Different sodium concentrations of noncancerous and cancerous prostate tissue seen on MRI using an external coil.

Background: Sodium (Na) MRI of prostate cancer (PCa) is a novel but underdocumented technique conventionally acquired using an endorectal coil. These endorectal coils are associated with challenges (e.g.

Evaluating trends in radical prostatectomy approach and 30-day complication rate in Ontario from 2010-2019.

Introduction: Radical prostatectomy (RP) for prostate cancer has changed over the years with the advent of minimally invasive (MIRP) approaches, which includes robotic-assisted RP (RARP). The MIRP approaches have been shown to reduce complication rate, but there remain barriers to adoption. The objective of this study was to quantitatively describe the trend in the RP approach in Ontario, and to assess the trend in complication rates.

The impact of the Ontario quality-based procedures funding model on radical prostatectomy outcomes.

Introduction: In 2015, radical prostatectomy (RP) in Ontario transitioned to the quality-based procedures (QBP) funding model, which assigns disbursement from surgical quality indicator (QI) outcome performance. The objective of this study was to assess the QBP QI outcomes before and after implementation of the QBP funding model for RP, and to determine whether changes seen were attributable to the QBP model.

Methods: We conducted a population-based, retrospective cohort study including all men who underwent RP for prostate cancer in Ontario from 2010-2019.

Hospital volume-outcome relationships for robot-assisted surgeries: a population-based analysis.

Background: Associations between procedure volumes and outcomes can inform minimum volume standards and the regionalization of health services. Robot-assisted surgery continues to expand globally; however, data are limited regarding which hospitals should be using the technology.

Study Design: Using administrative health data for all residents of Ontario, Canada, this retrospective cohort study included adult patients who underwent a robot-assisted radical prostatectomy (RARP), total robotic hysterectomy (TRH), robot-assisted partial nephrectomy (RAPN), or robotic portal lobectomy using 4 arms (RPL-4) between January 2010 and September 2021.

Hospital learning curves for robot-assisted surgeries: a population-based analysis.

Background: Robot-assisted surgery has been rapidly adopted. It is important to define the learning curve to inform credentialling requirements, training programs, identify fast and slow learners, and protect patients. This study aimed to characterize the hospital learning curve for common robot-assisted procedures.

The evolving use of robotic surgery: a population-based analysis.

Introduction: Robotic surgery has integrated into the healthcare system despite limited evidence demonstrating its clinical benefit. Our objectives were (i) to describe secular trends and (ii) patient- and system-level determinants of the receipt of robotic as compared to open or laparoscopic surgery.

Methods: This population-based retrospective cohort study included adult patients who, between 2009 and 2018 in Ontario, Canada, underwent one of four commonly performed robotic procedures: radical prostatectomy, total hysterectomy, thoracic lobectomy, partial nephrectomy.

Prostate cancer classification using radiomics and machine learning on mp-MRI validated using co-registered histology.

Background: Multi-parametric magnetic resonance imaging (mp-MRI) is emerging as a useful tool for prostate cancer (PCa) detection but currently has unaddressed limitations. Computer aided diagnosis (CAD) systems have been developed to address these needs, but many approaches used to generate and validate the models have inherent biases.

Method: All clinically significant PCa on histology was mapped to mp-MRI using a previously validated registration algorithm.

Adverse events following robotic surgery: population-based analysis.

Background: Robotic surgery was integrated into some healthcare systems despite there being few well designed, real-world studies on safety or benefit. This study compared the safety of robotic with laparoscopic, thoracoscopic, and open approaches in common robotic procedures.

Methods: This was a population-based, retrospective study of all adults who underwent prostatectomy, hysterectomy, pulmonary lobectomy, or partial nephrectomy in Ontario, Canada, between 2008 and 2018.

Targeting prostate lesions on multiparametric MRI with HDR brachytherapy: Optimal planning margins determined using whole-mount digital histology.

Purpose: Multiparametric magnetic resonance imaging (mpMRI) has demonstrated the ability to localize intraprostatic lesions. It is our goal to determine how to optimally target the underlying histopathological cancer within the setting of high-dose-rate brachytherapy (HDR-BT).

Methods And Materials: Ten prostatectomy patients had pathologist-annotated mid-gland histology registered to pre-procedural mpMRI, which were interpreted by four different observers.

A Robust Edge-Preserving Stereo Matching Method for Laparoscopic Images.

Stereo matching has become an active area of research in the field of computer vision. In minimally invasive surgery, stereo matching provides depth information to surgeons, with the potential to increase the safety of surgical procedures, particularly those performed laparoscopically. Many stereo matching methods have been reported to perform well for natural images, but for images acquired during a laparoscopic procedure, they are limited by image characteristics including illumination differences, weak texture content, specular highlights, and occlusions.

Short-duration dynamic [F]DCFPyL PET and CT perfusion imaging to localize dominant intraprostatic lesions in prostate cancer: validation against digital histopathology and comparison to [F]DCFPyL PET/MR at 120 minutes.

Purpose: Localized prostate cancer (PCa) in patients is characterized by a dominant focus in the gland (dominant intraprostatic lesion, DIL). Accurate DIL identification may enable more accurate diagnosis and therapy through more precise targeting of biopsy, radiotherapy and focal ablative therapies. The goal of this study is to validate the performance of [F]DCFPyL PET and CT perfusion (CTP) for detecting and localizing DIL against digital histopathological images.

Prostate specific membrane antigen positron emission tomography for lesion-directed high-dose-rate brachytherapy dose escalation.

Background And Purpose: Prostate specific membrane antigen positron emission tomography imaging (PSMA-PET) has demonstrated potential for intra-prostatic lesion localization. We leveraged our existing database of co-registered PSMA-PET imaging with cross sectional digitized pathology to model dose coverage of histologically-defined prostate cancer when tailoring brachytherapy dose escalation based on PSMA-PET imaging.

Materials And Methods: Using a previously-developed automated approach, we created segmentation volumes delineating underlying dominant intraprostatic lesions for ten men with co-registered pathology-imaging datasets.

Simple prostatectomy using the open and robotic approaches for lower urinary tract symptoms: A retrospective, case-control series.

Introduction: We aimed to assess the outcome of our series of simple prostatectomy at our institution using the open simple prostatectomy (OSP) and robotic-assisted simple prostatectomy (RASP) approaches.

Methods: We conducted a retrospective chart review of men who underwent OSP and RASP at Western University, in London, ON. Preoperative, intraoperative, and postoperative data were collected and analyzed.

Potential Pitfalls in Pre-implantation Genetic Diagnosis in a Patient with Tuberous Sclerosis and Isolated Mosaicism for a Variant in Renal Tissue.

Tuberous sclerosis complex (TSC) is an autosomal dominant disorder that displays a wide spectrum of clinical manifestations, often affecting multiple organs including the kidneys, brain, lungs, and skin. A pathogenic mutation in either the or gene can be detected in almost 85% of the cases, with mosaicism accounting for about half of the remaining cases. We report a case of TSC diagnosed clinically, requesting genetic counselling regarding reproductive risks.

A multiobserver study investigating the effectiveness of prostatic multiparametric magnetic resonance imaging to dose escalate corresponding histologic lesions using high-dose-rate brachytherapy.

Purpose: Using multiparametric MRI data and the pathologic data from radical prostatectomy specimens, we simulated the treatment planning of dose-escalated high-dose-rate brachytherapy (HDR-BT) to the Multiparametric MRI dominant intraprostatic lesion (mpMRI-DIL) to compare the dose potentially delivered to the pathologically confirmed locations of the high-grade component of the cancer.

Methods And Materials: Pathologist-annotated prostatectomy midgland histology sections from 12 patients were registered to preprostatectomy mpMRI scans that were interpreted by four radiologists. To simulate realistic HDR-BT, we registered each observer's mpMRI-DILs and corresponding histology to two transrectal ultrasound images of other HDR-BT patients with a 15-Gy whole-gland prescription.

Kinetic analysis of dominant intraprostatic lesion of prostate cancer using quantitative dynamic [F]DCFPyL-PET: comparison to [F]fluorocholine-PET.

Purpose: Identification of the dominant intraprostatic lesion(s) (DILs) can facilitate diagnosis and treatment by targeting biologically significant intra-prostatic foci. A PSMA ligand, [F]DCFPyL (2-(3-{1-carboxy-5-[(6-[F]fluoro-pyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid), is better than choline-based [F]FCH (fluorocholine) in detecting and localizing DIL because of higher tumour contrast, particularly when imaging is delayed to 1 h post-injection. The goal of this study was to investigate whether the different imaging performance of [F]FCH and [F]DCFPyL can be explained by their kinetic behaviour in prostate cancer (PCa) and to evaluate whether DIL can be accurately detected and localized using a short duration dynamic positron emission tomography (PET).

Long-term visual and anatomic outcomes of patients with peripapillary pachychoroid syndrome.

Background/aims: To analyse the long-term anatomic and visual outcomes of patients with peripapillary pachychoroid syndrome (PPS), a recently described entity in the pachychoroid disease spectrum.

Methods: This study retrospectively included patients from several retina centres worldwide. Visual acuity (VA), retinal thickness and choroidal thickness at baseline, 6 months and final follow-up were assessed.

The value of Tc-sestamibi single-photon emission computed tomography-computed tomography in the evaluation and risk stratification of renal masses.

Introduction: Differentiation of renal cell carcinoma (RCC) from oncocytoma is a common diagnostic dilemma. A few studies have shown that Tc-sestamibi (MIBI) imaging has the potential to characterize indeterminate renal masses. This comparative study evaluated the utility of MIBI single-photon emission computed tomography-computed tomography (SPECT-CT) in the assessment and risk stratification of renal masses.

Ureteral Stent Microbiota Is Associated with Patient Comorbidities but Not Antibiotic Exposure.

Ureteral stents are commonly used to prevent urinary obstruction but can become colonized by bacteria and encrusted, leading to clinical complications. Despite recent discovery and characterization of the healthy urinary microbiota, stent-associated bacteria and their impact on encrustation are largely underexplored. We profile the microbiota of patients with typical short-term stents, as well as over 30 atypical cases (all with paired mid-stream urine) from 241 patients.

Histologic validation of auto-contoured dominant intraprostatic lesions on [F] DCFPyL PSMA-PET imaging.

Background: PSMA-PET has shown good concordance with histology, but there is a need to investigate the ability of PSMA-PET to delineate DIL boundaries for guided biopsy and focal therapy planning.

Objective: To determine threshold and margin combinations that satisfy the following criteria: ≥95% sensitivity with max specificity and ≥95% specificity with max sensitivity.

Design, Setting And Participants: We registered pathologist-annotated whole-mount mid-gland prostatectomy histology sections cut in 4.

Automatic cancer detection on digital histopathology images of mid-gland radical prostatectomy specimens.

Automatic cancer detection on radical prostatectomy (RP) sections facilitates graphical and quantitative surgical pathology reporting, which can potentially benefit postsurgery follow-up care and treatment planning. It can also support imaging validation studies using a histologic reference standard and pathology research studies. This problem is challenging due to the large sizes of digital histopathology whole-mount whole-slide images (WSIs) of RP sections and staining variability across different WSIs.