scholarly journals Design, Development, and Multi-Characterization of an Integrated Clinical Transrectal Ultrasound and Photoacoustic Device for Human Prostate Imaging

Diagnostics ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 566 ◽  
Author(s):  
Sumit Agrawal ◽  
Kerrick Johnstonbaugh ◽  
Joseph Y. Clark ◽  
Jay D. Raman ◽  
Xueding Wang ◽  
...  
Keyword(s):  
Real Time ◽  
Needle Biopsy ◽  
Imaging Modality ◽  
Experimental Studies ◽  
Transrectal Ultrasound ◽  
Human Prostate ◽  
Design Development ◽  
Imaging Device ◽  
Prostate Imaging ◽  
Clinically Significant

The standard diagnostic procedure for prostate cancer (PCa) is transrectal ultrasound (TRUS)-guided needle biopsy. However, due to the low sensitivity of TRUS to cancerous tissue in the prostate, small yet clinically significant tumors can be missed. Magnetic resonance imaging (MRI) with TRUS fusion biopsy has recently been introduced as a way to improve the identification of clinically significant PCa in men. However, the spatial errors in coregistering the preprocedural MRI with the real-time TRUS causes false negatives. A real-time and intraprocedural imaging modality that can sensitively detect PCa tumors and, more importantly, differentiate aggressive from nonaggressive tumors could largely improve the guidance of biopsy sampling to improve diagnostic accuracy and patient risk stratification. In this work, we seek to fill this long-standing gap in clinical diagnosis of PCa via the development of a dual-modality imaging device that integrates the emerging photoacoustic imaging (PAI) technique with the established TRUS for improved guidance of PCa needle biopsy. Unlike previously published studies on the integration of TRUS with PAI capabilities, this work introduces a novel approach for integrating a focused light delivery mechanism with a clinical-grade commercial TRUS probe, while assuring much-needed ease of operation in the transrectal space. We further present the clinical potential of our device by (i) performing rigorous characterization studies, (ii) examining the acoustic and optical safety parameters for human prostate imaging, and (iii) demonstrating the structural and functional imaging capabilities using deep-tissue-mimicking phantoms. Our TRUSPA experimental studies demonstrated a field-of-view in the range of 130 to 150 degrees and spatial resolutions in the range of 300 μm to 400 μm at a soft tissue imaging depth of 5 cm.

Fusion of real-time transrectal ultrasound with preacquired MRI for multimodality prostate imaging

2007 ◽  
Author(s):  
Jochen Krücker ◽  
Sheng Xu ◽  
Neil Glossop ◽  
Peter Guion ◽  
Peter Choyke ◽  
...  
Keyword(s):  
Real Time ◽  
Transrectal Ultrasound ◽  
Prostate Imaging

scholarly journals The Prostate Health Index aids multi-parametric MRI in diagnosing significant prostate cancer

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yu-Hua Fan ◽  
Po-Hsun Pan ◽  
Wei-Ming Cheng ◽  
Hsin-Kai Wang ◽  
Shu-Huei Shen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Predictive Power ◽  
Transrectal Ultrasound ◽  
Health Index ◽  
Prostate Imaging ◽  
Prostate Biopsies ◽  
Prostate Health Index ◽  
Clinically Significant ◽  
Prostate Health

AbstractTo evaluate the performance of the Prostate Health Index (PHI) in magnetic resonance imaging-transrectal ultrasound (MRI-TRUS) fusion prostate biopsy for the detection of clinically significant prostate cancer (csPCa). We prospectively enrolled 164 patients with at least one Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) ≥ 3 lesions who underwent MRI-TRUS fusion prostate biopsy. Of the PSA-derived biomarkers, the PHI had the best performance in predicting csPCa (AUC 0.792, CI 0.707–0.877) in patients with PI-RADS 4/5 lesions. Furthermore, the predictive power of PHI was even higher in the patients with PI-RADS 3 lesions (AUC 0.884, CI 0.792–0.976). To minimize missing csPCa, we used a PHI cutoff of 27 and 7.4% of patients with PI-RADS 4/5 lesions could have avoided a biopsy. At this level, 2.0% of cases with csPCa would have been missed, with sensitivity and NPV rates of 98.0% and 87.5%, respectively. However, the subgroup of PI-RADS 3 was too small to define the optimal PHI cutoff. PHI was the best PSA-derived biomarker to predict csPCa in MRI-TRUS fusion prostate biopsies in men with PI-RADS ≥ 3 lesions, especially for the patients with PI-RADS 3 lesions who gained the most value.

Imaging characteristics of patients with prostate cancer with favorable 17-gene genomic prostate score on 3T multiparametric prostate MRI.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 14-14
Author(s):  
Aaron Katz ◽  
Corinne Liu ◽  
Kaitlin E. Kosinski
Keyword(s):  
Prostate Cancer ◽  
Transrectal Ultrasound ◽  
Prostate Mri ◽  
Prostate Imaging ◽  
Imaging Characteristics ◽  
Contrast Enhanced ◽  
Risk Prostate Cancer ◽  
Gene Test ◽  
Multiparametric Prostate Mri ◽  
Clinically Significant

14 Background: Our practice utilizes a biopsy-based 17 gene test that is clinically validated as a predictor of favorable pathology and used to guide use of active surveillance for men with very low, low, and intermediate risk prostate cancer. The purpose of this study was to evaluate the imaging characteristics and PIRADS score of prostate cancer patients with a Genomic Prostate Score (GPS) indicating favorable pathology. Methods: 300 consecutive 3T Multiparametric Prostate MRI (MP-MRI) were identified from March 26, 2012, to June 29, 2015. Thirty patients (age 44-84 years) with GPS scores indicating favorable pathology were included in the study. Prostate Imaging Reporting and Data System (PIRADS) scores were assigned to each MP-MRI. MRI index lesions were defined as discrete hypointense T2 signal with at least one anatomically corresponding abnormal functional MRI parameter (diffusion weighted and dynamic contrast-enhanced images). The MRI examinations were evaluated for number and laterality of MRI index lesions and in relation to biopsy pathology findings after the MP-MRI was performed. Results: Out of 30 MP-MRI, 7 (23.3%) PIRADS 5, 10 (33.3%) PIRADS 4, 10 (33.3%) PIRADS 3, 1 (3.3%) PIRADS 2, and 2 (6.7%) PIRADS 1. Thirteen (43%) had bilateral MRI index lesions. Twenty-six (87%) MP-MRI had 1-3 MRI index lesions, 2 (7%) had 4-6 MRI index lesions and 2 (7%) had no index lesions. Six (20%) patients underwent curative treatment. Four (13.3%) patients underwent a transrectal ultrasound guided targeted biopsy and one underwent a prostatectomy after the MP-MRI. One harbored Gleason 7 with a PIRADS 1, 2 harbored Gleason 7 with PIRADS 5, and two were benign with PIRADS scores of 3 and 4. Conclusions: Patients with prostate cancer with a GPS score indicating favorable pathology had PIRADS scores ranging from 5 to 1, with the majority indicating either high or very high likelihood of harboring clinically significant cancer. This may imply that MP-MRI should continue to play an important role in stratifying patients with prostate cancer, even in those with favorable pathology. A study with a larger sample size and biopsy results after the initial MP-MRI to look for tumor upgrading is needed.

scholarly journals Can multiparametric ultrasound improve cognitive MRI/TRUS fusion prostate biopsy

2020 ◽  
Vol 92 (2) ◽  
Author(s):  
Pietro Pepe ◽  
Ludovica Pepe ◽  
Paolo Panella ◽  
Michele Pennisi
Keyword(s):  
Prostate Biopsy ◽  
Transrectal Ultrasound ◽  
Contrast Enhanced Ultrasound ◽  
Tissue Elasticity ◽  
Cognitive Fusion ◽  
Prostate Imaging ◽  
Contrast Enhanced ◽  
Clinically Significant ◽  
Total Psa ◽  
Multiparametric Ultrasound

Objective: To evaluate the accuracy of multiparametric transrectal ultrasound (contrast- enhanced ultrasound plus elastosonography) in the detection of the suspicious area diagnosed by multiparametric magnetic resonance (mpMRI). Materials and methods: From June 2018 to June 2019 60 men (median age 63 years) with persistent suspicion of cancer underwent repeat saturation biopsy following pelvic mpMRI and the lesions characterized by a PI-RADS (Prostate Imaging Reporting and Data System) score ≥ 3 were submitted to 4 additional cores by transperineal cognitive fusion biopsy (TPBx). All patients, before prostate biopsy, underwent contrast- enhanced ultrasound (CEUS) following intravenous administration of a bolus of Sonovue® (2.4 mg of nonpyrogenic suspension of phospholipid/sulphur hexaphloride); in addition, a transrectal elastosonography (TRES) was done to evaluate prostate tissue elasticity. The accuracy of multiparametric ultrasound to detect the mpMRI lesions was evaluated. Results: In 27/60 (45%) of men a T1c prostate cancer (PCa) was diagnosed by TPBx and 21 (77.8%) of them were classified as clinically significant cancer (csPCa); in detail, 16/21 (76.2%) vs. 5/21 (23.8%) csPCa were located in the peripheric and anterior zone of the gland, respectively. Median total PSA was 10.3 ng/ml (range: 4.9-51 ng/ml). TRES and CEUS were positive for csPCa only in 6/21 (28.5%) and 13/21 (62%) of TPBx showing an increased accuracy directly related with the PI-RADS scores Conclusions: Multiparametric ultrasound using TRES and CEUS after Sonovue® administration did not improve the accuracy of TPBx in diagnosing csPCa.

Simultaneous transrectal ultrasound and photoacoustic human prostate imaging

2019 ◽  
Vol 11 (507) ◽  
pp. eaav2169 ◽  
Author(s):  
Sri-Rajasekhar Kothapalli ◽  
Geoffrey A. Sonn ◽  
Jung Woo Choe ◽  
Amin Nikoozadeh ◽  
Anshuman Bhuyan ◽  
...  
Keyword(s):  
Photoacoustic Imaging ◽  
Ultrasonic Transducer ◽  
Transrectal Ultrasound ◽  
Human Prostate ◽  
Therapeutic Monitoring ◽  
Prostate Imaging ◽  
Simultaneous Imaging ◽  
Capacitive Micromachined Ultrasonic Transducer ◽  
Molecular Information ◽  
Future Work

Imaging technologies that simultaneously provide anatomical, functional, and molecular information are emerging as an attractive choice for disease screening and management. Since the 1980s, transrectal ultrasound (TRUS) has been routinely used to visualize prostatic anatomy and guide needle biopsy, despite limited specificity. Photoacoustic imaging (PAI) provides functional and molecular information at ultrasonic resolution based on optical absorption. Combining the strengths of TRUS and PAI approaches, we report the development and bench-to-bedside translation of an integrated TRUS and photoacoustic (TRUSPA) device. TRUSPA uses a miniaturized capacitive micromachined ultrasonic transducer array for simultaneous imaging of anatomical and molecular optical contrasts [intrinsic: hemoglobin; extrinsic: intravenous indocyanine green (ICG)] of the human prostate. Hemoglobin absorption mapped vascularity of the prostate and surroundings, whereas ICG absorption enhanced the intraprostatic photoacoustic contrast. Future work using the TRUSPA device for biomarker-specific molecular imaging may enable a fundamentally new approach to prostate cancer diagnosis, prognostication, and therapeutic monitoring.

scholarly journals Interobserver agreement of Prostate Imaging–Reporting and Data System (PI-RADS–v2)

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Hala Maher Ahmed ◽  
Ahmed Ebrahim Ebeed ◽  
Ahmed Hamdy ◽  
Mohamed Abou El-Ghar ◽  
Ahmed Abdel Khalek Abdel Razek
Keyword(s):  
Interobserver Agreement ◽  
Imaging Modality ◽  
Peripheral Zone ◽  
Transitional Zone ◽  
Data System ◽  
3 Tesla ◽  
Prostate Imaging ◽  
Percent Agreement ◽  
3 Tesla Mri

Abstract Background A retrospective study was conducted on 71 consecutive patients with suspected prostate cancer (PCa) with a mean age of 56 years and underwent mp-MRI of the prostate at 3 Tesla MRI. Two readers recognized all prostatic lesions, and each lesion had a score according to Prostate Imaging–Reporting and Data System version 2 (PI-RADS-v2). Purpose of the study To evaluate the interobserver agreement of PI-RADS-v2 in characterization of prostatic lesions using multiparametric MRI (mp-MRI) at 3 Tesla MRI. Results The overall interobserver agreement of PI-RADS-v2 for both zones was excellent (k = 0.81, percent agreement = 94.9%). In the peripheral zone (PZ) lesions are the interobserver agreement for PI-RADS II (k = 0.78, percent agreement = 83.9%), PI-RADS III (k = 0.66, percent agreement = 91.3 %), PI-RADS IV (k = 0.69, percent agreement = 93.5%), and PI-RADS V (k = 0.91, percent agreement = 95.7 %). In the transitional zone (TZ) lesions are the interobserver agreement for PI-RADS I (k = 0.98, percent of agreement = 96%), PI-RADS II (k = 0.65, percent agreement = 96%), PI-RADS III (k = 0.65, percent agreement = 88%), PI-RADS IV (k = 0.83, percent agreement = 96%), and PI-RADS V (k = 0.82, percent agreement = 92%). Conclusion We concluded that PI-RADS-v2 is a reliable and a reproducible imaging modality for the characterization of prostatic lesions and detection of PCa.

One-year experience of government-funded magnetic resonance imaging prior to prostate biopsy: A case for omitting biopsy in men with a negative magnetic resonance imaging

2021 ◽  
pp. 205141582110043
Author(s):  
Hanna J El-Khoury ◽  
Niranjan J Sathianathen ◽  
Yuxin Jiao ◽  
Reza Farzan ◽  
Dennis Gyomber ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Prostate Biopsy ◽  
Multivariable Analysis ◽  
Transrectal Ultrasound ◽  
Resonance Imaging ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Clinically Significant

Objectives: This study aimed to characterise the accuracy of multiparametric magnetic resonance imaging (mpMRI) as an adjunct to prostate biopsy, and to assess the effect of the new Australian Medicare rebate on practice at a metropolitan public hospital. Patients and methods: We identified patients who underwent transrectal ultrasound (TRUS)-guided prostate biopsy at a single institution over a two-year period. Patients were placed into two groups, depending upon whether their consent was obtained before or after the introduction of the Australian Medicare rebate for mpMRI. We extracted data on mpMRI results and TRUS-guided biopsy histopathology. Descriptive statistics were used to demonstrate baseline patient characteristics as well as MRI and histopathology results. Results: A total of 252 patients were included for analysis, of whom 128 underwent biopsy following the introduction of the Medicare rebate for mpMRI. There was a significant association between Prostate Imaging Reporting and Data System v2 (PI-RADS) classification and the diagnosis of clinically significant prostate cancer ( p<0.01). Only one man with PI-RADS ⩽2 was found to have clinically significant prostate cancer. Four men with a PI-RADS 3 lesion were found to have clinically significant cancer. A PI-RADS 4 or 5 lesion was significantly associated with the diagnosis of clinically significant cancer on multivariable analysis. Conclusion: mpMRI is an important adjunct to biopsy in the diagnosis of clinically significant prostate cancer. Our findings support the safety of omitting/delaying prostate biopsy in men with negative mpMRI. Level of evidence: Level 3 retrospective case-control study.

Sign in / Sign up

Export Citation Format

Share Document