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  1. Article ; Online: Is multiparametric MRI always needed in biopsy-naïve patients with abnormal digital rectal examination? A single-institutional experience combining clinical and micro-ultrasonography-based factors to optimize prostate cancer detection.

    Avolio, Pier Paolo / Lazzeri, Massimo / Maffei, Davide / Fasulo, Vittorio / Frego, Nicola / Saitta, Cesare / de Carne, Fabio / Paciotti, Marco / Saita, Alberto / Hurle, Rodolfo / Guazzoni, Giorgio / Casale, Paolo / Buffi, Nicolò Maria / Lughezzani, Giovanni

    World journal of urology

    2024  Volume 42, Issue 1, Page(s) 9

    Abstract: Purpose: To assess the diagnostic performance of microultrasound-targeted biopsy (microUSTBx) and systematic biopsy (SBx) in detecting clinically significant prostate cancer (csPCa) among men with abnormal digital rectal examination (DRE) and suspicious ...

    Abstract Purpose: To assess the diagnostic performance of microultrasound-targeted biopsy (microUSTBx) and systematic biopsy (SBx) in detecting clinically significant prostate cancer (csPCa) among men with abnormal digital rectal examination (DRE) and suspicious lesions at multiparametric magnetic resonance imaging (mpMRI), and to compare the diagnostic performance of this approach with a mpMRI-guided targeted biopsy (MTBx) plus SBx-based strategy.
    Methods: Biopsy-naïve men with suspicious lesions at mpMRI and abnormal DRE were prospectively evaluated between October 2017 and January 2023. csPCa detection rate by microUSTBx plus SBx and MTBx plus SBx was assessed and then compared by McNemar's test. The added value of prostate-specific antigen density (PSAd) was also evaluated.
    Results: Overall, 182 biopsy naïve men were included. MicroUSTBx plus SBx achieved comparable detection rate to MTBx plus SBx in diagnosis of ciPCa and csPCa (ciPCa: 9.3% [17/182] vs 10% [19/182]; csPCa: 63% [114/182] vs 62% [113/182]). MicroUSTBx outperformed MTBx (ciPCa: 5.5% [10/182] vs 6.0% [11/182]; csPCa: 57% [103/182] vs 54% [99/182]). Using microUSTBx plus SBx would have avoided 68/182 (37%) unnecessary mpMRI, while missing only 2/116 (1.7%) csPCa. The decision curve analysis of suspicious microUS plus PSAd ≥ 0.15 ng/ml showed higher net benefit in the ability to identify true positives and reduce the number of unnecessary prostate biopsy in this subcategory of patients.
    Conclusions: The combination of microUSTBx and SBx showed equal diagnostic performance to an mpMRI-based approach in biopsy-naïve patients with an abnormal DRE. The combination of this approach with PSAd maximize the diagnostic accuracy while lowering the need for unnecessary biopsies.
    MeSH term(s) Male ; Humans ; Prostate/diagnostic imaging ; Digital Rectal Examination ; Multiparametric Magnetic Resonance Imaging ; Prostatic Neoplasms/diagnostic imaging ; Biopsy ; Ultrasonography
    Language English
    Publishing date 2024-01-06
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 380333-8
    ISSN 1433-8726 ; 0724-4983
    ISSN (online) 1433-8726
    ISSN 0724-4983
    DOI 10.1007/s00345-023-04722-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Development of a microultrasound-based nomogram to predict extra-prostatic extension in patients with prostate cancer undergoing robot-assisted radical prostatectomy.

    Frego, Nicola / Contieri, Roberto / Fasulo, Vittorio / Maffei, Davide / Avolio, Pier Paolo / Arena, Paola / Beatrici, Edoardo / Sordelli, Federica / De Carne, Fabio / Lazzeri, Massimo / Saita, Alberto / Hurle, Rodolfo / Buffi, Nicolò Maria / Casale, Paolo / Lughezzani, Giovanni

    Urologic oncology

    2024  Volume 42, Issue 5, Page(s) 159.e9–159.e16

    Abstract: Objectives: To develop a microultrasound-based nomogram including clinicopathological parameters and microultrasound findings to predict the presence of extra-prostatic extension and guide the grade of nerve-sparing.: Material and methods: All ... ...

    Abstract Objectives: To develop a microultrasound-based nomogram including clinicopathological parameters and microultrasound findings to predict the presence of extra-prostatic extension and guide the grade of nerve-sparing.
    Material and methods: All patients underwent microultrasound the day before robot-assisted radical prostatectomy. Variables significantly associated with extra-prostatic extension at univariable analysis were used to build the multivariable logistic model, and the regression coefficients were used to develop the nomogram. The model was subjected to 1000 bootstrap resamples for internal validation. The performance of the microultrasound-based model was evaluated using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve, calibration plot, and decision curve analysis (DCA).
    Results: Overall, 122/295 (41.4%) patients had a diagnosis of extra-prostatic extension on definitive pathology. Microultrasound correctly identify extra-prostatic extension in 84/122 (68.9%) cases showing a sensitivity and a specificity of 68.9% and 84.4%, with an AUC of 76.6%. After 1000 bootstrap resamples, the predictive accuracy of the microultrasound-based model was 85.9%. The calibration plot showed a satisfactory concordance between predicted probabilities and observed frequencies of extra-prostatic extension. The DCA showed a higher clinical net-benefit compared to the model including only clinical parameters. Considering a 4% cut-off, nerve-sparing was recommended in 173 (58.6%) patients and extra-prostatic extension was detected in 32 (18.5%) of them.
    Conclusion: We developed a microultrasound-based nomogram for the prediction of extra-prostatic extension that could aid in the decision whether to preserve or not neurovascular bundles. External validation and a direct comparison with mpMRI-based nomogram is crucial to corroborate our results.
    MeSH term(s) Male ; Humans ; Nomograms ; Robotics ; Prostatic Neoplasms/diagnostic imaging ; Prostatic Neoplasms/surgery ; Prostatic Neoplasms/pathology ; Prostate/diagnostic imaging ; Prostate/surgery ; Prostate/pathology ; Prostatectomy/methods ; Retrospective Studies
    Language English
    Publishing date 2024-02-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1336505-8
    ISSN 1873-2496 ; 1078-1439
    ISSN (online) 1873-2496
    ISSN 1078-1439
    DOI 10.1016/j.urolonc.2024.01.033
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    Zs.A 4817: Show issues Location:
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    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article: A Comparative Evaluation of Multiparametric Magnetic Resonance Imaging and Micro-Ultrasound for the Detection of Clinically Significant Prostate Cancer in Patients with Prior Negative Biopsies.

    Beatrici, Edoardo / Frego, Nicola / Chiarelli, Giuseppe / Sordelli, Federica / Mancon, Stefano / Saitta, Cesare / De Carne, Fabio / Garofano, Giuseppe / Arena, Paola / Avolio, Pier Paolo / Gobbo, Andrea / Uleri, Alessandro / Contieri, Roberto / Paciotti, Marco / Lazzeri, Massimo / Hurle, Rodolfo / Casale, Paolo / Buffi, Nicolò Maria / Lughezzani, Giovanni

    Diagnostics (Basel, Switzerland)

    2024  Volume 14, Issue 5

    Abstract: Background: The diagnostic process for prostate cancer after a negative biopsy is challenging. This study compares the diagnostic accuracy of micro-ultrasound (mUS) with multiparametric magnetic resonance imaging (mpMRI) for such cases.: Methods: A ... ...

    Abstract Background: The diagnostic process for prostate cancer after a negative biopsy is challenging. This study compares the diagnostic accuracy of micro-ultrasound (mUS) with multiparametric magnetic resonance imaging (mpMRI) for such cases.
    Methods: A retrospective cohort study was performed, targeting men with previous negative biopsies and using mUS and mpMRI to detect prostate cancer and clinically significant prostate cancer (csPCa).
    Results: In our cohort of 1397 men, 304 had a history of negative biopsies. mUS was more sensitive than mpMRI, with better predictive value for negative results. Importantly, mUS was significantly associated with csPCa detection (adjusted odds ratio [aOR]: 6.58; 95% confidence interval [CI]: 1.15-37.8;
    Conclusions: mUS may be preferable for diagnosing prostate cancer in previously biopsy-negative patients. However, the retrospective design of this study at a single institution suggests that further research across multiple centers is warranted.
    Language English
    Publishing date 2024-03-01
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662336-5
    ISSN 2075-4418
    ISSN 2075-4418
    DOI 10.3390/diagnostics14050525
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Diagnostic performance of microUltrasound at MRI-guided confirmatory biopsy in patients under active surveillance for low-risk prostate cancer.

    Maffei, Davide / Fasulo, Vittorio / Avolio, Pier Paolo / Saitta, Cesare / Paciotti, Marco / De Carne, Fabio / Colombo, Piergiuseppe / Pasini, Luisa / De Zorzi, Silvia Zandegiacomo / Saita, Alberto / Hurle, Rodolfo / Lazzeri, Massimo / Guazzoni, Giorgio Ferruccio / Casale, Paolo / Buffi, Nicolò Maria / Lughezzani, Giovanni

    The Prostate

    2023  Volume 83, Issue 9, Page(s) 886–895

    Abstract: Background: Active surveillance (AS) represents a standard of care of low-risk prostate cancer (PCa). However, the identification and monitoring of AS candidates remains challenging. Microultrasound (microUS) is a novel high-resolution imaging modality ... ...

    Abstract Background: Active surveillance (AS) represents a standard of care of low-risk prostate cancer (PCa). However, the identification and monitoring of AS candidates remains challenging. Microultrasound (microUS) is a novel high-resolution imaging modality for transrectal ultrasonography (TRUS). We explored the impact of microUS TRUS and targeted biopsies in mpMRI-guided confirmatory biopsies.
    Methods: Between October 2017 and September 2021, we prospectively enrolled 100 patients scheduled for MRI-guided confirmatory biopsy at 1 year from diagnosis of ISUP 1 PCa. TRUS was performed using the ExactVu microUS system; PRI-MUS protocol was applied to identify suspicious lesions (i.e., PRIMUS score ≥ 3). All patients received targeted biopsies of any identified microUS and mpMRI lesions and complementary systematic biopsies. The proportion of patients upgraded to clinically significant PCa (defined as ISUP ≥ 2 cancer; csPCa) at confirmatory biopsies was determined, and the diagnostic performance of microUS and mpMRI were compared.
    Results: Ninety-two patients had a suspicious MRI lesion classified PI-RADS 3, 4, and 5 in respectively 28, 16, and 18 patients. MicroUS identified 82 patients with suspicious lesions, classified as PRI-MUS 3, 4, and 5 in respectively 20, 50, and 12 patients, while 18 individuals had no lesions. Thirty-four patients were upgraded to ISUP ≥ 2 cancer and excluded from AS. MicroUS and mpMRI showed a sensitivity of 94.1% and 100%, and an NPV of 88.9% and 100%, respectively, in detecting ISUP ≥ 2 patients. A microUS-mandated protocol would have avoided confirmatory biopsies in 18 patients with no PRI-MUS ≥ 3 lesions at the cost of missing four upgraded patients.
    Conclusions: MicroUS and mpMRI represent valuable imaging modalities showing high sensitivity and NPV in detecting csPCa, thus allowing their use for event-triggered confirmatory biopsies in AS patients. MicroUS offers an alternative imaging modality to mpMRI for the identification and real-time targeting of suspicious lesions in AS patients.
    MeSH term(s) Male ; Humans ; Prostatic Neoplasms/diagnostic imaging ; Prostatic Neoplasms/pathology ; Magnetic Resonance Imaging/methods ; Watchful Waiting ; Image-Guided Biopsy/methods ; Ultrasonography
    Language English
    Publishing date 2023-04-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 604707-5
    ISSN 1097-0045 ; 0270-4137
    ISSN (online) 1097-0045
    ISSN 0270-4137
    DOI 10.1002/pros.24532
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1608: Show issues Location:
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