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1.
Am J Mens Health ; 18(3): 15579883241258319, 2024.
Article in English | MEDLINE | ID: mdl-38864148

ABSTRACT

This study assesses the morphological effectiveness of benign prostatic hyperplasia (BPH) surgery using multislice spiral computed tomography three-dimensional imaging (CT3D) with urethral contrast. Twenty-five male patients with BPH and bladder outlet obstruction (BOO) who underwent bipolar transurethral resection of the prostate were selected. Preoperative and postoperative CT3D indicators of retrograde and voiding cystourethrography, including bladder neck diameter, length of the posterior urethra, and degree of prostate protrusion into the bladder and upper and lower diameter of the prostate were used to assess bladder neck and posterior urethra morphology and BOO severity. In addition, preoperative and postoperative International Prostate Symptom Scores and maximum urine flow rates were compared. Postoperative CT3D was used to evaluate changes following obstruction relief postsurgery. Preoperative CT3D indicated significant BOO, whereas postoperative imaging showed improved patency but with irregular posterior urethral lumens and varying degrees of residual glandular tissue. Comparative analysis of preoperative and postoperative bladder outlet metrics revealed significant changes (p < .05). Urethral contrast CT3D effectively visualizes the prostate, bladder neck, and prostatic urethra. It quantifies changes in the urethral lumen postsurgery, correlating the extent of posterior urethral lumen spaciousness with urinary flow rates.


Subject(s)
Imaging, Three-Dimensional , Prostatic Hyperplasia , Urinary Bladder Neck Obstruction , Humans , Male , Prostatic Hyperplasia/surgery , Prostatic Hyperplasia/diagnostic imaging , Aged , Urinary Bladder Neck Obstruction/diagnostic imaging , Urinary Bladder Neck Obstruction/surgery , Urinary Bladder Neck Obstruction/etiology , Urethra/diagnostic imaging , Urethra/surgery , Middle Aged , Transurethral Resection of Prostate , Contrast Media , Aged, 80 and over
2.
J Int Med Res ; 52(5): 3000605241253756, 2024 May.
Article in English | MEDLINE | ID: mdl-38796313

ABSTRACT

Prostatic stromal tumors, encompassing prostatic sarcoma and stromal tumors of uncertain malignant potential (STUMP), represent an exceedingly rare category of prostatic diseases, with a prevalence of less than 1%. We present a rare case involving a man in his early 40s diagnosed with STUMP. Despite presenting with normal prostate-specific antigen (PSA) concentrations, the patient experienced persistent dysuria and gross hematuria for >7 months, leading to an initial misdiagnosis of benign prostatic hyperplasia. Persistent symptoms prompted further investigation, with magnetic resonance imaging (MRI) revealing a suspicious lesion on the left side of the prostate, initially thought to be malignant. Transrectal prostatic biopsy subsequently confirmed the presence of mucinous liposarcoma, with no medical history of diabetes, coronary heart disease, or hypertension. The treatment approach comprised robot-assisted laparoscopic radical prostatectomy, culminating in a postoperative pathological definitive diagnosis of STUMP. This case underscores the indispensable role of early MRI in the diagnostic process, highlighting the necessity of detailed pathological examination for a conclusive diagnosis. Our report aims to illuminate the diagnostic challenges and potential treatment pathways for STUMP, emphasizing its consideration in the differential diagnosis of prostatic tumors to advance clinical outcomes in this rare but important condition.


Subject(s)
Magnetic Resonance Imaging , Prostatic Neoplasms , Humans , Male , Prostatic Neoplasms/pathology , Prostatic Neoplasms/surgery , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/diagnostic imaging , Adult , Diagnosis, Differential , Prostatectomy , Prostate/pathology , Prostate/surgery , Prostate/diagnostic imaging , Prostate-Specific Antigen/blood , Prostatic Hyperplasia/surgery , Prostatic Hyperplasia/pathology , Prostatic Hyperplasia/diagnostic imaging , Prostatic Hyperplasia/diagnosis , Sarcoma/pathology , Sarcoma/surgery , Sarcoma/diagnosis , Sarcoma/diagnostic imaging
3.
Sci Rep ; 14(1): 7758, 2024 04 02.
Article in English | MEDLINE | ID: mdl-38565890

ABSTRACT

Knowledge about anatomical details seems to facilitate the procedure and planning of prostatic artery embolization (PAE) in patients with symptomatic benign prostatic hyperplasia (BPS). The aim of our study was the pre-interventional visualization of the prostatic artery (PA) with MRA and the correlation of iliac elongation and bifurcation angles with technical success of PAE and technical parameters. MRA data of patients with PAE were analysed retrospectively regarding PA visibility, PA type, vessel elongation, and defined angles were correlated with intervention time, fluoroscopy time, dose area product (DAP), cumulative air kerma (CAK), contrast media (CM) dose and technical success of embolization. T-test, ANOVA, Pearson correlation, and Kruskal-Wallis test was applied for statistical analysis. Between April 2018 and March 2021, a total of 78 patients were included. MRA identified the PA origin in 126 of 147 cases (accuracy 86%). Vessel elongation affected time for catheterization of right PA (p = 0.02), fluoroscopy time (p = 0.05), and CM dose (p = 0.02) significantly. Moderate correlation was observed for iliac bifurcation angles with DAP (r = 0.30 left; r = 0.34 right; p = 0.01) and CAK (r = 0.32 left; r = 0.36 right; p = 0.01) on both sides. Comparing the first half and second half of patients, median intervention time (125 vs. 105 min.) and number of iliac CBCT could be reduced (p < 0.001). We conclude that MRA could depict exact pelvic artery configuration, identify PA origin, and might obviate iliac CBCT. Vessel elongation of pelvic arteries increased intervention time and contrast media dose while the PA origin had no significant influence on intervention time and/or technical success.


Subject(s)
Embolization, Therapeutic , Prostatic Hyperplasia , Male , Humans , Prostate/diagnostic imaging , Prostate/blood supply , Prostatic Hyperplasia/diagnostic imaging , Prostatic Hyperplasia/therapy , Contrast Media , Embolization, Therapeutic/methods , Magnetic Resonance Angiography , Retrospective Studies , Arteries/diagnostic imaging , Treatment Outcome
6.
Radiology ; 310(3): e231877, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38441098

ABSTRACT

Background Prostatic artery embolization (PAE) is a safe, minimally invasive angiographic procedure that effectively treats benign prostatic hyperplasia; however, PAE-related patient radiation exposure and associated risks are not completely understood. Purpose To quantify radiation dose and assess radiation-related adverse events in patients who underwent PAE at multiple centers. Materials and Methods This retrospective study included patients undergoing PAE for any indication performed by experienced operators at 10 high-volume international centers from January 2014 to May 2021. Patient characteristics, procedural and radiation dose data, and radiation-related adverse events were collected. Procedural radiation effective doses were calculated by multiplying kerma-area product values by an established conversion factor for abdominopelvic fluoroscopy-guided procedures. Relationships between cumulative air kerma (CAK) or effective dose and patient body mass index (BMI), fluoroscopy time, or radiation field area were assessed with linear regression. Differences in radiation dose stemming from radiopaque prostheses or fluoroscopy unit type were assessed using two-sample t tests and Wilcoxon rank sum tests. Results A total of 1476 patients (mean age, 69.9 years ± 9.0 [SD]) were included, of whom 1345 (91.1%) and 131 (8.9%) underwent the procedure with fixed interventional or mobile fluoroscopy units, respectively. Median procedure effective dose was 17.8 mSv for fixed interventional units and 12.3 mSv for mobile units. CAK and effective dose both correlated positively with BMI (R2 = 0.15 and 0.17; P < .001) and fluoroscopy time (R2 = 0.16 and 0.08; P < .001). No radiation-related 90-day adverse events were reported. Patients with radiopaque implants versus those without implants had higher median CAK (1452 mGy [range, 900-2685 mGy] vs 1177 mGy [range, 700-1959 mGy], respectively; P = .01). Median effective dose was lower for mobile than for fixed interventional systems (12.3 mSv [range, 8.5-22.0 mSv] vs 20.4 mSv [range, 13.8-30.6 mSv], respectively; P < .001). Conclusion Patients who underwent PAE performed with fixed interventional or mobile fluoroscopy units were exposed to a median effective radiation dose of 17.8 mSv or 12.3 mSv, respectively. No radiation-related adverse events at 90 days were reported. © RSNA, 2024 See also the editorial by Mahesh in this issue.


Subject(s)
Embolization, Therapeutic , Prostatic Hyperplasia , Radiation Exposure , Humans , Male , Aged , Prostatic Hyperplasia/diagnostic imaging , Prostatic Hyperplasia/therapy , Retrospective Studies , Prostate/diagnostic imaging , Arteries/diagnostic imaging
7.
Investig Clin Urol ; 65(2): 148-156, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38454824

ABSTRACT

PURPOSE: This study aimed to assess the clinical outcome and safety of holmium laser enucleation of the prostate (HoLEP) following transrectal ultrasound-guided prostate biopsy (TR biopsy) in the treatment of benign prostate hyperplasia. MATERIALS AND METHODS: We retrospectively analyzed data from 556 patients who underwent HoLEP between 2014 and 2021. The patients were categorized into six groups: Group 1-A (n=45) underwent HoLEP within four months post TR biopsy. Group 1-B (n=94) underwent HoLEP more than four months post TR biopsy. Group 1-C (n=120) underwent HoLEP after a single TR biopsy. Group 1-D (n=19) underwent HoLEP after two or more TR biopsies. Group 1-total (n=139, group 1-A+group 1-B or group 1-C+group 1-D) underwent HoLEP post TR biopsy. Group 2 (control group, n=417) underwent HoLEP without prior TR biopsy. We examined perioperative parameters, safety, and functional outcomes. RESULTS: The age, body mass index, International Prostate Symptom Score (IPSS), uroflowmetry, and comorbid diseases between group 1-total and group 2 were comparable. However, group 1-total exhibited significantly elevated prostate-specific antigen levels and larger prostate volumes (p<0.01). Perioperative factors like enucleation time, enucleation weight, and catheterization duration were notably higher in group 1-total (p<0.01). All groups showed significant improvements in IPSS, postvoid residual urine, and maximum flow rate during the 1-year postoperative period (p<0.05). The rates of postoperative complications were similar between group 1-total and group 2. CONCLUSIONS: Enucleation time and catheterization duration were significantly longer in the TR biopsy group. However, postoperative complications were not significantly different between TR biopsy and non-TR biopsy groups.


Subject(s)
Lasers, Solid-State , Prostatic Hyperplasia , Transurethral Resection of Prostate , Male , Humans , Prostate/diagnostic imaging , Prostate/surgery , Prostatic Hyperplasia/diagnostic imaging , Prostatic Hyperplasia/surgery , Prostatic Hyperplasia/complications , Lasers, Solid-State/adverse effects , Retrospective Studies , Treatment Outcome , Quality of Life , Biopsy , Postoperative Complications/etiology , Postoperative Complications/surgery
9.
J Vasc Interv Radiol ; 35(5): 744-750, 2024 May.
Article in English | MEDLINE | ID: mdl-38311293

ABSTRACT

The purpose of this study was to report on prostatic artery embolization (PAE) outcomes in patients with refractory or recurrent lower urinary tract symptoms (LUTSs) due to benign prostatic hyperplasia (BPH) who had previously undergone a minimally invasive surgical technique (MIST). A single-center retrospective study identified 16 eligible patients. Baseline prostate volume at the time of PAE was 112.9 mL (SD ± 52.7). There were no adverse events throughout the follow-up period. There was significant improvement in International Prostate Symptom Score and quality of life from baseline of 23.5 (SD ± 5.1) and 4.9 (SD ± 0.9), respectively, to the last follow-up of 11.6 (SD ± 7.2) and 2 (SD ± 1.6), respectively. There was nonsignificant improvement in sexual function after PAE compared with baseline after MIST. PAE can be a safe and effective treatment in patients who have undergone prior MIST without negatively impacting erectile or ejaculatory function.


Subject(s)
Embolization, Therapeutic , Lower Urinary Tract Symptoms , Prostate , Prostatic Hyperplasia , Quality of Life , Humans , Male , Embolization, Therapeutic/adverse effects , Prostatic Hyperplasia/therapy , Prostatic Hyperplasia/surgery , Prostatic Hyperplasia/physiopathology , Prostatic Hyperplasia/diagnostic imaging , Prostatic Hyperplasia/complications , Lower Urinary Tract Symptoms/etiology , Lower Urinary Tract Symptoms/therapy , Lower Urinary Tract Symptoms/physiopathology , Retrospective Studies , Aged , Treatment Outcome , Prostate/blood supply , Middle Aged , Minimally Invasive Surgical Procedures , Time Factors , Recurrence , Recovery of Function , Aged, 80 and over
10.
Sci Rep ; 14(1): 3864, 2024 02 16.
Article in English | MEDLINE | ID: mdl-38366042

ABSTRACT

We aimed to evaluate the feasibility of MR elastography (MRE) using a transpelvic approach. Thirty-one patients who underwent prostate MRE and had a pathological diagnosis were included in this study. MRE was obtained using a passive driver placed at the umbilicus and iliac crests. The shear stiffness, clinical data, and conventional imaging findings of prostate cancer and benign prostatic hyperplasia (BPH) were compared. Inter-reader agreements were evaluated using the intraclass coefficient class (ICC). Prostate MRE was successfully performed for all patients (100% technical success rate). Nineteen cancer and 10 BPH lesions were visualized on MRE. The mean shear stiffness of cancer was significantly higher than that of BPH (5.99 ± 1.46 kPa vs. 4.67 ± 1.54 kPa, p = 0.045). One cancer was detected on MRE but not on conventional sequences. Six tiny cancer lesions were not visualized on MRE. The mean size of cancers that were not detected on MRE was smaller than that of cancers that were visible on MRE (0.8 ± 0.3 cm vs. 2.3 ± 1.8 cm, p = 0.001). The inter-reader agreement for interpreting MRE was excellent (ICC = 0.95). Prostate MRE with transpelvic vibration is feasible without intracavitary actuators. Transpelvic prostate MRE is reliable for detecting focal lesions, including clinically significant prostate cancer and BPH.


Subject(s)
Elasticity Imaging Techniques , Prostatic Hyperplasia , Prostatic Neoplasms , Male , Humans , Prostate/diagnostic imaging , Vibration , Elasticity Imaging Techniques/methods , Feasibility Studies , Prostatic Hyperplasia/diagnostic imaging , Prostatic Neoplasms/diagnostic imaging , Reproducibility of Results , Magnetic Resonance Imaging/methods
13.
Diagn Interv Imaging ; 105(4): 129-136, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38161141

ABSTRACT

PURPOSE: The purpose of this study was to assess the feasibility, safety, and 6-month outcomes of prostate artery embolization (PAE) using N-butyl-cyanoacrylate (NBCA) glue as the only embolic agent in patients with benign prostatic hyperplasia (BPH)-related lower urinary tract symptoms. MATERIALS AND METHODS: Patients with BPH-related lower urinary tract symptoms who were treated by PAE using methacryloxysulfolane-NBCA mixed with ethiodized oil (1:8 ratio) between September 2018 and January 2023 were retrospectively included. Vascular mapping was made using cone-beam computed tomography angiography. PAEs were performed as an outpatient procedure, under local anaesthesia. Outcomes were assessed at six months using the International Prostate Symptoms Score (IPSS) and associated quality-of-life score (IPSS-QoL), prostate-specific antigen (PSA) level, prostate volume, and International Index of Erectile Function form 5 (IIEF5). RESULTS: A total of 103 men with a mean age of 68.4 ± 6 (standard deviation [SD]) years were included. Technical success rate was 100%. The mean fluoroscopy time was 26.4 ± 12.5 (SD) min and the median radiation dose was 23 980 mGy·cm (Q1, Q3: 16 770, 38 450). Compared to baseline, statistically significant improvements were observed at six months for the IPSS (8.9 ± 6.2 [SD] vs. 20.2 ± 6.5 [SD]; P = 0.01), IPSS-QoL (2.1 ± 1.4 [SD] vs. 5.1 ± 0.9 [SD]; P = 0.01), PSA level (3.6 ± 3.2 [SD] ng/mL vs. 4.8 ± 4.2 [SD] ng/mL; P = 0.0001), and prostate volume (78.6 ± 43.5 [SD] mL vs. 119.1 ± 65.7 [SD] mL; P = 0.01). Minor adverse events developed in 19/103 (18.4%) patients. No major complications occurred. Compared to baseline, the IIEF5 did not change significantly at six months (15.3 ± 6.8 [SD] vs. 15.8 ± 6.8 [SD]; P = 0.078). CONCLUSION: PAE with NBCA is a feasible and safe method that provides good outcomes at six months in patients with BPH-related lower urinary tract symptoms. This method deserves further evaluation in randomized trials with longer follow-up.


Subject(s)
Embolization, Therapeutic , Enbucrilate , Lower Urinary Tract Symptoms , Prostatic Hyperplasia , Male , Humans , Middle Aged , Aged , Prostate/diagnostic imaging , Prostatic Hyperplasia/complications , Prostatic Hyperplasia/diagnostic imaging , Prostatic Hyperplasia/therapy , Enbucrilate/therapeutic use , Prostate-Specific Antigen , Retrospective Studies , Quality of Life , Arteries , Embolization, Therapeutic/methods , Lower Urinary Tract Symptoms/diagnosis , Lower Urinary Tract Symptoms/etiology , Lower Urinary Tract Symptoms/therapy , Treatment Outcome
14.
J Comput Assist Tomogr ; 48(2): 206-211, 2024.
Article in English | MEDLINE | ID: mdl-38149651

ABSTRACT

OBJECTIVE: To assess the performance of apparent diffusion coefficient (ADC; values or category) alone, Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1) scoring alone, and the two in combination, to diagnose transition zone prostate cancers (PCas). METHODS: This retrospective study included 222 patients who underwent multiparametric magnetic resonance imaging of the prostate between May 2020 and December 2022 and who had pathologically confirmed PCa or benign prostatic hyperplasia (BPH). Prostate Imaging Reporting and Data System version 2.1 and ADC (values or category) were used in the assessment of suspicious findings identified in the transition zone. The interobserver agreements for region-of-interest measurements were calculated by intraclass correlation coefficients. Logistic regression analyses were used to determine the performance of PI-RADS v2.1 alone and in combination with ADC (values or category) to diagnose PCa. Receiver operating characteristic curve and DeLong test were used to evaluate the diagnostic performance of the quantitative parameters. RESULTS: A total of 152 patients had BPH, and 70 patients had PCa. For BPH versus PCa, the ADC values of PCa (0.64 × 10 -3 ± 0.16 × 10 -3 mm 2 /s) were significantly lower than BPH (1.06 ± 0.18 × 10 -3 mm 2 /s; P < 0.001). The PI-RADS scores for PCa (5 [interquartile range, 5-5]) were significantly higher than BPH (2 [interquartile range, 2-3]; P < 0.001). For all patients who had PI-RADS 1-5, the combined use of ADC (values or category) together with PI-RADS v2.1 did not perform significantly better than the use of PI-RADS v2.1 alone. The receiver operating characteristic of ADC category in combination with PI-RADS v2.1 score, 0.756 (95% confidence interval, 0.646-0.846), was significantly higher than that for PI-RADS 2.1 alone, 0.631 (95% confidence interval, 0.514-0.738), in PI-RADS 3-4 lesions ( P = 0.047). CONCLUSION: The ADC category can help to improve the diagnostic performance of PI-RADS v2.1 category 3-4 lesions in diagnosing PCa.


Subject(s)
Prostatic Hyperplasia , Prostatic Neoplasms , Male , Humans , Prostatic Neoplasms/diagnostic imaging , Prostatic Neoplasms/pathology , Magnetic Resonance Imaging/methods , Retrospective Studies , Prostatic Hyperplasia/diagnostic imaging , Diffusion Magnetic Resonance Imaging/methods
15.
Abdom Radiol (NY) ; 49(3): 927-938, 2024 03.
Article in English | MEDLINE | ID: mdl-38158423

ABSTRACT

PURPOSE: To analyze the correlation between the prostate necrosis rate at 1-month after prostatic artery embolization (PAE) and the clinical efficacy at 1-year after PAE, and to explore potential predictors of clinical success after PAE for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH). METHODS: The prostate magnetic resonance imaging data at 1-month after PAE were imported into 3D Slicer software for calculating the prostate necrosis rate and thus analyzing the relationship between the prostate necrosis rate at 1-month after PAE and the efficacy score ratio at 1-year after PAE. The 151 patients with PAE technical success were divided into a clinical success group (n = 126) and a clinical failure group (n = 25). Independent predictors of clinical success after PAE were analyzed by multifactorial logistic regression, and the predictive performance of each factor was evaluated by applying the receiver operating characteristic curve and the area under the curve (AUC). RESULTS: There was a linear negative correlation between the prostate necrosis rate at 1-month after PAE and the efficacy score ratio at 1-year after surgery (P < 0.001). In the clinical success group, both the initial prostate volume (PV) and the prostate necrosis rate at 1-month after PAE were significantly higher than in the clinical failure group (P < 0.001), and acute urinary retention (AUR) and adenomatous-dominant BPH were also associated with clinical success (P < 0.05). Multifactorial logistic regression analysis revealed that larger initial PV, a higher prostate necrosis rate at 1-month after surgery, and AUR were independent predictors of clinical success after PAE. The AUC values for these three indicators and their combination were 0.720, 0.928, 0.599, and 0.951, respectively, in which the prostate necrosis rate at 1-month after PAE demonstrating a high predictive value. CONCLUSION: The higher the prostate necrosis rate at 1-month after PAE, the better the clinical efficacy at 1-year after PAE is likely to be, and the prostate necrosis rate at 1-month after PAE is expected to become a predictor of clinical success after PAE.


Subject(s)
Embolization, Therapeutic , Prostatic Hyperplasia , Male , Humans , Prostate/pathology , Prostatic Hyperplasia/complications , Prostatic Hyperplasia/diagnostic imaging , Prostatic Hyperplasia/therapy , Embolization, Therapeutic/methods , Correlation of Data , Treatment Outcome , Arteries , Necrosis/complications
17.
J Vasc Interv Radiol ; 35(4): 541-547, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38103863

ABSTRACT

PURPOSE: To compare prostatic artery embolization (PAE) via transradial access (TRA-PAE) versus transfemoral access (TFA-PAE) to assist access selection. MATERIAL AND METHODS: Procedural outcomes and adverse events were evaluated in 998 patients who underwent PAE at a single center from April 2014 to August 2022; 821 (82%) underwent TRA-PAE (Group R) and 177 (18%) underwent TFA-PAE (Group F). Mean age and prostate size of Groups R and F were 69.2 years (SD ± 8.4) and 117.4 g (SD ± 63.1) and 75.2 years (SD ± 12.1) and 127.2 g (SD ± 83.6), respectively (P < .01 and P = .16; postpropensity matching: P = .38 and P = .35, respectively). Indications for PAE included lower urinary tract symptoms, acute or chronic urinary retention, and hematuria. Procedural and patient-specific metrics were reviewed. Technical success was defined as bilateral PAE. Adverse events were recorded according to the Society of Interventional Radiology (SIR) adverse events classification. Statistical significance was defined as P < .05. RESULTS: Technical success was achieved in 798 (97.2%) patients in Group R and 165 (93.2%) patients in Group F. Mean procedural time, single- and continuous-rotation fluoroscopy time, dose area product, and air kerma were significantly lower in Group R than in Group F (P < .001). Moreover, 6 (0.7%) patients in Group R and 9 (5.5%) patients in Group F had access site ecchymoses, whereas 5 (0.6%) patients in Group R and 6 (3.6%) in Group F had access site hematomas. Two patients experienced transient ischemic attacks (TIAs) after TRA-PAE and recovered without intervention. Two occult radial artery occlusions were noted, but no patient experienced hand ischemia. CONCLUSIONS: In a large single interventional radiologist cohort, TRA-PAE demonstrated similar technical success to that of TFA-PAE with lower access site hemorrhagic complications and radiation requirements; however, TIA and occult radial artery occlusions remain a concern.


Subject(s)
Embolization, Therapeutic , Prostatic Hyperplasia , Male , Humans , Embolization, Therapeutic/adverse effects , Prostate/blood supply , Femoral Artery/diagnostic imaging , Prostatic Hyperplasia/diagnostic imaging , Prostatic Hyperplasia/therapy , Treatment Outcome , Radial Artery/diagnostic imaging , Retrospective Studies
19.
Sci Rep ; 13(1): 21849, 2023 12 09.
Article in English | MEDLINE | ID: mdl-38071254

ABSTRACT

Early detection of prostate cancer (PCa) and benign prostatic hyperplasia (BPH) is crucial for maintaining the health and well-being of aging male populations. This study aims to evaluate the performance of transfer learning with convolutional neural networks (CNNs) for efficient classification of PCa and BPH in transrectal ultrasound (TRUS) images. A retrospective experimental design was employed in this study, with 1380 TRUS images for PCa and 1530 for BPH. Seven state-of-the-art deep learning (DL) methods were employed as classifiers with transfer learning applied to popular CNN architectures. Performance indices, including sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), Kappa value, and Hindex (Youden's index), were used to assess the feasibility and efficacy of the CNN methods. The CNN methods with transfer learning demonstrated a high classification performance for TRUS images, with all accuracy, specificity, sensitivity, PPV, NPV, Kappa, and Hindex values surpassing 0.9400. The optimal accuracy, sensitivity, and specificity reached 0.9987, 0.9980, and 0.9980, respectively, as evaluated using twofold cross-validation. The investigated CNN methods with transfer learning showcased their efficiency and ability for the classification of PCa and BPH in TRUS images. Notably, the EfficientNetV2 with transfer learning displayed a high degree of effectiveness in distinguishing between PCa and BPH, making it a promising tool for future diagnostic applications.


Subject(s)
Prostatic Hyperplasia , Prostatic Neoplasms , Male , Humans , Prostatic Hyperplasia/diagnostic imaging , Retrospective Studies , Prostatic Neoplasms/diagnostic imaging , Neural Networks, Computer , Machine Learning
20.
Eur Rev Med Pharmacol Sci ; 27(22): 11122-11130, 2023 Nov.
Article in English | MEDLINE | ID: mdl-38039044

ABSTRACT

OBJECTIVE: Prostate cancer diagnosis and treatment are increasing in current public healthcare programs. An improved resolution multiparametric magnetic resonance imaging (MRI) has shown the potential to enhance the detection and differentiation of this medical condition. In this study, MR perfusion parameters were investigated in different ages and diseases to differentiate clinically significant prostate cancer. PATIENTS AND METHODS: From January 2017 to December 2022, 72 consecutive patients, who had undergone multiparametric MR imaging were enrolled in this study. Four different patient groups were formed: (1) those with prostate cancer, (2) those with prostatitis, (3) those with benign prostate hyperplasia (BPH), and (4) a control group. Quantitative dynamic contrast-enhanced (DCE)-MRI pharmacokinetic parameters included Ktrans, Kep, Ve, and iAUG. Different measurements were obtained from both the peripheral and transitional zones (PZ and TZ, respectively). Means values were compared between groups based on a univariate analysis. RESULTS: Ktrans and Kep values in the PZ were found to be statistically significantly lower in the control group (p = 0. 003 and p = 0. 011, respectively). It was seen that Ktrans and Ve measurements obtained from PZ had a statistically significant determinant in detecting malignancy (p = 0. 013 and p = 0. 036, respectively). It was seen that Ktrans, Ve, and iAUG obtained from the TZ showed a statistically significant difference in prostate cancer (p = 0.025, p = 0.005, and p = 0. 011, respectively) in contrast to other cases. Peripheral Ve values were statistically significantly lower than those measured Ve values from the TZ in prostate cancer cases (p = 0.002) in contrast to the other cases. CONCLUSIONS: Quantitative DCE-MRI parameters may vary according to age, disease, and zonal anatomy. These differences may contribute to the diagnosis of clinically relevant prostate cancer.


Subject(s)
Prostatic Hyperplasia , Prostatic Neoplasms , Male , Humans , Prostate/diagnostic imaging , Prostate/pathology , Contrast Media , Prostatic Neoplasms/diagnostic imaging , Prostatic Neoplasms/pathology , Magnetic Resonance Imaging/methods , Prostatic Hyperplasia/diagnostic imaging , Prostatic Hyperplasia/pathology , Retrospective Studies
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