BERKELEY, CA (UroToday.com) - Prostate HistoScanning™ is known as a user-friendly imaging technique that is able to accurately show suspicious lesions in prostate tissue. Currently, one of the most challenging issues in prostate cancer detection is improving the cancer yield on biopsy.
In this article, we analyzed the value of Prostate HistoScanning™ in detecting prostate cancer in a clinical context. During a 6-month period, all male patients consulting the outpatient clinic for individual prostate cancer screening were examined with Prostate HistoScanning™. Inclusion criteria were: a suspicious digital rectal examination (DRE), an elevated PSA value (>4.0 ng/mL), an elevated PSA velocity (> 0.75 ng/mL/year) or anxiety of having cancer. Of course, patients with known prostate cancer were excluded. The decision of performing the biopsy procedure was patient and investigator driven.
Overall, biopsies were carried out in 41 out of 94 patients. Twenty-four percent of biopsies were taken cognitively in Prostate HistoScanning™ suspicious zones, of which 58% showed an adenocarcinoma. The other 76% were systemic or random biopsies, only 13% of these cores were positive. In other words, directing biopsy increases efficiency 4.48-fold (P-value < 0.0001). Thereby, Prostate HistoScanning™ seems to have a great potential in reducing sampling errors and reducing false negative biopsy results.
In this study, we analyzed the influence of each variable (age, DRE, total lesion volume on Prostate HistoScanning™, and ratio of PSA to prostate volume) on the biopsy outcome in a logistic regression model. We found that the total suspicious lesion volume at Prostate HistoScanning™ is the strongest predictor of a positive biopsy result.
The value of DRE and PSA as clinical screening tools for prostate cancer was confirmed in our analysis. Patients with prostate cancer had significantly higher values of PSA and PSA density. When DRE was suspicious, the chance of finding prostate cancer increased threefold. Interestingly, suspicious DRE was positively correlated with the volume of lesions found after Prostate HistoScanning™ analysis.
This study confirms the value of Prostate HistoScanning™ in predicting biopsy results. This imaging technique might be used as a triage test to decide whether or not prostate biopsy is advisable. Because our data were collected in a clinical context, the value of Prostate HistoScanning™-inspired biopsies compared to randomized biopsies will be analyzed in a more standardized protocol in the near future.
Written by:
Vincent De Coninck, MD as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
Department of Urology, UZ Brussel, Free University of Brussels, Laarbeeklaan 101, Brussels 1090, Belgium. Email:
Prostate HistoScanning: A screening tool for prostate cancer? - Abstract
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