scholarly journals Detection of clinically significant cancer in the anterior prostate by transperineal biopsy

2020 ◽  
Vol 126 ◽  
pp. 33-37
Author(s):  
Tim Cowan ◽  
Emily Baker ◽  
Gabriella McCray ◽  
Fairleigh Reeves ◽  
Kimberley Houlihan ◽  
...  
Keyword(s):  
Clinically Significant ◽  
Anterior Prostate ◽  
Transperineal Biopsy

scholarly journals IDEAL Stage 2a experience with in-office, transperineal MRI/ultrasound software fusion targeted prostate biopsy

2019 ◽  
Vol 1 (1) ◽  
pp. e000025
Author(s):  
Michael Tzeng ◽  
Eliza Cricco-Lizza ◽  
Bashir Al Hussein Al Awamlh ◽  
Morgan Pantuck ◽  
Daniel J Margolis ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Adverse Events ◽  
Local Anesthesia ◽  
Active Surveillance ◽  
Robotic Arm ◽  
Targeted Biopsy ◽  
Pubic Arch ◽  
Clinically Significant ◽  
Transperineal Biopsy ◽  
Software Fusion

ObjectiveAlthough the feasibility of transperineal biopsy under local anesthesia has been demonstrated, little is known regarding the application of MRI/ultrasound software fusion targeted biopsy for transperineal biopsy under local anesthesia. The objective of our study is to describe our initial experience with in-office transperineal MRI/ultrasound software fusion targeted biopsy (Idea, Development, Exploration, Assessment, Long-term Follow-up [IDEAL] Stage 2a).MethodsBetween October 2017 and July 2019, 33 men underwent in-office transperineal MRI-targeted biopsy using the Artemis (Eigen, Grass Valley, CA, USA) fixed-robotic arm system. The indication for biopsy was elevated prostate specific antigen (PSA) (n=14), prior negative biopsy (n=10), active surveillance (n=6), and surveillance after partial gland cryoablation (n=3). We prospectively captured patient demographic and clinical characteristics, biopsy outcomes, and complications. Complications were classified according to Common Terminology Criteria for Adverse Events (CTCAE) V.5.0.ResultsThe median patient age was 67 years (IQR 61–71) and the median serum PSA level was 7.0 ng/mL (IQR 5.1–11.4). The median duration of in-office MRI-targeted transperineal biopsy was 26 min (IQR 23–28). Overall, transperineal MRI-targeted biopsy detected prostate cancer in 18 (54.6%) men, with 8 (24.2%) being clinically significant (Gleason Score ≥3+4, Grade Group ≥2). Clinically significant prostate cancer was detected in four (28.6%) biopsy naïve men, two (20.0%) men with a prior negative, one (16.7%) man on active surveillance and one (33.3%) man following partial gland ablation. Three (9.1%) men experienced complications: two hematuria and one urinary retention.ConclusionOur findings demonstrate the feasibility of the fixed-robotic arm fusion platform for in-office transperineal MRI-targeted biopsy and a low rate of adverse events. However, larger prostate size precludes MRI/ultrasound software fusion and pubic arch interference hindered the transperineal MRI-targeted approach in 9.1% of men. Pubic arch interference was overcome by a free-hand approach with software fusion guidance.

Transurethral (TURP) biopsy of suspected anterior prostate cancers identified by MRI: Pilot study of a novel technique.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 230-230
Author(s):  
Shawn Dason ◽  
Christopher Brian Allard ◽  
Keith Barrett ◽  
Ian Wright ◽  
Bobby Shayegan
Keyword(s):  
Pilot Study ◽  
Specific Antigen ◽  
Tumor Location ◽  
Mri Imaging ◽  
Novel Technique ◽  
Trus Biopsy ◽  
Positive Bacterial Culture ◽  
Tertiary Center ◽  
Clinically Significant ◽  
Anterior Prostate

230 Background: Prostatic MRI allows for identification of cancerous lesions in patients with a prior negative TRUS biopsy. Although in-gantry and MR-ultrasound fusion technologies have been reported, access to these technologies is limited. Here we present a novel technique to sample anterior lesions suspicious for prostate cancer (PCa) identified by MRI with transurethral (TURP) biopsy. Methods: MRI studies ordered by a single uro-oncologist at a tertiary center from 2007 to 2013 were reviewed. Patients were included if their studies met the following criteria: prostate MRI (n=148), indication for MRI was prior negative TRUS biopsy (n=48), PCa considered likely by reading radiologist (n=25) and anterior tumor location (n=7). Anterior tumors were those 17mm or more from the posterior prostate margin. Medical records were thoroughly reviewed. Additionally, regional medical databases were searched for 30 day readmission, emergency room (ER) visit, or positive bacterial culture result. Biopsy patients were treated with the standard monopolar TURP clinical pathway at our center. TURP sampling was directed by pre-procedural review of MRI images and report by the surgeon. MRI imaging was read by a single radiologist and obtained with a 3-T MRI with no endorectal coil employing T1, T2, DWI, and DCE sequences. Results: All seven patients identified with anterior tumors received TURP biopsy. Patients had a mean age of 63.6, Prostate-specific antigen of 13.3 ng/mL and a mean of 2.3 prior negative TRUS biopsies. There were no immediate complications reported. In 30 day follow-up data, no patients had a postoperative infection, although one patient was assessed in the ER for self-resolving hematuria and one patient was admitted for hematuria. Mean specimen weight was 4g and all but one patient had Gleason 7 or higher PCa on biopsy. This study demonstrated that MRI followed by TURP biopsy for anterior PCa had an 85.7% cancer detection rate for clinically significant anterior cancers. Conclusions: This pilot study demonstrates that cognitively directed TURP biopsy for MRI-identified anterior prostate lesions is feasible, has an excellent pickup rate for clinically significant cancer, and does not require access to limited technology.

Detection Rate of Anterior Prostate Cancer in 226 Patients Submitted to Initial and Repeat Transperineal Biopsy

2014 ◽  
Vol 93 (2) ◽  
pp. 189-192 ◽  
Author(s):  
Pietro Pepe ◽  
Giuseppe Dibenedetto ◽  
Michele Pennisi ◽  
Filippo Fraggetta ◽  
Maurizio Colecchia ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Detection Rate ◽  
Anterior Prostate ◽  
Transperineal Biopsy ◽  
Anterior Prostate Cancer

The Ratio of the Number of Biopsy Specimens to Prostate Volume (Biopsy Density) > 1.5 Improves the Detection of Clinically Significant Cancers in Men Undergoing Transperineal Biopsy of the Prostate

Brachytherapy ◽  
2019 ◽  
Vol 18 (3) ◽  
pp. S66-S67
Author(s):  
Nelson N. Stone ◽  
E. David Crawford ◽  
Vassilios Skouteris ◽  
M. Scott Lucia ◽  
Francisco G. La Rosa ◽  
...  
Keyword(s):  
Prostate Volume ◽  
Biopsy Specimens ◽  
Clinically Significant ◽  
Transperineal Biopsy

EM of human atherosclerosis: Aortic fatty streaks with transitional lesion features

1992 ◽  
Vol 50 (1) ◽  
pp. 622-623
Author(s):  
K. Florian Klemp ◽  
J.R. Guyton
Keyword(s):  
Foam Cell ◽  
Cell Formation ◽  
Processing Technique ◽  
Foam Cell Formation ◽  
Tissue Preparation ◽  
Electron Microscopic ◽  
Extracellular Lipid ◽  
Electron Microscopic Cytochemistry ◽  
Human Atherosclerosis ◽  
Clinically Significant

The earliest distinctive lesions in human atherosclerosis are fatty streaks (FS), characterized initially by lipid-laden foam cell formation. Fibrous plaques (FP), the clinically significant lesions, differ from FS in several respects. In addition to foam cells, the FP also exhibit fibromuscular proliferation and a necrotic core region rich in extracellular lipid. The possible transition of FS into mature FP has long been debated, however. A subset of FS described by Katz etal., was intermediate in lipid composition between ordinary FS and FP. We investigated this hypothesis by electron microscopic cytochemistry by employing a tissue processing technique previously described by our laboratory. Osmium-tannic acid-paraphenylenediamine (OTAP) tissue preparation enabled ultrastructural analysis of lipid deposits to discern features characteristic of mature fibrous plaques.

Supervision: A Case Study

1977 ◽  
Vol 8 (4) ◽  
pp. 256-263
Author(s):  
Roberta Chapey ◽  
Geraldine Chapey
Keyword(s):  
Organizational Communication ◽  
Behavioral Changes ◽  
Personal Problems ◽  
Clinically Significant

Occasionally, it is the responsibility of a supervisor to help a staff speech clinician resolve professional and or personal problems that interfere with the delivery of quality services. To deal with this situation, the supervisor must be equipped with the techniques and procedures for effective organizational communication. This article presents a case study in which a speech clinician demonstrated irresponsibility in various job areas. The supervisor’s philosophy and the procedures used in managing these problems are presented. The behavioral changes suggest that the supervisor’s interventive procedures were clinically significant and warrant further investigation.

Hearing Aid Gain Usage by Children

1989 ◽  
Vol 20 (2) ◽  
pp. 149-152 ◽  
Author(s):  
Kenneth W. Berger
Keyword(s):  
Hearing Aid ◽  
Appreciable Difference ◽  
Significant Difference ◽  
Clinically Significant

Hearing aid gain usage by two groups of children was examined. No appreciable difference was noted between the groups, nor was there a clinically significant difference between gain usage by these children as compared with a sample of adult hearing aid wearers.

Tools & Resources: Impairment and Disability Web Sites

1999 ◽  
Vol 4 (6) ◽  
pp. 5-6
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Interpersonal Relationships ◽  
Web Sites ◽  
Outpatient Psychotherapy ◽  
Obsessive Compulsive ◽  
Not Otherwise Specified ◽  
Cluster B Personality Disorders ◽  
Clinically Significant ◽  
And Behavior

Abstract Personality disorders are enduring patterns of inner experience and behavior that deviate markedly from those expected by the individual's culture; these inflexible and pervasive patterns reflect issues with cognition, affectivity, interpersonal functioning and impulse control, and lead to clinically significant distress or impairment in social, occupational, or other important areas of functioning. The AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, defines two specific personality disorders, in addition to an eleventh condition, Personality Disorder Not Otherwise Specified. Cluster A personality disorders include paranoid, schizoid, and schizotypal personalities; of these, Paranoid Personality Disorder probably is most common in the legal arena. Cluster B personality disorders include antisocial, borderline, histrionic, and narcissistic personality. Such people may suffer from frantic efforts to avoid perceived abandonment, patterns of unstable and intense interpersonal relationships, an identity disturbance, and impulsivity. Legal issues that involve individuals with cluster B personality disorders often involve determination of causation of the person's problems, assessment of claims of harassment, and assessment of the person's fitness for employment. Cluster C personality disorders include avoidant, dependent, and obsessive-compulsive personality. Two case histories illustrate some of the complexities of assessing impairment in workers with personality disorders, including drug abuse, hospitalizations, and inpatient and outpatient psychotherapy.

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