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Jelle O. Barentsz - One of the best experts on this subject based on the ideXlab platform.
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prostate cancer the european society of urogenital radiology prostate Imaging reporting and data system criteria for predicting extraprostatic extension by using 3 t multiparametric mr Imaging
Radiology, 2015Co-Authors: Kayat Bittencourt L, Geert Litjens, Baris Turkbey, Emerson L Gasparetto, Jelle O. BarentszAbstract:PURPOSE: To retrospectively assess the use of the European Society of Urogenital Radiology (ESUR) Prostate Imaging Reporting and Data System (PI-RADS) criteria and 3-T multiparametric magnetic resonance (MR) Imaging for detection of extraprostatic extension (EPE) of prostate cancer. MATERIALS AND METHODS: The institutional review board approval requirement was waived. Consecutive patients with prostate cancer (n = 133) underwent 3-T multiparametric MR Imaging before prostatectomy. Lesions were assessed by using ESUR/PI-RADS criteria for T2-weighted, diffusion-weighted, and Dynamic contrast material-enhanced Imaging, and by using the sum of these scores. Zonal dominant parameters corresponding to the score of diffusion-weighted Imaging for peripheral zone lesions and to T2-weighted Imaging scores for transitional zone lesions were calculated. In addition, the presence of EPE in each patient was evaluated on the basis of subjective multiparametric MR Imaging features. Histopathologic examination of whole-mount radical prostatectomy specimens was used as the reference standard. Sensitivity, specificity, positive predictive, and negative predictive values; likelihood ratios; and areas under the receiver operating characteristic curve were calculated for each parameter on the basis of its usefulness for prediction of EPE. RESULTS: EPE was found in 60 of 133 (45%) patients. Receiver operating characteristic curve analysis for the prediction of EPE revealed an area under the curve of 0.72 for T2-weighted, 0.67 for diffusion-weighted, and 0.64 for Dynamic Contrast-Enhanced Imaging; 0.74 for the dominant parameter; and 0.74 for the sum of the PI-RADS scores, and a score of 5 was defined as the best threshold for the individual parameters, with a score greater than or equal to 13 as the threshold for the sum of the PI-RADS scores. By applying these thresholds, sensitivity, negative predictive value, and negative likelihood ratio (ruling out EPE) were 77%, 77%, and 0.36, respectively, and specificity, positive predictive value, and positive likelihood ratio (ruling in EPE) were 64%, 64%, and 2.15, respectively, for the dominant parameter. Feature analysis showed an area under the curve of 0.72; sensitivity, negative predictive value, and negative likelihood ratio of 63%, 72%, and 0.56, respectively, and specificity, positive predictive value, and positive likelihood ratio of 78%, 70%, and 3.77, respectively. CONCLUSION: ESUR/PI-RADS criteria showed moderate overall accuracy for use in the prediction of EPE, and these results were similar to those of multiparametric MR Imaging assessment of features in this study sample.
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prostate cancer the european society of urogenital radiology prostate Imaging reporting and data system criteria for predicting extraprostatic extension by using 3 t
2015Co-Authors: Leonardo Kayat Bittencourt, Baris Turkbey, Geert Litjens, Emerson L Gasparetto, Jelle O. BarentszAbstract:The institutional review board approval requirement was waived. Consecutive patients with prostate cancer (n = 133) underwent 3-T multiparametric MR Imaging before prostatectomy. Lesions were assessed by using ESUR/PI-RADS criteria for T2-weighted, diffusion-weighted, and Dynamic contrast material–enhanced Imaging, and by using the sum of these scores. Zonal dominant parameters corresponding to the score of diffusion-weighted Imaging for peripheral zone lesions and to T2-weighted Imaging scores for transitional zone lesions were calculated. In addition, the presence of EPE in each patient was evaluated on the basis of subjective multiparametric MR Imaging features. Histopathologic examination of whole-mount radical prostatectomy specimens was used as the reference standard. Sensitivity, specificity, pos itive predictive, and negative predictive values; likelihood ratios; and areas under the receiver operating characteristic curve were calculated for each parameter on the basis of its usefulness for prediction of EPE. Results: EPE was found in 60 of 133 (45%) patients. Receiver operating characteristic curve analysis for the prediction of EPE revealed an area under the curve of 0.72 for T2-weighted, 0.67 for diffusion-weighted, and 0.64 for Dynamic Contrast-Enhanced Imaging; 0.74 for the dominant parameter; and 0.74 for the sum of the PI-RADS scores, and a score of 5 was defined as the best threshold for the individual param eters, with a score greater than or equal to 13 as the threshold for the sum of the PI-RADS scores. By applying these thresholds, sensitivity, negative predictive value, and negative likelihood ratio (ruling out EPE) were 77%, 77%, and 0.36, respectively, and specificity, positive predictive value, and positive likelihood ratio (ruling in EPE) were 64%, 64%, and 2.15, respectively, for the dominant parameter. Feature analysis showed an area under the curve of 0.72; sensitivity, negative predictive value, and negative likelihood ratio of 63%, 72%, and 0.56, respectively, and specificity, positive predictive value, and positive likelihood ratio of 78%, 70%, and 3.77, respectively.
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prospective assessment of prostate cancer aggressiveness using 3 t diffusion weighted magnetic resonance Imaging guided biopsies versus a systematic 10 core transrectal ultrasound prostate biopsy cohort
European Urology, 2012Co-Authors: Thomas Hambrock, Christina A. Hulsbergen–van De Kaa, C M A Hoeks, Jurgen J Futterer, Stefan A W Bouwense, Inge M Van Oort, Henkjan J Huisman, Tom W J Scheenen, Fritz H Schroder, Jelle O. BarentszAbstract:Abstract Background Accurate pretreatment assessment of prostate cancer (PCa) aggressiveness is important in decision making. Gleason grade is a critical predictor of the aggressiveness of PCa. Transrectal ultrasound–guided biopsies (TRUSBxs) show substantial undergrading of Gleason grades found after radical prostatectomy (RP). Diffusion-weighted magnetic resonance Imaging (MRI) has been shown to be a biomarker of tumour aggressiveness. Objective To improve pretreatment assessment of PCa aggressiveness, this study prospectively evaluated MRI-guided prostate biopsies (MR-GBs) of abnormalities determined on diffusion-weighted Imaging (DWI) apparent diffusion coefficient (ADC) maps. The results were compared with a 10-core TRUSBx cohort. RP findings served as the gold standard. Design, setting, and participants A 10-core TRUSBx ( n =64) or MR-GB ( n =34) was used for PCa diagnosis before RP in 98 patients. Measurements Using multiparametric 3-T MRI: T2-weighted, Dynamic Contrast-Enhanced Imaging, and DWI were performed to identify tumour-suspicious regions in patients with a negative TRUSBx. The regions with the highest restriction on ADC maps within the suspicions regions were used to direct MR-GB. A 10-core TRUSBx was used in a matched cohort. Following RP, the highest Gleason grades (HGGs) in biopsies and RP specimens were identified. Biopsy and RP Gleason grade results were evaluated using chi-square analysis. Results and limitations No significant differences on RP were observed for proportions of patients having a HGG of 3 (35% vs 28%; p =0.50), 4 (32% vs 41%; p =0.51), and 5 (32% vs 31%; p =0.61) for the MR-GB and TRUSBx cohort, respectively. MR-GB showed an exact performance with RP for overall HGG: 88% (30 of 34); for TRUS-GB it was 55% (35 of 64; p =0.001). In the MR-GB cohort, an exact performance with HGG 3 was 100% (12 of 12); for HGG 4, 91% (10 of 11); and for HGG 5, 73% (8 of 11). The corresponding performance rates for TRUSBx were 94% (17 of 18; p =0.41), 46% (12 of 26; p =0.02), and 30% (6 of 20; p =0.01), respectively. Conclusions This study shows prospectively that DWI-directed MR-GBs significantly improve pretreatment risk stratification by obtaining biopsies that are representative of true Gleason grade.
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prospective assessment of prostate cancer aggressiveness using 3 t diffusion weighted magnetic resonance Imaging guided biopsies versus a systematic 10 core transrectal ultrasound prostate biopsy cohort
European Urology, 2012Co-Authors: Thomas Hambrock, C M A Hoeks, Jurgen J Futterer, Stefan A W Bouwense, Henkjan J Huisman, Tom W J Scheenen, Fritz H Schroder, Inge M Van Oort, Jelle O. BarentszAbstract:BACKGROUND: Accurate pretreatment assessment of prostate cancer (PCa) aggressiveness is important in decision making. Gleason grade is a critical predictor of the aggressiveness of PCa. Transrectal ultrasound-guided biopsies (TRUSBxs) show substantial undergrading of Gleason grades found after radical prostatectomy (RP). Diffusion-weighted magnetic resonance Imaging (MRI) has been shown to be a biomarker of tumour aggressiveness. OBJECTIVE: To improve pretreatment assessment of PCa aggressiveness, this study prospectively evaluated MRI-guided prostate biopsies (MR-GBs) of abnormalities determined on diffusion-weighted Imaging (DWI) apparent diffusion coefficient (ADC) maps. The results were compared with a 10-core TRUSBx cohort. RP findings served as the gold standard. DESIGN, SETTING, AND PARTICIPANTS: A 10-core TRUSBx (n=64) or MR-GB (n=34) was used for PCa diagnosis before RP in 98 patients. MEASUREMENTS: Using multiparametric 3-T MRI: T2-weighted, Dynamic Contrast-Enhanced Imaging, and DWI were performed to identify tumour-suspicious regions in patients with a negative TRUSBx. The regions with the highest restriction on ADC maps within the suspicions regions were used to direct MR-GB. A 10-core TRUSBx was used in a matched cohort. Following RP, the highest Gleason grades (HGGs) in biopsies and RP specimens were identified. Biopsy and RP Gleason grade results were evaluated using chi-square analysis. RESULTS AND LIMITATIONS: No significant differences on RP were observed for proportions of patients having a HGG of 3 (35% vs 28%; p=0.50), 4 (32% vs 41%; p=0.51), and 5 (32% vs 31%; p=0.61) for the MR-GB and TRUSBx cohort, respectively. MR-GB showed an exact performance with RP for overall HGG: 88% (30 of 34); for TRUS-GB it was 55% (35 of 64; p=0.001). In the MR-GB cohort, an exact performance with HGG 3 was 100% (12 of 12); for HGG 4, 91% (10 of 11); and for HGG 5, 73% (8 of 11). The corresponding performance rates for TRUSBx were 94% (17 of 18; p=0.41), 46% (12 of 26; p=0.02), and 30% (6 of 20; p=0.01), respectively. CONCLUSIONS: This study shows prospectively that DWI-directed MR-GBs significantly improve pretreatment risk stratification by obtaining biopsies that are representative of true Gleason grade.
Jurgen J Futterer - One of the best experts on this subject based on the ideXlab platform.
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prospective assessment of prostate cancer aggressiveness using 3 t diffusion weighted magnetic resonance Imaging guided biopsies versus a systematic 10 core transrectal ultrasound prostate biopsy cohort
European Urology, 2012Co-Authors: Thomas Hambrock, C M A Hoeks, Jurgen J Futterer, Stefan A W Bouwense, Henkjan J Huisman, Tom W J Scheenen, Fritz H Schroder, Inge M Van Oort, Jelle O. BarentszAbstract:BACKGROUND: Accurate pretreatment assessment of prostate cancer (PCa) aggressiveness is important in decision making. Gleason grade is a critical predictor of the aggressiveness of PCa. Transrectal ultrasound-guided biopsies (TRUSBxs) show substantial undergrading of Gleason grades found after radical prostatectomy (RP). Diffusion-weighted magnetic resonance Imaging (MRI) has been shown to be a biomarker of tumour aggressiveness. OBJECTIVE: To improve pretreatment assessment of PCa aggressiveness, this study prospectively evaluated MRI-guided prostate biopsies (MR-GBs) of abnormalities determined on diffusion-weighted Imaging (DWI) apparent diffusion coefficient (ADC) maps. The results were compared with a 10-core TRUSBx cohort. RP findings served as the gold standard. DESIGN, SETTING, AND PARTICIPANTS: A 10-core TRUSBx (n=64) or MR-GB (n=34) was used for PCa diagnosis before RP in 98 patients. MEASUREMENTS: Using multiparametric 3-T MRI: T2-weighted, Dynamic Contrast-Enhanced Imaging, and DWI were performed to identify tumour-suspicious regions in patients with a negative TRUSBx. The regions with the highest restriction on ADC maps within the suspicions regions were used to direct MR-GB. A 10-core TRUSBx was used in a matched cohort. Following RP, the highest Gleason grades (HGGs) in biopsies and RP specimens were identified. Biopsy and RP Gleason grade results were evaluated using chi-square analysis. RESULTS AND LIMITATIONS: No significant differences on RP were observed for proportions of patients having a HGG of 3 (35% vs 28%; p=0.50), 4 (32% vs 41%; p=0.51), and 5 (32% vs 31%; p=0.61) for the MR-GB and TRUSBx cohort, respectively. MR-GB showed an exact performance with RP for overall HGG: 88% (30 of 34); for TRUS-GB it was 55% (35 of 64; p=0.001). In the MR-GB cohort, an exact performance with HGG 3 was 100% (12 of 12); for HGG 4, 91% (10 of 11); and for HGG 5, 73% (8 of 11). The corresponding performance rates for TRUSBx were 94% (17 of 18; p=0.41), 46% (12 of 26; p=0.02), and 30% (6 of 20; p=0.01), respectively. CONCLUSIONS: This study shows prospectively that DWI-directed MR-GBs significantly improve pretreatment risk stratification by obtaining biopsies that are representative of true Gleason grade.
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prospective assessment of prostate cancer aggressiveness using 3 t diffusion weighted magnetic resonance Imaging guided biopsies versus a systematic 10 core transrectal ultrasound prostate biopsy cohort
European Urology, 2012Co-Authors: Thomas Hambrock, Christina A. Hulsbergen–van De Kaa, C M A Hoeks, Jurgen J Futterer, Stefan A W Bouwense, Inge M Van Oort, Henkjan J Huisman, Tom W J Scheenen, Fritz H Schroder, Jelle O. BarentszAbstract:Abstract Background Accurate pretreatment assessment of prostate cancer (PCa) aggressiveness is important in decision making. Gleason grade is a critical predictor of the aggressiveness of PCa. Transrectal ultrasound–guided biopsies (TRUSBxs) show substantial undergrading of Gleason grades found after radical prostatectomy (RP). Diffusion-weighted magnetic resonance Imaging (MRI) has been shown to be a biomarker of tumour aggressiveness. Objective To improve pretreatment assessment of PCa aggressiveness, this study prospectively evaluated MRI-guided prostate biopsies (MR-GBs) of abnormalities determined on diffusion-weighted Imaging (DWI) apparent diffusion coefficient (ADC) maps. The results were compared with a 10-core TRUSBx cohort. RP findings served as the gold standard. Design, setting, and participants A 10-core TRUSBx ( n =64) or MR-GB ( n =34) was used for PCa diagnosis before RP in 98 patients. Measurements Using multiparametric 3-T MRI: T2-weighted, Dynamic Contrast-Enhanced Imaging, and DWI were performed to identify tumour-suspicious regions in patients with a negative TRUSBx. The regions with the highest restriction on ADC maps within the suspicions regions were used to direct MR-GB. A 10-core TRUSBx was used in a matched cohort. Following RP, the highest Gleason grades (HGGs) in biopsies and RP specimens were identified. Biopsy and RP Gleason grade results were evaluated using chi-square analysis. Results and limitations No significant differences on RP were observed for proportions of patients having a HGG of 3 (35% vs 28%; p =0.50), 4 (32% vs 41%; p =0.51), and 5 (32% vs 31%; p =0.61) for the MR-GB and TRUSBx cohort, respectively. MR-GB showed an exact performance with RP for overall HGG: 88% (30 of 34); for TRUS-GB it was 55% (35 of 64; p =0.001). In the MR-GB cohort, an exact performance with HGG 3 was 100% (12 of 12); for HGG 4, 91% (10 of 11); and for HGG 5, 73% (8 of 11). The corresponding performance rates for TRUSBx were 94% (17 of 18; p =0.41), 46% (12 of 26; p =0.02), and 30% (6 of 20; p =0.01), respectively. Conclusions This study shows prospectively that DWI-directed MR-GBs significantly improve pretreatment risk stratification by obtaining biopsies that are representative of true Gleason grade.
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Prostate Cancer Localization with Dynamic Contrast-Enhanced MR Imaging and Proton MR Spectroscopic Imaging
Radiology, 2006Co-Authors: Jurgen J Futterer, Stijn W. T. P. J. Heijmink, Jeroen Veltman, Pieter Vos, Christina A. Hulsbergen–van De Kaa, Henkjan J Huisman, Paul F M Krabbe, Tom W J Scheenen, J Alfred Witjes, Arend HeerschapAbstract:Purpose: To prospectively determine the accuracies of T2-weighted magnetic resonance (MR) Imaging, Dynamic contrast material-enhanced MR Imaging, and quantitative three-dimensional (3D) proton MR spectroscopic Imaging of the entire prostate for prostate cancer localization, with whole-mount histopathologic section findings as the reference standard. Materials and Methods: This study was approved by the institutional review board, and informed consent was obtained from all patients. Thirty-four consecutive men with a mean age of 60 years and a mean prostate-specific antigen level of 8 ng/mL were examined. The median biopsy Gleason score was 6. T2-weighted MR Imaging, Dynamic Contrast-Enhanced MR Imaging, and 3D MR spectroscopic Imaging were performed, and on the basis of the image data, two readers with different levels of experience recorded the location of the suspicious peripheral zone and central gland tumor nodules on each of 14 standardized regions of interest (ROIs) in the prostate. The degree of diagnostic confidence for each ROI was recorded on a five-point scale. Localization accuracy and ROI-based receiver operating characteristic (ROC) curves were calculated. Results: For both readers, areas under the ROC curve for T2-weighted MR, Dynamic Contrast-Enhanced MR, and 3D MR spectroscopic Imaging were 0.68, 0.91, and 0.80, respectively. Reader accuracy in tumor localization with Dynamic Contrast-Enhanced Imaging was significantly better than that with quantitative spectroscopic Imaging (P < .01). Reader accuracy in tumor localization with both Dynamic Contrast-Enhanced Imaging and spectroscopic Imaging was significantly better than that with T2-weighted Imaging (P < .01). Conclusion: Compared with use of T2-weighted MR Imaging, use of Dynamic Contrast-Enhanced MR Imaging and 3D MR spectroscopic Imaging facilitated significantly improved accuracy in prostate cancer localization. (C) RSNA, 2006
Henkjan J Huisman - One of the best experts on this subject based on the ideXlab platform.
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prospective assessment of prostate cancer aggressiveness using 3 t diffusion weighted magnetic resonance Imaging guided biopsies versus a systematic 10 core transrectal ultrasound prostate biopsy cohort
European Urology, 2012Co-Authors: Thomas Hambrock, C M A Hoeks, Jurgen J Futterer, Stefan A W Bouwense, Henkjan J Huisman, Tom W J Scheenen, Fritz H Schroder, Inge M Van Oort, Jelle O. BarentszAbstract:BACKGROUND: Accurate pretreatment assessment of prostate cancer (PCa) aggressiveness is important in decision making. Gleason grade is a critical predictor of the aggressiveness of PCa. Transrectal ultrasound-guided biopsies (TRUSBxs) show substantial undergrading of Gleason grades found after radical prostatectomy (RP). Diffusion-weighted magnetic resonance Imaging (MRI) has been shown to be a biomarker of tumour aggressiveness. OBJECTIVE: To improve pretreatment assessment of PCa aggressiveness, this study prospectively evaluated MRI-guided prostate biopsies (MR-GBs) of abnormalities determined on diffusion-weighted Imaging (DWI) apparent diffusion coefficient (ADC) maps. The results were compared with a 10-core TRUSBx cohort. RP findings served as the gold standard. DESIGN, SETTING, AND PARTICIPANTS: A 10-core TRUSBx (n=64) or MR-GB (n=34) was used for PCa diagnosis before RP in 98 patients. MEASUREMENTS: Using multiparametric 3-T MRI: T2-weighted, Dynamic Contrast-Enhanced Imaging, and DWI were performed to identify tumour-suspicious regions in patients with a negative TRUSBx. The regions with the highest restriction on ADC maps within the suspicions regions were used to direct MR-GB. A 10-core TRUSBx was used in a matched cohort. Following RP, the highest Gleason grades (HGGs) in biopsies and RP specimens were identified. Biopsy and RP Gleason grade results were evaluated using chi-square analysis. RESULTS AND LIMITATIONS: No significant differences on RP were observed for proportions of patients having a HGG of 3 (35% vs 28%; p=0.50), 4 (32% vs 41%; p=0.51), and 5 (32% vs 31%; p=0.61) for the MR-GB and TRUSBx cohort, respectively. MR-GB showed an exact performance with RP for overall HGG: 88% (30 of 34); for TRUS-GB it was 55% (35 of 64; p=0.001). In the MR-GB cohort, an exact performance with HGG 3 was 100% (12 of 12); for HGG 4, 91% (10 of 11); and for HGG 5, 73% (8 of 11). The corresponding performance rates for TRUSBx were 94% (17 of 18; p=0.41), 46% (12 of 26; p=0.02), and 30% (6 of 20; p=0.01), respectively. CONCLUSIONS: This study shows prospectively that DWI-directed MR-GBs significantly improve pretreatment risk stratification by obtaining biopsies that are representative of true Gleason grade.
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prospective assessment of prostate cancer aggressiveness using 3 t diffusion weighted magnetic resonance Imaging guided biopsies versus a systematic 10 core transrectal ultrasound prostate biopsy cohort
European Urology, 2012Co-Authors: Thomas Hambrock, Christina A. Hulsbergen–van De Kaa, C M A Hoeks, Jurgen J Futterer, Stefan A W Bouwense, Inge M Van Oort, Henkjan J Huisman, Tom W J Scheenen, Fritz H Schroder, Jelle O. BarentszAbstract:Abstract Background Accurate pretreatment assessment of prostate cancer (PCa) aggressiveness is important in decision making. Gleason grade is a critical predictor of the aggressiveness of PCa. Transrectal ultrasound–guided biopsies (TRUSBxs) show substantial undergrading of Gleason grades found after radical prostatectomy (RP). Diffusion-weighted magnetic resonance Imaging (MRI) has been shown to be a biomarker of tumour aggressiveness. Objective To improve pretreatment assessment of PCa aggressiveness, this study prospectively evaluated MRI-guided prostate biopsies (MR-GBs) of abnormalities determined on diffusion-weighted Imaging (DWI) apparent diffusion coefficient (ADC) maps. The results were compared with a 10-core TRUSBx cohort. RP findings served as the gold standard. Design, setting, and participants A 10-core TRUSBx ( n =64) or MR-GB ( n =34) was used for PCa diagnosis before RP in 98 patients. Measurements Using multiparametric 3-T MRI: T2-weighted, Dynamic Contrast-Enhanced Imaging, and DWI were performed to identify tumour-suspicious regions in patients with a negative TRUSBx. The regions with the highest restriction on ADC maps within the suspicions regions were used to direct MR-GB. A 10-core TRUSBx was used in a matched cohort. Following RP, the highest Gleason grades (HGGs) in biopsies and RP specimens were identified. Biopsy and RP Gleason grade results were evaluated using chi-square analysis. Results and limitations No significant differences on RP were observed for proportions of patients having a HGG of 3 (35% vs 28%; p =0.50), 4 (32% vs 41%; p =0.51), and 5 (32% vs 31%; p =0.61) for the MR-GB and TRUSBx cohort, respectively. MR-GB showed an exact performance with RP for overall HGG: 88% (30 of 34); for TRUS-GB it was 55% (35 of 64; p =0.001). In the MR-GB cohort, an exact performance with HGG 3 was 100% (12 of 12); for HGG 4, 91% (10 of 11); and for HGG 5, 73% (8 of 11). The corresponding performance rates for TRUSBx were 94% (17 of 18; p =0.41), 46% (12 of 26; p =0.02), and 30% (6 of 20; p =0.01), respectively. Conclusions This study shows prospectively that DWI-directed MR-GBs significantly improve pretreatment risk stratification by obtaining biopsies that are representative of true Gleason grade.
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Prostate Cancer Localization with Dynamic Contrast-Enhanced MR Imaging and Proton MR Spectroscopic Imaging
Radiology, 2006Co-Authors: Jurgen J Futterer, Stijn W. T. P. J. Heijmink, Jeroen Veltman, Pieter Vos, Christina A. Hulsbergen–van De Kaa, Henkjan J Huisman, Paul F M Krabbe, Tom W J Scheenen, J Alfred Witjes, Arend HeerschapAbstract:Purpose: To prospectively determine the accuracies of T2-weighted magnetic resonance (MR) Imaging, Dynamic contrast material-enhanced MR Imaging, and quantitative three-dimensional (3D) proton MR spectroscopic Imaging of the entire prostate for prostate cancer localization, with whole-mount histopathologic section findings as the reference standard. Materials and Methods: This study was approved by the institutional review board, and informed consent was obtained from all patients. Thirty-four consecutive men with a mean age of 60 years and a mean prostate-specific antigen level of 8 ng/mL were examined. The median biopsy Gleason score was 6. T2-weighted MR Imaging, Dynamic Contrast-Enhanced MR Imaging, and 3D MR spectroscopic Imaging were performed, and on the basis of the image data, two readers with different levels of experience recorded the location of the suspicious peripheral zone and central gland tumor nodules on each of 14 standardized regions of interest (ROIs) in the prostate. The degree of diagnostic confidence for each ROI was recorded on a five-point scale. Localization accuracy and ROI-based receiver operating characteristic (ROC) curves were calculated. Results: For both readers, areas under the ROC curve for T2-weighted MR, Dynamic Contrast-Enhanced MR, and 3D MR spectroscopic Imaging were 0.68, 0.91, and 0.80, respectively. Reader accuracy in tumor localization with Dynamic Contrast-Enhanced Imaging was significantly better than that with quantitative spectroscopic Imaging (P < .01). Reader accuracy in tumor localization with both Dynamic Contrast-Enhanced Imaging and spectroscopic Imaging was significantly better than that with T2-weighted Imaging (P < .01). Conclusion: Compared with use of T2-weighted MR Imaging, use of Dynamic Contrast-Enhanced MR Imaging and 3D MR spectroscopic Imaging facilitated significantly improved accuracy in prostate cancer localization. (C) RSNA, 2006
Tom W J Scheenen - One of the best experts on this subject based on the ideXlab platform.
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prospective assessment of prostate cancer aggressiveness using 3 t diffusion weighted magnetic resonance Imaging guided biopsies versus a systematic 10 core transrectal ultrasound prostate biopsy cohort
European Urology, 2012Co-Authors: Thomas Hambrock, C M A Hoeks, Jurgen J Futterer, Stefan A W Bouwense, Henkjan J Huisman, Tom W J Scheenen, Fritz H Schroder, Inge M Van Oort, Jelle O. BarentszAbstract:BACKGROUND: Accurate pretreatment assessment of prostate cancer (PCa) aggressiveness is important in decision making. Gleason grade is a critical predictor of the aggressiveness of PCa. Transrectal ultrasound-guided biopsies (TRUSBxs) show substantial undergrading of Gleason grades found after radical prostatectomy (RP). Diffusion-weighted magnetic resonance Imaging (MRI) has been shown to be a biomarker of tumour aggressiveness. OBJECTIVE: To improve pretreatment assessment of PCa aggressiveness, this study prospectively evaluated MRI-guided prostate biopsies (MR-GBs) of abnormalities determined on diffusion-weighted Imaging (DWI) apparent diffusion coefficient (ADC) maps. The results were compared with a 10-core TRUSBx cohort. RP findings served as the gold standard. DESIGN, SETTING, AND PARTICIPANTS: A 10-core TRUSBx (n=64) or MR-GB (n=34) was used for PCa diagnosis before RP in 98 patients. MEASUREMENTS: Using multiparametric 3-T MRI: T2-weighted, Dynamic Contrast-Enhanced Imaging, and DWI were performed to identify tumour-suspicious regions in patients with a negative TRUSBx. The regions with the highest restriction on ADC maps within the suspicions regions were used to direct MR-GB. A 10-core TRUSBx was used in a matched cohort. Following RP, the highest Gleason grades (HGGs) in biopsies and RP specimens were identified. Biopsy and RP Gleason grade results were evaluated using chi-square analysis. RESULTS AND LIMITATIONS: No significant differences on RP were observed for proportions of patients having a HGG of 3 (35% vs 28%; p=0.50), 4 (32% vs 41%; p=0.51), and 5 (32% vs 31%; p=0.61) for the MR-GB and TRUSBx cohort, respectively. MR-GB showed an exact performance with RP for overall HGG: 88% (30 of 34); for TRUS-GB it was 55% (35 of 64; p=0.001). In the MR-GB cohort, an exact performance with HGG 3 was 100% (12 of 12); for HGG 4, 91% (10 of 11); and for HGG 5, 73% (8 of 11). The corresponding performance rates for TRUSBx were 94% (17 of 18; p=0.41), 46% (12 of 26; p=0.02), and 30% (6 of 20; p=0.01), respectively. CONCLUSIONS: This study shows prospectively that DWI-directed MR-GBs significantly improve pretreatment risk stratification by obtaining biopsies that are representative of true Gleason grade.
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prospective assessment of prostate cancer aggressiveness using 3 t diffusion weighted magnetic resonance Imaging guided biopsies versus a systematic 10 core transrectal ultrasound prostate biopsy cohort
European Urology, 2012Co-Authors: Thomas Hambrock, Christina A. Hulsbergen–van De Kaa, C M A Hoeks, Jurgen J Futterer, Stefan A W Bouwense, Inge M Van Oort, Henkjan J Huisman, Tom W J Scheenen, Fritz H Schroder, Jelle O. BarentszAbstract:Abstract Background Accurate pretreatment assessment of prostate cancer (PCa) aggressiveness is important in decision making. Gleason grade is a critical predictor of the aggressiveness of PCa. Transrectal ultrasound–guided biopsies (TRUSBxs) show substantial undergrading of Gleason grades found after radical prostatectomy (RP). Diffusion-weighted magnetic resonance Imaging (MRI) has been shown to be a biomarker of tumour aggressiveness. Objective To improve pretreatment assessment of PCa aggressiveness, this study prospectively evaluated MRI-guided prostate biopsies (MR-GBs) of abnormalities determined on diffusion-weighted Imaging (DWI) apparent diffusion coefficient (ADC) maps. The results were compared with a 10-core TRUSBx cohort. RP findings served as the gold standard. Design, setting, and participants A 10-core TRUSBx ( n =64) or MR-GB ( n =34) was used for PCa diagnosis before RP in 98 patients. Measurements Using multiparametric 3-T MRI: T2-weighted, Dynamic Contrast-Enhanced Imaging, and DWI were performed to identify tumour-suspicious regions in patients with a negative TRUSBx. The regions with the highest restriction on ADC maps within the suspicions regions were used to direct MR-GB. A 10-core TRUSBx was used in a matched cohort. Following RP, the highest Gleason grades (HGGs) in biopsies and RP specimens were identified. Biopsy and RP Gleason grade results were evaluated using chi-square analysis. Results and limitations No significant differences on RP were observed for proportions of patients having a HGG of 3 (35% vs 28%; p =0.50), 4 (32% vs 41%; p =0.51), and 5 (32% vs 31%; p =0.61) for the MR-GB and TRUSBx cohort, respectively. MR-GB showed an exact performance with RP for overall HGG: 88% (30 of 34); for TRUS-GB it was 55% (35 of 64; p =0.001). In the MR-GB cohort, an exact performance with HGG 3 was 100% (12 of 12); for HGG 4, 91% (10 of 11); and for HGG 5, 73% (8 of 11). The corresponding performance rates for TRUSBx were 94% (17 of 18; p =0.41), 46% (12 of 26; p =0.02), and 30% (6 of 20; p =0.01), respectively. Conclusions This study shows prospectively that DWI-directed MR-GBs significantly improve pretreatment risk stratification by obtaining biopsies that are representative of true Gleason grade.
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Prostate Cancer Localization with Dynamic Contrast-Enhanced MR Imaging and Proton MR Spectroscopic Imaging
Radiology, 2006Co-Authors: Jurgen J Futterer, Stijn W. T. P. J. Heijmink, Jeroen Veltman, Pieter Vos, Christina A. Hulsbergen–van De Kaa, Henkjan J Huisman, Paul F M Krabbe, Tom W J Scheenen, J Alfred Witjes, Arend HeerschapAbstract:Purpose: To prospectively determine the accuracies of T2-weighted magnetic resonance (MR) Imaging, Dynamic contrast material-enhanced MR Imaging, and quantitative three-dimensional (3D) proton MR spectroscopic Imaging of the entire prostate for prostate cancer localization, with whole-mount histopathologic section findings as the reference standard. Materials and Methods: This study was approved by the institutional review board, and informed consent was obtained from all patients. Thirty-four consecutive men with a mean age of 60 years and a mean prostate-specific antigen level of 8 ng/mL were examined. The median biopsy Gleason score was 6. T2-weighted MR Imaging, Dynamic Contrast-Enhanced MR Imaging, and 3D MR spectroscopic Imaging were performed, and on the basis of the image data, two readers with different levels of experience recorded the location of the suspicious peripheral zone and central gland tumor nodules on each of 14 standardized regions of interest (ROIs) in the prostate. The degree of diagnostic confidence for each ROI was recorded on a five-point scale. Localization accuracy and ROI-based receiver operating characteristic (ROC) curves were calculated. Results: For both readers, areas under the ROC curve for T2-weighted MR, Dynamic Contrast-Enhanced MR, and 3D MR spectroscopic Imaging were 0.68, 0.91, and 0.80, respectively. Reader accuracy in tumor localization with Dynamic Contrast-Enhanced Imaging was significantly better than that with quantitative spectroscopic Imaging (P < .01). Reader accuracy in tumor localization with both Dynamic Contrast-Enhanced Imaging and spectroscopic Imaging was significantly better than that with T2-weighted Imaging (P < .01). Conclusion: Compared with use of T2-weighted MR Imaging, use of Dynamic Contrast-Enhanced MR Imaging and 3D MR spectroscopic Imaging facilitated significantly improved accuracy in prostate cancer localization. (C) RSNA, 2006
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prospective assessment of prostate cancer aggressiveness using 3 t diffusion weighted magnetic resonance Imaging guided biopsies versus a systematic 10 core transrectal ultrasound prostate biopsy cohort
European Urology, 2012Co-Authors: Thomas Hambrock, Christina A. Hulsbergen–van De Kaa, C M A Hoeks, Jurgen J Futterer, Stefan A W Bouwense, Inge M Van Oort, Henkjan J Huisman, Tom W J Scheenen, Fritz H Schroder, Jelle O. BarentszAbstract:Abstract Background Accurate pretreatment assessment of prostate cancer (PCa) aggressiveness is important in decision making. Gleason grade is a critical predictor of the aggressiveness of PCa. Transrectal ultrasound–guided biopsies (TRUSBxs) show substantial undergrading of Gleason grades found after radical prostatectomy (RP). Diffusion-weighted magnetic resonance Imaging (MRI) has been shown to be a biomarker of tumour aggressiveness. Objective To improve pretreatment assessment of PCa aggressiveness, this study prospectively evaluated MRI-guided prostate biopsies (MR-GBs) of abnormalities determined on diffusion-weighted Imaging (DWI) apparent diffusion coefficient (ADC) maps. The results were compared with a 10-core TRUSBx cohort. RP findings served as the gold standard. Design, setting, and participants A 10-core TRUSBx ( n =64) or MR-GB ( n =34) was used for PCa diagnosis before RP in 98 patients. Measurements Using multiparametric 3-T MRI: T2-weighted, Dynamic Contrast-Enhanced Imaging, and DWI were performed to identify tumour-suspicious regions in patients with a negative TRUSBx. The regions with the highest restriction on ADC maps within the suspicions regions were used to direct MR-GB. A 10-core TRUSBx was used in a matched cohort. Following RP, the highest Gleason grades (HGGs) in biopsies and RP specimens were identified. Biopsy and RP Gleason grade results were evaluated using chi-square analysis. Results and limitations No significant differences on RP were observed for proportions of patients having a HGG of 3 (35% vs 28%; p =0.50), 4 (32% vs 41%; p =0.51), and 5 (32% vs 31%; p =0.61) for the MR-GB and TRUSBx cohort, respectively. MR-GB showed an exact performance with RP for overall HGG: 88% (30 of 34); for TRUS-GB it was 55% (35 of 64; p =0.001). In the MR-GB cohort, an exact performance with HGG 3 was 100% (12 of 12); for HGG 4, 91% (10 of 11); and for HGG 5, 73% (8 of 11). The corresponding performance rates for TRUSBx were 94% (17 of 18; p =0.41), 46% (12 of 26; p =0.02), and 30% (6 of 20; p =0.01), respectively. Conclusions This study shows prospectively that DWI-directed MR-GBs significantly improve pretreatment risk stratification by obtaining biopsies that are representative of true Gleason grade.
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prospective assessment of prostate cancer aggressiveness using 3 t diffusion weighted magnetic resonance Imaging guided biopsies versus a systematic 10 core transrectal ultrasound prostate biopsy cohort
European Urology, 2012Co-Authors: Thomas Hambrock, C M A Hoeks, Jurgen J Futterer, Stefan A W Bouwense, Henkjan J Huisman, Tom W J Scheenen, Fritz H Schroder, Inge M Van Oort, Jelle O. BarentszAbstract:BACKGROUND: Accurate pretreatment assessment of prostate cancer (PCa) aggressiveness is important in decision making. Gleason grade is a critical predictor of the aggressiveness of PCa. Transrectal ultrasound-guided biopsies (TRUSBxs) show substantial undergrading of Gleason grades found after radical prostatectomy (RP). Diffusion-weighted magnetic resonance Imaging (MRI) has been shown to be a biomarker of tumour aggressiveness. OBJECTIVE: To improve pretreatment assessment of PCa aggressiveness, this study prospectively evaluated MRI-guided prostate biopsies (MR-GBs) of abnormalities determined on diffusion-weighted Imaging (DWI) apparent diffusion coefficient (ADC) maps. The results were compared with a 10-core TRUSBx cohort. RP findings served as the gold standard. DESIGN, SETTING, AND PARTICIPANTS: A 10-core TRUSBx (n=64) or MR-GB (n=34) was used for PCa diagnosis before RP in 98 patients. MEASUREMENTS: Using multiparametric 3-T MRI: T2-weighted, Dynamic Contrast-Enhanced Imaging, and DWI were performed to identify tumour-suspicious regions in patients with a negative TRUSBx. The regions with the highest restriction on ADC maps within the suspicions regions were used to direct MR-GB. A 10-core TRUSBx was used in a matched cohort. Following RP, the highest Gleason grades (HGGs) in biopsies and RP specimens were identified. Biopsy and RP Gleason grade results were evaluated using chi-square analysis. RESULTS AND LIMITATIONS: No significant differences on RP were observed for proportions of patients having a HGG of 3 (35% vs 28%; p=0.50), 4 (32% vs 41%; p=0.51), and 5 (32% vs 31%; p=0.61) for the MR-GB and TRUSBx cohort, respectively. MR-GB showed an exact performance with RP for overall HGG: 88% (30 of 34); for TRUS-GB it was 55% (35 of 64; p=0.001). In the MR-GB cohort, an exact performance with HGG 3 was 100% (12 of 12); for HGG 4, 91% (10 of 11); and for HGG 5, 73% (8 of 11). The corresponding performance rates for TRUSBx were 94% (17 of 18; p=0.41), 46% (12 of 26; p=0.02), and 30% (6 of 20; p=0.01), respectively. CONCLUSIONS: This study shows prospectively that DWI-directed MR-GBs significantly improve pretreatment risk stratification by obtaining biopsies that are representative of true Gleason grade.
