Diagnosis Of Prostatic Lesions Research Articles

A retrospective study on significance of total and free Prostate specific antigen (PSA) level with their ratio in diagnosis of prostatic lesions at a tertiary care centre

A retrospective study on significance of total and free Prostate specific antigen (PSA) level with their ratio in diagnosis of prostatic lesions at a tertiary care centre

Evaluation of the Efficiency of MRI-Based Radiomics Classifiers in the Diagnosis of Prostate Lesions.

ObjectiveTo compare the performance of different imaging classifiers in the prospective diagnosis of prostate diseases based on multiparameter MRI.MethodsA total of 238 patients with pathological outcomes were enrolled from September 2019 to July 2021, including 142 in the training set and 96 in the test set. After the regions of interest were manually segmented, decision tree (DT), Gaussian naive Bayes (GNB), XGBoost, logistic regression, random forest (RF) and support vector machine classifier (SVC) models were established on the training set and tested on the independent test set. The prospective diagnostic performance of each classifier was compared by using the AUC, F1-score and Brier score.ResultsIn the patient-based data set, the top three classifiers of combined sequences in terms of the AUC were logistic regression (0.865), RF (0.862), and DT (0.852); RF “was significantly different from the other two classifiers (P =0.022, P =0.005), while logistic regression and DT had no statistical significance (P =0.802). In the lesions-based data set, the top three classifiers of combined sequences in terms of the AUC were RF (0.931), logistic regression (0.922) and GNB (0.922). These three classifiers were significantly different from.ConclusionThe results of this experiment show that radiomics has a high diagnostic efficiency for prostate lesions. The RF classifier generally performed better overall than the other classifiers in the experiment. The XGBoost and logistic regression models also had high classification value in the lesions-based data set.

Role of MRI in diagnosis of prostate cancer and correlation of results with transrectal ultrasound guided biopsy “TRUS”

BackgroundProstate cancer is the most common cancer in elderly men, and the second leading cause of cancer-related death in developed countries. For a long time, TRUS is used in screening, diagnosis of prostate lesions. Recently the implementation of multi parametric MRI into a screening program currently seems to be the most promising technique to improve the early detection of prostate cancer.ResultsThirty Patients were referred from urological outpatient clinics complaining of urological symptoms (dysuria, frequency and urine retention). The study was carried, and the patients were submitted to Ultrasonography, conventional magnetic resonance, diffusion weighted images and MR spectroscopy techniques, these results were correlated with histopathological data. In this study Conventional MRI has moderate sensitivity 81.8% and low specificity 37.3% in diagnosing prostate malignancy. Using of mpMRI combination of diffusion-weighted, Dynamic contrast enhanced and MR spectroscopic imaging is a promising approach for discriminating between benign and malignant lesions in the PZ and increase sensitivity 100% and specificity 96.6% in diagnosing prostate malignancy.ConclusionsThe standard for the definitive diagnosis of prostate cancer is trans-rectal ultrasound biopsy. However, TRUS guided biopsy has a significant sampling error and can miss up to 30% of cancers and may show underestimation of Gleason grade, especially in anteriorly located tumors. It may lead to an increase in complications. MRI has an essential role to play in making safer in diagnosis. It can aid in staging also and surgery or radiation treatment planning. Although T2W MRI has been used widely for diagnosis on the basis of its excellent soft tissue resolution, but its accuracy for the detection and localization of cancer prostate is unsatisfactory. The implementation of multi parametric MRI: MR spectroscopy, Dynamic contrast enhanced and diffusion weighted imaging into a diagnosis program improve the diagnostic performance. These advances are beginning to translate into better treatment selection and more accurate image-guided therapies. In addition, early detection of local recurrence.

Diagnostic Utility of Proliferative Cell Markers in Prostatic Lesions: An Institutional Experience

Background: Prostatic cancer is a complex and biologically heterogenous disease. Diagnosis of prostatic lesions with immunohistochemistry still faces challenges because of difference in reactivity of monoclonal antibodies in benign, equivocal, and malignant lesions. Proliferative markers Ki-67 and Proliferating Cell Nuclear Antigen (PCNA) can be used for diagnosis and prognostic stratification of prostatic carcinoma.
 Methods: A total of hundred prostate biopsies with 50 cases each of benign prostatic hyperplasia and prostate carcinoma received in the Department of Pathology, PGIMS, Rohtak, India were included in the study. Ki-67 and PCNA expression was studied immunohistochemically in each case.
 Result: Ki-67 expression was significantly upregulated in malignant cases and increased with increasing Gleason grade. PCNA expression was also found to be increased in increasing Gleason grades in carcinoma cases, however, the results were ambiguous as it was found to be positive in all benign cases also.
 Conclusion: Ki-67 is useful in predicting biological behavior in prostate carcinoma cases, however PCNA expression needs to be studied further.

Role of transrectal ultrasound and elastography in the diagnosis of prostate lesions

Background: The incidence of malignancy of prostate gland has displayed a rapid rise over recent times. Transrectal ultrasound (TRUS) has brought revolution to radiologist's human prostate imaging methods. Information regarding elasticity of suspicious or abnormal lesions provided by strain elastography can enhance the detection rate of prostate malignancies as well as serve as a reliable visual guide for biopsy from these sites. In this prospective study, we aim to appraise the use of TRUS for diagnosing prostatic lesions, both benign and malignant, and compare it to the utility of strain elastography to precisely locate and guide biopsies of lesions while referring to the pathological diagnosis as the reference standard, wherever possible/needed. Materials and Methods: This was a prospective, cross-sectional study involving 82 male patients who were clinically suspected to have prostate malignancy. The patients were referred to the Department of Radiodiagnosis, AVBRH, where they underwent transrectal ultrasonography and elastography with Hitachi Aloka ultrasound (USG) Machine Arietta S70 with biplane high-frequency transrectal probe (6–10 MHz) with elastography. Results: TRUS had high sensitivity (92.45%) and specificity (78.38%) for cancer detection. Strain elastography had a sensitivity of 96.23%, specificity of 81.08%, positive predictive value (PPV) of 70.83%, and negative predictive value (NPV) of 97.83%. Based on our findings, real-time elastography had more sensitivity and higher NPV than TRUS for the identification of prostatic cancer. Hence, it can be concluded that elastography is an effective assessment tool for ruling out the possibility of malignant tumors, helping to reduce redundant biopsies. Conclusions: Transrectal ultrasonography (TRUS) is an effective tool for the assessment of prostatic lesions. TRUS has high specificity, sensitivity, NPV, and PPV when assessing lesions for prostatic cancer. Elastography has high sensitivity, high specificity, high PPV, and reliable NPV when detecting for prostatic cancer. The combination of TRUS and elastography can help more efficiently assess lesions and guide biopsies to increase the identification rate of prostatic cancer.

Systematic review & meta-analysis of positron emission tomography/computed tomography and bone scan in the diagnosis of prostate lesions.

BackgroundTo date, the results of studies into the effectiveness of positron emission tomography (PET) combined with computed tomography (CT) and bone scan (BS) in the diagnosis of malignant prostate lesions have been inconsistent, and the advantages and disadvantages of the two methods cannot be accurately judged.MethodsArticles were retrieved from the China National Knowledge Infrastructure (CNKI) database, Wan Fang Medical Network, PubMed, Excerpta Medica data BASE (EMBASE), Medline, and Cochrane database. The keywords used in the search were: 68Ga-prostate specific membrane antibody (68Ga-PSMA), PET/CT, prostate lesions, prostate adenocarcinoma, bone metastasis, and BS.ResultsUltimately, 3 publications were selected for inclusion in the meta-analysis. A total of 215 patients were considered in the 3 articles that met the inclusion criteria. All of the included articles were small sample studies, with sample sizes ranging from 28 to 113 cases. In this study, from the 3 randomized controlled trials, only 2 (66.67%) randomized controls described the correct randomized allocation method, and only 1 (33.33%) described the hidden allocation scheme in detail. The highest sensitivity for 68Ga-PSMA PET/CT was 0.96, with 95% CI: 0.87, 1.00, and the highest specificity was 1.00, with 95% CI: 0.96, 1.00. The highest sensitivity and specificity of BS were 0.92 with 95% CI: 0.81, 0.98 and 0.96 with 95% CI: 0.78, 1.00, respectively. The results of meta-analysis of 68Ga-PSMA PET/CT diagnosis with confirmation by surgical and histopathological examination showed that the area under the summary receiver operating characteristics (SROC) curve (AUC) =0.826 and standard error (SE) (AUC) =0.0425. The results of meta-analysis of BS diagnosis with confirmation by surgical and histopathological examination showed that the area under the SROC curve (AUC) =0.714 and SE (AUC) =0.0034.DiscussionThe meta-analysis showed that 68Ga-PSMA PET/CT has clear advantages over BS in the diagnosis of bone metastases of malignant prostate tumors, and could improve the diagnostic accuracy of bone metastases.

Role of prostatic basal cell marker in diagnosis of prostatic lesions

Role of prostatic basal cell marker in diagnosis of prostatic lesions

Immunohistochemical expression of α-methylacyl coenzyme-A racemase in prostatic carcinoma: correlation with image morphometric parameters

Background/aim Prostate cancer is the second leading cause of death in men. Although prostate-specific antigen is the most commonly used biomarker for monitoring prostate cancer, it has poor specificity. This study aimed to evaluate the diagnostic utility of α-methylacyl coenzyme-A racemase (AMACR) as a predictive marker for prostate carcinoma. The expression of AMACR will be correlated with nuclear and glandular morphometric parameters with the aim to enhance the possibility of finding a sensitive immune marker for diagnosing prostatic carcinoma.Patients and methods Prostatic lesions including 30 benign prostatic hyperplasia, 25 prostatic intraepithelial neoplasia (PIN), and 50 prostatic carcinoma cases were included in this study. Immunohistochemical staining for AMACR was done in formalin-fixed, paraffin-embedded tissue sections. Nuclear and glandular morphometric parameters for all cases were evaluated using an image analysis system.Results All cases of benign prostatic hyperplasia as well as normal controls were negative for AMACR. In contrast, 28% of PIN cases and 94% of prostatic carcinoma cases were positively stained for AMACR. Its expression was associated with high-grade PIN and carcinoma. Glandular area and glandular area% were significantly different between the studied prostatic lesions, and they were significantly increased with grade in cases of carcinoma.Conclusion Expression of AMACR plays an important role in the diagnosis of prostatic lesions and may be used as a potentially important prostatic tumor marker. A combination of AMACR and morphometry is of great value in increasing the diagnostic accuracy of prostatic carcinoma and may have value for resolving suspicious cases.

Validity of Fine Needle Aspiration Cytology in Diagnosis of Prostatic Lesions and Correlation with Trucut Biopsy

Validity of Fine Needle Aspiration Cytology in Diagnosis of Prostatic Lesions and Correlation with Trucut Biopsy

Validity of Fine Needle Aspiration Cytology in Diagnosis of Prostatic Lesions and Correlation with Trucut Biopsy

Prostate fine needle aspiration (FNA) is an easy-to-perform outpatient procedure requiring no expensive equipment or anesthesia. The aim of this study was to analyze the cytomorphology of prostatic lesions and to correlate the findings in cytology with that of the histopathological appearance. In doing so we also assessed the diagnostic accuracy of fine needle aspiration cytology and identified possible pitfalls. The study was carried out in 100 patients who underwent tru-cut biopsy in the department of Urology at Kottayam Medical College, India during the period spanning from March 2010 to March 2011. Fine needle aspiration cytology (FNAC) was done with Franzen needle and followed by tru-cut biopsy after which the results of both were compared. FNAC gave a benign diagnosis in 64 cases and identified a malignant pattern in 36 cases. The overall accuracy of FNAC in this series in diagnosing prostatic lesions was 97% with a sensitivity of 100% and specificity of 95.5%. This shows that FNAC prostate is a reliable, relatively painless tool, which can be used for the diagnosis of prostatic carcinoma, especially in patients with high risk complications such as bleeding and infections in whom a tru-cut biopsy is more invasive. In addition it is also cost-effective and may sample a larger area.