive (PI-RADS 3: 8%; PI-RADS 4: 21%; PI-RADS 5: 38%). Two hundred and thirteen of 262 patients underwent a biopsy. ISUP ≥2 cancer detection rates were 8% (5/61) for PI-RADS 1-2, 18% (3/17) for PI-RADS 3, 49% (22/45) for PI-RADS 4, and 80% (72/90) for PI-RADS 5. Proportions of ISUP ≥2 increased with higher PSA densities in positive patients (%ISUP ≥2 for PSA density groups
Source: Clinical Prostate Cancer - Category: Cancer & Oncology Authors: Tags: Clin Radiol Source Type: research

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(Wiley) Multiparametric magnetic resonance imaging of the prostate (mpMRIp) is a promising tool for diagnosing prostate cancer, and prior to its availability, detection relied on clinical exams and prostate specific antigen screening.
Source: EurekAlert! - Medicine and Health - Category: International Medicine & Public Health Source Type: news
This study underscores the important research that is ongoing to help minimize invasive procedures for clinically localized prostate cancer in men who opt for active surveillance,” said Dr. Marc Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of HarvardProstateKnowledge.org. Garnick added that in his practice, patients who have completely stable repeat biopsies for several years, as well as stable prostate MRI studies, are followed with a combination of “PSA values, physical exam, presence or absence of urinary symptoms, ...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Health Living With Prostate Cancer Prostate Knowledge HPK Source Type: blogs
CONCLUSIONS: Among multiple abbreviated mpMRI-derived protocols, cesMRI was the one equaling mpMRI in terms of csPCa detection and minimizing PI-RADSv2 category 3 assignments. PMID: 33016030 [PubMed - as supplied by publisher]
Source: Minerva Urologica e Nefrologica - Category: Urology & Nephrology Tags: Minerva Urol Nefrol Source Type: research
In this study, we evaluated prostate multiparametric MRI (mpMRI) before and after neoadjuvant enzalutamide plus ADT. EXPERIMENTAL DESIGN: Men with localized intermediate- or high-risk prostate cancer underwent a baseline mpMRI and mpMRI-targeted biopsy followed by a second mpMRI after 6 months of enzalutamide and ADT prior to RP. Specimens were sectioned in the same plane as mpMRI using patient-specific 3D-printed molds to permit mpMRI-targeted biopsies to be compared to the same lesion from the RP. Specimens were analyzed for imaging and histologic correlates of response. RESULTS: Of 39 patients enrolled, 36 com...
Source: Clinical Cancer Research - Category: Cancer & Oncology Authors: Tags: Clin Cancer Res Source Type: research
CONCLUSIONS: No significant difference was found in the detection of CSPC between TB and SB; however, both techniques revealed substantial added value and combination of TB and SB could further improve this detection rate without increasing the detection of CIPC. PMID: 32996795 [PubMed - as supplied by publisher]
Source: Journal of Investigative Surgery - Category: Surgery Tags: J Invest Surg Source Type: research
Abstract The PI-RADS guidelines set out the minimal technical requirements for the acquisition of multiparametric magnetic resonance imaging (mpMRI) of the prostate. However, the rapid diffusion of this technique has inevitably led to variability in scan quality among centres across the UK and the world. Suboptimal image acquisitionreduces the sensitivity and specificity of this technique for the detection of clinically significant prostate cancer and result in clinicians losing confidence in the technique.Two expert panels (one from the UK and one from the ESUR/ESUI) have stressed the importance to establish qual...
Source: The British Journal of Radiology - Category: Radiology Authors: Tags: Br J Radiol Source Type: research
CONCLUSIONS.—: Findings support high potential for complete interpretation of prostate core biopsies using solely multiphoton microscopy of intact specimens, with potential diagnostic benefits as well as reduced processing time and reduced processing complexity. PMID: 32991670 [PubMed - as supplied by publisher]
Source: Archives of Pathology and Laboratory Medicine - Category: Laboratory Medicine Authors: Tags: Arch Pathol Lab Med Source Type: research
Abstract INTRODUCTION: We aimed to determine if clinical and imaging features can stratify men at higher risk for clinically significant (CS, International Society of Urological Pathology [ISUP] grade group ≥2) prostate cancer (PCa) in equivocal Prostate Imaging and Data Reporting System (PI-RADS) category 3 lesions on magnetic resonance imaging (MRI). METHODS: Approved by the institutional review board-approved, this retrospective study involved 184 men with 198 lesions who underwent 3T-MRI and MRI-directed transrectal ultrasound biopsy for PI-RADS 3 lesions. Men were evaluated including clinical stage, p...
Source: Canadian Urological Association Journal - Category: Urology & Nephrology Authors: Tags: Can Urol Assoc J Source Type: research
CONCLUSIONS: A prostate MRI PACERR has been developed to communicate the most important findings relevant to decision-making in prostate cancer using patient-oriented design principles. The ability of this tool to improve patient knowledge and communication will be explored. PMID: 33007175 [PubMed - as supplied by publisher]
Source: Canadian Urological Association Journal - Category: Urology & Nephrology Authors: Tags: Can Urol Assoc J Source Type: research
We read with great interest the authors ’ take on pelvic lymph node involvement as detected on Gallium-68-prostate specific membrane antigen (Ga68-PSMA) positron emission tomography (PET) computed tomography (CT) and congratulate them on their possibly practice-changing findings [1]. Till recently, the standard staging investigations fo r a patient with carcinoma prostate would include a CT or magnetic resonance imaging (MRI) of pelvis along with a bone scan; paucity of anatomic abdominal imaging or whole body biologic imaging resulted in the fact that small or early common iliac and lower paraaortic nodal metastases...
Source: Radiotherapy and Oncology - Category: Radiology Authors: Tags: Letter to the Editor Source Type: research
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