Assessment of high-grade prostate cancer risk using prostate cancer biomarkers.

Introduction: To identify patients at risk of high-grade prostate cancer using prostate cancer biomarkers.

Materials And Methods: A total of 601 men were screened for prostate cancer in 2012, 2015, and 2016 using prostate cancer biomarkers: prostate health index (phi), 4KScore, and SelectMDx. The first two are blood tests that incorporate several PSA isoforms; SelectMDx measures mRNA levels of homeobox C6 and distal-less homeobox 1 in post-digital rectal examination urine samples.

The Ratio of the Number of Biopsy Specimens to Prostate Volume (Biopsy Density) Greater Than 1.5 Improves the Prostate Cancer Detection Rate in Men Undergoing Transperineal Biopsy of the Prostate.

Purpose: We sought to determine the minimum number of transperineal prostate mapping biopsies needed to optimize the prostate cancer detection rate.

Materials And Methods: A total of 436 men underwent transperineal prostate mapping biopsy at 2 institutions. Biopsy density was calculated as the ratio of the total number of specimens retrieved (mean 59.

Assessment of PI-RADS v2 categories ≥ 3 for diagnosis of clinically significant prostate cancer.

Purpose: To assess the diagnostic accuracy of PI-RADS v2 categories ≥ 3 to detect clinically significant prostate cancer (csPCa) against histopathology of Transperineal Mapping Biopsy (TPMB).

Materials And Methods: IRB-approved retrospective cohort study included 47 men who had 3.0 T multi-parametric MRI (mpMRI) and TPMB of prostate.

The effect of digital rectal exam on the 4Kscore for aggressive prostate cancer.

Background: The 4Kscore is a new commercially available blood-based diagnostic test which predicts risk for aggressive, clinically significant prostate cancer on prostate biopsy. The 4Kscore is currently restricted to patients who have not had a digital rectal exam (DRE) in the previous 96 h, owing to prior mixed data suggesting that prostate specific antigen (PSA) isoforms may increase by a statistically significant-if not necessarily clinically significant-amount shortly after DRE. Our primary objective was to determine if 4Kscore test results are affected by a preceding DRE.

Laparoscopic Versus Percutaneous Cryoablation of Small Renal Mass: Systematic Review and Cumulative Analysis of Comparative Studies.

The objective of this study was to compare the surgical, oncological, and functional outcomes of laparoscopic and percutaneous cryoablation for the treatment of small renal masses. A systematic review of the literature was performed through March 2016 using PubMed, Scopus, and Ovid databases. Article selection proceeded according to the search strategy on the basis of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria.

Human feasibility study of fluorescence spectroscopy guided optical biopsy needle for prostate cancer diagnosis.

Current prostate biopsy cores have a very low diagnostic yield. These biopsies often fail to diagnose prostate cancer since 90% of cores are histopathologically classified as benign. The concentrations of endogenous fluorophores in prostate tissue vary with disease states.

Diffuse reflectance spectroscopy can differentiate high grade and low grade prostatic carcinoma.

Prostate tumors are graded by the revised Gleason Score (GS) which is the sum of the two predominant Gleason grades present ranging from 6-10. GS 6 cancer exclusively with Gleason grade 3 is designated as low grade (LG) and correlates with better clinical prognosis for patients. GS >7 cancer with at least one of the Gleason grades 4 and 5 is designated as HG indicate worse prognosis for patients.

Diagnosis of prostatic carcinoma on multiparametric magnetic resonance imaging using shearlet transform.

This paper presents a method to diagnose prostate cancer on multiparametric magnetic resonance imaging (Mp-MRI) using the shearlet transform. The objective is classification of benign and malignant regions on transverse relaxation time weighted (T2W), dynamic contrast enhanced (DCE), and apparent diffusion coefficient (ADC) images. Compared with conventional wavelet filters, shearlet has inherent directional sensitivity, which makes it suitable for characterizing small contours of cancer cells.

Ethnic minorities (African American and Hispanic) males prefer prostate cryoablation as aggressive treatment of localized prostate cancer.

Introduction: Our safety net hospital offers minimally invasive, traditional open and perineal radical prostatectomies, as well as radiation therapy and medical oncological services when appropriate. Historically, only few African American and Hispanic patients elected surgical procedures due to unknown reasons. Interestingly, after initiation of the prostate cryoablation program (Whole Gland) in 2003 at Denver Health Medical Center (DHMC) we noticed a trend towards cryotherapy in these specific patient populations for the treatment of localized prostate cancer.

Targeted Therapy for Metastatic Renal Carcinoma: an Update.

Conventional chemotherapy is associated with poor outcomes in metastatic renal cell carcinoma (RCC). Advances in the understanding of tumor molecular biology and the implementation of new drugs that target these molecular pathways have increased the arsenal against advanced RCC and improved outcomes in these patients. Herein, we briefly describe the latest data on targeted therapies used in the treatment of advanced renal cell carcinoma.

Anterior tumors of the prostate: diagnosis and significance.

Introduction: Prostate biopsies are usually taken from the peripheral rather than anterior region of the prostate. Consequently, tumors originating from the anterior apical region and transition zones may be under-sampled. We examined whether addition of transrectal anterior biopsy (TAB) would improve efficacy of prostate biopsies.

Clinical-pathologic correlation between transperineal mapping biopsies of the prostate and three-dimensional reconstruction of prostatectomy specimens.

Background: Extended transrectal ultrasound guided biopsies (TRUSB) of the prostate may not accurately convey true morphometric information and Gleason score (GS) of prostate cancer (PCa) and the clinical use of template-guided (5-mm grid) transperineal mapping biopsies (TPMBs) remains controversial.

Methods: We correlated the clinical-pathologic results of 1,403 TPMB cores obtained from 25 men diagnosed with PCa with 64 cancer lesions found in their corresponding radical prostatectomy (RP) specimens. Special computer models of three-dimensional, whole-mounted radical prostatectomy (3D-WMRP) specimens were generated and used as gold standard to determine tumor morphometric data.

Optimization of prostate cancer diagnosis by increasing the number of core biopsies based on gland volume.

In this prospective, non-randomized phase-I clinical trial, we comparatively studied the performance of six laterally-directed biopsies or the modified fan-shaped biopsies (MFSB), midline sextant biopsies (MB), and transition zone biopsies (TZB) and examine their prostate cancer (PCa) detection rates. A total of 114 patients received combinations of MFSB, MB, and TZB based on prostate gland volume: those ≤15 cc received 8 biopsies; those >15 cc but ≤ 50 cc received 14 biopsies; and those >50 cc received 20 biopsies. The mean prostate-specific antigen (PSA) level, Gleason score, and prostate volume were 8.

Proliferative tumor doubling times of prostatic carcinoma.

Prostate cancer (PCa) has a variable biology ranging from latent cancer to extremely aggressive tumors. Proliferative activities of cancers may indicate their biological potential. A flow cytometric assay to calculate maximum proliferative doubling times (T(max)) of PCa in radical prostatectomy specimens after preoperative in vivo bromodeoxyuridine (BrdU) infusion is presented.

Digital quantification of five high-grade prostate cancer patterns, including the cribriform pattern, and their association with adverse outcome.

Proper grading of the cribriform prostate cancer pattern has not previously been supported by outcome-based evidence. Among 153 men who underwent radical prostatectomy, 76 with prostate-specific antigen (PSA) failure (≥0.2 ng/mL [0.

Carcinoid tumor of the verumontanum (colliculus seminalis) of the prostatic urethra with a coexisting prostatic adenocarcinoma: a case report.

Introduction: Urethral carcinoid tumors are very rare tumors with only four cases described in the literature.

Case Presentation: We present the case of a 61-year-old man with a primary carcinoid tumor of the verumontanum (colliculis seminalis) portion of the prostatic urethra with a coexisting prostatic adenocarcinoma. In addition to whole mount hematoxylin and eosin staining, special immunoperoxidase staining specific for chromogranin A, neuron specific enolase, synaptophysin, pan-cytokeratin and PSA, and a special combined staining for racemase (alpha-methyl CoA) antigen and p63 antigen were performed.

Image registration accuracy of a 3-dimensional transrectal ultrasound-guided prostate biopsy system.

Objective: For a follow-up prostate biopsy procedure, it is useful to know the previous biopsy locations in anatomic relation to the current transrectal ultrasound (TRUS) scan. The goal of this study was to validate the performance of a 3-dimensional TRUS-guided prostate biopsy system that can accurately relocate previous biopsy sites.

Methods: To correlate biopsy locations from a sequence of visits by a patient, the prostate surface data obtained from a previous visit needs to be registered to the follow-up visits.

Three-dimensional sonography with needle tracking: role in diagnosis and treatment of prostate cancer.

Objective: Image-guided prostate biopsy has become routine in medical diagnosis. Although it improves biopsy outcome, it mostly operates in 2 dimensions, therefore lacking presentation of information in the complete 3-dimensional (3D) space. Because prostatic carcinomas are nonuniformly distributed within the prostate gland, it is crucial to accurately guide the needles toward clinically important locations within the 3D volume for both diagnosis and treatment.

Three different strategies for real-time prostate capsule volume computation from 3-D end-fire transrectal ultrasound.

estimation of prostate capsule volume via segmentation of the prostate from 3-D ultrasound volumetric ultrasound images is a valuable clinical tool, especially during biopsy. Normally, a physician traces the boundaries of the prostate manually, but this process is tedious, laborious, and subject to errors. The prostate capsule edge is computed using three different strategies: (a) least square approach, (b) level set approach, and (c) Discrete Dynamic Contour approach.

Clinical staging of prostate cancer: a computer-simulated study of transperineal prostate biopsy.

Objective: To identify the precise location of prostate cancer within the gland and thus possibly permit more aggressive therapy of the lesion, while potentially sparing the noncancerous gland from ablative therapy.

Materials And Methods: Three-dimensional "solid" computer models were reconstructed for 86 autopsy specimens and 20 stage T1c radical prostatectomy specimens. Transperineal biopsies were simulated for grid sizes of 5-mm (method A) and 10-mm (method B) with an 18 G, 23-mm long biopsy needle.

Biomorphometric analysis of human prostatic carcinoma by using three-dimensional computer models.

Advances in the detection of carcinoma of the prostate during the last 15 years have accounted for a sharp increase and then an abrupt decrease in the incidence of the disease. A more recent decline in its mortality rates has been variously interpreted as either the success of early detection and improved treatment or lead-time bias. The recently reported Prostate Cancer Prevention Trial had an overall detection rate that approached the 30%-40% prevalence rates reported in autopsy series in which men died of other causes.

Aberrant HOXC expression accompanies the malignant phenotype in human prostate.

Dysregulation of HOX gene expression has been implicated as a factor in malignancies for a number of years. However, no consensus has emerged regarding specific causative genes. Using a degenerate reverse transcription-PCR technique, we show up-regulation of genes from the HOXC cluster in malignant prostate cell lines and lymph node metastases.

Laterally directed biopsies detect more clinically threatening prostate cancer: computer simulated results.

Background: The purpose of this study was to determine, whether a modified fan-shaped biopsy (MFSB) technique which utilizes six laterally directed biopsies would lead to higher detection rates of clinically threatening prostatic carcinoma than the six random systematic core biopsy (SRSCB) method.

Methods: We reconstructed 3-dimensional solid computer models of 86 autopsy prostates and 40 radical prostatatectomy specimens. Simulations of SRSCB and MFSB were then performed using the same biopsy sites except that the biopsy probe was rotated 45 degrees toward posterolateral peripheral zone for MFSB.