MRI-directed Micro-US-guided Transperineal Focal Laser Ablation for Localized Prostate Cancer: A 1-year Follow-up Study.

Background MRI-guided focal laser ablation (FLA) is a promising treatment in localized prostate cancer (PCa). MRI-guided micro-US FLA shows potential for outpatient use, but its clinical application remains unexplored. Purpose To evaluate the safety, feasibility, and 12-month functional and oncologic outcomes of MRI-guided micro-US transperineal FLA in localized PCa and to assess the accuracy of micro-US in showing lesions depicted at MRI with Prostate Imaging Reporting and Data System (PI-RADS) score of 3 or higher.

Transperineal laser ablation of the prostate as a treatment for benign prostatic hyperplasia and prostate cancer: The results of a Delphi consensus project.

Objective: To evaluate transperineal laser ablation (TPLA) with Echolaser® (Echolaser® TPLA, Elesta S.p.A.

Performance of a Region of Interest-based Algorithm in Diagnosing International Society of Urological Pathology Grade Group ≥2 Prostate Cancer on the MRI-FIRST Database-CAD-FIRST Study.

Background And Objective: Prostate multiparametric magnetic resonance imaging (MRI) shows high sensitivity for International Society of Urological Pathology grade group (GG) ≥2 cancers. Many artificial intelligence algorithms have shown promising results in diagnosing clinically significant prostate cancer on MRI. To assess a region-of-interest-based machine-learning algorithm aimed at characterising GG ≥2 prostate cancer on multiparametric MRI.

Post-MRI transrectal micro-ultrasonography of transition zone PI-RADS > 2 lesions for biopsy guidance.

Objective: To prospectively determine the value of post-MRI micro-ultrasonography (microUS) in the diagnosis of transition zone (TZ) significant prostate cancer (sPCa).

Patients And Methods: Eighty-four consecutive men (66 ± 6.3 years) with a mean PSA level of 10.

Cellular density of low-grade transition zone prostate cancer: A limiting factor to correlate restricted diffusion with tumor aggressiveness.

Objective: To compare the mean apparent diffusion coefficient (ADCmean) and glandular density of Gleason score (GS) 3 + 3 transition zone prostate cancers (TZ-PCa) with those of the peripheral zone (PZ-PCa).

Material & Methods: Seventy-nine men (mean age: 65 ± 6 [SD] years; range: 52-81 years) with 37 TZ-PCa (37/79; 53 %) and 42 PZ-PCa (42/79; 47 %) had prostate MRI before radical prostatectomy. Glandular cell density was semi-quantitatively evaluated in all tumors.

MRI-directed high-frequency (29MhZ) TRUS-guided biopsies: initial results of a single-center study.

Objectives: To evaluate the ability of high-frequency (29 MHz) transrectal micro-ultrasound (microUS) as a second-look examination after biparametric MRI (bp-MRI) and to reidentify focal lesions seen on diagnostic MRI and to detect new ones METHODS: A total of 118 consecutive men (mean age, 66 ± 13 [SD] years; range, 49-93 years) with a mean prostate-specific antigen level of 11 ± 19 (SD) ng/mL (range, 2-200 ng/mL) and at least one focal lesion (MRI+) with a score > 2 on bp-MRI were included. Of these, 79/118 (66.9%) were biopsy-naïve and 102/118 (86.

In-Bore Transrectal MRI-Guided Biopsy With Robotic Assistance in the Diagnosis of Prostate Cancer: An Analysis of 57 Patients.

The objective of our study was to analyze the feasibility and potential role of robotic-assisted transrectal MRI-guided biopsy for the diagnosis of prostate cancer. A total of 57 patients (mean age, 67 ± 6 [SD] years; age range, 57-83 years; mean prostate-specific antigen level, 10.7 ± 6.

PI-RADS Steering Committee: The PI-RADS Multiparametric MRI and MRI-directed Biopsy Pathway.

High-quality evidence shows that MRI in biopsy-naive men can reduce the number of men who need prostate biopsy and can reduce the number of diagnoses of clinically insignificant cancers that are unlikely to cause harm. In men with prior negative biopsy results who remain under persistent suspicion, MRI improves the detection and localization of life-threatening prostate cancer with greater clinical utility than the current standard of care, systematic transrectal US-guided biopsy. Systematic analyses show that MRI-directed biopsy increases the effectiveness of the prostate cancer diagnosis pathway.

Prostate Imaging Reporting and Data System Version 2.1: 2019 Update of Prostate Imaging Reporting and Data System Version 2.

The Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) was developed with a consensus-based process using a combination of published data, and expert observations and opinions. In the short time since its release, numerous studies have validated the value of PI-RADS v2 but, as expected, have also identified a number of ambiguities and limitations, some of which have been documented in the literature with potential solutions offered. To address these issues, the PI-RADS Steering Committee, again using a consensus-based process, has recommended several modifications to PI-RADS v2, maintaining the framework of assigning scores to individual sequences and using these scores to derive an overall assessment category.

MR imaging-guided prostate interventional imaging: Ready for a clinical use?

Prostate interventional magnetic resonance imaging (MRI) is now routinely performed in many centers. Its more widespread acceptance is limited by the cost of the use of MRI largely related to the long duration time of the procedures. However, the benefit of a robotic assistance has generated a new interest, because it substantially shortens the procedure time, while improving the accuracy.

Precision Matters in MR Imaging-targeted Prostate Biopsies: Evidence from a Prospective Study of Cognitive and Elastic Fusion Registration Transrectal Biopsies.

Purpose To measure the precision in placement of a biopsy needle in a magnetic resonance (MR) imaging-detected target with transrectal ultrasonography (US), to document the clinical relevance of precision, and to report on the precision of cognitive and software-based registrations. Materials and Methods This prospective study was approved by the institutional review board and performed between June 2013 and September 2013. Patients provided informed verbal consent.

Diffusion-weighted imaging of the prostate: should we use quantitative metrics to better characterize focal lesions originating in the peripheral zone?

Purpose: To compare inter-reader concordance and accuracy of qualitative diffusion-weighted (DW) PIRADSv2.0 score with those of quantitative DW-MRI for the diagnosis of peripheral zone prostate cancer.

Materials And Methods: Two radiologists independently assigned a DW-MRI-PIRADS score to 92 PZ-foci, in 74 patients (64.

An update of pitfalls in prostate mpMRI: a practical approach through the lens of PI-RADS v. 2 guidelines.

Objectives: The aim of the current report is to provide an update in the imaging interpretation of prostate cancer on multiparametric magnetic resonance imaging (mpMRI), with a special focus on how to discriminate pathological tissue from the most common pitfalls that may be encountered during daily clinical practice using the Prostate Imaging Reporting and Data System (PI-RADS) version 2 guidelines.

Methods: All the cases that are shown in this pictorial review comply with the European Society of Urogenital Radiology (ESUR) guidelines for technical mpMRI requirements.

Results: Despite the standardised manner to report mpMRI (PI-RADS v.

[Pathological findings of visible and non-visible tumors on multiparametric magnetic resonance imaging (MRI) prior to radical prostatectomy].

Introduction: As urologists are questioned about the overtreatment of localized prostate cancer, multiparametric MRI can diagnose significant prostate cancer thanks to targeted biopsies. However, some tumors cannot be detected by MRI. What are the pathological characteristics of those tumors?

Materials And Methods: We have selected 144 consecutive patients treated with radical prostatectomy for clinically localized prostate cancer diagnosed on systematic and targeted biopsies (Koelis) according to multiparametric MRI findings.

Are Magnetic Resonance Imaging-Transrectal Ultrasound Guided Targeted Biopsies Noninferior to Transrectal Ultrasound Guided Systematic Biopsies for the Detection of Prostate Cancer?

Purpose: In men with suspicion of prostate cancer the standard of cancer detection is transrectal ultrasound guided 10 to 12-core systematic biopsy. The targeted biopsy only strategy using magnetic resonance imaging-transrectal ultrasound image registration is gaining in popularity. We assessed the noninferiority of targeted vs systematic biopsy.

PI-RADS Prostate Imaging - Reporting and Data System: 2015, Version 2.

The Prostate Imaging - Reporting and Data System Version 2 (PI-RADS™ v2) is the product of an international collaboration of the American College of Radiology (ACR), European Society of Uroradiology (ESUR), and AdMetech Foundation. It is designed to promote global standardization and diminish variation in the acquisition, interpretation, and reporting of prostate multiparametric magnetic resonance imaging (mpMRI) examination, and it is based on the best available evidence and expert consensus opinion. It establishes minimum acceptable technical parameters for prostate mpMRI, simplifies and standardizes terminology and content of reports, and provides assessment categories that summarize levels of suspicion or risk of clinically significant prostate cancer that can be used to assist selection of patients for biopsies and management.

Can multiparametric MRI rule in or rule out significant prostate cancer?

Purpose Of Review: To show how multiparametric MRI can rule in the presence of significant prostate cancer (PCa), allowing for magnetic resonance-targeted biopsies to detect aggressive tumors eligible for immediate treatment and to evaluate if mp-MRI can rule out significant tumor foci to avoid overdiagnosis and overtreatment of PCa.

Recent Findings: Diffusion-weighted MRI plays a major role to detect tumor foci and to rule in significant PCa. A low apparent diffusion coefficient (ADC) value indicates that high Gleason grade tumors are present.

Pitfalls in Interpreting mp-MRI of the Prostate: A Pictorial Review with Pathologic Correlation.

Objectives: The purpose of this pictorial review is to present a wide spectrum of prostate multiparametric MRI (mp-MRI) pitfalls that may occur in clinical practice, with radiological and pathological correlation.

Methods: All examinations were performed according to ESUR Guidelines protocols.

Results And Conclusion: mp-MRI imaging of the prostate often leads to interpreting doubts and misdiagnosis due to the many interpretative pitfalls that a tissue, whether healthy or treated, may cause.