Back-table specimen scanning using gantry-free hybrid hSPECT/LiDAR imaging: a feasibility study during PSMA-radioguided surgery.

Introduction: Prostate-specific membrane antigen (PSMA) targeted precision surgery is becoming increasingly popular. However, the relatively low levels of PSMA-receptor expression and background signal can hinder in vivo lesion detection and margin evaluation. Back-table imaging (ex vivo) potentially provides a means to confirm surgical accuracy.

Prostate Volume and PSA-Density Estimation by Transabdominal Ultrasound: Prospective Evidence of Comparative Accuracy to MRI and Transrectal Ultrasound in Prostate Cancer Early Diagnostics.

Background: Prostate-specific antigen (PSA) density is an easily available predictor for clinically significant PCa. While transrectal ultrasound (TRUS) is utilized for PSA density (PSAD) estimation, transabdominal ultrasound (TAUS) is a more accessible, noninvasive alternative that can be used to decide if follow-up diagnostics are necessary. This study aims to compare prostate volume (PV) and PSAD across TAUS, TRUS and MRI, comparing the clinical utility of TAUS and TRUS for PSAD-based risk stratification.

Automatic prostate volume estimation in transabdominal ultrasound images.

Introduction: Prostate cancer is a major health concern requiring accurate and accessible methods for early detection and risk stratification. Prostate volume (PV) is a key parameter in multivariate risk assessment, traditionally measured using transrectal ultrasound (TRUS). While TRUS provides precise measurements, its invasive nature affects patient comfort.

Renal clearance of fluorescent agents can compromise image-guided surgery along the urinary tract.

Objectives: To study the effect of renally cleared fluorescent agents on image-guided surgery along the urinary tract by using the renally cleared, non-tumour-specific, fluorescent dye fluorescein.

Subjects And Methods: Sixteen patients who underwent robot-assisted radical prostatectomy (RARP) with lymph node dissection received an intradermal injection of fluorescein. The slow-release of the fluorescein from the skin into the lymph- and bloodstream were used as a pharmacokinetic model for slow release from receptor-targeted agents.

Magnetic Resonance Imaging-based Biopsy Strategies in Prostate Cancer Screening: A Systematic Review.

Background And Objective: Prostate cancer (PCa) screening using prostate-specific antigen (PSA) thresholding and systematic biopsies reduces advanced disease presentations and cancer-specific mortality, but also leads to overdiagnosis. Magnetic resonance imaging (MRI) integration may maintain screening benefits, while reducing overdiagnosis and unnecessary biopsies. This review analyses the benefit-harm balance when MRI is integrated as first-line and second-stage (after PSA >3 ng/ml) test in PCa screening.

Comparing AI and Manual Segmentation of Prostate MRI: Towards AI-Driven 3D-Model-Guided Prostatectomy.

: Robot-assisted radical prostatectomy (RARP) is a common treatment option for prostate cancer. A 3D model for surgical guidance can improve surgical outcomes. Manual expert radiologist segmentation of the prostate and tumor in prostate MRI to create 3D models is labor-intensive and prone to inter-observer variability, highlighting the need for automated segmentation methods.

Beyond Gleason grading: MRI radiomics to differentiate cribriform growth from non-cribriform growth in prostate cancer men.

Objective: To differentiate cribriform (GP4Crib+) from non-cribriform growth and Gleason 3 patterns (GP4Crib-/GP3) using MRI.

Methods: Two hundred and ninety-one operated prostate cancer men with pre-treatment MRI and whole-mount prostate histology were retrospectively included. T2-weighted, apparent diffusion coefficient (ADC) and fractional blood volume maps from 1.

Oncological Outcomes in Patients with Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography-detected Oligometastatic Prostate Cancer Treated with Metastasis-directed Radiotherapy as the Single Treatment Modality.

Background And Objective: In patients with biochemical recurrence (BCR), prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) can detect oligometastatic prostate cancer (PCa). However, the optimal treatment approach for oligometastatic disease remains unclear. This study aims to assess the oncological outcomes of metachronous oligometastatic PCa patients treated with metastasis-directed radiotherapy (MDRT).

Evaluation of short term surgical outcomes of radical prostatectomy in the decade following the introduction of minimum volume standards in the Netherlands.

Introduction: A minimum volume standard (MVS) of 20 radical prostatectomies (RPs) per institution per year was implemented in the Netherlands in 2014, and raised to 50 RPs in 2018 and 100 in 2019. This study aimed to evaluate the effects of implementing a MVS on the extent of care centralization and short term surgical outcomes.

Methods: All patients who underwent RP between 2014 and 2022 were identified in the nationwide Netherlands Cancer Registry.

How Does Routine Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography Modify the Current Management of Prostate Cancer? A Multidisciplinary View.

Background And Objective: Prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA-PET/CT) and new treatment modalities have expanded the possibilities for diagnosing and managing metastatic prostate cancer, but have also raised questions about their implementation in daily clinical practice. We sought consensus on definitions, preferred imaging modality for staging, and treatment selection in the era of next-generation imaging.

Methods: A modified Delphi method involved two voting rounds and a face-to-face multidisciplinary meeting with 40 Dutch prostate cancer (PCa) experts.

A Personalized, Risk-Based Approach to Active Surveillance for Prostate Cancer with Takeaways from Broader Oncology Practices: A Mixed Methods Review.

: To summarize the current state of knowledge regarding personalized, risk-based approaches in active surveillance (AS) for prostate cancer (PCa) and to explore the lessons learned from AS practices in other types of cancer. : This mixed methods review combined a systematic review and a narrative review. The systematic review was conducted according to the Preferred Reporting Items for Systematic rviews and Meta-Analyses (PRISMA) guidelines, with searches performed in the Medline, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and Google Scholar databases.

Early Cost-Effectiveness Analysis of Using Whole-Genome Sequencing for Patients With Castration-Resistant Prostate Cancer.

Objectives: This study aims to assess the potential cost-effectiveness of using whole-genome sequencing (WGS)-guided systemic therapy in metastatic castrate-resistant prostate cancer compared with the European Association of Urology guideline recommended diagnostics from a Dutch societal perspective.

Methods: A decision analytic model combining a decision tree and partitioned survival models was developed to link diagnostic results with subsequent biomarker-guided treatments. Two diagnostic strategies, WGS and guideline-recommended practice-the genomic testing for breast cancer gene 1/2 (BRCA1/2) and deficient mismatch repair, were simulated to compare the health outcome and cost.

Prognostic Value of Cribriform and Intraductal Carcinoma in Grade Group 2 Prostate Cancer With and Without Synchronous Nodal Metastases at Radical Prostatectomy: Results From a Case-control Matched, Multicenter Study.

Objective: To evaluate the occurrence and the oncological predictive value of cribriform growth and/or intraductal carcinoma (CR/IDC) in patients with ISUP grade group (GG) 2 prostate cancer (PCa) at radical prostatectomy (RP) with and without synchronous nodal metastases in a multicenter, international cohort.

Methods: We identified 1060 patients who underwent RP with ISUP GG2 PCa at histopathology and a pelvic lymph node dissection from 3 tertiary referral centers. Of these, 79 (7.

Intravesical Instillation of Chemotherapy Before Radical Surgery for Upper Urinary Tract Urothelial Carcinoma: The REBACARE Trial.

Background And Objective: Intravesical instillation of chemotherapy (IIC) after radical surgery for upper urinary tract urothelial carcinoma (UTUC) reduces the risk of intravesical recurrence (IVR). However, compliance is low because of possible extravesical leakage after bladder cuff excision. The aim of this study was to evaluate the efficacy of preoperative IIC in reducing the risk of IVR.

Enhancing Data Completeness in Early Detection Pathway of Prostate Cancer: Integration of a Dashboard-Driven Feedback Tool to Improve Quality of Care.

: Quality assurance in data collection is essential as data quality directly impacts the accuracy and reliability of outcomes. In the context of early detection of prostate cancer, improving data completeness is a key focus for enhancing patient care. This study aimed to evaluate the effectiveness of a data-driven feedback tool, visualized through a dashboard, in improving the completeness of data collection by healthcare professionals.

Surgical navigation for targeted retroperitoneal lymph-node removal: a randomised, controlled, phase 3 trial.

Background: Metastatic retroperitoneal lymph node dissection (LND) for nodal recurrence is applied for a variety of cancers, such as urological, gynaecological and rectal cancer. Precise localisation and resection of these lymph nodes (LNs) during surgery can be challenging, especially after previous radiotherapy or surgery. The objective of this study was to assess the added value of surgical navigation for targeted LND in the retroperitoneum.

Early Oncological Outcomes in Patients who Underwent Staging Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography Compared with Conventional Imaging Before Radical Prostatectomy and Extended Pelvic Lymph Node Dissection.

Background And Objective: Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) is increasingly used for primary staging in prostate cancer. Owing to accurate detection of small metastases on PSMA-PET/CT, patient selection for robot-assisted radical prostatectomy (RARP) has likely changed. This study analyzes oncological outcomes in patients undergoing RARP and extended pelvic lymph node dissection (ePLND) after PSMA-PET/CT staging, compared with those without PSMA-PET/CT.

Multispectral Fluorescence Imaging as a Tool to Distinguish Pelvic Lymphatic Drainage Patterns During Robot-assisted Lymph Node Dissection in Prostate Cancer.

Background: The invasive nature of extended pelvic lymph node dissection (ePLND) prompts the need for alternative lymphatic mapping technologies. To change the focus to "sparing nodes that are not involved," the first step is to research the feasibility of intraoperatively distinguishing the lymph drainage patterns of the prostate from healthy organs.

Methods: We performed a prospective study (NCT05120973) that included 16 patients who underwent a robot-assisted radical prostatectomy + ePLND + sentinel node (using indocyanine green-Tc-nanocolloid).

Staging Accuracy and Prognostic Value of Prostate-Specific Membrane Antigen PET/CT Strongly Depends on Lymph Node Tumor Burden.

: To explore the factors affecting the lymph node metastasis (LNM) detection performance of prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) and to evaluate its prognostic value for biochemical recurrence after radical prostatectomy (RP). : Patients who had intermediate- or high-risk prostate cancer and underwent robot-assisted (RA)RP between 2017 and 2021 were included. Initial lymph node staging was carried out using PSMA PET/CT.

The effect of PSMA PET/CT on clinical decision-making of radical prostatectomy and pelvic lymph node dissection.

Objective: To evaluate the effect of prostate-specific membrane antigen (PSMA) PET/computed tomography (CT) on clinical decision-making of radical prostatectomy (RP) and pelvic lymph node dissection (PLND) after its utilization in daily clinical practice at an European high-volume cancer center.

Materials And Methods: Patients who had unfavorable intermediate- and high-risk prostate cancer between 2017 and 2021 were included retrospectively and divided into two groups; those who staged using PSMA PET/CT (group 1) and those who staged using conventional modalities (group 2). Clinical decision-making of RP over nonsurgical treatments and f PLND were primary endpoints and evaluated using regression models.

Prostate-specific Membrane Antigen Positron Emission Tomography Before Reaching the Phoenix Criteria for Biochemical Recurrence of Prostate Cancer After Radiotherapy: Earlier Detection of Recurrences.

Background And Objective: Biochemical recurrence (BCR) of prostate cancer (PCa) after curative radiotherapy (RT) is defined according to the Phoenix criteria, which is a prostate-specific antigen (PSA) rise of ≥2.0 ng/ml above the PSA nadir. Prostate-specific membrane antigen (PSMA)-based positron emission tomography/computed tomography (PET/CT) can identify PCa recurrences at very low PSA values.