This document summarizes three studies related to imaging techniques for renal calculi:
1) A study comparing radiation exposure from CT scans used today to diagnose renal colic versus intravenous urograms (IVU) used in 1990, finding that radiation exposure is only marginally higher with current CT techniques.
2) A study evaluating the ability of digital plain X-rays to detect calcium-based urinary calculi compared to CT scans, finding that X-rays detected over 74% of stones on average and sensitivity was over 83% for stones larger than 5mm.
3) A preliminary study of 9 patients undergoing MRI/ultrasound fusion-guided prostate biopsies which detected prostate cancer in 67% of
These slides are from versions of a talk I gave at ESTRO in 2014 and again in Lille in 2015.
The talk aims to explain the importance of correctly defining the CTV with respect to nodes in curative radiotherapy planning.
The lecture makes some important points about the function of lymph glands and their potential to act as stem cell 'rests' for malignant cells: this fact might explain whilst lymph node failure rates don't necessarily equate to disease failure rates.
The lecture then goes on to emphasise the utility of the best imaging technologies may more accurately identify involved nodes.
Shrinking fields with confidence may be the best way to reduce radiation toxicity.
These slides are from versions of a talk I gave at ESTRO in 2014 and again in Lille in 2015.
The talk aims to explain the importance of correctly defining the CTV with respect to nodes in curative radiotherapy planning.
The lecture makes some important points about the function of lymph glands and their potential to act as stem cell 'rests' for malignant cells: this fact might explain whilst lymph node failure rates don't necessarily equate to disease failure rates.
The lecture then goes on to emphasise the utility of the best imaging technologies may more accurately identify involved nodes.
Shrinking fields with confidence may be the best way to reduce radiation toxicity.
USE OF PET – HEALTH CARE POLICY PERSPECTIVESRuby Med Plus
POSITRON EMISSION TOMOGRAPHY (PET) USE BY TERTIARY HEALTH CARE CENT RES AND ITS ACCESSIBILITY TO POPULATION: A POLICY PERSPECTIVE. a BRIEF Cost-Benefit analysis.
Molecular imaging has revolutionized our perceptions of imaging. This high impact field is finding transformative applications in the understanding, detection, and treatment of nearly all diseases.
The field of molecular imaging is a an exciting fusion and integration of many different disciplines including molecular biology, chemistry and probe design, imaging technologies, visualization, and image analysis, that are focused on understanding, detecting, and treating oncological, neurological, cardiovascular, inflammatory, metabolic, and infectious diseases. Based on their strengths, different imaging modalities provide different but equally valuable information that can be integrated in advancing our understanding of these diseases.
As the era of ‘omics’ progresses towards personalized medicine, the field of molecular imaging is finding multiple uses in noninvasive characterization of the molecular features of diseases and their impact on function. In complex diseases such as cancer, with its tremendous genetic diversity, it is becoming increasingly important to develop molecularly-targeted treatment strategies that combine detection with treatment.
Multimodality Molecular Imaging – An Overview With Special Focus on PET/CTApollo Hospitals
Imaging capabilities have evolved from those that provide anatomical pictures to those that capture functional information and, more recently, molecular information (nuclear medicine, PET, SPECT, PET/CT, SPECT/CT, MRS, contrast-enhanced ultrasound, fluorescence and bioluminescence imaging). Multimodality imaging has emerged as a technology that utilizes the strengths of different modalities and yields a hybrid imaging platform with benefits superior to those of any of its individual components, considered alone. Leading edge hybrid imaging (combining multiple, complementary imaging technologies such as PET and CT) offer unique opportunities to “view” the molecular biology of disease, and the use of this equipment is on the rise.
Çalışmalar Işığında ExactVu US Biyopsi ile MRI Füzyon Biyopsi Karşılaştırması
http://e.andromed.com.tr/2020-Klotz-CUAJ-MulticenterMRIComparison
Abstract
Introduction: High-resolution micro-ultrasound has the capability of imaging prostate cancer based on detecting alterations in ductal anatomy, analogous to multiparametric magnetic resonance imaging (mpMRI). This technology has the potential advantages of relatively low
cost, simplicity, and accessibility compared to mpMRI. This multicenter, prospective registry aims to compare the sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of mpMRI with high-resolution micro-ultrasound imaging for the
detection of clinically significant prostate cancer.
Methods: We included 1040 subjects at 11 sites in seven countries who had prior mpMRI and underwent ExactVu micro-ultrasound-guided biopsy. Biopsies were taken from both mpMRI targets (PI-RADS >3 and micro-ultrasound targets (PRIMUS >3). Systematic biopsies (up to 14 cores) were also performed. Various strategies were used for mpMRI target sampling, including cognitive fusion with micro-ultrasound, separate software-fusion systems, and software-fusion using the micro-ultrasound FusionVu system. Clinically significant cancer was those with Gleason grade group ≥2.
Co-relation of multidetector CT scan based preoperative staging with intra-op...Apollo Hospitals
To assess the accuracy of CT scan in preoperative staging, to correlate preoperative findings with operative findings and with post-operative histopathological findings of colorectal carcinoma.
USE OF PET – HEALTH CARE POLICY PERSPECTIVESRuby Med Plus
POSITRON EMISSION TOMOGRAPHY (PET) USE BY TERTIARY HEALTH CARE CENT RES AND ITS ACCESSIBILITY TO POPULATION: A POLICY PERSPECTIVE. a BRIEF Cost-Benefit analysis.
Molecular imaging has revolutionized our perceptions of imaging. This high impact field is finding transformative applications in the understanding, detection, and treatment of nearly all diseases.
The field of molecular imaging is a an exciting fusion and integration of many different disciplines including molecular biology, chemistry and probe design, imaging technologies, visualization, and image analysis, that are focused on understanding, detecting, and treating oncological, neurological, cardiovascular, inflammatory, metabolic, and infectious diseases. Based on their strengths, different imaging modalities provide different but equally valuable information that can be integrated in advancing our understanding of these diseases.
As the era of ‘omics’ progresses towards personalized medicine, the field of molecular imaging is finding multiple uses in noninvasive characterization of the molecular features of diseases and their impact on function. In complex diseases such as cancer, with its tremendous genetic diversity, it is becoming increasingly important to develop molecularly-targeted treatment strategies that combine detection with treatment.
Multimodality Molecular Imaging – An Overview With Special Focus on PET/CTApollo Hospitals
Imaging capabilities have evolved from those that provide anatomical pictures to those that capture functional information and, more recently, molecular information (nuclear medicine, PET, SPECT, PET/CT, SPECT/CT, MRS, contrast-enhanced ultrasound, fluorescence and bioluminescence imaging). Multimodality imaging has emerged as a technology that utilizes the strengths of different modalities and yields a hybrid imaging platform with benefits superior to those of any of its individual components, considered alone. Leading edge hybrid imaging (combining multiple, complementary imaging technologies such as PET and CT) offer unique opportunities to “view” the molecular biology of disease, and the use of this equipment is on the rise.
Çalışmalar Işığında ExactVu US Biyopsi ile MRI Füzyon Biyopsi Karşılaştırması
http://e.andromed.com.tr/2020-Klotz-CUAJ-MulticenterMRIComparison
Abstract
Introduction: High-resolution micro-ultrasound has the capability of imaging prostate cancer based on detecting alterations in ductal anatomy, analogous to multiparametric magnetic resonance imaging (mpMRI). This technology has the potential advantages of relatively low
cost, simplicity, and accessibility compared to mpMRI. This multicenter, prospective registry aims to compare the sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of mpMRI with high-resolution micro-ultrasound imaging for the
detection of clinically significant prostate cancer.
Methods: We included 1040 subjects at 11 sites in seven countries who had prior mpMRI and underwent ExactVu micro-ultrasound-guided biopsy. Biopsies were taken from both mpMRI targets (PI-RADS >3 and micro-ultrasound targets (PRIMUS >3). Systematic biopsies (up to 14 cores) were also performed. Various strategies were used for mpMRI target sampling, including cognitive fusion with micro-ultrasound, separate software-fusion systems, and software-fusion using the micro-ultrasound FusionVu system. Clinically significant cancer was those with Gleason grade group ≥2.
Co-relation of multidetector CT scan based preoperative staging with intra-op...Apollo Hospitals
To assess the accuracy of CT scan in preoperative staging, to correlate preoperative findings with operative findings and with post-operative histopathological findings of colorectal carcinoma.
Journal of the Formosan Medical Association (2011) 110, 695e70.docxcroysierkathey
Journal of the Formosan Medical Association (2011) 110, 695e700
Available online at www.sciencedirect.com
journal homepage: www.jfma-online.com
ORIGINAL ARTICLE
A multivariable logistic regression equation to
evaluate prostate cancer
Jhih-Cheng Wang a, Steven K. Huan a, Jinn-Rung Kuo b, Chin-Li Lu c,
Hung Lin a, Kun-Hung Shen a,*
a Division of Urology, Departments of Surgery, Chi-Mei Medical Center, Tainan, Taiwan
b Division of Neurosurgery, Department of Surgery, Chi-Mei Medical Center, Tainan, Taiwan
c Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan
Received 29 January 2010; received in revised form 14 May 2010; accepted 9 August 2010
KEYWORDS
Logistic regression;
men’s health;
probability;
prostate cancer;
risk factor;
score
* Corresponding author. Division of U
Taiwan 710.
E-mail address: [email protected]
0929-6646/$ - see front matter Copyr
doi:10.1016/j.jfma.2011.09.005
Background/Purpose: A possible means of decreasing prostate cancer mortality is through
improved early detection. We attempted to create an equation to predict the likelihood of
having prostate cancer.
Methods: Between January 2005 and May 2008, patients who received prostate biopsies were
retrospective evaluated. The relationship between the possibility of prostate cancer and the
following variables were evaluated: age; serum prostate specific antigen (PSA) level, prostate
volume, numbers of prostatic biopsies, digital rectal examination (DRE) findings, and the pres-
ence of hypoechoic nodule under transrectal ultrasonography.
Results: A multivariate regression model was created to predict the possibility of having pros-
tate cancer, and a receiver-operating characteristic (ROC) curve was drawn based on the
predictive scoring equation. Using a predictive equation, P Z 1/(1 � e�x), where X Z
�4.88, þ 1.11 (if DRE positive), þ 0.75 (if hypoechoic nodule of prostate present), þ 1.27
(when 7 < PSA � 10), þ 2.02 (when 10 < PSA � 24), þ 2.28 (when 24 < PSA � 50), þ 3.93 (when
50 < PSA), þ 1.23 (when 65 < age � 75), þ 1.66 (when 75 < age), followed by ROC curve
analysis, we showed that the sensitivity was 88.5% and specificity was 79.1% in predicting
the possibility of prostate cancer.
Conclusion: Clinicians can tailor each patient’s follow-up according to the nomogram based on
this equation to increase the efficacy of evaluating for prostate cancer.
Copyright ª 2011, Elsevier Taiwan LLC & Formosan Medical Association. All rights reserved.
rology, Department of Surgery, Chi-Mei Medical Center, 901 Chung Hwa Road, Yung Kang City, Tainan,
il.com (K.-H. Shen).
ight ª 2011, Elsevier Taiwan LLC & Formosan Medical Association. All rights reserved.
mailto:[email protected]
http://dx.doi.org/10.1016/j.jfma.2011.09.005
www.sciencedirect.com/science/journal/09296646
http://www.jfma-online.com
http://dx.doi.org/10.1016/j.jfma.2011.09.005
http://dx.doi.org/10.1016/j.jfma.2011.09.005
696 J.-C. Wang et al.
Prostate cancer is the most common solid malignancy ...
EIS Technology: bioimpedance chronoamperometry in adjunct to screen the prost...ES-Teck India
Through the 6 tactile electrodes, a weak DC current is sending alternatively between 2 electrodes with a sequence and the EIS system is recording the electrical conductance of 11 pathways of the human body.
Sentinel lymph node biopsy before neoadjuvant chemotherapy for clinical axill...Dr./ Ihab Samy
Ihab S. Fayeka MD; Fouad A. Saleepa MD; Hany F. Habashyb MD; Alfred E. Namourc MD ; Iman G. Farahatd MD ;Magdy Kotbe MD
a: department of surgical oncology - national cancer institute - Cairo university - Egypt.
b: department of surgery - Fayoum university hospital - El Fayoum - Egypt.
c: department of medical oncology - national cancer institute - Cairo university - Egypt.
d: department of surgical pathology - national cancer institute - Cairo university - Egypt.
e: department of nuclear medicine - national cancer institute - Cairo university - Egypt.
For correspondance contact: drihab74@hotmail.com
Kasr el-aini journal of surgery Volume 14, No.1, January 2013
MRI Guided Trans Rectal Ultrasound Biopsy: A Molecular Approach to Diagnosing...Apollo Hospitals
The purpose of this study is to assess the efficacy of second-look Trans- rectal Ultrasound guided biopsy by comparing the histopathological results obtained by Trans Rectal Ultra Sound guided extended sextant core biopsy of the prostate done before and after
localization of lesions using MRI & MRS done prior to the procedure.
Effect of Time of Echo on 1H-magnetic Resonance Spectroscopy Imaging of Metab...submissionclinmedima
The aim of this study is to evaluate the effect of time of echo (TE) on magnetic resonance spectroscopy imaging (MRSI) of metabolites in maxillofacial carcinoma. 1.2. Methods: Twenty maxillofacial carcinoma patients and 10 healthy volunteers were recruited to undergo 1.5-Tesla high-resolution routine MRI and multi-voxel MRSI with a TE of 35 ms and 144 ms.
Austin Journal of Nuclear Medicine and Radiotherapy is an open access, peer reviewed, scholarly journal dedicated to publish articles in all areas of Nuclear Medicine and Radiation. AJNMR supports in using radioactive substances in the diagnosis and treatment of disease by addressing the technologies that are revolutionizing the clinical examination and treatment by providing multi modality approach to the clinical problems.
The aim of the journal is to provide a forum for researcher scholars, physicians, and other health professionals for the exchange of scientific information in the areas of Nuclear Medicine and Radiotherapy.
Austin Journal of Nuclear Medicine and Radiotherapy accepts original research articles, review articles, case reports, commentaries, clinical images and rapid communication on all the aspects of Nuclear Medicine and Radio Therapy.
1. CONCLUSIONS: SPIO-R11 was synthesized successfully via
chemical methods whihout significant change on physicochem-
ical properties. It has the uptake properties of safety, high effi-
ciency and specificity in T24 bladder cancer cell. The in vitro
experiment indicated that SPIO-R11 may be an valuable MR
contrast agent for further in vivo animal experiment and diag-
nostic applications in human.
SOURCE OF FUNDING: None
MP25-11 COMPARISON OF HISTORIC VS CONTEM-
PORARY RADIATION DOSAGE IN RENAL COLIC
Dermot O’Kane1,2, T Manning2, E How2, J Quinn3, A Hawes3,
Neil Smith2, Nathan Lawrentschuk1, Damien Bolton1
1Austin Hospital Department of Urology, University
of Melbourne Department of Surgery (Australia)
2Department of Urology, Gold Coast University Hospital
(Australia)
3Faculty of Medicine, Griffith University (Australia)
INTRODUCTION AND OBJECTIVES: Serial CT scanning
for renal calculus disease remains contentious because of con-
cerns about increased radiation exposure above previous estab-
lished levels. We aimed to quantify contemporaneous radiation
exposure with that deliviered in the era of IVU.
METHODS: We searched our hospital database for all patients
who presented to the emergency department over a one month
period (March) in 1990 with a diagnosis of renal colic and
compared them with a contemporaneous series. The estimated
effective radiation dose exposure for each patient was calculated,
and correlated with size and location of calculi.
RESULTS: The average effective radiation dose per patient in the
1990 group, for initial diagnosis and subsequent follow-up, was
4.61–2.83mSv. The average follow-up time in this group was
37.29 days, with a range from 0–122.99 days. The average effective
radiation dose per patient in the 2013 group was 4.75–2.27mSv.
The average follow-up time in this group was 62.79 days, with a
range from 0–171.60 days. Data was also collected on patient length
of stay and time to diagnosis. In the 1990 group there was a mean
delay to definitive diagnosis which ranged from 0.93–1.92 days.
CONCLUSIONS: The estimated effective radiation exposure
dose to each patient currently is only marginally higher than in
the era of IVU, with improvements in length of hospital stay and
time to definitive diagnosis. Improvements in technology and
judicious use of CT scanning should continue to lead to reduced
radiation exposure in the future.
SOURCE OF FUNDING: None
MP25-12 CONTEMPORARY SENSITIVITY AND SPECIFI-
CITY OF DIGITAL PLAIN X RAY FOR IDENTIFICATION OF
VARIANT CALCIUM COMPOSITION URINARY CALCULI
Dermot O’Kane1,2, T Manning2, E Gow2, J Quinn3,
A Hawes3, Neil Smith2, Nathan Lawrentschuk1,
Damien Bolton1
1Austin Hospital Department of Urology, University
of Melbourne Department of Surgery (Australia)
2Urology Department Gold Coast University Hospital
(Australia)
3School of Medicine Griffith University (Australia)
INTRODUCTION AND OBJECTIVES: Radiological imag-
ing remains ubiquitous in the follow-up of patients with renal
tract calculi. Concern exists regarding radiation dosage with
serial CT scanning. We assessed whether newer digital imaging
technology improved the utility of plain X Rays in determining
the size and location of calcium based urinary calculi.
METHODS: Laboratory databases across two urology centres
were audited, for calculi containing > 85% calcium oxalate or
> 85% calcium hydrogen phosphate. We identified 113 calculi
(91 calcium oxalate, 22 calcium hydrogen phosphate). Digital
imaging for each of these patients was obtained through hospital
radiology systems and analysed to determine whether CT iden-
tified calculi were visible on X-ray KUB.
RESULTS: The average calculus seen on X-ray was 8.43+ / -
4.99mm, and the average calculus not seen on X-ray even when
CT imaging was available was 5.39 + / - 3.20mm as measured on
CT (p < 0.001). 74.3% of all calculi were visible of digital X-ray.
X-ray was found to be 83.1% sensitive for calculi > 5 mm. 50% of
stones < 5 mm were not seen on X- ray. Statistical significance
was noted for the relationship between visibility and position in
the renal pelvis and proximal ureter (82%). 50% of mid-ureteric
calculi and 75% of distal ureteric calculi were visible.
CONCLUSIONS: Digital X-ray KUB is sensitive for calcium
salts calculi > 5 mm especially in the upper renal tract. Sensi-
tivity for other calculi may be below best practice standards. This
would suggest that CT or ultrasound as an adjunct to plain X- ray
for accurate follow-up may be required in many instances despite
radiation dosage.
SOURCE OF FUNDING: None
MP25-13 MRI AND US COMBINED STEREOTASSIC PRO-
STATIC BIOPSY: OUR PRELIMINARY EXPERIENCE
Rani Matteo1, Martorana Eugenio1, Territo Angelo1,
Galli Riccardo1, Paterlini Maurizio1, Micali Salvatore1,
Bianchi Giampaolo1
1University of Modena and Reggio Emilia (Italy)
INTRODUCTION AND OBJECTIVES: Explain our experi-
ence with stereotassic prostatic biopsy by fusion of MRI (Mag-
netic Risonance Imaging)/US (Ultra Sounds) immagines in real
time (BiopSeeÒ, Tema Sinergie, Germany).
METHODS: From December 2013 to Febbraury 2014, 9
‘‘prostate cancer (PCa) high risk patients’’ were processed to
trans-perineal stereotassic prostatic biopsy. All patients had a
previous prostatic mapping, negative for PCa. The average age
was 68 years (range 59 – 71 years), the average prostate volume
was 74 ml (ragne 50 – 106 ml) and the average PSA amounted to
7,5 ng/ml (range 2,4 – 14 ng/ml). 6 patientes had suspected me-
thastasys by previous MRI analisys. These information were
integrated by BiopSee System with data obtained by a biplanar
TRUS trasducer on a stepper. As results, prostatic MRI sospi-
ciuos lesions were merged, in real time, with TRUS images.
Then a transperineal saturation biopsy was done (32 samples);
sospiciuos MRI areas were included. Every target was recorded
by the software.
RESULTS: PCa diagnosis in 6/9 patients (detection rate = 67%).
Positive correlation between MRI sospicious lesion and histolog-
ical results in 4/6 patients (67% of patients). Patients with no
sospicious MRI areas, underwent to saturation biopsy, had 8,3% of
samples affected by PCa (5/60 samples). Only 1 patients reported a
post-operatory bleeding, spontaneously concluded. No patients
with urinary tract infections and/or urinary acute retention.
CONCLUSIONS: Our preliminary experience with stereotassic
biopsy reveals itself as a safe procedure, easy to use with high
-A234- MP25 ENDOUROLOGY: IMAGING 2