Concordance of MRI-Guided Fusion and Systematic 12-Core Prostate Biopsy for the Detection of Prostate Cancer.

Background: MRI-guided fusion biopsy is increasingly utilized over systematic 12-core biopsy for men with MRI-visible prostate lesions.

Patients And Methods: Patients with MRI visible lesions who underwent MRI-guided fusion and systematic 12-core biopsy from 2016-2020 in the Intermountain Healthcare (IHC) system were consecutively analyzed. This was in the setting of a continuous quality assurance initiative among the reading radiologists.

Personalizing Localized Prostate Cancer: Validation of a Combined Clinical Cell-cycle Risk (CCR) Score Threshold for Prognosticating Benefit From Multimodality Therapy.

Introduction: The combined clinical cell-cycle risk (CCR) score is a validated model that combines the cell-cycle progression (CCP) score with the University of California San Francisco Cancer of the Prostate Risk Assessment (CAPRA) score. This score determines the risk of progressive disease for men with prostate cancer. Here, we further validate the prognostic ability of the CCR score and evaluate its ability to help determine which patients may safely forgo multimodality therapy.

Prognostic capabilities and clinical utility of cell cycle progression testing, prostate imaging reporting and data system, version 2, and clinicopathologic data in management of localized prostate cancer.

Objectives: To compare the prognostic capabilities and clinical utility of the cell cycle progression (CCP) gene expression classifier test, multiparametric magnetic resonance imaging (mpMRI) with Prostate Imaging Reporting and Data System (PI-RADS) scoring, and clinicopathologic data in select prostate cancer (PCa) medical management scenarios.

Patients And Methods: Retrospective, observational analysis of patients (N = 222) ascertained sequentially from a single urology practice from January 2015 to June 2018. Men were included if they had localized PCa, a CCP score, and an mpMRI PI-RADS v2 score.

Economic burden of illness associated with localized prostate cancer in the United States.

Prior studies have established the economic burden of prostate cancer on society. However, changes to screening, novel therapies and increased use of active surveillance (AS) create a need for an updated analysis. A deterministic, decision-analytic model was developed to estimate medical costs associated with localized prostate cancer over 10 years.

Analysis of the prognostic utility of the cell cycle progression (CCP) score generated from needle biopsy in men treated with definitive therapy.

Background: Accurate risk stratification can help guide appropriate treatment decisions in men with localized prostate cancer. Here, we evaluated the independent ability of the molecular cell cycle progression (CCP) score and the combined cell-cycle clinical risk (CCR) score to predict 10-year risk of progression to metastatic disease in a large, pooled analysis of men with definitively treated prostate cancer.

Methods: The pooled analysis included 1,062 patients from four institutions (Martini Clinic, Durham VA Medical Center, Intermountain Healthcare, Ochsner Clinic) treated definitively for localized prostate cancer by either radical prostatectomy or radiotherapy (brachytherapy or external beam radiotherapy ± hormone therapy).

Meta-analytic and primary investigations of the role of followers in ratings of leadership behavior in organizations.

Leader-centric views of leadership tend to regard followers as passive recipients of leaders' influences. As such, researchers often control for follower characteristics (e.g.

Intraoperative utilization of advanced imaging modalities in a complex kidney stone case: a pilot case study.

Purpose: Despite the increasing use of advanced 3D imaging techniques and 3D printing, these techniques have not yet been comprehensively compared in a surgical setting. The purpose of this study is to explore the effectiveness of five different advanced imaging modalities during a complex renal surgical procedure.

Methods: A patient with a horseshoe kidney and multiple large, symptomatic stones that had failed Extracorporeal Shock Wave Lithotripsy (ESWL) and ureteroscopy treatment was used for this evaluation.

Prognostic utility of biopsy-derived cell cycle progression score in patients with National Comprehensive Cancer Network low-risk prostate cancer undergoing radical prostatectomy: implications for treatment guidance.

Objectives: To determine the prognostic utility of the cell cycle progression (CCP) score in men with National Comprehensive Cancer Network (NCCN)-defined low-risk prostate cancer (PCa) undergoing radical prostatectomy (RP).

Patients And Methods: Men who underwent RP for Gleason score ≤6 PCa at three institutions (Martini Clinic [MC], Durham Veterans Affairs Medical Center [DVA] and Intermountain Healthcare [IH]) were identified. The CCP score was obtained from diagnostic (DVA, IH) or simulated biopsies (MC).

Long-term health effects among testicular cancer survivors.

Purpose: Testicular cancer is diagnosed at a young age and survival rates are high; thus, the long-term effects of cancer treatment need to be assessed. Our objectives are to estimate the incidence rates and determinants of late effects in testicular cancer survivors.

Methods: We conducted a population-based cohort study of testicular cancer survivors, diagnosed 1991-2007, followed up for a median of 10 years.

Using Electronic Health Record Data to Identify Prostate Cancer Patients That May Qualify for Active Surveillance.

Introduction: The introduction of the protein-specific antigen (PSA) test in care means that prostate cancer (PCa) is being detected earlier and more frequently. The result of increased screening using PSA, digital rectal examination and awareness of prostate was an increase in the number of men with low risk cancers. Active surveillance has become a viable alternative to immediate treatment with surgery, radiation and other forms of localized treatment.

ACR Appropriateness Criteria indeterminate renal mass.

Renal masses are increasingly detected in asymptomatic individuals as incidental findings. An indeterminate renal mass is one that cannot be diagnosed confidently as benign or malignant at the time it is discovered. CT, ultrasonography, and MRI of renal masses with fast-scan techniques and intravenous (IV) contrast are the mainstays of evaluation.

ACR Appropriateness Criteria(®) on renal failure.

Imaging plays a role in the management of patients with acute kidney injury or chronic kidney disease. However, clinical circumstances strongly impact the appropriateness of imaging use. In patients with newly detected renal dysfunction, ultrasonography can assess for reversible causes, assess renal size and echogenicity, and thus, establish the chronicity of disease.

ACR appropriateness criteria post-treatment follow-up of renal cell carcinoma.

Although localized renal cell carcinoma can be effectively treated by surgery or ablative therapies, local or distant metastatic recurrence after treatment is not uncommon. Because recurrent disease can be effectively treated, patient surveillance after treatment of renal cell carcinoma is very important. Surveillance protocols are generally based on the primary tumor's size, stage, and nuclear grade at the time of resection, as well as patterns of tumor recurrence, including where and when metastases occur.

Prognostic utility of the cell cycle progression score generated from biopsy in men treated with prostatectomy.

Purpose: The cell cycle progression score is associated with prostate cancer outcomes in various clinical settings. However, previous studies of men treated with radical prostatectomy evaluated cell cycle progression scores generated from resected tumor tissue. We evaluated the prognostic usefulness of the score derived from biopsy specimens in men treated with radical prostatectomy.

Patient and provider attitudes toward genomic testing for prostate cancer susceptibility: a mixed method study.

Background: The strong association between family history and prostate cancer (PCa) suggests a significant genetic contribution, yet specific highly penetrant PCa susceptibility genes have not been identified. Certain single-nucleotide-polymorphisms have been found to correlate with PCa risk; however uncertainty remains regarding their clinical utility and how to best incorporate this information into clinical decision-making. Genetic testing is available directly to consumers and both patients and healthcare providers are becoming more aware of this technology.

Follow-up for Clinically Localized Renal Neoplasms: AUA Guideline.

Purpose: The purpose of this guideline is to provide a clinical framework for follow-up of clinically localized renal neoplasms undergoing active surveillance, or following definitive therapy.

Materials And Methods: A systematic literature review identified published articles in the English literature between January 1999 and 2011 relevant to key questions specified by the Panel related to kidney neoplasms and their follow-up (imaging, renal function, markers, biopsy, prognosis). Study designs consisting of clinical trials (randomized or not), observational studies (cohort, case-control, case series) and systematic reviews were included.

ACR Appropriateness Criteria® acute onset flank pain--suspicion of stone disease.

Low dose (<3 mSv) noncontrast CT (NCCT) is the imaging study of choice for accurate evaluation of patients with acute onset of flank pain and suspicion of stone disease (sensitivity 97%, specificity 95%). NCCT can reliably characterize the location and size of an offending ureteral calculus, identify complications, and diagnose alternative etiologies of abdominal pain such as appendicitis. By comparison, the sensitivity of radiographs (59%) and ultrasound (24-57%) for the detection of renal and ureteral calculi is relatively poor.

ACR Appropriateness Criteria ® acute onset of scrotal pain--without trauma, without antecedent mass.

Men or boys, who present with acute scrotal pain without prior trauma or a known mass, most commonly suffer from torsion of the spermatic cord; epididymitis or epididymoorchitis; or torsion of the testicular appendages. Less common causes of pain include a strangulated hernia, segmental testicular infarction, or a previously undiagnosed testicular tumor. Ultrasound is the study of choice to distinguish these disorders; it has supplanted Tc-99 m scrotal scintigraphy for the diagnosis of spermatic cord torsion.

ACR Appropriateness Criteria® posttreatment follow-up of prostate cancer.

Although prostate cancer can be effectively treated, recurrent or residual disease after therapy is not uncommon and is usually detected by a rise in prostate-specific antigen. Patients with biochemical prostate-specific antigen relapse should undergo a prompt search for the presence of local recurrence or distant metastatic disease, each requiring different forms of therapy. Various imaging modalities and image-guided procedures may be used in the evaluation of these patients.

Skill based mentored laparoscopy course participation leads to laparoscopic practice expansion and assists in transition to robotic surgery.

Purpose: Prior studies suggest poor long-term incorporation of laparoscopy into urology practice after a postgraduate course. We evaluated the influence of the American Urological Association Mentored Laparoscopy Course on urologist clinical practice.

Materials And Methods: The 2-day Mentored Laparoscopy Course includes lectures, standardized dry laboratory training with videotape analysis and a porcine laboratory with consistent mentors.

Overprescription of postoperative narcotics: a look at postoperative pain medication delivery, consumption and disposal in urological practice.

Purpose: Prescription narcotic abuse is a significant social problem. Surplus medication following surgery is 1 source of prescription diversion. We assessed prescribing practices, consumption and disposal of prescribed narcotics after urological surgery.

A solitary seminoma renal metastasis presenting as an incidental renal mass.

A 34-year-old man with an extensive medical history received a CT scan for chronic leg and back pain. Imaging revealed a single, enhancing 8-cm mass in the upper pole of the right kidney. Laparoscopic radical nephrectomy was performed and pathologic finding revealed seminoma.

Skills-based laparoscopy training demonstrates long-term transfer of clinical laparoscopic practice: additional follow-up.

Objectives: The American Urological Association Hands on Laparoscopy course was designed to help practitioners without laparoscopic training advance their skills. We evaluated the long-term effect of this course on urologists' practice.

Methods: A total of 52 urologists, 37-61 years old (mean 50.

Feasibility of laparoscopic renal cooling with near-freezing saline irrigation delivered with a standard irrigator aspirator.

Objectives: To determine the feasibility of laparoscopic renal cooling with near-freezing saline irrigation in the porcine model delivered using readily available operating room equipment.

Methods: Five pigs underwent laparoscopic renal surgery with temperature sensors placed in the medulla and upper, middle, and lower pole renal cortex. After complete occlusion of the renal artery and vein, near-freezing saline was delivered with a standard irrigator/aspirator onto the renal surface.