The Experts below are selected from a list of 9009 Experts worldwide ranked by ideXlab platform
Fumiya Hongo - One of the best experts on this subject based on the ideXlab platform.
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magnetic resonance imaging transrectal ultrasound fusion targeted prostate biopsy using three dimensional ultrasound based organ tracking technology initial experience in japan
International Journal of Urology, 2019Co-Authors: Yasuhiro Yamada, Atsuko Fujihara, Takumi Shiraishi, Takashi Ueda, Takeshi Yamada, Akihisa Ueno, Yuta Inoue, Masatomo Kaneko, Kazumi Kamoi, Fumiya HongoAbstract:OBJECTIVE To evaluate the impact of magnetic resonance imaging/transrectal ultrasound fusion-targeted prostate biopsy on the diagnosis of clinically significant prostate cancer using real-time three-dimensional ultrasound-based organ-tracking technology. METHODS The present study was a retrospective review of 262 consecutive patients with prostate-specific antigen of 7.1 ng/mL (interquartile range 4.0-19.8). All patients received pre-biopsy magnetic resonance imaging and had a Suspicious Lesion for clinically significant prostate cancer. All patients underwent a combination of systematic biopsy (6 cores) and three-dimensional ultrasound-based magnetic resonance imaging/transrectal ultrasound fusion-targeted biopsy (2 cores). The positive rate of any cancer, positive rate of clinically significant prostate cancer, Gleason score and maximum cancer core length were compared between systematic biopsy versus magnetic resonance imaging/transrectal ultrasound fusion-targeted prostate biopsy. RESULTS Overall, the positive rate of any cancer per patient was 61% (160/262) in systematic biopsy versus 79% (207/262) in magnetic resonance imaging/transrectal ultrasound fusion-targeted biopsy (P < 0.0001); and that of clinically significant prostate cancer per patient was 46% (120/262) in systematic biopsy versus 70% (181/262) in magnetic resonance imaging/transrectal ultrasound fusion-targeted biopsy (P < 0.0001). The positive rate of any cancer per core was 21.7% (330/1523) in systematic biopsy versus 68.6% (406/592) in magnetic resonance imaging/transrectal ultrasound fusion-targeted biopsy (P < 0.0001), and that of clinically significant prostate cancer per core was 12.7% (193/1423) in systematic biopsy versus 60.3% (357/592) in magnetic resonance imaging/transrectal ultrasound fusion-targeted biopsy (P < 0.0001). Adding systematic biopsy leads to 13 more cancer cases (5%). The distribution of Gleason score (6/7/8/9/10) was 59/71/23/6/1 in systematic biopsy versus 48/105/36/15/2 in magnetic resonance imaging/transrectal ultrasound fusion-targeted biopsy (P = 0.005). The maximum cancer core length was 5 mm (0.5-16) in systematic biopsy versus 8 mm (1-19 mm) in magnetic resonance imaging/transrectal ultrasound fusion-targeted biopsy (P < 0.0001). CONCLUSIONS Three-dimensional ultrasound-based magnetic resonance imaging/transrectal ultrasound fusion-targeted biopsy seems to be associated with a higher detection rate of clinically significant prostate cancer, with fewer cores than systematic random biopsy. However, significant cancer can still be detected by the systematic technique only. A combination of systematic biopsy with the targeted biopsy technique would avoid the underdiagnosis of clinically significant prostate cancer.
Yasuhiro Yamada - One of the best experts on this subject based on the ideXlab platform.
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magnetic resonance imaging transrectal ultrasound fusion targeted prostate biopsy using three dimensional ultrasound based organ tracking technology initial experience in japan
International Journal of Urology, 2019Co-Authors: Yasuhiro Yamada, Atsuko Fujihara, Takumi Shiraishi, Takashi Ueda, Takeshi Yamada, Akihisa Ueno, Yuta Inoue, Masatomo Kaneko, Kazumi Kamoi, Fumiya HongoAbstract:OBJECTIVE To evaluate the impact of magnetic resonance imaging/transrectal ultrasound fusion-targeted prostate biopsy on the diagnosis of clinically significant prostate cancer using real-time three-dimensional ultrasound-based organ-tracking technology. METHODS The present study was a retrospective review of 262 consecutive patients with prostate-specific antigen of 7.1 ng/mL (interquartile range 4.0-19.8). All patients received pre-biopsy magnetic resonance imaging and had a Suspicious Lesion for clinically significant prostate cancer. All patients underwent a combination of systematic biopsy (6 cores) and three-dimensional ultrasound-based magnetic resonance imaging/transrectal ultrasound fusion-targeted biopsy (2 cores). The positive rate of any cancer, positive rate of clinically significant prostate cancer, Gleason score and maximum cancer core length were compared between systematic biopsy versus magnetic resonance imaging/transrectal ultrasound fusion-targeted prostate biopsy. RESULTS Overall, the positive rate of any cancer per patient was 61% (160/262) in systematic biopsy versus 79% (207/262) in magnetic resonance imaging/transrectal ultrasound fusion-targeted biopsy (P < 0.0001); and that of clinically significant prostate cancer per patient was 46% (120/262) in systematic biopsy versus 70% (181/262) in magnetic resonance imaging/transrectal ultrasound fusion-targeted biopsy (P < 0.0001). The positive rate of any cancer per core was 21.7% (330/1523) in systematic biopsy versus 68.6% (406/592) in magnetic resonance imaging/transrectal ultrasound fusion-targeted biopsy (P < 0.0001), and that of clinically significant prostate cancer per core was 12.7% (193/1423) in systematic biopsy versus 60.3% (357/592) in magnetic resonance imaging/transrectal ultrasound fusion-targeted biopsy (P < 0.0001). Adding systematic biopsy leads to 13 more cancer cases (5%). The distribution of Gleason score (6/7/8/9/10) was 59/71/23/6/1 in systematic biopsy versus 48/105/36/15/2 in magnetic resonance imaging/transrectal ultrasound fusion-targeted biopsy (P = 0.005). The maximum cancer core length was 5 mm (0.5-16) in systematic biopsy versus 8 mm (1-19 mm) in magnetic resonance imaging/transrectal ultrasound fusion-targeted biopsy (P < 0.0001). CONCLUSIONS Three-dimensional ultrasound-based magnetic resonance imaging/transrectal ultrasound fusion-targeted biopsy seems to be associated with a higher detection rate of clinically significant prostate cancer, with fewer cores than systematic random biopsy. However, significant cancer can still be detected by the systematic technique only. A combination of systematic biopsy with the targeted biopsy technique would avoid the underdiagnosis of clinically significant prostate cancer.
Donald Plewes - One of the best experts on this subject based on the ideXlab platform.
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systematic review using magnetic resonance imaging to screen women at high risk for breast cancer
Annals of Internal Medicine, 2008Co-Authors: Ellen Warner, Hans Messersmith, Petrina Causer, Andrea Eisen, Rene Shumak, Donald PlewesAbstract:Background: A sensitive and acceptable screening regimen for women at high risk for breast cancer is essential. Contrast-enhanced magnetic resonance imaging (MRI) of the breast is highly sensitive for diagnosis of breast cancer but has variable specificity. Purpose: To summarize the sensitivity, specificity, likelihood ratios, and posttest probability associated with adding MRI to annual mammography screening of women at very high risk for breast cancer. Data Sources: English-language literature search of the MEDLINE, EMBASE, and Cochrane databases from January 1995 to September 2007, supplemented by hand searches of pertinent articles. Study Selection: Prospective studies published after 1994 in which MRI and mammography (with or without additional tests) were used to screen women at very high risk for breast cancer. Data Extraction: Methods and potential biases of studies were assessed by 2 reviewers, and data were extracted and entered into 2 × 2 tables that compared American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) scores of MRI plus mammography, mammography alone, or MRI alone with results of breast tissue biopsies. Data Synthesis: Eleven relevant, prospective, nonrandomized studies that ranged from small single-center studies with only 1 round of patient screening to large multicenter studies with repeated rounds of annual screening were identified. Characteristics of women that varied across study samples included age range, history of breast cancer, and BRCA1 or BRCA2 mutation status. Studies used dynamic contrast-enhanced MRI with axial or coronal plane images (European studies) or sagittal images (North American studies) that were usually interpreted without knowledge of mammography results. The summary negative likelihood ratio and the probability of a BI-RADS-Suspicious Lesion (given negative test findings and assuming a 2% pretest probability of disease) were 0.70 (95% Cl, 0.59 to 0.82) and 1.4% (Cl, 1.2% to 1.6%) for mammography alone and 0.14 (Cl, 0.05 to 0.42) and 0.3% (Cl, 0.1% to 0.8%) for the combination of MRI plus mammography, using a BI-RADS score of 4 or higher as the definition of positive. Limitations: Differences in patient population, center experience, and criteria for positive screening results led to between-study heterogeneity. Data on patients with nonfamilial high risk were limited, and no data were available on recurrence or survival. Conclusion: Screening with both MRI and mammography might rule out cancerous Lesions better than mammography alone in women who are known or likely to have an inherited predisposition to breast cancer.
Ismail Hirani - One of the best experts on this subject based on the ideXlab platform.
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transoral flexible laryngoscope biopsy safety and accuracy
World Journal of Otorhinolaryngology - Head and Neck Surgery, 2019Co-Authors: Nabeel Humayun Hassan, Rahila Usman, Ahmad Nawaz Ahmad, Muhammad Yousuf, Ismail HiraniAbstract:Abstract Objective To determine the accuracy of transoral flexible laryngoscope (TFL) biopsy and also to identify the safety as office based procedure in terms of complications. Methods This is a diagnostic study; the type of intervention is outpatient department based biopsy of laryngeal Lesions. All patients seen in ENT outpatient department of Lyari General Hospital with Suspicious Lesions of Larynx were referred for Transoral Flexible Laryngoscopy Biopsy under local anesthesia. The specimens were sent for histopathology. The patients with benign pathology or carcinoma in situ were referred for direct laryngoscopy and biopsy. The sensitivity and specificity were calculated and the frequencies of complications were monitored to determine the complication rate. Results During the course of study a total of 47 patients underwent TFL biopsy in office settings. Out of these patients 16 patients were referred for direct laryngoscopy biopsy. The study population included 32 men and 15 women with ages ranging from 28 to 52 years and mean of (39 ± 6) years. Among 43 patients squamous cell carcinoma was the final diagnosis in 31 patients. In the rest of 12 patients’ dysplasia and benign Lesion was the diagnosis in 9 and 3 patients respectively. These 12 patients underwent direct laryngoscopy biopsy and 10 of them diagnosed with invasive carcinoma rest had benign Lesions. Hence the specificity was 75.6% and sensitivity was 100%. None of the patients developed any serious complication. Conclusions All patients with a Suspicious Lesion diagnosed by TFL biopsy as being benign or carcinoma in situ should have direct laryngoscopy for verification of the findings. But the results positive for carcinoma are reliable. In addition, this is a safe procedure.
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Transoral flexible laryngoscope biopsy: Safety and accuracy
KeAi, 2019Co-Authors: Nabeel Humayun Hassan, Rahila Usman, Ahmad Nawaz Ahmad, Muhammad Yousuf, Ismail HiraniAbstract:Objective: To determine the accuracy of transoral flexible laryngoscope (TFL) biopsy and also to identify the safety as office based procedure in terms of complications. Methods: This is a diagnostic study; the type of intervention is outpatient department based biopsy of laryngeal Lesions. All patients seen in ENT outpatient department of Lyari General Hospital with Suspicious Lesions of Larynx were referred for Transoral Flexible Laryngoscopy Biopsy under local anesthesia. The specimens were sent for histopathology. The patients with benign pathology or carcinoma in situ were referred for direct laryngoscopy and biopsy. The sensitivity and specificity were calculated and the frequencies of complications were monitored to determine the complication rate. Results: During the course of study a total of 47 patients underwent TFL biopsy in office settings. Out of these patients 16 patients were referred for direct laryngoscopy biopsy. The study population included 32 men and 15 women with ages ranging from 28 to 52 years and mean of (39 ± 6) years. Among 43 patients squamous cell carcinoma was the final diagnosis in 31 patients. In the rest of 12 patients’ dysplasia and benign Lesion was the diagnosis in 9 and 3 patients respectively. These 12 patients underwent direct laryngoscopy biopsy and 10 of them diagnosed with invasive carcinoma rest had benign Lesions. Hence the specificity was 75.6% and sensitivity was 100%. None of the patients developed any serious complication. Conclusions: All patients with a Suspicious Lesion diagnosed by TFL biopsy as being benign or carcinoma in situ should have direct laryngoscopy for verification of the findings. But the results positive for carcinoma are reliable. In addition, this is a safe procedure. Keywords: Biopsy, Flexible laryngoscopy, Squamous cell carcinoma, Laryn
Robin L Travers - One of the best experts on this subject based on the ideXlab platform.
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training cosmetology students in arkansas to help dermatologists find skin cancers earlier results of a cluster randomized controlled trial
Journal of Public Health, 2020Co-Authors: Lori A Fischbach, Mohammed F Faramawi, Deborah Girard, Susan Thapa, Robin L TraversAbstract:BACKGROUND We tested an educational video in cosmetology schools to increase students' knowledge about skin cancer, sun-safety practices, identifying Suspicious Lesions and recommending clients consult a dermatologist when a Suspicious Lesion is observed. METHODS We used a cluster-randomized controlled study design to randomize 22 cosmetology schools to receive our educational video or a publicly accessible healthy lifestyle video (control). RESULTS Students who received the intervention were more likely than controls to increase their knowledge of skin cancer, risk factors and how to identify potential skin cancers (risk ratio [RR] and 95% confidence interval = 2.86 [1.58-5.20]). At follow-up, students in the intervention group were more likely than those in the control group to look for Suspicious moles on their clients' faces, scalps and necks (RRs = 1.75, 2.16 and 2.90, respectively). Additionally, students in the intervention group were more likely to communicate with clients about sun-safety practices (RR = 1.74 [1.11-2.73]) and consulting a dermatologist about Suspicious moles (RR = 1.57 [1.03-2.41]). CONCLUSIONS Our educational video helped cosmetology students recognize potential skin cancers and talk with clients about sun safety and consulting a dermatologist about Suspicious moles. Such videos may play a role in the public health surveillance of skin cancers in communities.
