Suspicion Of Cancer Research Articles

To determine the frequency of prostate cancer in patients of suspicion of prostate cancer.

Objective: To determine the frequency of prostate cancer among patients with clinical suspicion and analyze the impact of age and symptom duration on diagnostic outcomes. Study Design: Cross-sectional study. Setting: Bilawal Medical College for Boys, Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro. Period: October 1, 2023, to March 31, 2024. Methods: The study included 101 male patients aged 50 years and older who presented with elevated prostate-specific antigen (PSA) levels, abnormal digital rectal examination (DRE) findings, or relevant symptoms. Data were collected retrospectively from medical records, including demographic details, PSA levels, symptom duration, DRE findings, prostate volume, and biopsy results. Prostate cancer diagnosis was confirmed through histopathological examination. Stratified analyses by age groups (50-60 years and >60 years) and symptom duration (1-3 months and >3 months) were conducted using chi-square tests. Results: Prostate cancer was diagnosed in 16.8% of patients. Age and symptom duration were not significantly associated with prostate cancer frequency (p=0.828 and p=0.264, respectively). The mean age was 63.8 years, and the mean prostate volume was 54.7 ml. Conclusion: Age and symptom duration do not significantly influence prostate cancer risk among suspected patients. Comprehensive diagnostic strategies incorporating multiple risk factors are recommended to improve detection and management.

Pathological and radiological assessment of benign breast lesions with BIRADS IVc/V subtypes. should we repeat the biopsy?

BackgroundTimely diagnosis is a crucial factor in decreasing the death rate of patients with breast cancer. BI-RADS categories IVc and V indicate a strong suspicion of cancer. The categorisation of each group is determined by the characteristics of the lesion. Certain benign breast lesions might have radiological features indicative of malignancy; thus, biopsy is mandatory. This study aimed to identify the histopathological diagnosis of benign breast masses classified into BIRADS IVc and V subgroups, investigate the radiological characteristics of these masses, and identify ultrasound features that could lead to false positive results (benign lesions that mimic malignancy on imaging).MethodsThis was a retrospective cross-sectional study at a single facility. Breast lesions reported as BIRADS IVc and V that underwent needle core/stereotactic vacuum-assisted biopsy were reviewed. Patients with benign pathologic diagnoses were analysed, delineating pathological diagnoses. Radiological descriptors were compared to those of a matched control of 50 malignant cases with BIRADS IVc.ResultsA total of 828 breast lesions classified as BIRADS IVc or V were detected during the period spanning from 2015 to 2022. Forty-four lesions (44/828, 5.3%) were benign at initial biopsy, while 784 lesions (784/828, 94.7%) were malignant. After histopathological testing and repeat biopsy, 26/828 (3.14%) patients had discordant benign diagnosis. Half of the repeated biopsies (10/20, 50%) showed malignant pathology. Compared to that in the control group, the presence of an oval shape of the mass was significantly more common in patients with benign pathology (p = 0.035). Conversely, the presence of posterior shadowing was significantly less common (p = 0.050) in benign lesions. No significant differences were observed for the other radiological characteristics. The most common histopathological diagnosis was fibrocystic change.ConclusionThis study highlights key findings regarding the sonographic imaging descriptors and histopathological diagnoses of benign breast lesions categorised as BIRADS IVc/V. The study recommends a correlation between clinical and radiological findings and encourages multidisciplinary decision-making among radiologists, pathologists, and clinicians to determine if a repeat biopsy is warranted. There is a need for continuous research to improve the diagnosis and treatment of breast lesions and reduce false-positive rates by incorporating other methodologies such as sonoelastography and incorporating deep learning and artificial intelligence in the decision-making to eliminate unnecessary procedures.

Meta Analysis of Efficacy and Safety of Prostate Biopsy: A Comparison Between Transperineal and Transrectal Approach.

Improved prostate biopsy procedures have been developed to overcome traditional limitations, aiming to enhance cancer diagnosis accuracy. To assess the existing knowledge of the effectiveness and risks linked to transperineal (TP) vs. transrectal (TR) prostate biopsy. Approaches: a comprehensive search was carried out in PubMed, Embase, Web of Science, and Cochrane Library to locate all pertinent papers published till June 8, 2023. Data on cancer detection rate and complications after prostate biopsy were gathered and analyzed via Review Manager software. A subgroup analysis was conducted to evaluate the influence of the study type. A total of 19 publications, involving 80133 patients with suspicion of prostate cancer who underwent prostate biopsy, were enrolled in the analysis. The pooled estimate demonstrated no significant differences in the cancer detection rate between TR and TP (risk difference (RD)=0.03; 95% CI: -0.01 to 0.08; P = .12). In terms of complications, the TP approach significantly decreased the risk of rectal bleeding (odds ratio (OR)=0.24; 95% CI: 0.12-0.51; P < .001), fever and urinary tract infection (OR=0.28; 95% CI: 0.15-0.52; P < .001), and sepsis (OR=0.50; 95% CI: 0.28-0.90; P=.02) compared to the TR approach. In conclusion, there was no significant disparity in the cancer detection rate between TP and TR approaches. However, the TP strategy exhibited an advantage over TR due to a reduced risk of infection and rectal bleeding. Further research is needed to validate these results and develop a more efficient diagnostic approach for prostate cancer.

Evaluation of malignancies and F18-FDG PET/CT imaging of patients living with HIV/AIDS in a university hospital

Aim:Human immunodeficiency virus (HIV) can cause tumoral changes in immune cells and lead to the development of AIDS-defining malignancies. As malignancies in HIV-infected individuals tend to be quite aggressive with a worse prognosis, making a definitive and early decision about HIV-related malignancies is very important.Therefore, the aim of this study was to examine HIV-related malignancies in HIV-positive patients and evaluate F-18 FDG PET/CT results. Materials and Methods: This single-centre, retrospective study was conducted on adult patients with HIV infection at a university hospital between January 2018 and December 2022. The demographic data, medication use, viral loads, and F-18 FDG PET/CT results of the patients were accessed retrospectively from the automated hospital records system and patient files. F18-FDG PET/CT images of patients were evaluated for those with suspicion of cancer and staging of cancer. Results: The study included 254 patients (median age: 33±13.8 years, male sex: 81.9%). Malignancy was diagnosed in 3.1% (8/254) of HIV-positive patients. Non-Hodgkin Lymphoma and Kaposi Sarcoma were the most common cancers. F-18 FDG PET/CT was performed in 3.5% (9/254) of patients, of which 2.76% (7/254) had findings suggestive of malignancy. As a result of the biopsy, malignancy was detected in five of these patients, and HIV-related lymphadenopathy was detected in two. In two patients, there were no F-18 FDGPET/CT imaging findings suggestive of malignancy. Conclusion: F-18 FDG PET/CT can be used in in the evaluation of HIV-infected patients with suspected malignancy.

Value of Systematic and MRI-Ultrasound Fusion Prostate Biopsy in Different Prostate Specific Antigen (PSA) Levels.

Current approach to clinically suspicious biopsy-naïve men consists performing prostate MRI, followed by combined systematic (TRUS-Bx) and MRI-Ultrasound fusion biopsy (MRI-TBx) in those with PIRADS score ≥ 3. Researchers have attempted to determine who benefits from each biopsy method, but the results do not support the safe use of one method alone. This study aims to determine the optimal approach in biopsy-naïve men, according to their PSA levels. A retrospective chart review of clinically suspicious biopsy-naïve men who underwent both TRUS-Bx and MRI-TBx was done. Prostate specific antigen (PSA) levels were compared between patients only positive for MRI-TBx and those with positive TRUS-Bx. Further, cancer cases were divided to < 10 and ≥ 10 PSA groups and the pathology results, obtained by each method, were compared. Out of 195 men, 36 were diagnosed with prostate cancer (PCa). PCa was diagnosed by both MRI-TBx and TRUS-Bx in 26 men, half of whom had PSA > 10 ng/mL. At PSA ≤ 10 ng/mL, PCa would have been missed in 4 men (11.1%) had MRI-TBx not been done, and in 6 men (16.6%) had TRUS-Bx not been done. Despite attempts to perform only one biopsy method in men with clinical suspicion of prostate cancer, we propose that at least in men with PSA ≤ 10 ng/mL, both systematic and MRI-targeted biopsies be performed.

Advanced Restriction Imaging and Reconstruction Technology for Prostate Magnetic Resonance Imaging (ART-Pro): A Study Protocol for a Multicenter, Multinational Trial Evaluating Biparametric Magnetic Resonance Imaging and Advanced, Quantitative Diffusion Magnetic Resonance Imaging for the Detection of Prostate Cancer.

Multiparametric magnetic resonance imaging (mpMRI) is strongly recommended by current clinical guidelines for improved detection of clinically significant prostate cancer (csPCa). However, the major limitations are the need for intravenous (IV) contrast and dependence on reader expertise. Efforts to address these issues include use of biparametric magnetic resonance imaging (bpMRI) and advanced, quantitative magnetic resonance imaging (MRI) techniques. One such advanced technique is the Restriction Spectrum Imaging restriction score (RSIrs), an imaging biomarker that has been shown to improve quantitative accuracy of patient-level csPCa detection. Advanced Restriction imaging and reconstruction Technology for Prostate MRI (ART-Pro) is a multisite, multinational trial that aims to evaluate whether IV contrast can be avoided in the setting of standardized, state-of-the-art image acquisition, with or without addition of RSIrs. Additionally, RSIrs will be evaluated as a stand-alone, quantitative, objective biomarker. ART-Pro will be conducted in two stages and will include a total of 500 patients referred for multiparametric prostate MRI with a clinical suspicion of prostate cancer at the participating sites. ART-Pro-1 will evaluate bpMRI, mpMRI, and RSIrs on the accuracy of expert radiologists' detection of csPCa and will evaluate RSIrs as a stand-alone, quantitative, objective biomarker. ART-Pro-2 will evaluate the same MRI techniques on the accuracy of nonexpert radiologists' detection of csPCa, and findings will be evaluated against the expertly created dataset from ART-Pro-1. The primary endpoint is to evaluate whether bpMRI is noninferior to mpMRI among expert (ART-Pro-1) and nonexpert (ART-Pro-2) radiologists for the detection of grade group ≥2 csPCa. This trial is registered in the US National Library of Medicine Trial Registry (NCT number: NCT06579417) at ClinicalTrials.gov. Patient accrual at the first site (UC San Diego) began in December 2023. Initial results are anticipated by the end of 2026.

Psychosocial impact associated with a multicancer early detection test (PATHFINDER): a prospective, multicentre, cohort study.

PATHFINDER was a prospective cohort study of multicancer early detection (MCED) testing in an outpatient ambulatory population. The aim of this study is to report the patient-reported outcomes (PROs) collected as secondary and exploratory measures in the PATHFINDER study. PATHFINDER is a prospective, multicentre, cohort study that enrolled existing healthy ambulatory outpatients at seven health networks in the USA, including hospitals, academic medical centres, and integrated health systems. Enrolled adults were aged 50 years or older without clinical suspicion of cancer, with or without additional cancer risk factors (smoking history, genetic predisposition, or previous cancer diagnosis). The primary objective was time to diagnostic resolution after an MCED cancer signal detected (CSD) result and extent of testing pursued. The objectives of the 12-month PATHFINDER study reported here were assessment of patient-reported outcomes and perceptions with MCED testing (the effect of the MCED test result disclosure, general anxiety symptoms, health-related quality of life, and satisfaction with the MCED test). PRO instruments used included an adapted Multidimensional Impact of Cancer Risk Assessment (MICRA) for distress, uncertainty, and positive experience at MCED test result disclosure; PRO Measurement Information System (PROMIS) Anxiety short-form for anxiety symptoms; and Short Form 12-Item Health Survey (SF-12v2) for health-related quality of life. Intentions towards adherence to guideline recommended screening was also assessed as an exploratory objective. This study is registered at ClinicalTrials.gov, NCT04241796, and is complete. Between Dec 12, 2019, and Dec 4, 2020, 6662 participants were recruited and 6621 eligible participants had analysable MCED test results (n=92 CSD and n=6529 no CSD [NCSD]). The majority of participants were women (4204 [63·5%] of 6621) and White (6071 [91·7%] of 6621). For participants who completed the MICRA at results disclosure, the mean total MICRA score was 28·4 (SD 14·9) for the 50 patients with a CSD result and 8·8 (7·2) for those with an NCSD result (n=5864 completed the full questionnaire). Mean general anxiety scores increased in true-positive and false-positive groups at results disclosure. The PROMIS anxiety true-positive group baseline score of 46·2 (SD 6·5; n=35) increased to 48·4 (7·3; n=19) and the scores in the false-positive group increased from 47·3 (7·3; n=52) to 49·7 (7·7; n=30). Mean scores in both groups returned towards baseline by end of study (true positive 46·8, SD 8·0; n=28; false positive 46·9, 8·1; n=41). Mean SF-12v2 mental component summary and scale scores were within the average general population range at all timepoints. A high proportion of participants (5749 [97·1%] of 5920) responded they were "satisfied", "very satisfied", or "extremely satisfied" with the MCED test, with this proportion highest in those with NCSD (5698 [97·2%] of 5861), followed by those with a true-positive MCED result (23 [92·0%] of 25) and those with a false-positive result (28 [82·4%] of 34). Most participants indicated they were likely or very likely to adhere to health-care providers' future cancer screening recommendations at end of study (5182 [95·6%] of 5418). The negative patient-reported effects associated with a CSD result from MCED testing were small and returned to baseline within 12 months for participants with or without a cancer diagnosis. PATHFINDER results indicate potential clinical benefit of early cancer detection and minimal patient distress associated with MCED testing. GRAIL.

18F-FDG PET/CT of Intrapulmonary Schwannoma Mimicking Lung Cancer in the Right Lower Lobe.

A 53-year-old woman was found to have a soft tissue mass in the right lower lung lobe on chest CT, raising suspicion of lung cancer. For staging, 18F-FDG PET/CT was performed, which demonstrated intense tracer uptake in the mass (SUVmax, 14.6). Subsequently, surgical excision was undertaken, and histopathological examination of the resected specimen confirmed the diagnosis of a schwannoma.

LIBELULE: a randomized phase III study to evaluate the clinical relevance of early liquid biopsy in patients with suspicious metastatic lung cancer.

Genomic profiling is a major component for first-line treatment decisions in patients with non-small cell lung cancer (NSCLC) and the timeliness of biomarker testing is essential to improve time to treatment initiation (TTI) or avoid inappropriate treatment. The phase III LIBELULE trial (NCT03721120) included patients with radiological suspicion of advanced lung cancer. They were randomized (1:1), the control arm receiving diagnostic procedures according to each center's practice and the liquid biopsy arm with additional testing performed at the first visit using the InVisionFirst®-Lung assay. Treatment initiation and type were defined according to ESMO guidelines. Primary endpoint was the time from randomization to initiation of appropriate treatment based on informative genomic and pathological results in the intention-to-treat population. 319 patients were enrolled (LB: 161; control: 158). Median age was 68 years, 28.8% were non-smokers, 18.1% had PS≥2 and 56.7% had adenocarcinoma. In LB arm, 81% of patients had circulating tumor DNA findings. The mean TTI was not significantly reduced (LB: 29.0 days (d); control 34d (p=0.26)). Sensitivity analyses showed a shorter TTI in patients from the LB arm who received systemic treatment (LB: 29.1d; control: 38.8d, p=0.01), in patients with advanced non-squamous NSCLC (LB: 29.5d; control: 40.3d, p=0.01), and in patients with first-line targetable alterations (LB: 21d; control 37.4d) (p=0.004). Time to contributory genomic results was significantly reduced (LB: 17.9d; control 25.6d, p<0.001). Early liquid biopsy testing did not significantly shorten the TTI in unselected patients referred for suspected advanced lung cancer. Nevertheless, it could reduce the TTI in patients eligible for systemic treatment, particularly for those with actionable alterations.

In The Presence of Risk Factors High Rate of Incidental Multifocal Microcarcinoma Detection in Solitary Thyroid Nodule and Multinodular Goitre Justifies Total Thyroidectomy

Aim: Thyroid nodules are commonly encountered with increasing age. Majority of them are benign. In the present study, our goal was to identify both the false negative rate (FNR) of preoperative cytology, radiology results, risk factors for malignancy, and the prevalence of thyroid carcinoma in cases to whom operation performed for solitary thyroid nodule (STN) with multinodular goitre (MNG) and the final histopathological report. Methods: A retrospective study among 141 patients who were operated for suspicion of thyroid cancer between 2019-2022. 118 were women (83.6%) and 23 were men (16.3%). The mean age was 50.2(23.1). Demographic characteristics and factors predicting malignancy were questioned for all patients preoperatively. Preoperative ultrasonography (US), fine needle aspiration cytology (FNAc) results and postoperative histopathology data were collected. Ultrasound features (ACR-TIRADS), FNAc results, histopathology records, risk factors and malignancy rates was registered. Statistical analysis was done with Fisher's precision and Mann-Whitney U tests. Results: 141 patients underwent total thyroidectomy for STN (n=28, 19.8%) and MNG (n=113, 80.1%). The correlation of FNAc with final histopathology revealed that FNR in MNG was more often than that of STN (33.3% vs 66.6%, p

Autoimmune Pancreatitis Type 1: A Rare Cause of Epigastric Pain, About a Case

Type 1 autoimmune pancreatitis is a rare autoimmune disorder, part of a systemic disease known as IgG4 related disease. Its diagnosis is based on a group of criteria defined according to an international consensus on the disease (ICDC criteria). This diagnosis is challenging, as the clinical, biological and radiological signs of the disease can be similar to those of pancreatic cancer. We report a case of type 1 AIP diagnosed after a suspicion of pancreatic cancer.

Estimated diagnostic performance of prostate MRI performed with clinical suspicion of prostate cancer

PurposeTo assess the diagnostic performance of prostate MRI by estimating the proportion of clinically significant prostate cancer (csPCa) in patients without prostate pathology.Materials and methodsThis three-center retrospective study included prostate MRI examinations performed for clinical suspicion of csPCa (Grade group ≥ 2) between 2018 and 2022. Examinations were divided into two groups: pathological diagnosis within 1 year after the MRI (post-MRI pathology) is present and absent. Risk prediction models were developed using the extracted eleven common predictive variables from the patients with post-MRI pathology. Then, the csPCa proportion in the patients without post-MRI pathology was estimated by applying the model. The area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and positive and negative predictive values (PPV/NPV) of prostate MRI in diagnosing csPCa were subsequently calculated for patients with and without post-MRI prostate pathology (estimated statistics) with a positive threshold of PI-RADS ≥ 3.ResultsOf 12,191 examinations enrolled (mean age, 65.7 years ± 8.4 [standard deviation]), PI-RADS 1–2 was most frequently assigned (55.4%) with the lowest pathological confirmation rate of 14.0–18.2%. Post-MRI prostate pathology was found in 5670 (46.5%) examinations. The estimated csPCa proportions across facilities were 12.6–15.3%, 18.4–31.4%, 45.7–69.9%, and 75.4–88.3% in PI-RADS scores of 1–2, 3, 4, and 5, respectively. The estimated (observed) performance statistics were as follows: AUC, 0.78–0.81 (0.76–0.79); sensitivity, 76.6–77.3%; specificity, 67.5–78.6%; PPV, 49.8–66.6% (52.0–67.7%); and NPV, 84.4–87.2% (82.4–86.6%).ConclusionWe proposed a method to estimate the probabilities harboring csPCa for patients who underwent prostate MRI examinations, which allows us to understand the PI-RADS diagnostic performance with several metrics.Clinical relevance statementThe reported estimated performance metrics are expected to aid in understanding the true diagnostic value of PI-RADS in the entire prostate MRI population performed with clinical suspicion of prostate cancer.Key PointsCalculating performance metrics only from patients who underwent prostate biopsy may be biased due to biopsy selection criteria, especially in PI-RADS 1–2.The estimated area under the receiver operating characteristic curve of PI-RADS in the entire prostate MRI population ranged from 0.78 to 0.81 at three facilities.The estimated statistics are expected to help us understand the true PI-RADS performance and serve as a reference for future studies.Graphical

Germline pathogenic variants in RNF43 in patients with and without serrated polyposis syndrome

Serrated Polyposis Syndrome (SPS) is characterized by multiple and/or large serrated polyps in the colon and an increased risk of colorectal cancer (CRC). The etiology is largely unknown, but in a subset of patients with SPS, monoallelic pathogenic variants in RNF43 are detected. To date, however, the penetrance and phenotypic spectrum of patients carrying pathogenic variants (PV) in RNF43 are poorly described. We present eight patients both with and without serrated polyps from four unrelated families with likely pathogenic variants (LPV) in RNF43 and compare the results to current literature. The patients were referred to genetic counseling due to suspicion of hereditary cancer. They underwent genetic testing with custom NGS gene panels including RNF43 as part of a routine genetic work-up. Three LPVs, one multi-exon deletion and two nonsense variants, were detected in four families. Family I had a history of CRC and serrated polyps, but in the three other families (II‒IV) there was no history of CRC or serrated polyps. Colonoscopies in the probands of these families did not reveal any serrated polyps and/or CRC despite some of them being relatively old. Our findings suggest that the penetrance of RNF43-related disease is much lower than previously thought, and raise questions about the connection between RNF43 and disease. The results highlight the complexity of genetic counseling in RNF43 positive families– particularly in families without polyposis. Further research is needed to elucidate the role of RNF43 in the risk of SPS and CRC.

BIOM-10. CLINICAL PERFORMANCE EVALUATION OF A BRAIN CANCER LIQUID BIOPSY

Abstract Diagnostic delays impact the quality of life and survival of patients with brain cancer. Currently, with no blood test to assist them, clinicians must make their referral decision based on symptoms. Existing symptom-based referral guidelines inadequately stratify patients for brain imaging based on suspicion of cancer. A simple, rapid liquid biopsy placed in a primary care setting would enable more efficient triage of patients with non-specific symptoms related to brain cancer. The Dxcover® Liquid Biopsy is a rapid multi-omic liquid biopsy that interrogates a blood sample with infrared radiation and produces a distinctive signature that represents the whole biomolecular profile of the sample, and is sensitive to the hallmarks of brain cancer. The nature of the technology also allows for the diagnostic models to be tailored towards higher sensitivity (or specificity) depending on clinical priorities and international healthcare markets. In initial feasibility studies, we recruited 988 patients prospectively with non-specific symptoms associated with a brain tumor, and the algorithm detected 96% of the patients with brain tumors and 100% of glioblastomas (GBM), when tuned for greater sensitivity. EMBRACE is a prospective, observational, multicenter study, currently recruiting patients across seven sites in the United Kingdom, Belgium, Sweden and Switzerland. The study duration is 24 months and will recruit a minimum of 2200 participants. The target population is comprised of patients presenting to primary care with non-specific symptoms that are associated with brain cancer, such as headache and new onset neurological defect. The primary objective is to determine the clinical performance of the liquid biopsy for patients with brain cancer, in terms of diagnostic sensitivity and specificity. The test performance will be determined by comparing the liquid biopsy result to diagnostic imaging. Earlier and expeditious diagnoses in these patients are crucial to reduce the morbidities and mortalities associated with brain cancer. This simple, non-invasive liquid biopsy would facilitate the triage of brain tumor patients for rapid imaging.

A head-to-head comparison of [68Ga]Ga-DOTA-FGFR1 and [18F]FDG PET/CT in the diagnosis of lung cancer.

This study aimed to compare the diagnostic value of [68Ga]Ga-DOTA-FGFR1 and [18F]FDG PET/CT in the evaluation of lung cancer patients. A prospective study was conducted between March 2023 and July 2023. Patients with high clinical suspicion of lung cancer were recruited. Each participant underwent PET/CT scanning using [68Ga]Ga-DOTA-FGFR1 and [18F]FDG within 6 days. Histopathology and clinical follow-up results serve as reference criteria for final diagnosis. We used a paired samples t-test or a Wilcoxon signed-rank test to compare the uptake of [68Ga]Ga-DOTA-FGFR1 and [18F]FDG. The diagnostic performance between the two tracers was compared using the McNemar χ² test. A total of 101 participants were included (mean age 63.267 ± 9.344 [range 39-86 years]). In benign lung lesions, [68Ga]Ga-DOTA-FGFR1 had lower TBR and SUVmax than [18F]FDG (2.924 vs. 5.705, P < 0.001;1.395 vs. 4.014, P < 0.001). The TBR of [68Ga]Ga-DOTA-FGFR1 in benign lymph nodes was also lower than [18F]FDG (0.880 vs. 1.25, P < 0.001). [68Ga]Ga-DOTA-FGFR1 had a higher diagnostic specificity for primary tumors than [18F]FDG (52% vs. 28%, P = 0.031). The specificity, accuracy, and PPV of [68Ga]Ga-DOTA-FGFR1 for detecting lymph node metastasis were 82.54%, 78.66%, and 53.73%, respectively, higher than that of [18F]FDG (53.80%, P < 0.001, 63.15%, P < 0.001 and 38.35%, P = 0.003). However, its sensitivity in the diagnosis of lymph node and distant metastasis was not as good as [18F]FDG PET/CT (P < 0.001, P = 0.016, respectively). There was a significant correlation between [68Ga]Ga-DOTA-FGFR1 uptake and FGFR1 expression (Spearman r = 0.6901, p < 0.0001). [68Ga]Ga-DOTA-FGFR1 PET/CT had higher specificity than [18F]FDG PET/CT for the detection of primary lung cancer. In addition, [68Ga]Ga-DOTA-FGFR1 PET/CT also had higher diagnostic accuracy, specificity, and NPV for lymph node metastasis, but its diagnostic sensitivity for metastatic lesions was lower than [18F]FDG PET/CT. Therefore, [68Ga]Ga-DOTA-FGFR1 can be used as an effective supplement to [18F]FDG to a certain extent.

Emergency department use before cancer diagnosis in Ontario, Canada: a population-based study.

Although suspicions of cancer may be raised in patients who visit the emergency department, little is known about emergency department use before a cancer diagnosis. We sought to describe emergency department use among patients in Ontario within the 90 days before confirmed cancer diagnosis and to evaluate factors associated with this emergency department use. We conducted a retrospective, population-based study of patients aged 18 years or older who had a confirmed cancer diagnosis in Ontario from 2014 to 2021 using linked administrative databases. The primary outcome was any emergency department visit within 90 days before the cancer diagnosis date. We used multivariable logistic regression to evaluate factors associated with emergency department use, such as demographics (e.g., age, sex, rurality, Ontario Health region, indicators of marginalization), comorbidities, previous emergency department visits and hospital admissions, continuity of primary care, type of cancer, and year of cancer diagnosis. We included 651 071 patients with cancer. Of these, 229 683 (35.3%) had an emergency department visit within 90 days before diagnosis, 51.4% of whom were admitted to hospital from the emergency department. Factors associated with increased odds of emergency department use before cancer diagnosis included rurality (odds ratio [OR] 1.15, 95% confidence interval [CI] 1.13-1.17), residence in northern Ontario (North East region OR 1.14, 95% CI 1.10-1.17 and North West region OR 1.27, 95% CI 1.21-1.32, v. Toronto region), and living in the most marginalized areas (material resources OR 1.37, 95% CI 1.35-1.40 and housing OR 1.09, 95% CI 1.06-1.11, v. least marginalized quintile). We observed significant variation in emergency department use by cancer type, with high odds of emergency department use among patients with intracranial, pancreatic, liver or gallbladder, or thoracic cancer. Emergency department use is common before cancer diagnosis, with about one-third of patients with cancer in Ontario using the emergency department before diagnosis. Understanding why patients visit the emergency department before cancer diagnosis is important, particularly for patients who live in rural or marginalized areas, or those who have specific cancer types.

Comparing visual inspection with acetic acid, with and without Lugol’s Iodine for triage of HPV self-sample positive women in Ethiopia: a randomized controlled trial

BackgroundMost women who are high-risk human papilloma virus (hrHPV) positive in a cervical cancer screening test will spontaneously heal from their infection. Visual inspection with acetic acid (VIA) is recommended...

P004 Diagnostic accuracy of microultrasound in patients with a suspicion of prostate cancer: Update from a large single center experience

P004 Diagnostic accuracy of microultrasound in patients with a suspicion of prostate cancer: Update from a large single center experience

P033 Mid-term follow up analysis of a cohort of patients with initial MRI at suspicion of prostate cancer. How it can be useful for exclusion of PC and avoid unnecesary biopsies

P033 Mid-term follow up analysis of a cohort of patients with initial MRI at suspicion of prostate cancer. How it can be useful for exclusion of PC and avoid unnecesary biopsies

The Role of Freehand Transperineal Prostate Biopsy Under Local Anesthesia Without Antibiotics in Outpatient Settings.

The objectives of this study were to evaluate and compare the application of freehand transperineal prostate biopsy (FTPB) under local anesthesia (LA) versus systematic transperineal prostate biopsy (STPB) in an outpatient setting without antibiotics. A total of 218 biopsy-naive patients with suspicion of prostate cancer (PCa) based on multiparametric magnetic resonance imaging (mpMRI) were retrospectively analyzed. Suspicious areas on mpMRI were graded using the Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1). FTPB was performed for each suspicious lesion, followed by a 12-core STPB under LA. Histopathological outcomes, complications, and tolerability were recorded. The results showed that PCa was detected in 129 (59.17%) patients, with 104 (47.71%) being clinically significant prostate cancer (csPCa). There was agreement between FTPB and STPB in 94 (72.88%) patients. FTPB diagnosed fewer PCa cases but more csPCa cases than STPB. LA-FTPB was well-tolerated with no severe complications. The conclusions suggest that FTPB under LA in an outpatient setting without antibiotics is safe, feasible, and efficient.