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Englman C, Barrett T, Moore CM, Giganti F. Active Surveillance for Prostate Cancer: Expanding the Role of MR Imaging and the Use of PRECISE Criteria. Radiol Clin North Am 2024; 62:69-92. [PMID: 37973246 DOI: 10.1016/j.rcl.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Multiparametric magnetic resonance (MR) imaging has had an expanding role in active surveillance (AS) for prostate cancer. It can improve the accuracy of prostate biopsies, assist in patient selection, and help monitor cancer progression. The PRECISE recommendations standardize reporting of serial MR imaging scans during AS. We summarize the evidence on MR imaging-led AS and provide a clinical primer to help report using the PRECISE criteria. Some limitations to both serial imaging and the PRECISE recommendations must be considered as we move toward a more individualized risk-stratified approach to AS.
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Affiliation(s)
- Cameron Englman
- Department of Radiology, University College London Hospital NHS Foundation Trust, 3rd Floor, Charles Bell House, 43-45 Foley Street, London, W1W7TY, UK; Division of Surgery & Interventional Science, University College London, 3rd Floor, Charles Bell House, 43-45 Foley Street, London, W1W7TY, UK
| | - Tristan Barrett
- Department of Radiology, University of Cambridge, Box 218, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK; Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Box 218, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK
| | - Caroline M Moore
- Division of Surgery & Interventional Science, University College London, 3rd Floor, Charles Bell House, 43-45 Foley Street, London, W1W7TY, UK; Department of Urology, University College London Hospital NHS Foundation Trust, 3rd Floor, Charles Bell House, 43-45 Foley Street, London, W1W7TY, UK
| | - Francesco Giganti
- Department of Radiology, University College London Hospital NHS Foundation Trust, 3rd Floor, Charles Bell House, 43-45 Foley Street, London, W1W7TY, UK; Division of Surgery & Interventional Science, University College London, 3rd Floor, Charles Bell House, 43-45 Foley Street, London, W1W7TY, UK.
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2
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Rodler S, Ramacciotti LS, Maas M, Mokhtar D, Hershenhouse J, De Castro Abreu AL, Fuchs G, Stief CG, Gill IS, Cacciamani GE. The Impact of Telemedicine in Reducing the Carbon Footprint in Health Care: A Systematic Review and Cumulative Analysis of 68 Million Clinical Consultations. Eur Urol Focus 2023; 9:873-887. [PMID: 38036339 DOI: 10.1016/j.euf.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/23/2023] [Indexed: 12/02/2023]
Abstract
CONTEXT Carbon footprint (CF) has emerged as an important factor when assessing health care interventions. OBJECTIVE To investigate the reduction in CF for patients utilizing telemedicine. EVIDENCE ACQUISITION The PubMed, Scopus, and Web of Science databases were queried for studies describing telemedicine consultation and reporting on carbon emissions saved and the carbon emissions of telemedicine devices as primary outcomes, and travel distance and time and cost savings and safety as secondary outcomes. Outcomes were tabulated and calculated per consultation. Carbon emissions and travel distances were also calculated for each total study cohort. Risk of bias was assessed using the Newcastle-Ottawa scale, and the Oxford level of evidence was determined. EVIDENCE SYNTHESIS A total of 48 studies met the inclusion criteria, covering 68 465 481 telemedicine consultations and savings of 691 825 tons of CO2 emissions and 3 318 464 047 km of travel distance. Carbon assessment was mostly reported as the estimated distance saved using a conversion factor. Medical specialties used telemedicine to connect specialists with patients at home (n = 25) or at a local center (n = 6). Surgical specialties used telemedicine for virtual preoperative assessment (n = 9), follow-up (n = 4), and general consultation (n = 4). The savings per consultation were 21.9-632.17 min and $1.85-$325. More studies focused on the COVID-19 time frame (n = 33) than before the pandemic (n = 15). The studies are limited by calculations, mostly for the travel distance for carbon savings, and appropriate follow-up to analyze the real impact on travel and appointments. CONCLUSIONS Telemedicine reduces the CF of the health care sector. Expanding the use of telemedicine and educating providers and patients could further decrease CO2 emissions and save both money and time. PATIENT SUMMARY We reviewed 48 studies on the use of telemedicine. We found that people used their cars less and saved time and money, as well as CO2 emissions, if they used teleconsultations. Some studies only looked at how much CO2 from driving was saved, so there might be more to learn about the benefits of teleconsultations. The use of online doctor appointments is not only good for our planet but also helps patients in saving time and money. This review is registered on the PROSPERO database for systematic reviews (CRD42023456839).
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Affiliation(s)
- Severin Rodler
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Artificial Intelligence Center, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA; Department of Urology, University Hospital of LMU Munich, Munich, Germany
| | - Lorenzo Storino Ramacciotti
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Artificial Intelligence Center, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Marissa Maas
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Artificial Intelligence Center, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Daniel Mokhtar
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Artificial Intelligence Center, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Jacob Hershenhouse
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Artificial Intelligence Center, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Andre Luis De Castro Abreu
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Artificial Intelligence Center, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Gerhard Fuchs
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Artificial Intelligence Center, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Christian G Stief
- Department of Urology, University Hospital of LMU Munich, Munich, Germany
| | - Inderbir S Gill
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Artificial Intelligence Center, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Giovanni E Cacciamani
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Artificial Intelligence Center, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA.
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Kaneko M, Medina LG, Lenon MSL, Hemal S, Sayegh AS, Jadvar DS, Ramacciotti LS, Paralkar D, Cacciamani GE, Lebastchi AH, Salhia B, Aron M, Hopstone M, Duddalwar V, Palmer SL, Gill IS, Abreu AL. Transperineal vs transrectal magnetic resonance and ultrasound image fusion prostate biopsy: a pair-matched comparison. Sci Rep 2023; 13:13457. [PMID: 37596374 PMCID: PMC10439224 DOI: 10.1038/s41598-023-40371-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 08/09/2023] [Indexed: 08/20/2023] Open
Abstract
The objective of this study was to compare transperineal (TP) versus transrectal (TR) magnetic resonance imaging (MRI) and transrectal ultrasound (TRUS) fusion prostate biopsy (PBx). Consecutive men who underwent prostate MRI followed by a systematic biopsy. Additional target biopsies were performed from Prostate Imaging Reporting & Data System (PIRADS) 3-5 lesions. Men who underwent TP PBx were matched 1:2 with a synchronous cohort undergoing TR PBx by PSA, Prostate volume (PV) and PIRADS score. Endpoint of the study was the detection of clinically significant prostate cancer (CSPCa; Grade Group ≥ 2). Univariate and multivariable analyses were performed. Results were considered statistically significant if p < 0.05. Overall, 504 patients met the inclusion criteria. A total of 168 TP PBx were pair-matched to 336 TR PBx patients. Baseline demographics and imaging characteristics were similar between the groups. Per patient, the CSPCa detection was 2.1% vs 6.3% (p = 0.4) for PIRADS 1-2, and 59% vs 60% (p = 0.9) for PIRADS 3-5, on TP vs TR PBx, respectively. Per lesion, the CSPCa detection for PIRADS 3 (21% vs 16%; p = 0.4), PIRADS 4 (51% vs 44%; p = 0.8) and PIRADS 5 (76% vs 84%; p = 0.3) was similar for TP vs TR PBx, respectively. However, the TP PBx showed a longer maximum cancer core length (11 vs 9 mm; p = 0.02) and higher cancer core involvement (83% vs 65%; p < 0.001) than TR PBx. Independent predictors for CSPCa detection were age, PSA, PV, abnormal digital rectal examination findings, and PIRADS 3-5. Our study demonstrated transperineal MRI/TRUS fusion PBx provides similar CSPCa detection, with larger prostate cancer core length and percent of core involvement, than transrectal PBx.
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Affiliation(s)
- Masatomo Kaneko
- Center for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA, 90089, USA
- Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Luis G Medina
- Center for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA, 90089, USA
| | - Maria Sarah L Lenon
- Center for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA, 90089, USA
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sij Hemal
- Center for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA, 90089, USA
| | - Aref S Sayegh
- Center for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA, 90089, USA
| | - Donya S Jadvar
- Dornsife School of Letters and Science, University of Southern California, Los Angeles, CA, USA
| | - Lorenzo Storino Ramacciotti
- Center for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA, 90089, USA
| | - Divyangi Paralkar
- Center for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA, 90089, USA
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Giovanni E Cacciamani
- Center for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA, 90089, USA
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Amir H Lebastchi
- Center for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA, 90089, USA
| | - Bodour Salhia
- Department of Translational Genomics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Manju Aron
- Center for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA, 90089, USA
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Michelle Hopstone
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Vinay Duddalwar
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Suzanne L Palmer
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Inderbir S Gill
- Center for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA, 90089, USA
| | - Andre Luis Abreu
- Center for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA, 90089, USA.
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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4
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Okoli GN, Lam OLT, Reddy VK, Copstein L, Askin N, Prashad A, Stiff J, Khare SR, Leonard R, Zarin W, Tricco AC, Abou-Setta AM. Interventions to improve early cancer diagnosis of symptomatic individuals: a scoping review. BMJ Open 2021; 11:e055488. [PMID: 34753768 PMCID: PMC8578990 DOI: 10.1136/bmjopen-2021-055488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/21/2021] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES To summarise the current evidence regarding interventions for accurate and timely cancer diagnosis among symptomatic individuals. DESIGN A scoping review following the Joanna Briggs Institute's methodological framework for the conduct of scoping reviews and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. DATA SOURCES MEDLINE (Ovid), CINAHL (EBSCOhost) and PsycINFO (Ovid) bibliographic databases, and websites of relevant organisations. Published and unpublished literature (grey literature) of any study type in the English language were searched for from January 2017 to January 2021. ELIGIBILITY AND CRITERIA Study participants were individuals of any age presenting at clinics with symptoms indicative of cancer. Interventions included practice guidelines, care pathways or other initiatives focused on achieving predefined benchmarks or targets for wait times, streamlined or rapid cancer diagnostic services, multidisciplinary teams and patient navigation strategies. Outcomes included accuracy and timeliness of cancer diagnosis. DATA EXTRACTION AND SYNTHESIS We summarised findings graphically and descriptively. RESULTS From 21 298 retrieved citations, 88 unique published articles and 16 unique unpublished documents (on 18 study reports), met the eligibility for inclusion. About half of the published literature and 83% of the unpublished literature were from the UK. Most of the studies were on interventions in patients with lung cancer. Rapid referral pathways and technology for supporting and streamlining the cancer diagnosis process were the most studied interventions. Interventions were mostly complex and organisation-specific. Common themes among the studies that concluded intervention was effective were multidisciplinary collaboration and the use of a nurse navigator. CONCLUSIONS Multidisciplinary cooperation and involvement of a nurse navigator may be unique features to consider when designing, delivering and evaluating interventions focused on improving accurate and timely cancer diagnosis among symptomatic individuals. Future research should examine the effectiveness of the interventions identified through this review.
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Affiliation(s)
- George N Okoli
- George and Fay Yee Centre for Healthcare Innovation, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Otto L T Lam
- George and Fay Yee Centre for Healthcare Innovation, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Viraj K Reddy
- George and Fay Yee Centre for Healthcare Innovation, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Leslie Copstein
- George and Fay Yee Centre for Healthcare Innovation, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Nicole Askin
- Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Anubha Prashad
- Canadian Partnership Against Cancer (the Partnership), Toronto, Ontario, Canada
| | - Jennifer Stiff
- Canadian Partnership Against Cancer (the Partnership), Toronto, Ontario, Canada
| | - Satya Rashi Khare
- Canadian Partnership Against Cancer (the Partnership), Toronto, Ontario, Canada
| | - Robyn Leonard
- Canadian Partnership Against Cancer (the Partnership), Toronto, Ontario, Canada
| | - Wasifa Zarin
- Knowledge Translation Program, St. Michael's Hospital, Unity Health, Toronto, Ontario, Canada
| | - Andrea C Tricco
- Knowledge Translation Program, St. Michael's Hospital, Unity Health, Toronto, Ontario, Canada
- Epidemiology Division and Institute for Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Queen's Collaboration for Health Care Quality, Joanna Briggs Institute (JBI) Centre of Excellence at Queen's University, Kingston, Ontario, Canada
| | - Ahmed M Abou-Setta
- George and Fay Yee Centre for Healthcare Innovation, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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5
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Allgood E, Abreu AL, Palmer SL. Expedited Workflow for "One-Stop" Magnetic Resonance Imaging and Image Fusion Prostate Biopsy: Implementation and Lessons Learned. Semin Roentgenol 2021; 56:406-409. [PMID: 34688343 DOI: 10.1053/j.ro.2021.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/08/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Evan Allgood
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Andre Luis Abreu
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA; USC Institute of Urology, Center for Image-guided Surgery and Focal Therapy, University of Southern California, Los Angeles, CA
| | - Suzanne L Palmer
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA.
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6
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Winter M, Patel MI. Difficulties of delivering urological care to remote areas. ANZ J Surg 2021; 91:483-484. [PMID: 33847058 DOI: 10.1111/ans.16688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Matthew Winter
- Nepean Urology Research Group, Nepean Hospital, Sydney, New South Wales, Australia.,Department of Urology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Manish I Patel
- Specialty of Surgery, Sydney Medical School, Sydney, New South Wales, Australia.,Department of Urology, Westmead Hospital, Sydney, New South Wales, Australia
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7
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Sugano D, Kaneko M, Yip W, Lebastchi AH, Cacciamani GE, Abreu AL. Comparative Effectiveness of Techniques in Targeted Prostate Biopsy. Cancers (Basel) 2021; 13:cancers13061449. [PMID: 33810065 PMCID: PMC8004898 DOI: 10.3390/cancers13061449] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/15/2021] [Accepted: 03/17/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary Prostate cancer is one of the most common cancers in men. Traditionally, prostate cancer is diagnosed via transrectal ultrasound-guided prostate biopsy, using a systematic random template. Using multiparametric magnetic resonance imaging, lesions suspicious for prostate cancer can be identified, and subsequently targeted on biopsy, allowing for increased diagnostic accuracy. This article reviewed the current literature surrounding various types of targeted biopsy, such as transperineal biopsy, allowing for comparison not only between targeted biopsy and systematic biopsy, but also between different varieties of targeted biopsy. Abstract In this review, we evaluated literature regarding different modalities for multiparametric magnetic resonance imaging (mpMRI) and mpMRI-targeted biopsy (TB) for the detection of prostate cancer (PCa). We identified studies evaluating systematic biopsy (SB) and TB in the same patient, thereby allowing each patient to serve as their own control. Although the evidence supports the accuracy of TB, there is still a proportion of clinically significant PCa (csPCa) that is detected only in SB, indicating the importance of maintaining SB in the diagnostic pathway, albeit with additional cost and morbidity. There is a growing subset of data which supports the role of TB alone, which may allow for increased efficiency and decreased complications. We also compared the literature on transrectal (TR) vs. transperineal (TP) TB. Although further high-level evidence is necessary, current evidence supports similar csPCa detection rate for both approaches. We also evaluated various TB techniques such as cognitive fusion biopsy (COG-TB) and in-bore biopsy (IB-TB). COG-TB has comparable detection rates to software fusion, but is operator-dependent and may have reduced accuracy for smaller lesions. IB-TB may allow for greater precision as lesions are directly targeted; however, this is costly and time-consuming, and does not account for MRI-invisible lesions.
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Affiliation(s)
- Dordaneh Sugano
- USC Institute of Urology and Catherine & Joseph Aresty Department of Urology, Center for Image-Guided and Focal Therapy for Prostate Cancer, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA; (D.S.); (M.K.); (W.Y.); (A.H.L.); (G.E.C.)
| | - Masatomo Kaneko
- USC Institute of Urology and Catherine & Joseph Aresty Department of Urology, Center for Image-Guided and Focal Therapy for Prostate Cancer, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA; (D.S.); (M.K.); (W.Y.); (A.H.L.); (G.E.C.)
- Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Wesley Yip
- USC Institute of Urology and Catherine & Joseph Aresty Department of Urology, Center for Image-Guided and Focal Therapy for Prostate Cancer, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA; (D.S.); (M.K.); (W.Y.); (A.H.L.); (G.E.C.)
| | - Amir H. Lebastchi
- USC Institute of Urology and Catherine & Joseph Aresty Department of Urology, Center for Image-Guided and Focal Therapy for Prostate Cancer, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA; (D.S.); (M.K.); (W.Y.); (A.H.L.); (G.E.C.)
| | - Giovanni E. Cacciamani
- USC Institute of Urology and Catherine & Joseph Aresty Department of Urology, Center for Image-Guided and Focal Therapy for Prostate Cancer, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA; (D.S.); (M.K.); (W.Y.); (A.H.L.); (G.E.C.)
| | - Andre Luis Abreu
- USC Institute of Urology and Catherine & Joseph Aresty Department of Urology, Center for Image-Guided and Focal Therapy for Prostate Cancer, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA; (D.S.); (M.K.); (W.Y.); (A.H.L.); (G.E.C.)
- Correspondence: ; Tel.: +1-323-865-3700
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8
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Abstract
PURPOSE OF REVIEW The goal of this study is to review recent findings and evaluate the utility of MRI transrectal ultrasound fusion biopsy (FBx) techniques and discuss future directions. RECENT FINDINGS FBx detects significantly higher rates of clinically significant prostate cancer (csPCa) than ultrasound-guided systematic prostate biopsy (SBx), particularly in repeat biopsy settings. FBx has also been shown to detect significantly lower rates of clinically insignificant prostate cancer. In addition, a dedicated prostate MRI can assist in more accurately predicting the Gleason score and provide further information regarding the index cancer location, prostate volume, and clinical stage. The ability to accurately evaluate specific lesions is vital to both focal therapy and active surveillance, for treatment selection, planning, and adequate follow-up. FBx has been demonstrated in multiple high-quality studies to have improved performance in diagnosis of csPCa compared to SBx. The combination of FBx with novel technologies including radiomics, prostate-specific membrane antigen positron emission tomography (PSMA PET), and high-resolution micro-ultrasound may have the potential to further enhance this performance.
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9
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Wu RC, Lebastchi AH, Hadaschik BA, Emberton M, Moore C, Laguna P, Fütterer JJ, George AK. Role of MRI for the detection of prostate cancer. World J Urol 2021; 39:637-649. [PMID: 33394091 DOI: 10.1007/s00345-020-03530-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 11/13/2020] [Indexed: 01/24/2023] Open
Abstract
The use of multiparametric MRI has been hastened under expanding, novel indications for its use in the diagnostic and management pathway of men with prostate cancer. This has helped drive a large body of the literature describing its evolving role over the last decade. Despite this, prostate cancer remains the only solid organ malignancy routinely diagnosed with random sampling. Herein, we summarize the components of multiparametric MRI and interpretation, and present a critical review of the current literature supporting is use in prostate cancer detection, risk stratification, and management.
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Affiliation(s)
- Richard C Wu
- Department of Urology, E-Da Hospital, Kaohsiung, Taiwan
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Amir H Lebastchi
- Department of Urology, University of Southern California, Los Angeles, CA, USA
| | - Boris A Hadaschik
- University Hospital Heidelberg and German Cancer Research Center, Heidelberg, Germany
| | - Mark Emberton
- Division of Surgery and Interventional Science, University College London, London, UK
| | - Caroline Moore
- Division of Surgery and Interventional Science, University College London, London, UK
| | - Pilar Laguna
- Department of Urology, Medipol University Research Hospital, Istanbul, Turkey
| | - Jurgen J Fütterer
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Arvin K George
- Department of Urology, University of Michigan, Ann Arbor, MI, USA.
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10
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Fujihara A, Iwata T, Shakir A, Tafuri A, Cacciamani GE, Gill K, Ashrafi A, Ukimura O, Desai M, Duddalwar V, Stern MS, Aron M, Palmer SL, Gill IS, Abreu AL. Multiparametric magnetic resonance imaging facilitates reclassification during active surveillance for prostate cancer. BJU Int 2020; 127:712-721. [PMID: 33043575 DOI: 10.1111/bju.15272] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate the utility of multiparametric magnetic resonance imaging (mpMRI) in the reassessment and monitoring of patients on active surveillance (AS) for Grade Group (GG) 1 prostate cancer (PCa). PATIENTS AND METHODS We identified, from our prospectively maintained institutional review board-approved database, 181 consecutive men enrolled on AS for GG 1 PCa who underwent at least one surveillance mpMRI followed by MRI/prostate biopsy (PBx). A subset analysis was performed among 68 patients who underwent serial (at least two) mpMRI/PBx during AS. Pathological progression (PP) was defined as upgrade to GG ≥2 on follow up biopsy. RESULTS Baseline MRI was performed in 34 patients (19%). At a median follow-up of 2.2 years for the overall cohort, the PP was 12% (6/49) for Prostate Imaging Reporting and Data System (PI-RADS) 1-2 lesions and 37% (48/129) for the PI-RADS ≥3 lesions. The 2-year PP-free survival rate was 84%. Surveillance prostate-specific antigen density (P < 0.001) and surveillance PI-RADS ≥3 (P = 0.002) were independent predictors of PP on reassessment MRI/PBx. In the serial MRI cohort, the 2-year PP-free survival was 95% for the No-MRI-progression group vs 85% for the MRI-progression group (P = 0.02). MRI progression was significantly higher in the PP (62%) than in the No-PP (31%) group (P = 0.04). If serial MRI were used for PCa surveillance and biopsy were triggered based only on MRI progression, 63% of PBx might be postponed at the cost of missing 12% of GG ≥2 PCa in those with stable MRI. Conversely, this strategy would miss 38% of those with upgrading to GG ≥2 PCa on biopsy. Stable serial mpMRI correlates with no reclassification to GG ≥3 PCa during AS. CONCLUSION On surveillance mpMRI, PI-RADS ≥3 was associated with increased risk of PCa reclassification. Surveillance biopsy based only on MRI progression may avoid a large number of biopsies at the cost of missing many PCa reclassifications.
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Affiliation(s)
- Atsuko Fujihara
- USC Institute of Urology and Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA.,Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tsuyoshi Iwata
- USC Institute of Urology and Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA.,Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Aliasger Shakir
- USC Institute of Urology and Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA
| | - Alessandro Tafuri
- USC Institute of Urology and Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA.,Department of Urology, University of Verona, Verona, Italy
| | - Giovanni E Cacciamani
- USC Institute of Urology and Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA
| | - Karanvir Gill
- USC Institute of Urology and Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA
| | - Akbar Ashrafi
- USC Institute of Urology and Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA
| | - Osamu Ukimura
- Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Mihir Desai
- USC Institute of Urology and Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA
| | - Vinay Duddalwar
- USC Institute of Urology and Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA.,Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Mariana S Stern
- USC Institute of Urology and Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA
| | - Manju Aron
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Suzanne L Palmer
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Inderbir S Gill
- USC Institute of Urology and Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA
| | - Andre Luis Abreu
- USC Institute of Urology and Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA
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11
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O'Connor LP, Lebastchi AH, Horuz R, Rastinehad AR, Siddiqui MM, Grummet J, Kastner C, Ahmed HU, Pinto PA, Turkbey B. Role of multiparametric prostate MRI in the management of prostate cancer. World J Urol 2020; 39:651-659. [PMID: 32583039 DOI: 10.1007/s00345-020-03310-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 06/11/2020] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Prostate cancer has traditionally been diagnosed by an elevation in PSA or abnormal exam leading to a systematic transrectal ultrasound (TRUS)-guided biopsy. This diagnostic pathway underdiagnoses clinically significant disease while over diagnosing clinically insignificant disease. In this review, we aim to provide an overview of the recent literature regarding the role of multiparametric MRI (mpMRI) in the management of prostate cancer. MATERIALS AND METHODS A thorough literature review was performed using PubMed to identify articles discussing use of mpMRI of the prostate in management of prostate cancer. CONCLUSION The incorporation of mpMRI of the prostate addresses the shortcomings of the prostate biopsy while providing several other advantages. mpMRI allows some men to avoid an immediate biopsy and permits visualization of areas likely to harbor clinically significant cancer prior to biopsy to facilitate use of MR-targeted prostate biopsies. This allows for reduction in diagnosis of clinically insignificant disease as well as improved detection and better characterization of higher risk cancers, as well as the improved selection of patients for active surveillance. In addition, mpMRI can be used for selection and monitoring of patients for active surveillance and treatment planning during surgery and focal therapy.
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Affiliation(s)
- Luke P O'Connor
- Urologic Oncology Branch, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Amir H Lebastchi
- Urologic Oncology Branch, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Rahim Horuz
- Department of Urology, Istanbul Medipol University, Istanbul, Turkey
| | | | - M Minhaj Siddiqui
- Division of Urology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Jeremy Grummet
- Department of Surgery, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Christof Kastner
- Department of Urology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Hashim U Ahmed
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Peter A Pinto
- Urologic Oncology Branch, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Baris Turkbey
- Molecular Imaging Program, National Cancer Institute, NIH, 10 Center Drive Room B3B85, Bethesda, MD, USA. .,, 10 Center Drive Room B3B85, Bethesda, MD, 20814, USA.
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12
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Abreu AL. The Pillars for Sustained Growth of Magnetic Resonance Imaging Pathway for Prostate Cancer Diagnosis: Quality, Reproducibility, Accessibility, Cost Effectiveness, and Training. Eur Urol 2020; 77:491-493. [PMID: 31982194 DOI: 10.1016/j.eururo.2020.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 01/02/2020] [Indexed: 01/22/2023]
Affiliation(s)
- Andre Luis Abreu
- USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Catherine & Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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13
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Tokas T, Junker D, Nagele U. One-stop biparametric MRI and MRI/ultrasound fusion-guided biopsy: can we include the histopathology result and our treatment recommendations in our diagnostic pathway? World J Urol 2019; 38:2067-2068. [PMID: 31529245 DOI: 10.1007/s00345-019-02940-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 08/28/2019] [Indexed: 11/27/2022] Open
Affiliation(s)
- Theodoros Tokas
- Department of Urology and Andrology, General Hospital Hall in Tirol, Milser Str. 10, 6060, Hall in Tirol, Austria.
| | - Daniel Junker
- Department of Radiology, General Hospital Hall in Tirol, Hall in Tirol, Austria
| | - Udo Nagele
- Department of Urology and Andrology, General Hospital Hall in Tirol, Milser Str. 10, 6060, Hall in Tirol, Austria
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