Detection, localisation and characterisation of prostate cancer by Prostate HistoScanning

What's known on the subject? and What does the study add? Prostate cancer is one of the few solid‐organ cancers in which imaging is not used in the diagnostic process. Novel functional magnetic resonance imaging techniques offer promise but may not be cost‐effective. Prostate HistoScanning™ (PH...

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Published inBJU international Vol. 110; no. 1; pp. 28 - 35
Main Authors Simmons, Lucy A.M., Autier, Philippe, Zát'ura, Frantiŝek, Braeckman, Johan, Peltier, Alexandre, Romic, Imre, Stenzl, Arnulf, Treurnicht, Karien, Walker, Tara, Nir, Dror, Moore, Caroline M., Emberton, Mark
Format Journal Article
LanguageEnglish
Published Oxford, UK Blackwell Publishing Ltd 01.07.2012
Wiley-Blackwell
Wiley Subscription Services, Inc
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Online AccessGet full text
ISSN1464-4096
1464-410X
1464-410X
DOI10.1111/j.1464-410X.2011.10734.x

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Abstract What's known on the subject? and What does the study add? Prostate cancer is one of the few solid‐organ cancers in which imaging is not used in the diagnostic process. Novel functional magnetic resonance imaging techniques offer promise but may not be cost‐effective. Prostate HistoScanning™ (PHS) is an ultrasound‐based tissue characterisation technique that has previously shown encouraging results in the detection of clinically significant prostate cancer. The present study reports on the open ‘unblinded’ phase of a European multicentre study. The prospective ‘blind’ phase is currently in progress and will determine the value of PHS in a robust fashion overcoming many of the biases inherent in evaluating prostate imaging. OBJECTIVE •  To evaluate the ability of prostate HistoScanning™ (PHS) an ultrasound (US)‐based tissue characterization application, to detect cancer foci by correlating results with detailed radical prostatectomy (RP) histology. PATIENT AND METHODS •  In all, 31 patients with organ‐confined prostate cancer, diagnosed on transrectal biopsies taken using US guidance, and scheduled for RP were recruited from six European centres. •  Before RP three‐dimensional (3D) US raw data for PHS analysis was obtained. Histology by Bostwick Laboratories (London) examined sections obtained from whole mounted glands cut every 3–4 mm. •  Location and volume estimation of cancer foci by PHS were undertaken using two methods; a manual method and an embedded software tool. •  In this report we evaluate data obtained from a planned open study phase. The second phase of the study is ‘blinded’, and currently in progress. RESULTS •  31 patients were eligible for this phase. Three patients were excluded from analysis due to inadequate scan acquisition and pathology violations of the standard operating procedure. One patient withdrew from the study after 3D TRUS examination. •  PHS detected cancer ≥0.20 mL in 25/27 prostates (sensitivity 93%). •  In all, 23 patients had an index focus ≥0.5 mL at pathology, of which 21 were identified as ≥0.5 mL by PHS using the manual method (sensitivity 91%) and 19 were correctly identified as ≥0.5 mL by the embedded tool (sensitivity 83%). •  In 27 patients, histological analysis found 32 cancerous foci ≥0.2 mL, located in 97 of 162 sextants. After sextant analysis, PHS showed a 90% sensitivity and 72% specificity for the localisation of lesions ≥0.2 mL within a sextant. CONCLUSIONS •  PHS has the ability to identify and locate prostate cancer and consequently may aid in pre‐treatment and pre‐surgical planning. •  In men with a lesion identified, it has potential to enable improved targeting, allowing better risk stratification by obtaining more representative cores. •  However further verification from the results of the blinded phase of this study are awaited.
AbstractList What's known on the subject? and What does the study add? Prostate cancer is one of the few solid‐organ cancers in which imaging is not used in the diagnostic process. Novel functional magnetic resonance imaging techniques offer promise but may not be cost‐effective. Prostate HistoScanning™ (PHS) is an ultrasound‐based tissue characterisation technique that has previously shown encouraging results in the detection of clinically significant prostate cancer. The present study reports on the open ‘unblinded’ phase of a European multicentre study. The prospective ‘blind’ phase is currently in progress and will determine the value of PHS in a robust fashion overcoming many of the biases inherent in evaluating prostate imaging. OBJECTIVE •  To evaluate the ability of prostate HistoScanning™ (PHS) an ultrasound (US)‐based tissue characterization application, to detect cancer foci by correlating results with detailed radical prostatectomy (RP) histology. PATIENT AND METHODS •  In all, 31 patients with organ‐confined prostate cancer, diagnosed on transrectal biopsies taken using US guidance, and scheduled for RP were recruited from six European centres. •  Before RP three‐dimensional (3D) US raw data for PHS analysis was obtained. Histology by Bostwick Laboratories (London) examined sections obtained from whole mounted glands cut every 3–4 mm. •  Location and volume estimation of cancer foci by PHS were undertaken using two methods; a manual method and an embedded software tool. •  In this report we evaluate data obtained from a planned open study phase. The second phase of the study is ‘blinded’, and currently in progress. RESULTS •  31 patients were eligible for this phase. Three patients were excluded from analysis due to inadequate scan acquisition and pathology violations of the standard operating procedure. One patient withdrew from the study after 3D TRUS examination. •  PHS detected cancer ≥0.20 mL in 25/27 prostates (sensitivity 93%). •  In all, 23 patients had an index focus ≥0.5 mL at pathology, of which 21 were identified as ≥0.5 mL by PHS using the manual method (sensitivity 91%) and 19 were correctly identified as ≥0.5 mL by the embedded tool (sensitivity 83%). •  In 27 patients, histological analysis found 32 cancerous foci ≥0.2 mL, located in 97 of 162 sextants. After sextant analysis, PHS showed a 90% sensitivity and 72% specificity for the localisation of lesions ≥0.2 mL within a sextant. CONCLUSIONS •  PHS has the ability to identify and locate prostate cancer and consequently may aid in pre‐treatment and pre‐surgical planning. •  In men with a lesion identified, it has potential to enable improved targeting, allowing better risk stratification by obtaining more representative cores. •  However further verification from the results of the blinded phase of this study are awaited.
What's known on the subject? and What does the study add? Prostate cancer is one of the few solid-organ cancers in which imaging is not used in the diagnostic process. Novel functional magnetic resonance imaging techniques offer promise but may not be cost-effective. Prostate HistoScanning(™) (PHS) is an ultrasound-based tissue characterisation technique that has previously shown encouraging results in the detection of clinically significant prostate cancer. The present study reports on the open 'unblinded' phase of a European multicentre study. The prospective 'blind' phase is currently in progress and will determine the value of PHS in a robust fashion overcoming many of the biases inherent in evaluating prostate imaging.UNLABELLEDWhat's known on the subject? and What does the study add? Prostate cancer is one of the few solid-organ cancers in which imaging is not used in the diagnostic process. Novel functional magnetic resonance imaging techniques offer promise but may not be cost-effective. Prostate HistoScanning(™) (PHS) is an ultrasound-based tissue characterisation technique that has previously shown encouraging results in the detection of clinically significant prostate cancer. The present study reports on the open 'unblinded' phase of a European multicentre study. The prospective 'blind' phase is currently in progress and will determine the value of PHS in a robust fashion overcoming many of the biases inherent in evaluating prostate imaging.To evaluate the ability of prostate HistoScanning(™) (PHS) an ultrasound (US)-based tissue characterization application, to detect cancer foci by correlating results with detailed radical prostatectomy (RP) histology.OBJECTIVETo evaluate the ability of prostate HistoScanning(™) (PHS) an ultrasound (US)-based tissue characterization application, to detect cancer foci by correlating results with detailed radical prostatectomy (RP) histology.In all, 31 patients with organ-confined prostate cancer, diagnosed on transrectal biopsies taken using US guidance, and scheduled for RP were recruited from six European centres. Before RP three-dimensional (3D) US raw data for PHS analysis was obtained. Histology by Bostwick Laboratories (London) examined sections obtained from whole mounted glands cut every 3-4 mm. Location and volume estimation of cancer foci by PHS were undertaken using two methods; a manual method and an embedded software tool. In this report we evaluate data obtained from a planned open study phase. The second phase of the study is 'blinded', and currently in progress.PATIENT AND METHODSIn all, 31 patients with organ-confined prostate cancer, diagnosed on transrectal biopsies taken using US guidance, and scheduled for RP were recruited from six European centres. Before RP three-dimensional (3D) US raw data for PHS analysis was obtained. Histology by Bostwick Laboratories (London) examined sections obtained from whole mounted glands cut every 3-4 mm. Location and volume estimation of cancer foci by PHS were undertaken using two methods; a manual method and an embedded software tool. In this report we evaluate data obtained from a planned open study phase. The second phase of the study is 'blinded', and currently in progress.31 patients were eligible for this phase. Three patients were excluded from analysis due to inadequate scan acquisition and pathology violations of the standard operating procedure. One patient withdrew from the study after 3D TRUS examination. PHS detected cancer ≥ 0.20 mL in 25/27 prostates (sensitivity 93%). In all, 23 patients had an index focus ≥ 0.5 mL at pathology, of which 21 were identified as ≥ 0.5 mL by PHS using the manual method (sensitivity 91%) and 19 were correctly identified as ≥ 0.5 mL by the embedded tool (sensitivity 83%). In 27 patients, histological analysis found 32 cancerous foci ≥ 0.2 mL, located in 97 of 162 sextants. After sextant analysis, PHS showed a 90% sensitivity and 72% specificity for the localisation of lesions ≥ 0.2 mL within a sextant.RESULTS31 patients were eligible for this phase. Three patients were excluded from analysis due to inadequate scan acquisition and pathology violations of the standard operating procedure. One patient withdrew from the study after 3D TRUS examination. PHS detected cancer ≥ 0.20 mL in 25/27 prostates (sensitivity 93%). In all, 23 patients had an index focus ≥ 0.5 mL at pathology, of which 21 were identified as ≥ 0.5 mL by PHS using the manual method (sensitivity 91%) and 19 were correctly identified as ≥ 0.5 mL by the embedded tool (sensitivity 83%). In 27 patients, histological analysis found 32 cancerous foci ≥ 0.2 mL, located in 97 of 162 sextants. After sextant analysis, PHS showed a 90% sensitivity and 72% specificity for the localisation of lesions ≥ 0.2 mL within a sextant.PHS has the ability to identify and locate prostate cancer and consequently may aid in pre-treatment and pre-surgical planning. In men with a lesion identified, it has potential to enable improved targeting, allowing better risk stratification by obtaining more representative cores. However further verification from the results of the blinded phase of this study are awaited.CONCLUSIONSPHS has the ability to identify and locate prostate cancer and consequently may aid in pre-treatment and pre-surgical planning. In men with a lesion identified, it has potential to enable improved targeting, allowing better risk stratification by obtaining more representative cores. However further verification from the results of the blinded phase of this study are awaited.
What's known on the subject? and What does the study add? Prostate cancer is one of the few solid-organ cancers in which imaging is not used in the diagnostic process. Novel functional magnetic resonance imaging techniques offer promise but may not be cost-effective. Prostate HistoScanning(™) (PHS) is an ultrasound-based tissue characterisation technique that has previously shown encouraging results in the detection of clinically significant prostate cancer. The present study reports on the open 'unblinded' phase of a European multicentre study. The prospective 'blind' phase is currently in progress and will determine the value of PHS in a robust fashion overcoming many of the biases inherent in evaluating prostate imaging. To evaluate the ability of prostate HistoScanning(™) (PHS) an ultrasound (US)-based tissue characterization application, to detect cancer foci by correlating results with detailed radical prostatectomy (RP) histology. In all, 31 patients with organ-confined prostate cancer, diagnosed on transrectal biopsies taken using US guidance, and scheduled for RP were recruited from six European centres. Before RP three-dimensional (3D) US raw data for PHS analysis was obtained. Histology by Bostwick Laboratories (London) examined sections obtained from whole mounted glands cut every 3-4 mm. Location and volume estimation of cancer foci by PHS were undertaken using two methods; a manual method and an embedded software tool. In this report we evaluate data obtained from a planned open study phase. The second phase of the study is 'blinded', and currently in progress. 31 patients were eligible for this phase. Three patients were excluded from analysis due to inadequate scan acquisition and pathology violations of the standard operating procedure. One patient withdrew from the study after 3D TRUS examination. PHS detected cancer ≥ 0.20 mL in 25/27 prostates (sensitivity 93%). In all, 23 patients had an index focus ≥ 0.5 mL at pathology, of which 21 were identified as ≥ 0.5 mL by PHS using the manual method (sensitivity 91%) and 19 were correctly identified as ≥ 0.5 mL by the embedded tool (sensitivity 83%). In 27 patients, histological analysis found 32 cancerous foci ≥ 0.2 mL, located in 97 of 162 sextants. After sextant analysis, PHS showed a 90% sensitivity and 72% specificity for the localisation of lesions ≥ 0.2 mL within a sextant. PHS has the ability to identify and locate prostate cancer and consequently may aid in pre-treatment and pre-surgical planning. In men with a lesion identified, it has potential to enable improved targeting, allowing better risk stratification by obtaining more representative cores. However further verification from the results of the blinded phase of this study are awaited.
What's known on the subject? and What does the study add? Prostate cancer is one of the few solid-organ cancers in which imaging is not used in the diagnostic process. Novel functional magnetic resonance imaging techniques offer promise but may not be cost-effective. Prostate HistoScanning(TM) (PHS) is an ultrasound-based tissue characterisation technique that has previously shown encouraging results in the detection of clinically significant prostate cancer. The present study reports on the open 'unblinded' phase of a European multicentre study. The prospective 'blind' phase is currently in progress and will determine the value of PHS in a robust fashion overcoming many of the biases inherent in evaluating prostate imaging. OBJECTIVE * To evaluate the ability of prostate HistoScanning(TM) (PHS) an ultrasound (US)-based tissue characterization application, to detect cancer foci by correlating results with detailed radical prostatectomy (RP) histology. PATIENT AND METHODS * In all, 31 patients with organ-confined prostate cancer, diagnosed on transrectal biopsies taken using US guidance, and scheduled for RP were recruited from six European centres. * Before RP three-dimensional (3D) US raw data for PHS analysis was obtained. Histology by Bostwick Laboratories (London) examined sections obtained from whole mounted glands cut every 3-4 mm. * Location and volume estimation of cancer foci by PHS were undertaken using two methods; a manual method and an embedded software tool. * In this report we evaluate data obtained from a planned open study phase. The second phase of the study is 'blinded', and currently in progress. RESULTS * 31 patients were eligible for this phase. Three patients were excluded from analysis due to inadequate scan acquisition and pathology violations of the standard operating procedure. One patient withdrew from the study after 3D TRUS examination. * PHS detected cancer ≥0.20 mL in 25/27 prostates (sensitivity 93%). * In all, 23 patients had an index focus ≥0.5 mL at pathology, of which 21 were identified as ≥0.5 mL by PHS using the manual method (sensitivity 91%) and 19 were correctly identified as ≥0.5 mL by the embedded tool (sensitivity 83%). * In 27 patients, histological analysis found 32 cancerous foci ≥0.2 mL, located in 97 of 162 sextants. After sextant analysis, PHS showed a 90% sensitivity and 72% specificity for the localisation of lesions ≥0.2 mL within a sextant. CONCLUSIONS * PHS has the ability to identify and locate prostate cancer and consequently may aid in pre-treatment and pre-surgical planning. * In men with a lesion identified, it has potential to enable improved targeting, allowing better risk stratification by obtaining more representative cores. * However further verification from the results of the blinded phase of this study are awaited.
Author Moore, Caroline M.
Braeckman, Johan
Stenzl, Arnulf
Zát'ura, Frantiŝek
Peltier, Alexandre
Nir, Dror
Treurnicht, Karien
Simmons, Lucy A.M.
Emberton, Mark
Autier, Philippe
Romic, Imre
Walker, Tara
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Issue 1
Keywords Nephrology
detection
Urinary system disease
Prostate disease
HistoScanning
Malignant tumor
Diagnosis
Male genital diseases
Prostate cancer
Urology
Cancer
Language English
License CC BY 4.0
2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.
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Snippet What's known on the subject? and What does the study add? Prostate cancer is one of the few solid‐organ cancers in which imaging is not used in the diagnostic...
What's known on the subject? and What does the study add? Prostate cancer is one of the few solid-organ cancers in which imaging is not used in the diagnostic...
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SubjectTerms Aged
Biological and medical sciences
detection
diagnosis
Gynecology. Andrology. Obstetrics
Histology
HistoScanning
Humans
Localization
Male
Male genital diseases
Medical sciences
Middle Aged
Nephrology. Urinary tract diseases
Patients
Prostate - diagnostic imaging
Prostate - pathology
Prostate cancer
Prostatectomy
Prostatic Neoplasms - diagnostic imaging
Prostatic Neoplasms - pathology
Prostatic Neoplasms - surgery
Tumor Burden
Tumors
Tumors of the urinary system
Ultrasonic imaging
Ultrasonography
Urinary tract. Prostate gland
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Title Detection, localisation and characterisation of prostate cancer by Prostate HistoScanning
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