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Dan Stoianovici - One of the best experts on this subject based on the ideXlab platform.
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Robotic Transrectal Ultrasound Guided Prostate Biopsy
IEEE Transactions on Biomedical Engineering, 2019Co-Authors: Doyoung Chang, Doru Petrisor, Dan StoianoviciAbstract:We present a robot-assisted approach for transrectal ultrasound (TRUS) guided Prostate Biopsy. The robot is a hands-free probe manipulator that moves the probe with the same 4 DoF that are used manually. Software was developed for three-dimensional (3-D) imaging, Biopsy planning, robot control, and navigation. Methods to minimize the deformation of the Prostate caused by the probe at 3-D imaging and needle targeting were developed to reduce Biopsy targeting errors. We also present a Prostate coordinate system (PCS). The PCS helps defining a systematic Biopsy plan without the need for Prostate segmentation. Comprehensive tests were performed, including two bench tests, one imaging test, two in vitro targeting tests, and an IRB-approved clinical trial on five patients. Preclinical tests showed that image-based needle targeting can be accomplished with accuracy on the order of 1 mm. Prostate Biopsy can be accomplished with minimal TRUS pressure on the gland and submillimetric Prostate deformations. All five clinical cases were successful with an average procedure time of 13 min and millimeter targeting accuracy. Hands-free TRUS operation, transrectal TRUS guided Prostate Biopsy with minimal Prostate deformations, and the PCS-based Biopsy plan are novel methods. Robot-assisted Prostate Biopsy is safe and feasible. Accurate needle targeting has the potential to increase the detection of clinically significant Prostate cancer.
Stacy Loeb - One of the best experts on this subject based on the ideXlab platform.
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complications after systematic random and image guided Prostate Biopsy
European Urology, 2017Co-Authors: Marco Borghesi, Hashim U Ahmed, Samir S. Taneja, Edward M Schaeffer, Riccardo Schiavina, W Weidner, Stacy LoebAbstract:Abstract Context Prostate Biopsy (PB) represents the gold standard method to confirm the presence of cancer. In addition to traditional random or systematic approaches, a magnetic resonance imaging (MRI)–guided technique has been introduced recently. Objective To perform a systematic review of complications after transrectal ultrasound (TRUS)–guided, transperineal, and MRI-guided PB. Evidence acquisition We performed a systematic literature search of Web of Science, Embase, and Scopus databases up to October 2015, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Complications and mortality following random, systematic, and image-guided PBs were reviewed. Eighty-five references were included. Evidence synthesis The most frequent complication after PB was minor and self-limiting bleeding (hematuria and hematospermia), regardless of the Biopsy approach. Occurrence of rectal bleeding was comparable for traditional TRUS-guided and image-guided PBs. Almost 25% of patients experienced lower urinary tract symptoms, but only a few had urinary retention, with higher rates after a transperineal approach. Temporary erectile dysfunction was not negligible, with a return to baseline after 1–6 mo. The incidence of infective complications is increasing, with higher rates among men with medical comorbidities and older age. Transperineal and in-bore MRI–targeted Biopsy may reduce the risk of severe infectious complications. Mortality after PB is uncommon, regardless of Biopsy technique. Conclusions Complications after PB are frequent but often self-limiting. The incidence of hospitalization due to severe infections is continuously increasing. The patient's general health status, risk factors, and likelihood of antimicrobial resistance should be carefully appraised before scheduling a PB. Patient summary We reviewed the variety and incidence of complications after Prostate Biopsy. Even if frequent, complications seldom represent a problem for the patient. The most troublesome complications are infections. To minimize this risk, the patient's medical condition should be carefully evaluated before Biopsy.
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systematic review of complications of Prostate Biopsy
European Urology, 2013Co-Authors: Stacy Loeb, Annelies Vellekoop, Hashim U Ahmed, James W F Catto, Mark Emberton, Derek J Rosario, Vincenzo Scattoni, Yair LotanAbstract:Abstract Context Prostate Biopsy is commonly performed for cancer detection and management. The benefits and risks of Prostate Biopsy are germane to ongoing debates about Prostate cancer screening and treatment. Objective To perform a systematic review of complications from Prostate Biopsy. Evidence acquisition A literature search was performed using PubMed and Embase, supplemented with additional references. Articles were reviewed for data on the following complications: hematuria, rectal bleeding, hematospermia, infection, pain, lower urinary tract symptoms (LUTS), urinary retention, erectile dysfunction, and mortality. Evidence synthesis After Biopsy, hematuria and hematospermia are common but typically mild and self-limiting. Severe rectal bleeding is uncommon. Despite antimicrobial prophylaxis, infectious complications are increasing over time and are the most common reason for hospitalization after Biopsy. Pain may occur at several stages of Prostate Biopsy and can be mitigated by anesthetic agents and anxiety-reduction techniques. Up to 25% of men have transient LUTS after Biopsy, and Conclusions Preparation for Biopsy should include antimicrobial prophylaxis and pain management. Prostate Biopsy is frequently associated with minor bleeding and urinary symptoms that usually do not require intervention. Infectious complications can be serious, requiring prompt management and continued work into preventative strategies.
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complications after Prostate Biopsy data from seer medicare
The Journal of Urology, 2011Co-Authors: Stacy Loeb, Ballentine H Carter, Sonja I Berndt, Winnie Ricker, Edward M SchaefferAbstract:Purpose: More than 1 million Prostate biopsies are performed annually among Medicare beneficiaries. We determined the risk of serious complications requiring hospitalization. We hypothesized that with emerging multidrug resistant organisms there may be an increasing risk of infectious complications.Materials and Methods: In a 5% random sample of Medicare participants in SEER (Surveillance, Epidemiology and End Results) regions from 1991 to 2007 we compared 30-day hospitalization rates and ICD-9 primary diagnosis codes for admissions between 17,472 men who underwent Prostate Biopsy and a random sample of 134,977 controls. Multivariate logistic and Poisson regression were used to examine the risk and predictors of serious infectious and noninfectious complications with time.Results: The 30-day hospitalization rate was 6.9% within 30 days of Prostate Biopsy, which was substantially higher than the 2.7% in the control population. After adjusting for age, race, SEER region, year and comorbidities Prostate biop...
Hashim U Ahmed - One of the best experts on this subject based on the ideXlab platform.
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Value of systematic sampling in an mp-MRI targeted Prostate Biopsy strategy
Translational Andrology and Urology, 2019Co-Authors: Martin J. Connor, Hashim U Ahmed, Saiful Miah, Rajiv Jayadevan, Christopher C. Khoo, David Eldred-evans, Taimur T. Shah, Leonard S. MarksAbstract:The clinical utility of systematic Prostate Biopsy in addition to multi-parametric magnetic resonance imagining (mp-MRI) targeted Biopsy pathways remains unclear. Despite radiological advancements in mp-MRI and utilisation of international standardised reporting systems (i.e., PI-RADS, LIKERT), undetected clinically significant Prostate cancer (csPCa) on imaging persists. This has prevented the widespread adoption of an exclusively targeted Biopsy approach. The current evidence on csPCa cancer detection rates in mp-MRI targeted alone and combined with a non-targeted systematic sampling is presented. Arguments for and against routine limited systematic sampling as an adjunct to an mp-MRI targeted Biopsy are discussed. Our review will report the clinical utility of a combined sampling strategy on csPCa detection rate. The available evidence suggests that we are yet to reach a stage where non-targeted systematic Prostate Biopsy can be routinely omitted in mp-MRI targeted Prostate Biopsy pathways. Research should focus on improving the accuracy of mp-MRI, Prostate Biopsy techniques, and in identifying those men that will most benefit from a combined Prostate Biopsy. Such strategies may help future urologists reduce the burden of non-targeted cores in modern mp-MRI Prostate Biopsy pathways.
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complications after systematic random and image guided Prostate Biopsy
European Urology, 2017Co-Authors: Marco Borghesi, Hashim U Ahmed, Samir S. Taneja, Edward M Schaeffer, Riccardo Schiavina, W Weidner, Stacy LoebAbstract:Abstract Context Prostate Biopsy (PB) represents the gold standard method to confirm the presence of cancer. In addition to traditional random or systematic approaches, a magnetic resonance imaging (MRI)–guided technique has been introduced recently. Objective To perform a systematic review of complications after transrectal ultrasound (TRUS)–guided, transperineal, and MRI-guided PB. Evidence acquisition We performed a systematic literature search of Web of Science, Embase, and Scopus databases up to October 2015, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Complications and mortality following random, systematic, and image-guided PBs were reviewed. Eighty-five references were included. Evidence synthesis The most frequent complication after PB was minor and self-limiting bleeding (hematuria and hematospermia), regardless of the Biopsy approach. Occurrence of rectal bleeding was comparable for traditional TRUS-guided and image-guided PBs. Almost 25% of patients experienced lower urinary tract symptoms, but only a few had urinary retention, with higher rates after a transperineal approach. Temporary erectile dysfunction was not negligible, with a return to baseline after 1–6 mo. The incidence of infective complications is increasing, with higher rates among men with medical comorbidities and older age. Transperineal and in-bore MRI–targeted Biopsy may reduce the risk of severe infectious complications. Mortality after PB is uncommon, regardless of Biopsy technique. Conclusions Complications after PB are frequent but often self-limiting. The incidence of hospitalization due to severe infections is continuously increasing. The patient's general health status, risk factors, and likelihood of antimicrobial resistance should be carefully appraised before scheduling a PB. Patient summary We reviewed the variety and incidence of complications after Prostate Biopsy. Even if frequent, complications seldom represent a problem for the patient. The most troublesome complications are infections. To minimize this risk, the patient's medical condition should be carefully evaluated before Biopsy.
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systematic review of complications of Prostate Biopsy
European Urology, 2013Co-Authors: Stacy Loeb, Annelies Vellekoop, Hashim U Ahmed, James W F Catto, Mark Emberton, Derek J Rosario, Vincenzo Scattoni, Yair LotanAbstract:Abstract Context Prostate Biopsy is commonly performed for cancer detection and management. The benefits and risks of Prostate Biopsy are germane to ongoing debates about Prostate cancer screening and treatment. Objective To perform a systematic review of complications from Prostate Biopsy. Evidence acquisition A literature search was performed using PubMed and Embase, supplemented with additional references. Articles were reviewed for data on the following complications: hematuria, rectal bleeding, hematospermia, infection, pain, lower urinary tract symptoms (LUTS), urinary retention, erectile dysfunction, and mortality. Evidence synthesis After Biopsy, hematuria and hematospermia are common but typically mild and self-limiting. Severe rectal bleeding is uncommon. Despite antimicrobial prophylaxis, infectious complications are increasing over time and are the most common reason for hospitalization after Biopsy. Pain may occur at several stages of Prostate Biopsy and can be mitigated by anesthetic agents and anxiety-reduction techniques. Up to 25% of men have transient LUTS after Biopsy, and Conclusions Preparation for Biopsy should include antimicrobial prophylaxis and pain management. Prostate Biopsy is frequently associated with minor bleeding and urinary symptoms that usually do not require intervention. Infectious complications can be serious, requiring prompt management and continued work into preventative strategies.
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transperineal magnetic resonance image targeted Prostate Biopsy versus transperineal template Prostate Biopsy in the detection of clinically significant Prostate cancer
The Journal of Urology, 2013Co-Authors: Veeru Kasivisvanathan, Hashim U Ahmed, Robert Dufour, Caroline M Moore, Mohamed Abdalazeez, Susan C Charman, Alex Freeman, C Allen, Alex Kirkham, Jan Van Der MeulenAbstract:Purpose: Multiparametric magnetic resonance imaging can be used to guide Prostate Biopsy by targeting biopsies to areas in the Prostate at high risk for cancer. We compared the detection of clinically significant and insignificant cancer by transperineal magnetic resonance imaging targeted Biopsy and transperineal template guided Prostate Biopsy.Materials and Methods: A total of 182 men with a lesion suspicious for cancer on multiparametric magnetic resonance imaging underwent transperineal magnetic resonance imaging targeted Biopsy using a cognitive registration technique, followed by systematic transperineal template guided Prostate Biopsy. The primary outcome was the detection rate of clinically significant Prostate cancer. Clinical significance was defined using maximum cancer core length 4 mm or greater and/or Gleason grade 3 + 4 or greater (University College London definition 2). We secondarily evaluated other commonly used thresholds of clinically significant disease, including maximum cancer core...
Doyoung Chang - One of the best experts on this subject based on the ideXlab platform.
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Robotic Transrectal Ultrasound Guided Prostate Biopsy
IEEE Transactions on Biomedical Engineering, 2019Co-Authors: Doyoung Chang, Doru Petrisor, Dan StoianoviciAbstract:We present a robot-assisted approach for transrectal ultrasound (TRUS) guided Prostate Biopsy. The robot is a hands-free probe manipulator that moves the probe with the same 4 DoF that are used manually. Software was developed for three-dimensional (3-D) imaging, Biopsy planning, robot control, and navigation. Methods to minimize the deformation of the Prostate caused by the probe at 3-D imaging and needle targeting were developed to reduce Biopsy targeting errors. We also present a Prostate coordinate system (PCS). The PCS helps defining a systematic Biopsy plan without the need for Prostate segmentation. Comprehensive tests were performed, including two bench tests, one imaging test, two in vitro targeting tests, and an IRB-approved clinical trial on five patients. Preclinical tests showed that image-based needle targeting can be accomplished with accuracy on the order of 1 mm. Prostate Biopsy can be accomplished with minimal TRUS pressure on the gland and submillimetric Prostate deformations. All five clinical cases were successful with an average procedure time of 13 min and millimeter targeting accuracy. Hands-free TRUS operation, transrectal TRUS guided Prostate Biopsy with minimal Prostate deformations, and the PCS-based Biopsy plan are novel methods. Robot-assisted Prostate Biopsy is safe and feasible. Accurate needle targeting has the potential to increase the detection of clinically significant Prostate cancer.
Riccardo Autorino - One of the best experts on this subject based on the ideXlab platform.
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Predicting Prostate Biopsy outcome: Prostate health index (phi) and Prostate cancer antigen 3 (PCA3) are useful biomarkers
Clinica Chimica Acta, 2012Co-Authors: Matteo Ferro, Dario Bruzzese, Claudia Mazzarella, Angelina Di Carlo, Ada Marino, Giuseppe Di Lorenzo, Sisto Perdonà, Alessandra Sorrentino, Riccardo Autorino, Carlo BuonerbaAbstract:Indication for Prostate Biopsy is presently mainly based on Prostate-specific antigen (PSA) serum levels and digital-rectal examination (DRE). In view of the unsatisfactory accuracy of these two diagnostic exams, research has focused on novel markers to improve pre-Biopsy Prostate cancer detection, such as phi and PCA3.The purpose of this prospective study was to assess the diagnostic accuracy of phi and PCA3 for Prostate cancer using Biopsy as gold standard.Phi index (Beckman coulter immunoassay), PCA3 score (Progensa PCA3 assay) and other established biomarkers (tPSA, fPSA and %fPSA) were assessed before a 18-core Prostate Biopsy in a group of 251 subjects at their first Biopsy.Values of %p2PSA and phi were significantly higher in patients with PCa compared with PCa-negative group (p < 0.001) and also compared with high grade prostatic intraepithelial neoplasia (HGPIN) (p < 0.001). PCA3 score values were significantly higher in PCa compared with PCa-negative subjects (p < 0.001) and in HGPIN vs PCa-negative patients (p < 0.001). ROC curve analysis showed that %p2PSA, phi and PCA3 are predictive of malignancy.In conclusion, %p2PSA, phi and PCA3 may predict a diagnosis of PCa in men undergoing their first Prostate Biopsy. PCA3 score is more useful in discriminating between HGPIN and non-cancer. © 2012 Elsevier B.V.
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How to decrease pain during transrectal ultrasound guided Prostate Biopsy: A look at the literature
Journal of Urology, 2005Co-Authors: Riccardo Autorino, Rossana Damiano, Luca Cindolo, Giuseppe Di Lorenzo, Sisto Perdonà, M De Sio, Massimo D'armientoAbstract:Purpose: There is growing interest among urologists on the need for decreasing pain during transrectal ultrasound (TRUS) guided Prostate Biopsy. Materials and Methods: We performed a systematic MEDLINE search of clinical trials of any kind of anesthesia, analgesia or sedation during TRUS guided Prostate Biopsy published since 2000. We critically analyzed the impact of pain and discomfort associated with the procedure, the described methods for evaluating it and the different techniques that have been described. Results: There is strong evidence in the current literature that patient tolerance and comfort during TRUS guided Prostate Biopsy can be improved by anesthesia/analgesia. What remains is the need to urge all urologists to introduce it in clinical practice as a routine part of the procedure, whatever the Biopsy scheme. Conclusions: Of the various options periprostatic anesthetic infiltration has been shown to be safe, easy to perform and highly effective. It should be considered the gold standard at the moment, even if the optimal technique remains to be established. Further studies addressing this issue are warranted. Copyright © 2005 by American Urological Association.
